Opioid Treatment Program Helps Keep Families Together

Mar 29, 2018
Originally published on May 27, 2018 4:00 am

Velva Poole has spent about 20 years as a social worker, mostly in Louisville, Ky. She's seen people ravaged by methamphetamines and cocaine; now it's mostly opioids. Most of her clients are parents who have lost custody of their children because of drug use. Poole remembers one mom in particular.

"She had her kids removed the first time for cocaine. And then she had actually gotten them back," she says. But three months later, the mother relapsed and overdosed on heroin.

"She had to go through the whole thing all over again — having supervised visits with the kids, then having overnights," Poole recalls. Starting again from the bottom, the mom took steps to reclaim her life.

And, eventually, she did regain custody of her children. Poole recently ran into the woman at the grocery store.

"She hugged me," Poole says. "I don't know how to describe it. It just makes you feel like, wow, what you did really did make a difference in someone's life."

Poole is now a supervisor in the Sobriety Treatment and Recovery Teams program, which is funded primarily by the state. It's an intensive program for parents who have had their kids taken away because of substance abuse and the resulting neglect or mistreatment of the children. The goal is to create a faster process to reunite those families.

It works like this in Kentucky: Someone reports a parent to Child Protective Services if they suspect the adult has an addiction problem and children aren't being taken care of. If there's evidence to support the claim, the parent then has a choice — they can go through the standard CPS process, or enroll in START.

Both options have the parent meet with a social worker, and include weekly drug screenings and daily drug treatment, as well as regular attendance at meetings of Alcoholics Anonymous or Narcotics Anonymous. But START also assigns a mentor to families; the parent has to meet with the mentor once a week. The mentor also drives the parent to and from some appointments and helps them get other services they may need.

Rhonda Maddox is one the family mentors.

"I'm able to open that door, and say, 'I've been where you are. We might not walk down the same road but I done some of the same things you have,' " Maddox says.

She stopped using drugs 14 years ago.

"I began using drugs at the age of 9," Maddox recalls. "My mom was gone [and] my dad was gone, due to their addictions. So I started using. It stayed like that for a long time, going on into high school. I had a few kids then, and then I abandoned those two kids on my granny."

Maddox eventually got sober and regained custody of her children. Hearing her story makes it easier for clients to open up and and accept help, Poole says.

"It's very helpful for the client to be able to relate to someone that's been in their shoes," she says.

The START program began in Ohio and expanded into Kentucky in 2007. Since then, research has shown it has a higher success rate in reuniting families than the traditional child welfare process.

But the opioid crisis has posed new challenges, Maddox says.

"I had a few of my clients that passed away [after] an overdose — was kind of devastating," she says. "Sometimes I wonder if there was something else I could have done."

In each case, Maddox and Poole have a year to try to reunite START parents with their children.

Former START director Tina Willauer says, despite the benefits of enrolling in the START program, parents are still up against significant societal stigma because of their drug use.

"There's this question, 'should we even give them treatment?' — almost as if they're throwaway because they have an opioid use disorder," Willauer says.

She believes there are important reasons to keep families together.

"If you're pulling a child out of a home and putting them in a foster home, we're removing them from the only people they know — their family. They might have to leave their church; they might have to leave their community," Willauer says. "So, everything they know. It's traumatic on many, many levels."

Willauer and the staff at START wish every parent could go through their demanding program. But START costs more money than the standard, less-intensive process of child protective services. With the state of Kentucky facing a budget crunch, expansion of START is not likely to happen anytime soon.

This story is part of NPR's reporting partnership with Louisville Public Media and Kaiser Health News.

Copyright 2018 Louisville Public Media. To see more, visit Louisville Public Media.

MICHEL MARTIN, HOST:

And now we're going to hear about one of the realities of the opioid crisis - parents losing custody of their children. A new program in Kentucky tries to help parents get immediate addiction treatment and to reunite those parents with their children. Lisa Gillespie from Louisville reports on the success and challenges of this program called START.

LISA GILLESPIE, BYLINE: Velva Poole spent years as a social worker in Kentucky. She's seen people ravaged by meth and cocaine. Now it's mostly opioids. Her clients were parents who'd had their children taken away because of drug use. Poole remembers one mom in particular.

VELVA POOLE: She had her kids removed the first time for cocaine, and then she had actually gotten them back.

GILLESPIE: But, three months later, the mom relapsed and overdosed on heroin.

POOLE: She had to go through the whole thing all over again - having supervised visits with her kids, going through that whole thing, then having overnights, working her way up to that.

GILLESPIE: But that mom did eventually regain custody of her children. Poole recently ran into her at the grocery store

POOLE: And she hugged me. I mean, it just makes you feel, like, wow. You know, what you did really did make a difference in somebody's life.

MARTIN: Poole is now a supervisor on the Sobriety Treatment and Recovery Teams program, or START, in Kentucky. It works like this. Someone reports a parent to child protective services if they suspect child maltreatment due to a parent's substance abuse. If there's evidence to support the claim, the parent then has a choice - go the standard CPS route or enroll in START. Both mean a social worker, weekly drug screenings, AA or NA meetings and daily drug treatment.

START also includes a family mentor. The mentor meets with the parent once a week, drives them to and from some appointments and helps them get other services. Rhonda Maddox is one of these family mentors.

RHONDA MADDOX: I'm able to open that door and say, I've been where you are. You know what I'm saying? We might not walk down the same road, but I've done some of those same things that you have.

GILLESPIE: Maddox stopped using drugs 14 years ago.

MADDOX: I began using drugs at about the age of 9. My mom was gone and my dad was gone due to their addictions. And it stayed like that for a long time, going on into high school. I had a few kids then, and then I abandoned those two kids on my granny.

GILLESPIE: Maddox eventually got sober and regained custody of her kids. Hearing that story makes it easier for clients to open up and accept help, says supervisor Velva Poole.

POOLE: It's very helpful for the client to be able to relate to someone who has been in their shoes.

GILLESPIE: The START program began in Ohio and expanded into Kentucky in 2007. Since then, research shows it has higher success rates than the traditional child welfare process. But the opioid crisis has posed new challenges, says Maddox.

MADDOX: I had a few of my clients that passed away to a overdose - kind of devastating. But, you know, I'm seeing it, and sometimes I wonder if it was something else I could have done.

GILLESPIE: Maddox and Poole have a year to try to reunite START parents with their children. And parents who go through START are much more likely to be reunited with their children than parents that do not. Former START director Tina Willauer notes that they are fighting the stigma of parents using drugs.

TINA WILLAUER: There's - this question is, do these parents - should we even give them treatment? You know, almost as if they're throw-away because they have an opioid use disorder.

GILLESPIE: She says there are huge benefits to keeping families together.

WILLAUER: If you're pulling a child out of a home and putting them in a foster home, we're removing them from the only people that they know - their family, potentially their siblings. They might have to leave their school, their church, their community - so everything that they know. It's traumatic on many, many levels.

GILLESPIE: Willauer and the START workers all wish every parent could go through their rigorous program. But compared to the less intensive standard Child Protective Services process, START costs more money. Workers have fewer cases, and every parent gets a family mentor. So, with a budget crunch in Kentucky, expansion is not likely to happen anytime soon.

For NPR News, I'm Lisa Gillespie in Louisville.

MARTIN: This story is part of a reporting partnership with NPR, Louisville Public Media and Kaiser Health News.

(SOUNDBITE OF MIJA'S "NOTICE ME") Transcript provided by NPR, Copyright NPR.