Substance Use and Opioids

The Challenge

The growing epidemic of opioids has been declared a national emergency. Many experts say there is no immediate end in sight for this epidemic. It is critical that courts and communities are properly resourced and educated and collaborate to address this public health crisis.

Child Welfare
96,400 children were removed from their homes in FY2017 due to drug use by the parent/caretakers, accounting for over 1/3 of all removals (36%). Although the data do not specify removal due to opioid abuse, the opioid epidemic is contributing to removals. Alarmingly high numbers of infants are born addicted to opioids due to maternal use, known as Neonatal Abstinence Syndrome (NAS). In 2014, it was estimated that every 15 minutes a baby was born with NAS, and in 2013, West Virginia reported that 33.4 cases per 1,000 involved NAS. West Virginia was the state that reported the highest rate of NAS for 2013.

Juvenile Justice
Youth use opioids at a much lower rate compared to adults, however, there is a risk of opioid dependency among older adolescents. Statistics reveal that between 1999 and 2015, the death rate for drug overdoses was highest for opioids among 15-19-year-old youth, and drug overdose deaths were highest for heroin. In 2016, 3.6 percent of youth 12-17 reported that they had misused opioids in the past year, which was found to be especially true for prescription opioids.

Family Violence
Researchers have examined the relationship between opioid dependence and intimate partner violence (IPV) and found that opioid-dependent fathers reported a greater prevalence of physical, sexual, and psychological aggression towards mothers. Opioid use has also been found to be higher among survivors of domestic violence than the general population.

Role of the Judge and the NCJFCJ

Recognizing that juvenile and family courts are often the initial contact point for opioid abusers, and a critical partner in providing opioid abusers with substance abuse treatment and support, it is vitally important that juvenile and family court judges be part of national and local conversations on how to best address the opioid epidemic. The National Council of Juvenile and Family Court Judges (NCJFCJ) provides leadership and assistance to juvenile and family court judges and personnel to navigate the ever-changing complexities of juvenile and family law matters.

Recommended Practices and Judicial Education for Judges

Judges should:

• Request and receive training on:
  • the purpose of Medically Assisted Treatment (MAT) for opioids;
  • psychopharmacology, addiction, and substance abuse treatment;
  • the ramifications of opioid treatment on the Adoption and Safe Families Act (ASFA) and reunification timelines;
  • adolescent development and the impact of substance abuse on the adolescent brain; and
  • Identify gaps in services and needed funding to support the necessary resources and services.
• Provide leadership in developing evidence-based prevention and intervention protocols for opioid users.
• Provide leadership to interrupt the illegal distribution pipeline for prescription opioids.
• With training and an understanding of opioid addiction and treatment, make determinations regarding the best interests of the child in child abuse and neglect proceedings.
• With training and an understanding of opioid addiction and treatment, interrupt the substance abuse cycle in young people.
• Refer opioid users to appropriate substance abuse treatment and ensure treatment completion.
• Follow guidance from the Department of Justice in order to ensure that adolescents and families have access to MAT and use MAT as prescribed.
• Follow guidance found in 42 C.F.R. 8 and the Substance Abuse and Mental Health Services Administration (SAMHSA) regarding services for individuals who are prescribed MAT.
• Advocate for prevention strategies with youth in school or community settings.
• Advocate for substance abuse treatment in detention and other secure settings.
• Develop a community response team to include medical professionals and local public health departments.

Use the NCJFCJ as Your Resource

As an organization, NCJFCJ is dedicated to providing resources and training and technical assistance to juvenile and family court judges in order to help mitigate the effects of the opioid epidemic on children and families. Developed by the NCJFCJ, the following resources contain strategies to address the opioid crisis as well as recommended practices related to substance use and dependency.

• Resolution Regarding Access to Medication-Assisted Treatment for Adolescents and Adults in the Juvenile and Family Justice System
• Juvenile Drug Treatment Court Information Center
• Enhanced Resource Guidelines – best practices in child abuse and neglect cases
• Questions Every Judge and Lawyer Should Ask About Infants and Children in the Child Welfare System – how to address child welfare cases involving alcohol and other drugs
• Engage, Involve, Empower: Family Engagement in Juvenile Drug Treatment Courts
• Using Sober Support Groups in Your Juvenile Court
• The Unique Role of the Judge in Juvenile Drug Treatment Courts: Advice From the Field
• Tools for Planning and Improving Your Juvenile Drug Court’s Referral and Acceptance Process
• Guidance to States: Recommendations for Developing Family Drug Court Guidelines – published by Children and Family Futures and developed with input from the NCJFCJ

Upcoming Work

• Technical Assistance Briefs and Webinars
  • 5 Ways Juvenile Court Judges Can Use Public Health Data
  • 5 Ways Juvenile Probation Administrators Can Use Public Health Data
  • 5 Ways Legal Agencies Can Use Public Health Data
  • 5 Ways Social Service Agencies Can Use Public Health Data
• Enhanced Resource Guidelines Companion Guide on Opioids
• Child Abuse and Neglect Institute Curriculum Update

To request training or technical assistance, invite the NCJFCJ to your conversation, or to learn more about how the NCJFCJ can be a resource to you, please contact Cheri Ely at cely@ncjfcj.org or (775) 507-4797.