Pubdate: Wed, 28 Oct 2015 Source: Sentinel Review (CN ON) Copyright: 2015 Woodstock Sentinel Review Contact: http://www.woodstocksentinelreview.com/letters Website: http://www.woodstocksentinelreview.com/ Details: http://www.mapinc.org/media/2385 Author: Megan Stacey Page: A1 PARENTING WITH ADDICTIONS - AND CHILD SAFETY CHILDREN'S AID SOCIETY: The third in a series marking the 120th anniversary of the Oxford agency Maybe they go to school without a lunch. A doctor's appointment is missed. Little fingers are without mittens in the frosty winter air. All parents can relate to that sinking feeling that comes with forgetting something a child needs. But sometimes those experiences turn from an innocent mistake to a pattern of red flags. Those red flags could be pointing to an addiction. - --- --- --- Challenges with substance use are certainly not uncommon in Oxford -- a region that once earned the nickname "Oxy County," and not just because of similarities in name. The ripple effect that comes with an addiction means children can be caught in the crossfire. "Anyone who is using a substance is going to struggle to parent, because our substance use impacts our regular abilities, skills, personalities, emotional regulation," said Lisa Longworth, community services co-ordinator and counsellor at the Ingersoll Nurse Practitioner-Led Clinic. "In addition to that, when someone is in withdrawal from a substance, all of those things are exacerbated, because we don't feel well -- emotionally or physically," she said. Children's aid societies are tasked with drawing that line between safety and parental behaviour. It's a tough balance to strike, and the Children's Aid workers in Oxford -- the ones who have to ask the tough questions about child safety -- know the intricacies that can make any decision infinitely more complicated. A child protection worker at Oxford Children's Aid Society, who didn't want to be identified in order to protect her clients, said there is an important question the agency can use as a barometer when addictions may be a concern. "We try to identify, what is the impact on the children?" The agency does tend to err on the side of caution, said director of services Rob Neill. "In general, we will open (the cases) to check the situation out. So we may have a lot of cases that open, we check it out, maybe there's some marijuana use or some alcohol use, but we determine that there isn't a major impact on the children, so we close the investigation stage," he said. It's all about answering that question: Is the addiction affecting children? "For myself as a worker, and most of the front-line workers, we worry about what impact it has when a parent is actively using in the home," the protection worker said. "How does that impact their parenting? Are they less attentive, less available, less patient than they want to be or are normally?" She outlined some of the other potential impacts: - - Withdrawal symptoms that make someone physically unable to parent (vomiting, diarrhea, shakes, etc.) - Financial problems as a result of buying substances - Criminal involvement, even jail time, that could disrupt a child/parent relationship - An unsafe environment created by the substances, or by those visiting the home (other users, dealers, etc.) "Pretty well any bad thing that can happen to a child just gets a little bit worse -- or a lot worse -- when substance use is involved," said Pam Hill, director of clinical services at Addiction Services Thames Valley. - --- --- --- But it's not necessarily about what a parent is doing. It could also be about what they're not. "We look at drug-endangered children where the neglect happens, most of all, when the parent is sleeping it off," Longworth said. A sleeping parent can't prevent accidents, or stop their children from getting into harmful substances, she added. "One of the things that we're finding is extremely dangerous now is Fentanyl patches that are disposed of in a garbage can. Even if a child picked that up, they can absorb it through the skin," Longworth said. Fentanyl patches are intended to provide the slow release of a powerful painkiller when used as a patch. Even once it comes off the skin, the patch is still potent enough to harm a child. There are many recorded cases of children overdosing after inadvertently picking up the patches or playing with them. As with most things in life, addictions are very individual. No symptoms are guaranteed just because a parent is using a certain drug. "The reality for that particular family that you're working with is much more important than what a textbook says a family might experience when using a drug," the protection worker said. In fact, sometimes substance use can actually help a parent have better quality time with their children, Hill said. "We've known women who have a much better time with their kids when they're using, because it's managing their pain in some way ... But a very advanced addiction will make the drug the centre of a person's life," she said. "It's a tool for coping, for just helping them feel normal in life, but it's a coping mechanism that goes awry." That's one of the issues Children's Aid has to navigate when they investigate a case that involves substance use. "We certainly try to talk to parents about developing healthy coping skills. When things aren't going well, and you used to rely on your addiction to meet those needs, we need to find different coping skills, and role modeling that to your children," the protection worker said. For parents, fear of losing their kids can be a huge challenge. It may even keep them from seeking treatment. "They're terrified -- it's probably the major barrier -- that if they ask for help, they will lose control of choices around their children, that they'll have to be reported to the Children's Aid Society or Child Protection Services, and that they'll lose control of everything," Hill said. - --- --- --- Of course, substances don't have to be illegal to lead to an addiction. Despite the idea that opioids (like OxyContin) reign supreme in Woodstock and other parts of Oxford, statistics suggest that legal substances are wreaking much more havoc than any other drug. "There's a lot of fear around 'hard drugs,' but what we know is that 53 per cent of the open admissions we had for our clients in Oxford County were about alcohol dependency. That's been the norm," said Hill of local residents seeking treatment between 2013 and 2014. There were more than 2,300 hospitalizations in Oxford due to mental and behavioural disorders that could be linked to substance use between 2002 and 2014, according to stats provided by the county. But the vast majority of those hospitalizations treated alcohol use, a whopping 56 per cent compared to 8 per cent for opioids. Tobacco came next, accounting for just over 6 per cent of hospitalizations. Deaths that were traced back to substance use in the county between 2000 and 2011 (the most recent data available, again provided by Oxford County) were related to alcohol in 79 per cent of cases. "The legality or illegality of the drug is really an irrelevant issue. The issue is how is it impacting the child? Alcohol, for example, is a legal drug and many people manage their alcohol use responsibly," said Neill. The drugs of choice -- often those that are most affordable and accessible -- have changed since OxyContin was pulled off the market. "It's no longer the OxyContin, it's the hydromorphine and more often, methamphetamines," said the CAS protection worker. "As opioids have been harder to get, people are choosing other options such as crystal meth, crack cocaine, heroine," Longworth added. "My prediction in looking at what's trending now with more limited access to opioids, there is a potential for those drugs to become more prominent." - --- --- --- "There's a lot of stigma associated with (addiction), and judgment," said Neill. The challenge for Children's Aid is putting aside stereotypes or particular wishes for a family, and instead assessing whether children are safe. But for parenting struggling with substance use, the societal stigma can be overwhelming. Hill said mothers often feel isolated and judged at mommy groups or other community programs. The experts want communities to realize that addicted parents don't love their kids any less than parents without substance use challenges. "They love their kids. It's just that the substance use becomes more of a priority," Longworth said. Addiction is enough to cripple any family, and it's tough to explain to kids. Children might feel confused or even wonder if they have done something wrong when they see mommy or daddy acting strange, angry, or sick. "There's no doubt in my mind that people with addictions issues love their kids as much as anybody else does," Hill said. "In fact, the vast majority of them come to us and their motivation is 'I want to be a better parent. I don't want my child to have this experience that I'm having.'" Sometimes working with Children's Aid can push parents to make a change. Protection workers can also educate parents about where to look for help. The good news in Oxford County is that those who reach out for help are no longer waiting for months to receive it. "We've gone from having one counsellor come from London ... to offering six counsellors (at) shared walk-in intakes across the county," Longworth explained. That outreach is a partnership between four local community resources - -- Thames Valley Addiction Services, Canadian Mental Health Association, the Ingersoll Nurse Practitioner-Led Clinic, and the Woodstock and Area Community Health Centre. "They can just show up at any one of these walk-in intakes, and they will be seen. We do a full intake and assessment on them, and that helps us determine what the best kind of treatment would be," Longworth said. Folks with addiction or gambling issues no longer have to find transportation to London. They no longer have to wait months to talk with someone. Longworth said clients at these walk-in sessions are usually lined up for their next appointment within three to five days. The hope is that, one day, these counsellors might work themselves out of a job. But for now, Children's Aid is hoping that struggling parents will reach out for help. "I remember seeing a pamphlet when I worked in Toronto a decade ago, put out by the one of the shelters that also provided addiction therapy," Neill said. "The name of the pamphlet was 'love is not enough.' You would think it would be, when it came to your children - what more powerful motivator can there be? But where you have a deep-seated addiction issue, it's an extremely difficult problem to extract yourself from." - --- MAP posted-by: Jay Bergstrom