Dr. Wells: Child Abuse & Neglect

Child Abuse and Neglect
Author: Kathryn Wells, MD
Medical Director
Denver Family Crisis Center
(720) 944-3747
E-Mail: kathryn.wells@dhha.org

There are several aspects of child abuse and neglect in drug-endangered homes. The environments themselves are frequently so dangerous that simply allowing a child to live there constitutes child endangerment. Substance abuse also affects the caregiver's ability to parent, placing the child at additional risk for abuse and neglect.

It has been shown that a large portion (80 - 90%) of caretakers involved in the child welfare system for child abuse issues have substance abuse as one of the major personal issues that they face. Substance abuse is believed to cause or exacerbate 7 out of 10 cases of child abuse and neglect. In fact, children whose parents abuse drugs and alcohol are three times more likely to be abused and four times more likely to be neglected (No Safe Haven: Children of Substance-Abusing Parents, The National Center on Addiction and Substance Abuse at Columbia, January, 1999).

Clandestine Methamphetamine labs ("Meth labs") create an environment that is so dangerous that some states have made allowing children to live there even part of the time to constitute child endangerment/abuse/neglect. About 30 - 35% of Meth labs seized are in residences where children live. Children are at an increased risk in a Meth lab environment because of their physiologic status (higher rates of growth, metabolism, respiration, and development) and their behaviors (hand-to-mouth behaviors and increased contact with their physical environment). At least two reports have demonstrated that 35 - 70% of children removed from labs have a urine drug screen that is positive for Methamphetamine at the time of removal from the home. 

The specific hazards to children living in these labs are numerous. The children are exposed to toxic chemicals and are at risk on inhalation of toxic fumes. Clothing and skin contact of improperly stored chemicals, chemical waste dumped in play areas, and potential explosions and fires (the specific risks of the different chemicals are outlined in the Clandestine Lab section) are also possible. They are frequently exposed to a hazardous environment which often includes accessible drugs, exposure to drug users, cooks and dealers, hypodermic needles within reach of children, accessible glass smoking pipes, razor blades and other drug paraphernalia, weapons left accessible and booby traps placed to "protect" the clandestine laboratory and its contents from intruders.

The use of illegal drugs or excessive amounts of alcohol affects the caregiver's judgment, rendering them unable to provide the consistent, supervision and guidance that children need for appropriate development. Therefore, substance abuse in adults is a critical factor in the child welfare system. With specific reference to Methamphetamine, children are frequently neglected during their caregiver's long periods of sleep while "crashing" from a drug binge. The caregiver's also frequently display inconsistent and paranoid behavior, especially if they are using Methamphetamine. They are often irritable and have a "short fuse" which may ultimately lead to physical abuse. Children in these homes are often exposed to violence as well as unsavory individuals. Unfortunately, these caregivers were often not parented well themselves and therefore did not learn effective parenting skills.

Finally, the caregiver's ability to provide a nurturing home for a child is complicated by the caregiver's own mental health issues which may have contributed to or resulted from substance abuse.

Children whose caregivers are substance abusers are frequently neglected. They often do not have enough food, are not adequately groomed, do not have appropriate sleeping conditions, and usually have not had adequate medical or dental care. These children are frequently not well supervised, placing them at additional risk of injury. Children raised by substance-abusing caregivers are often exposed to pornographic material, often emotionally abused and have a heightened risk for sexual abuse. Additionally, they frequently do not get the appropriate amount of support, encouragement, discipline, and guidance they need to thrive.

It is clear for many reasons that caregivers who are using illegal substances or excessive amounts of alcohol are not able to provide safe and nurturing homes for their children. It is for this reason that multiple agencies (law enforcement, fire departments, EMS, social services, the medical community, public health departments, the judicial system, legislators, substance abuse and mental health treatment providers and our entire communities) need to work together to first and foremost assure that these children are safe and then work to break the cycle to improve the futures for our children, our families, and our communities.