Drug-endangered children.

The number of children in the United States exposed to the inherently hazardous processes used in the illicit manufacture of the controlled dangerous substance methamphetamine or meth has more than doubled in the past few years. Unfortunately, despite law enforcement efforts, these numbers continue to rise.

Just as alarming is the number of children negatively impacted by physical and emotional abuse, as well as neglect, by parents, guardians, or other adults who expose them to toxic meth lab operations, firearms, pornographic material, criminals and their unlawful activity, and domestic violence, just to name a few of the dangers. Methamphetamine abuse and production have become major factors in the increase of child abuse and neglect cases handled by the child welfare system.

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The Growing Menace

Estimates have indicated that children are found in approximately one-third of all seized meth labs. Of those children, about 35 percent test positive for toxic levels of chemicals in their bodies. In other areas, those numbers have proven even higher. More alarming, however, is the possibility that 90 percent of all meth labs go undetected, leaving many children to suffer needlessly. (1)

Although statistics are limited at present, an abundance of anecdotal evidence exists about the enormous physical, developmental, emotional, and psychosocial damage suffered by children exposed to illegal home-based drug production. The evidence comes from professionals in the fields of law enforcement, human services, medicine, education, and others who have first-hand experience with children living in homes where methamphetamine is illegally manufactured.

Children who inhabit homes where parents, guardians, or other adults undertake the illegal manufacturing of methamphetamine risk multiple exposures to many different chemicals and combinations of chemicals and their byproducts. They further risk toxic poisoning from the inhalation of chemical gases and vapors that damage their respiratory and circulatory systems; chemical burns; and the ingestion, absorption, or injection of drugs or chemicals. Such children also face the peril of injury or death from fires or explosions.

Often, these children live in poor conditions. Homes that house labs frequently are dirty, sometimes lacking water, heat, and electricity. The children typically have little to eat and do not receive adequate medical care, including immunizations, and dental services. The mothers rarely seek prenatal care for some of the same exposures. This constitutes not only child endangerment but, even worse, child abuse.

Exposure to these dangerous substances can cause serious short- and long-term health problems, including damage to the brain, liver, kidneys, lungs, eyes, and skin. The chaotic lifestyle of individuals involved in methamphetamine manufacturing and use places children at risk for physical and emotional trauma. To compound the problem, neglect or inconsistent parenting can interfere with children's cognitive, emotional, and social development. The children become exposed to drug-related violence and physical and sexual abuse at the hands of family members, neighbors, and an array of strangers who pass through the house to buy or sell drugs.

Relatively few states have programs in place to deal with the problems associated with the manufacture of methamphetamine, especially when it comes to the children caught up in this illegal activity. The social and legal aspects of these types of cases are enormous. The parents, more often than not, have been getting away with the abuse and neglect of their children for a long time. The children found at these meth lab sites have suffered greatly and been denied access to social and health-related services. What can be done to protect these drug-endangered children?

Oklahoma's Response

In Oklahoma, a program began operating ad hoc after months of preparation and training. Meetings involved representatives from social, medical, law enforcement, and criminal justice agencies. These professionals saw the need and, thus, conjointly formed a state drug-endangered children (DEC) effort that, so far, has attempted to mirror the DEC program in California. (2)

The goal of the DEC effort is to intervene on behalf of children found living in horrific conditions produced by the unlawful and dangerous clandestine methamphetamine manufacturing processes and the environment associated with addiction. A further goal involves creating a collaborative multidisciplinary community response to identify and meet the short- and long-term needs of the children endangered by this exposure.

To accomplish this goal, the DEC program steering committee was set up to offer assistance to the multidisciplinary child abuse and neglect teams (CAN) that Oklahoma has mandated every county to establish. Currently, there are 50 functional teams, with more forming. The CAN teams, comprised of law enforcement officers, child protective service workers, mental health employees, medical personnel, prosecutors, and other professionals, address problems of child abuse and neglect and currently are the best suited to respond to the needs of drug-endangered children. Many teams, who have been called upon to do so, have worked in concert with other professionals to see that these children receive the kind of short- and long-term care needed and, when appropriate, ensure that the violators are prosecuted for child endangerment.

Only by working collaboratively can these professionals succeed in their endeavors. They must work toward a "win-win" situation in the best interest of the children. First responders must recognize that intervention on behalf of these children is of the utmost importance. This intervention, however, must take place without creating additional trauma to the children. Law enforcement officers take the children into protective custody, move them to a safe location, and attend to their immediate needs. Child protective services (CPS) personnel arrive on the scene as soon as possible to help the officers assess the needs of the children. Emergency medical technicians (EMTs), firefighters, and hazardous material professionals also stand by if needed.

Such coordinated efforts prove invaluable to medical technicians (EMTs), firefighters, and hazardous material professionals also stand by if needed.

Such coordinated efforts prove invaluable to the well-being of the children and must be worked out in advance and included in the operational protocols of the CAN team. For example, because removal of clothes and decontamination procedures according to federal instructions are certain to cause an increased sense of vulnerability and trauma to all but the smallest infants, this only should occur prior to CPS arrival in the most pressing and urgent circumstances.

The children should be transported to the appropriate medical screening facility for further evaluation as soon as possible after the intervention. If grossly contaminated children are discovered, they should be examined on the scene by trained EMTs. The children then should be transported by ambulance just in case complications arise en route. EMTs also should consider that they are traveling in a confined space and should allow for ventilation.

Determining which member of the team should transport the children proves crucial to the CAN team's effectiveness. In the best interest of the children, team members must agree on the most appropriate method of transporting them. In some cases, a CPS worker may be the best choice. CAN members must consider the children's ages, as well as the safety of the person providing the transportation. While officers must maintain control of the situation, they may encounter difficulties in transporting the children to a medical screening facility out of their jurisdiction. The number of officers on duty may dictate whether they can leave their jurisdiction for that purpose. When officers provide the transportation, they cannot remain with the children at the medical screening facility for any length of time, no matter how much they would wish to, because they must return to their official duties. Similarly, the CAN team also must coordinate transportation to the receiving facility. The vast majority of the children taken into protective custody are eventually placed with relatives, while the remainder are sent to shelters.

Having a standing court order from the jurisdictional judge when children are found in meth labs expedites assuming temporary custody for the CPS worker. A standing court order regarding toxicology testing also helps in testing for ingested or assimilated chemicals and drugs. Based on the results of a urinalysis test, a blood test may be warranted and in the best interest of the children's health in terms of follow-up care. Although it is strongly recommended that children's urine/blood be obtained if possible within 2 hours as part of evidence collection, this is not absolutely necessary to conduct a thorough DEC investigation or prosecution. While the presence of toxins in the child's urine or blood will support child abuse charges, it is most important as a possible indicator of other chemical exposures and for identifying and treating any adverse health effects. (3)

Conclusion

Based on the California Drug-Endangered Children Program and what Oklahoma authorities have seen thus far, an effective comprehensive response to the needs of children endangered by the epidemic of methamphetamine use and production, as well as all substance abuse, must include prevention, intervention, enforcement, interdiction, and treatment. Multidisciplinary collaboration is key to ensuring that this comprehensive range of responses is activated.

In the state of Oklahoma, social, medical, law enforcement, and criminal justice agencies began working together to address this escalating problem. The team approach has become a valuable model of intervention for children and families endangered by the devastating intergenerational cycle of alcohol and drug abuse of all kinds.

Participating agencies and elected representatives support this type of program. No better reason exists for this than the safety and health of innocent children. No one must add to the trauma and suffering these children have endured, and, more important, no one must fail to respond to their needs.

Endnotes

(1) The author based these estimates on various reports that he has reviewed and on his personal experience as a narcotics agent for nearly 25 years.

(2) For information on the California program, see Tom Manning, "Drug Labs and Endangered Children," FBI Law Enforcement Bulletin, July 1999, 10-14.

(3) The state of California has established models of multidisciplinary protocols for intervening on behalf of children found in home-based meth labs. Their medical protocols for screening drug-endangered children will give medical professionals a starting point. While many physicians may find these protocols acceptable, most medical screening facilities will want to establish their own medical protocols. Medical professionals in any state should approach this situation with great care and establish medical protocols in the best interest of the child.

By Jerry Harris, M.S.

Agent Harris heads the Training and Education Section at the headquarters of the Oklahoma Bureau of Narcotics and Dangerous Drugs Control in Oklahoma City.