One year of the opioid epidemic touched the lives of 14,000 New Hampshire children, according to a report published this month by the United Hospital Fund.

“The trauma related to what they have lived with, and witnessed, is significant,” said Marcia Sink, CEO of CASA-NH, a group that advocates for abused and neglected children.

The report estimated 10,500 New Hampshire children were living with a parent who had an opioid use disorder in 2017. That year, 800 children were removed from their parents’ care because of opioids, and 1,500 children’s parents died or were imprisoned. That year, about 800 children and teenagers either accidentally ingested opioids, or struggled with an addiction of their own.

Living with the day-to-day uncertainty can have long-term effects on a child, Sink said. Some children whom CASA has worked with have seen their parents overdose, Sink said. Some have watched their parents die.

The United Hospital Fund report estimated the number of children in the U.S. affected by the opioid epidemic is 2.2 million. The things those children have seen are traumatic, the report’s authors say. The effects of that trauma will ripple out in ways that affect everyone: higher health care costs, more children likely to need special education, and more children in foster care.

By 2030, the report estimates, 4.3 million children will be affected by opioids every year. The cost of the epidemic will reach $400 billion in 2030, based on increased spending on health care, on special education, and in the child welfare and criminal justice systems.

In New Hampshire, the cost of the epidemic in 2030 is estimated to be $2.5 billion.

Dosage samples comparing heroin, fentanyl and carfentanil

Samples of the dosage of pure drugs that could kill the average human — heroin, fentanyl and carfentanil, a synthetic opioid 100 times more powerful than fentanyl — are displayed at the New Hampshire State Police Forensic Laboratory in Concord.

Steven Chapman, a pediatrician in Lebanon, and chapter president of the NH Pediatric Society, said dealing with the long-term effects of childhood trauma will be more difficult than preventing trauma by investing in parents’ recovery.

Childhood trauma has lifelong effects on health, Chapman said. Adverse childhood experiences are also linked to physical ailments like cancer and heart disease, he said.

Childhood trauma can translate to higher rates of smoking, drug and alcohol use, obesity and depression, and a higher likelihood of being arrested, the report said.

Working to prevent these traumatizing experiences, by offering robust recovery support to parents and pregnant women, will have benefits for decades to come, Chapman said.

“It’s not just a benefit for now but something we’ll see in the health of adolescents, in better school attendance and performance. It’s something that we’ll see in fewer DCYF and foster care placements, fewer juvenile arrests and criminal justice engagement. And a generation from now, we’ll see this in people better positioned to be parents.”

“It is not as daunting as the consequences of not dealing with it,” Chapman said.

“What we’re seeing with kids and families, it’s like every check engine light going off on your car, all at once,” he said. “We can respond to the check engine light, or we can just keep driving and ignore it. But we do that at our own peril, and at the peril of the parents and the kids that are affected by this epidemic.”

Chapman said he has seen pregnancy and parenting motivate parents to get into recovery, so they can be good parents. Recovery support needs to be available to parents as soon as possible, he said. People in recovery can become great parents, Chapman said.

“My hope is we, as a state, reach out and offer supports early, before kids are hurt and before parents get into worse addiction difficulties,” he said.

A key piece of that puzzle is making sure pregnant women and new mothers feel like they can seek health care for themselves and their babies.

“Many of the women I work with are feeling such shame and self blame,” Chapman said. “If we aren’t supportive and welcoming, we can really drive people away from a system that’s meant to help.”

Health care providers can help by offering empathetic, non-judgmental care for both the parent and the child and connecting families to local supports. Chapman said it was important that health care and social service providers focus on developing a parent’s strengths, rather than focusing on their addiction.

Emily Lawrence, associate director of the state’s Office of the Child Advocate, said New Hampshire is making progress.

The Legislature passed two key child welfare bills in the 2019 session, and the Governor’s Commission on Alcohol and Other Drugs created a perinatal task force.

But she said there is still work to be done in making sure parents feel they can seek drug treatment without fearing their children will be taken away.

And she said there needs to be more coordination between healthcare, child welfare agencies and schools—so all those systems can work together to help keep families on the best paths.

“When families are supported, the children will be better off,” Lawrence said.

Sink, of CASA, agreed that New Hampshire is making progress in supporting families. And in some families, Sink said, there have been happy endings.

“Some of these kids are incredibly resilient, and a lot of our parents are working really hard at recovery,” she said.

Monday, December 09, 2019