Children Placed in Foster Care Because of Substance Use Now More Likely to Go to Relatives than Non-relatives, A Report Finds

The recently updated report from Generations United, Raising Children of the Opioid Epidemic: Solutions and Support for Grandfamilies, shows that -- overall -- foster care systems are relying more on grandparents and other relatives to care for children when their parents cannot. The report includes recommendations on how to connect grandfamilies to the same supports and services that traditional unrelated foster families receive. Read the release, then see the updated report

To prevent youth opioid misuse, many states are more effectively regulating prescriptions

SEP 04, 2018
AUTHORS: ANDRA WILKINSON, HANNAH WINSLOW

The majority of people who misuse drugs start before their 18th birthday. Furthermore, the risk of addiction increases when drug use starts in adolescence, making this period a key prevention window. Leftover prescription pills, either from one’s own prescription or those of family or friends, are the dominant source of opioid pain relievers for adolescents who misuse them.[1] By the end of high school, approximately 13 percent of teens will have misused opioid pain relievers (i.e., used them without prescription, in a manner not prescribed, or to get high). Strategies that address adolescent misuse of prescription opioid pain relievers represent a critical component of any successful effort to address the opioid crisis.

A national study of 12th graders found that, among those with no prior history of drug use and strong disapproval of illegal drug use, a prescription for opioids in high school was associated with a threefold increased risk of later opioid misuse. Opioid pain reliever misuse can substantially increase the risk of initiating heroin use. As such, decreasing excessive opioid prescribing and lowering the number of leftover pills are important strategies for preventing opioid pain reliever misuse—and, potentially, later heroin or fentanyl (a more powerful and lethal synthetic opioid) use among youth.

Adolescent outreach and education is necessary but not sufficient for prevention. To prevent adolescent misuse, many states have implemented policies designed to limit unnecessary prescribing. Recent legislative efforts have included the following strategies:

Despite their effectiveness at reducing misuse, policies targeting the supply of prescription opioids have met varying degrees of resistance. In recent years, opioid prescribing has dropped. Teen prescription opioid and heroin use is now at a historic low, fueling concerns that these new policies may not be necessary, and that poorly implemented policies can—and are—harming terminal patients and those with chronic pain. Furthermore, increased regulation of prescription opioids generally correlates with upticks in heroin use. Ohio, the state with the second-highest opioid overdose death rate, has in recent years passed legislation that includes all three of the previously mentioned policy approaches. In subsequent years, the state saw opioid prescribing fall 20 percent, while its overall overdose death rate continued to rise as the proportion of deaths due to heroin and fentanyl increased.

However, the relationship observed between decreasing supplies of prescription opioids and increases in heroin use is complex, and research shows that the overall increase in heroin use began long before efforts to decrease opioid prescribing. For this reason, lawmakers should consider ways to expand treatment while taking careful steps to limit supply, as confirmed by a recent predictive model. Although prescribing has dropped overall, it still varies considerably across states; for example, certain states have prescribing rates more than twice as high as their neighbors. Some researchers also assert that state policies are important for continued declines in prescription opioid use among youth.

Policies regulating access to prescription opioids are certainly not a cure-all, but they do provide an opportunity for policymakers to intervene before youth addiction begins. As prescription pain relievers continue to be one of the most common drugs of choice for first-time users in adolescence, state policy initiatives to reduce excessive prescribing may be a powerful tool for lawmakers. However, to ensure that prescription opioid regulation corresponds with decreases in overdose deaths, policies limiting supply must not harm chronic pain patients and must go hand-in-hand with expanded and comprehensive addiction treatment.

[1] Child Trends analyses of the 2016 National Survey on Drug Use and Health.

[2] State policies related to opioid prescribing change rapidly. For the most up-to-date information, please consult http://www.ncsl.org/research/health/injury-prevention-legislation-database.aspx.

 
Published in Children's Justice Act

The Opioid Crisis and its Impact on Children

Legal Executive Institute - August 23, 2018

Although the impact on adults is tragic, an increasing number of children are also suffering, especially as opioid addiction reaches crisis levels. From birth on, these children are living with the consequences of their parents' addiction.

http://www.legalexecutiveinstitute.com/opioid-crisis-impact-on-children/

Published in Children's Justice Act

CMS Initiative to Create Pediatric APMs to Address Opioid Crisis

Revenue Cycle Intelligence - August 23, 2018

The recently announced Integrated Care for Kids (InCK) initiative will require Medicaid and local providers to develop alternative payment models to combat the opioid crisis for children. To address the opioid crisis affecting children, The Centers for Medicare & Medicaid Services (CMS) intends to use the InCK initiative to support physical and behavioral health integration for the pediatric population. One in three children in Medicaid and CHIP has some type of behavioral need, but one one-third of these individuals receive care, the federal agency reported.

Also: Integrated Care for Kids (InCK) Model Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/integrated-care-kids-inck-model

https://revcycleintelligence.com/news/cms-initiative-to-create-pediatric-apms-to-address-opioid-crisis

Published in Children's Justice Act
Tuesday, 26 June 2018 16:55

Opioid Resources/Information: Louisiana

How Prevalent is Opioid Abuse?

Opioid abuse is a problem in Louisiana where almost all indicators … addiction to opioid medications, overdose deaths, emergency room admissions and over-prescribing … are evidence of the problem. 

A link for LDH’s website with Opioid related information is as follows: Opioid Get Help navigation

Additional Documents are attached:

FINAL Opioid Substance Abuse Status Report

SAMHSA Overdose Toolkit

Opioid Epidemic PPT

CY 2016 - Valid Drug/Alcohol Affected Newborn Victims - Chart

 

Published in Children's Justice Act

This guidebook was created through a partnership with Louisiana Department of Children and Family Services and Louisiana Department of Health. The State of Louisiana has participated in several policy academies, consortia and innovative projects to help guide the integration of behavioral health services into physical health in order to enhance services and improve patient care. Louisiana's participation in the Center for Medicare and Medicaid Services Innovations Accelerator Program for Substance Use Disorders (IAP/SUD) is just one example of a collaborative effort for stakeholders to come together to address substance use disorders (SUD) and related conditions.

This Toolkit has been approved the the Louisiana Perinatal Commission, which will serve as a partner for statewide dissemination and integration into future projects and initiatives. 

This guide is intended for use in medical settings, but may have a broader use as a reference guide.

Link to Toolkit: http://ldh.la.gov/assets/docs/BehavioralHealth/NASBooklet.pdf 

Published in Children's Justice Act

Born addicted: Louisiana's rate of newborns dependent on opioids is rising, pregnant women lack treatment options

Advocate - May 05, 2018

Kemper's agony has become more common among Louisiana newborns amid a national opioid addiction epidemic. The rate of Louisiana babies diagnosed with neonatal abstinence syndrome quadrupled between 2005 and 2015, the most recent year on state records. OB-GYNs and neonatologists also acknowledge that some prenatal care providers are hesitant to take on addicted patients. State health officials and hospital administrators have discouraged providers from cutting off prenatal care for pregnant addicts, worried that turning away mothers will result in more unhealthy children.

http://www.theadvocate.com/baton_rouge/news/article_a157bb42-4d9a-11e8-b271-03082af75e27.html

Published in Children's Justice Act
Wednesday, 09 May 2018 16:44

Children of the Opioid Epidemic

Children of the Opioid Epidemic

New York Times Magazine - May 09, 2018

Of the estimated 2.1 million Americans currently in the grip of opioid addiction, many are women of childbearing age. The young-adult population has been hardest hit, proportionately, with nearly 400,000 adults ages 18 to 25 suffering from addiction to prescription painkillers (the vast majority) or heroin.

Also: Information Gateway Resource: Substance Use Disorder Treatment Services: https://www.childwelfare.gov/topics/systemwide/bhw/treatment/

https://www.nytimes.com/2018/05/09/magazine/children-of-the-opioid-epidemic.html

Published in Children's Justice Act

Early Treatment Program for Opioid-Dependent Newborns Significantly Reduces Cost While Maintaining Medical and Safety Outcomes (Press release)

Joint Commission - May 03, 2018

Findings showed no significant differences between the two groups regarding medical and safety outcomes, or child protective services involvement. However, the traditional care NAS infants were more likely to be treated in a higher-level nursery or to have emergency department visits, and the median per-birth charges were approximately $8,204 lower for MAiN infants.

Also: Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006-2014: https://www.jointcommissionjournal.com/article/S1553-7250(17)30299-4/pdf

Also: Management of Neonatal Abstinence Syndrome: The Importance of a Multifaceted Program Spanning Inpatient and Outpatient Care (Commentary): https://www.jointcommissionjournal.com/article/S1553-7250(18)30155-7/pdf

http://www.sectorpublishingintelligence.co.uk/news/1975602/early+treatment+program+for+opioiddependent+newborns+significantly+reduces+cost+while+maintaining+medical+and+safety+outcomes

Published in Children's Justice Act

Opioid-Related Deaths Children and Teens, Ages 10-17. 

This is a graphic document with quite a few current statistics - national perspective. Published in November 2017


Quick-Look: Child Death Review Case Reporting System (CDR-CRS)
National Center for Fatality Review and Prevention.
2017
https://www.ncfrp.org/wp-content/uploads/NCRPCD-Docs/opioid-related_deaths_prnt.pdf

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