4.1.11 Children of Drug Misusing Parents |
Contents
Procedures
Children Of Drug Misusing Parents
The advisory Council on Misuse of Drugs (ACMD) report ‘Hidden Harm – responding to the needs of problem drug user’ estimated that there are between 200,000 – 300,000 children of problem drug users in England and Wales, i.e. 2-3% of all children under the age of 16. The report also concluded that parental problem drug use can and does cause serious harm to children at every age from conception to adulthood. Parental problem drug use is a characteristic by the use of multiple drugs, often by injection and is strongly associated with economic deprivation and other factors that effect parenting capacity. The adverse consequences for the child are typically multiple and cumulative and will vary according to the child’s age of development and other factors about their life experience. Some of the key features of the impact of parental drug misuse are:
- Physical Abuse and Emotional Abuse and Neglect
- Dangerously inadequate supervision and other inappropriate parenting practices
- Intermittent and permanent separation
- Inadequate accommodation and frequent changes in residence
- Toxic substances in the home
- Interrupted and unsatisfactory education
- Exposure to criminal or other inappropriate adult behaviour
An appropriate response to these children often require the close collaboration of a number of agencies including health, maternity services, adults and children’s social care, adult treatment, courts, prisons and probation services and the Community Drugs Team (CDT).
Referrals
Where there is concern that a parents drug use is placing his or her Child at risk of Significant Harm, the concerns must be referred to the Children’s Social Care Services or the Police, preferably in partnership with the Parent.
This includes concerns about the drug use of a pregnant woman where the unborn child is considered to be suffering or at risk of Significant Harm.
It will not be for those working with the drug-using parent to assess the need for child protection, but only to refer the child to Children’s Social Care Services for an assessment.
The procedures for referring, undertaking initial and other assessments and enquiries where Significant Harm is suspected are contained in Referrals Procedure, Initial Assessment and Core Assessment Procedure and The Section 47 Enquiry Procedure.
This chapter summarises the additional matters that should be considered where Significant Harm might result to a child, before or after birth, from a parents drug use.
Communicating with Parents
Where a referral is made by an agency worker who is working with a parent in relation to his or her drug use, the parent should be advised that the referral is to be made and their consent obtained if possible, unless to do so would increase the risk to the child. The parent should already be aware of the circumstances in which the agency worker would consider that a referral to Children’s Social Care Services would be necessary.
Please see the section below on Confidentiality.
Initial Assessment
See Initial and Core Assessment Procedure for detailed procedures.
Children’s Social Care Services will need to involve in their Initial Assessment those from specialist agencies working with the parents in relation to their drug use.
The Initial Assessment will need to consider the effect of the drugs on:
- The needs of the child
- Whether there is a risk or evidence of the child having suffered Significant Harm
- The parents’ skills in caring for the child
- The family and its support network, and how it copes with the drug use
- How help can be provided and how willing the parents are to accept and to benefit from help.
Child Protection Conferences
See Child Protection Conferences Procedure for detailed procedures.
If a Child Protection Conference is called, those from agencies who have worked with the parents in relation to their drug use must be invited to attend.
If the child protection conference is called in relation to an unborn child, the maternity services must also be invited to attend.
Guidance
Impact of Drug use on Parenting
The effects of Drug use on New Born Babies
Drug use in itself is not a reason for considering a child to be suffering or at risk of Significant Harm although it may be a contributing factor.
Professionals working with children need to understand the complexity of the lives of drug users and gain confidence in working with people who use drugs.
Adult agencies need also to be aware of the needs of children and these procedures, and be able to identify where a child may be at risk and how best to deal with it.
Impact of Drug Use on Parenting
The circumstances surrounding dependent, heavy or chaotic drug use may inhibit responsible childcare, for example, drug use may lead to poor physical health or to mental health problems, financial problems and a breakdown in family support networks.
Where there is concern that a parent is involved in drug use, the effect on the Child needs to be considered including:
- The child’s physical safety while drug (and alcohol use) is taking place
- Possible trauma to the child resulting from changes in the parents mood or behaviour
- The impact of the parents drug use on the child’s development including the emotional and psychological well being, education and friendships
- The extent to which the parents drug use disrupts the child’s normal daily routines and prejudices the child’s physical and emotional development
- The impact on the child of being in a household where illegal activity is taking place particularly if the home is used for drug dealing
- How safely the parents drugs and equipment are stored
Confidentiality
Also see Keyword ‘Confidentiality’
Confidentiality is important in developing trust between drug using parents and staff in agencies working with them in relation to their drug use.
Families with a drug-using parent need to be able to ask for advice from appropriate agencies and to work together with them to safeguard their children. Services need to be accessible and attractive to drug using parents and pregnant women who use drugs. Parents may be reluctant to seek help if they think Children’s Social Care Services will be informed and their competence as parents scrutinised.
No agency can guarantee absolute confidentiality, however.
All agencies, both statutory and non-statutory, should have written procedures on confidentiality, which include provision for informing Children’s Social Care Services where there is concern about the welfare of a child who may be suffering or at risk of suffering Significant Harm. When agencies start any work with drug-using parents or with pregnant women who use drugs, these procedures must be explained to them.
Pregnant Women Who Use Drugs
All maternity services should have procedures for pregnant women who use drugs that encourage them to go to antenatal services and help them to stabilise, reduce or stop their drug use.
When a woman with a drug problem attends for antenatal care, she should be encouraged to contact the specialist Community Drugs Team (CDT) for assessment and advice on the treatment options available to her.
Appropriate drug treatment will depend on past history, the amount and type of drugs used, the combination of drugs used and the method of use as well as the woman’s motivation and current situation.
Planning meetings attended by staff from the maternity and neonatal services and specialist drug agency should be held during the pregnancy to review the management of the mothers drug use. Consideration will also need to be given to how the mothers drug use will affect the baby both before and after birth and, if there is concern about the effect of the drug use on the parents child care abilities, a referral should be made to the Children’s Social Care Services under these procedures. See Child Protection Conferences, Pre-Birth Conferences Procedure.
Because of the increased risks of complications, drug-using women should have their babies in hospital and should be encouraged to visit the special care baby unit before the birth.
The parent or parents should be given information before the birth about the health problems the baby may have and offered support both before and after the birth.
The Effects of Drug Use on New Born Babies
Babies may experience withdrawal symptoms or exhibit signs of maternal drug use after birth. Symptoms include a high-pitched cry, rapid breathing, hunger but difficulty feeding, inability to establish sleep patterns, fast heart rate, sweating,
fever, vomiting, diarrhoea and seizures. Withdrawal symptoms normally appear within 24 to 48 hours of delivery but this varies and can be longer depending on the type of drug used.
Babies may also have a low birth weight and/or impaired growth.
HIV
Services should offer information and counselling to women on the implications of being HIV positive, both for themselves and their babies.
For further information on the procedures and guidance in relation to HIV, please see HIV Procedure.
Areas for Development
All areas should develop policies and guidance on drug-using parents and their children with the local authority, Health, GP’s, the Community Drugs Team (CDT), probation and non-statutory agencies. All maternity services should have policies
and procedures for pregnant women who use drugs that encourage them to go to antenatal services and help them to stabilise, reduce or stop their drug use. There should also be policies and procedures for the care of newborn babies of drug users. These policies and procedures should be agreed by the CSCB and widely disseminated to drug users who are pregnant or who have children.
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