# Presentation: 652709

## All Meth’d Up:  Frightening Impacts on Tribal Children & Families

- Diane Payne, Children’s Justice Specialist
- Tribal Law & Policy Institute

## Meth Variations

- Strawberry meth

- Peanut butter meth

## What is Methamphetamine?

- Methamphetamine is a powerful central nervous system stimulant that strongly activates multiple systems in the brain.
- Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater.

## TRENDS IN INDIAN COUNTRY

## TRENDS:  USE & DISTRIBUTION IN TRIBAL COMMUNITIES

- “Sample” meth given to youth; youth users are coerced into smurffing
- Youth are getting their drugs by being drivers and couriers for dealers (youth drivers get lighter sentences)
- Young women from border reservations serving as “mules” to transport over Canadian border

## METH ON THE RODEO & POW-WOW TRAILS

- Users supplied by individuals who work as vendors on summer rodeo & pow-wow circuits
- Relatives traveling & taking passengers between reservations are unknowingly transporting meth after family gatherings

**Notes:**
N. California route north into Oregon and east into Nevada then distribution throughout NW & Montana, Wyoming, Dakotas, Nebraska via “normal” visiting routes as well as via migrant workers

## NEAH BAY -- Christina Pendleton......Makah woman was romanced on her remote Pacific Northwest reservation by a Mexican drug dealer who fed her methamphetamine addiction and then peddled dope to her tribe.
Clean and sober since December, she now has a job in tribal government and takes every opportunity to warn of the dangers of meth. 
"They are told in Mexico, even before they come here, to find an Indian woman and marry her," she said of the dealers. "You will get a free home, a free clinic. And they basically do it and set up shop."
Pendleton knows. Her former lover made her home on the reservation his personal drug den. He's gone now, but she's fighting to regain custody of their meth-affected little boy.
http://seattlepi.nwsource.com/national/328272_fbinative20.html 

- Clean and sober since December, she now has a job in tribal government and takes every opportunity to warn of the dangers of meth.
- "They are told in Mexico, even before they come here, to find an Indian woman and marry her," she said of the dealers. "You will get a free home, a free clinic. And they basically do it and set up shop."
- Pendleton knows. Her former lover made her home on the reservation his personal drug den. He's gone now, but she's fighting to regain custody of their meth-affected little boy.
- _[http://seattlepi.nwsource.com/national/328272_fbinative20.html](http://seattlepi.nwsource.com/national/328272_fbinative20.html)__ _

## ASSESSING EFFECTS OF METH ON CHILDREN

- Prenatal effects
- Household safety
- Childhood supervision
- Neglect
- Physical abuse
- Sexual abuse
- Lack of positive support system

**Notes:**
Prenatal – children may experience developmental and learning delays (Rawson...2002)  these children may need special resources
Exposure to toxins – assessment needs to include carefully looking at what household products and paraphernalia are within the child’s reach or within the child’s air, food, sleep and play environments
Supervision – parents sleeping excessively may lead to neglect; parents have suppressed appetite so may not have food or may not prepare or use nutritional food
Physical – agitation and violence during withdrawal or crash phase
Sexual abuse – increased sex drive and others in child’s environment that are not adequately supervised may molest child

Lack of positive support – meth using parents may have limited support system, or are only associated with others who use meth

## DEFINITION:  DRUG ENDANGERED CHILD

**children in homes where alcohol and drug abuse is present**

## VULNERABLE CHILDREN

## Slide 11

## Slide 12

## Meth promotes..... 

- Inconsistent parenting, chaotic home
- Poor supervision, nutrition
- Exposure to interpersonal violence
- Exposure to second-hand smoke, toxic chemicals, burns
- Exposure to pornography and sexual abuse
- HIV exposure from needle use by parent
- Normalizing criminal behavior
- Pregnancy problems

**Notes:**
Pre-term delivery
Preganancy complications – preterm delivery or rush/ doses of meth may cause fetus to experience stroke or brain hemorrhage before birth

## EMOTIONAL & SOCIAL CONSEQUENCES FOR CHILDREN 

- DELINQUENCY
- LEARNING PROBLEMS
- CRIMINAL BEHAVIOR
- HOMELESSNESS
- SHAME
- ATTACHMENT DISORDERS

- ISOLATION
- POOR PEER RELATIONSHIPS
- POVERTY
- ADDICTIONS
- POOR ANGER MGMT
- CHAOTIC LIFESTYLE

## EXPOSURE TO METH – PRENATAL 20% of pregnant women seen in IHS had been using meth in 2003

- IMPACT:  brain, heart, kidneys, spinal cord
- 		Smaller head circumference
- 		Cerebral hemorrhage, systolic murmur
- 		Neonatal death & blindness
- Meth is a neurotoxin
- Prenatal exposure can impact neurological & physiological development
- Smaller babies
- Effects on brain development
- Vascular restriction, possible limb deformities
- Undescended testes

## Prolonged exposure in gestation may increase levels of aggression toward peers & impact social development

**40% of women using meth seek **_**NO**_** prenatal care (Dr. Rizwan Shah)**

## THE SITUATION ACHILD IS BORN INTO ...HAS AN EQUAL ,IF NOT GREATER IMPACT

## EXPOSURE TO METH -INFANTS

_***2006 NIH Meconium research at 4 hospitals***_***:***
**Low birth weight **
**	****(study showed more than 3 x likely to be born too small)**
_**Other research reports**_
**Sleep disturbances **
**	****(may sleep so deeply that they do not eat well)**
**Sensory problems:  light, noise, touch **
**	****(may resist being touched on head & feet)**
**Tremors & coordination problems**
**Lack of expression – meth exposed baby does not cry over discomfort, hunger, etc. OR**
**Difficult to comfort, agitated**

## Breastfeeding

- 34 year old mother in California charged with involuntary manslaughter for using meth while breast-feeding.  Baby died of “acute methamphetamine intoxication” per autopsy
- 	(2006)
- Babies exposed pre-natally may have suck/swallow difficulties

**Notes:**
Challenges to think about the “bonding” need of baby vs the level of meth used by mom and potential for harm

## EXPOSURE TO METH -CRAWLERS/TODDLERS

- Chemical spills on floor
- Drug paraphernalia within reach
- Smoke residue on floor & surfaces
- Hand-to-mouth era
- Respiratory problems
- Infections
- Poor sleeping & eating habits
- Dependent on others

## A child could havereached this!		acid

## EXPOSURE TO METH - WALKERS/RUNNERS

- Chemical & smoke exposure enhanced by physical activity level
- Increased respiratory illness
- Behavioral challenges
- Vulnerability to sexual abuse increased
- Personal hygiene left to child

## SIGNS OF EXPOSURE TO CHEMICALS OR METH SMOKE

_**Acute**_
- Inhaled:  Respiratory irritation, Headache
- Absorbed:  local skin irritation, ulceration
- Ingested:  nausea, vomiting
- _Chronic_
- Inhaled:  pulmonary edema, bronchitis, nervous system damage
- Absorbed:  allergies, chronic skin irritation
- Ingested:  cancer, liver/kidney necrosis

## Children with Meth-using caregivers may experience

**Confusion – roles and boundaries constantly changing**
**Fear – people exploding into arguments, violence for no logical reason**
**Incest, sexual abuse**
**Rejection, isolation –caregiver emotionally unavailable**
**Parental duties for younger sibs– caregiver physically unavailable **
**Secrecy, lack of emotion**
**Broken promises, loss of trust**
**Chronic or ignored medical problems**

**Notes:**
People come and go without schedules; child may have chaos for long periods and then be along for days
Watching adults hurt each other is painful for children
Adults not able to provide touch, have empathy or comfort child
Adults not physically able to provide care - child learns to “make do” and becomes accustomed to being in charge of younger sibs, reluctant to leave them, resistant to returning to school – angry at separations, etc
Children stop feeling when the consequences for having feelings are too painful.  These children are robbed of the essential part of being a child – having expression.  These children are also often deprived of touch.  They have not been held as infants, not cuddled and can be resistant to physical comforting.  
No birthdays, no Christmas, missed sports activities, school activities, etc.    

##  Highest Risk to Children: Where Methamphetamine Is Manufactured

-  **Highest Risk to Children: Where Methamphetamine Is **_**Manufactured**_

**Notes:**
15 year old girl tested positive for meth when an active meth lab was found in her parents bedroom. 

## Second Highest Risk to Children - Drug Environment: Selling, Using, Transporting

- Second Highest Risk to Children - Drug **Environment**: Selling, Using, Transporting

- Pipes, Razor Blades, residue...
- Hypodermic Needles

**Notes:**
Level II cases can also be extremely harmful to a child.  Measure the reach of a child and compare to location of drugs, paraphernalia or lab equipment.  Acoma example.

## Environmental dangers to children in meth environments

## Risk of Great Bodily Harm

-  **Children have access to hazardous chemicals**
** ****Hundreds of meth labs catch fire and explode every year**
** ****Dangerous chemical combinations & improper  storage of  chemicals**
** ****Poor ventilation**

**Notes:**
Teenage boy burned from lab chemicals.

## Risk of Great Bodily Harm (con’t)

- Acute and chronic affects of exposure
- Access to chemicals
- Access to the drug lab

- Access to hazardous waste
- Presence of chemicals in children’s bodies
- Lack of safety equip.

##    Physical Neglect

- Lack of Essential Food/Nutrition
- Inappropriate Sleeping Conditions
- Lack of Medical / Dental Treatment
- Lack of Supervision
- Lack of Grooming

## GUNS, WEAPONS

- Drug dealers are criminals, parolees, probationers & have no regard for safety of children

## Drugs Accessible/ Drugs Normalized

**Meth in child’s headboard**

**Poor adult role models**

## High Risk of Child Sexual Abuse 

- Accessible Pornographic Material
- Lack of empathy
- Self-centered and demanding
- Meth users have increased sex drive

**PORNOGRAPHY**

## SEXUAL ABUSE AND DEVIANCY

- Reports of large quantities of hard core pornography
- Violent sexual assaults on adults
- Sexual victimization of children ignored
- Children prostituted by parents to get drug
- Increased sexual activity of teens
- High risk sexual activity – greater exposure to HIV and STDs
- Normalized inappropriate sexual behavior

## METH USE SYMPTOMS IMPACT PARENTING SKILLS!

**Increased heart rate, shortness of breath**
**Moodiness, outbursts of anger**
**Aggressive & violent behavior**
**Paranoia (“someone is following them”)**
**Hallucinations**
**Uncontrollable movements, twitching**

**Convulsions, seizures, strokes**
**Sleep problems – awake for days, then sleeping for days to recover**
**Excessive talking, grinding teeth**
**Sexually transmitted diseases**
**Brain damage**
**Death**

## Parenting on Meth

- BINGE:  can last up to 3 days, is characterized by re-dosing in attempt to get the original rush, and closes with period of confusion
_**BINGE STAGE DANGERS TO CHILDREN**_:
**Physical abuse**:  parent is agitated, increased likelihood of violence
**Sexual abuse**:  libido is increased, risk of sexual abuse high
**Neglect**:  parent is focused on own needs, ignores child’s needs

## Parenting on Meth

- _CRASH HAS 4 PHASES_:
- 	1.	Insomnia, exhaustion, fatigue, paranoia, 	auditory hallucinations, violence, irritability, 	aggression
- 	2.	Intense sleep:  up to 3 days, body can 		starve & begin to catabolize muscle; 	danger of coma & seizure
- 	3.	Intense hunger, eating, disorientation, 	depression
- 	4.  depression:  lasting up to 5 months

## CRASH PHASE DANGERS TO CHILDREN

- _Physical Abuse_:  violence, caretaker easily agitated
- _Neglect_:  lack of supervision, child’s basic needs ignored, not taking child to school, medical and dental neglect;
- _Emotional/physical_:  child may be locked in room or restrained so caretaker isn’t interrupted or bothered by child’s demands
- _Sexual abuse_:  caretaker unaware of who has access to children; may leave kids with unsafe people; may “sell” child to drug dealers or prostitute children

## Factors Affecting Negative Adverse Impacts on Children

- Temperament of child
- Positive early childhood experiences
- Positive & accessible positive role 	models
- Positive school experiences

**Notes:**
Some children are more resilient
School may be a refuge from chaotic home environment and allow others to identify and intervene with meth affected families

## Signs of Meth Exposure in Children(things for teachers, day care workers and others who care for children to watch for & report)

- Watery eyes
- Discharge from eyes
- Eye pain, burning
- Skin irritation, redness
- Sneezing, coughing
- Congestion of the voice box
- Chest pain
- Nausea & vomiting
- Abdominal pain
- Diarrhea

**Notes:**
Teachers, day care workers and others with children regularly may observe some or many of these symptoms

## Signs of Meth Exposure in Children

- Moderate to severe headache
- Rapid heart rate
- Dark colored urine
- Fever
- Decrease in mental status
- Yellow jaundice
- Hallucinations
- Extreme irritability severe neglect
- Difficult & labored breathing

## PARENT & FAMILY INTERVENTIONS

- CHILD-SPECIFIC INTERVENTIONS

## REUNIFICATION MONITORING AND SUPPORT FOR CHILDREN

- Children from drug use environments may sabotage parent (lying, stealing)
- Children may have anti-social behaviors (lacking social skills)
- Parents lack skills to address child’s behaviors
- Extended family supporters may expect that everything should be normal when parent is clean & sober
- Parentified children

## SOME TIPS FOR SOCIAL SERVICES AND CHILD PROTECTION TEAMS  WHEN PLANNING FOR REUNIFICATION

- Look for “Observable changes” as parent gets clean & sober
- Parent should demonstrate protective behaviors
- Parent should be self-aware
- Parent should be positively motivated in general
- Parent should be specifically motivated regarding child care responsibilities
- Parent should be able to verbalize and demonstrate concern for child’s well-being

## Family Support - What to expect

- Need to replace many losses – job, housing, clothing, relationships
- Medical/health problems ongoing
- Need for job training
- Need for mental health assistance
- Difficulty ending “risk taking” behaviors
- Relapse
- Up to 2 years (after ending meth use) for cognitive functioning to reach maximum capacity (often not pre-use level of ability)

## RESOURCES

- National Alliance for Drug Endangered Children 	_[www.nationaldec.org](http://www.nationaldec.org/)__ (national medial protocol, articles, links, research and education strategies)_
- Office of National Drug Control Policy, _[www.whitehousedrugpolicy.gov](http://www.whitehousedrugpolicy.gov/)__ (many links to statistics, federal and state initiatives, etc.)_
- Colorado Alliance for Drug Endangered Children _[www.colodec.org](http://www.colodec.org/)__ (articles, links to news video clips, sample protocols for CPS and others, best practices, etc.)_

## Specific Resources for Indian Country

**Meth Awareness and Prevention Project, **_[www.mappsd.org](http://www.mappsd.org/)__ (South Dakota site with Indian Country information & resources)_
**“****G” – video about methamphetamine issues on the Navajo reservation, **_[www.sheepheadfilms.org](http://www.sheepheadfilms.org/)__ – video clips available individually online; some PSAs also available for download and use_