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34–207—PDF 2006

S. HRG. 109–854

SOCIAL AND ECONOMIC EFFECTS OF

THE METHAMPHETAMINE EPIDEMIC ON

AMERICA’S CHILD WELFARE SYSTEM

HEARING

BEFORE THE

COMMITTEE ON FINANCE

UNITED STATES SENATE

ONE HUNDRED NINTH CONGRESS

SECOND SESSION

APRIL 25, 2006

(

Printed for the use of the Committee on Finance

COMMITTEE ON FINANCE

CHARLES E. GRASSLEY, Iowa, Chairman

ORRIN G. HATCH, Utah

TRENT LOTT, Mississippi

OLYMPIA J. SNOWE, Maine

JON KYL, Arizona

CRAIG THOMAS, Wyoming

RICK SANTORUM, Pennsylvania

BILL FRIST, Tennessee

GORDON SMITH, Oregon

JIM BUNNING, Kentucky

MIKE CRAPO, Idaho

MAX BAUCUS, Montana

JOHN D. ROCKEFELLER IV, West Virginia

KENT CONRAD, North Dakota

JAMES M. JEFFORDS (I), Vermont

JEFF BINGAMAN, New Mexico

JOHN F. KERRY, Massachusetts

BLANCHE L. LINCOLN, Arkansas

RON WYDEN, Oregon

CHARLES E. SCHUMER, New York

KOLAN DAVIS, Staff Director and Chief Counsel

RUSSELL SULLIVAN, Democratic Staff Director

(II)

(III)

C O N T E N T S

OPENING STATEMENTS

Page

Grassley, Hon. Charles E., a U.S. Senator from Iowa, chairman, Committee

on Finance ............................................................................................................ 1

Baucus, Hon. Max, a U.S. Senator from Montana ................................................ 2

WITNESSES

Bruno, Allison, mother in recovery from methamphetamine addiction .............. 4

Noble, Aaronette, mother in recovery from methamphetamine addiction .......... 6

Noble, Darren, father in recovery from methamphetamine addiction ................ 8

Binkley, Joey, son of a mother in recovery from methamphetamine addiction ........................................................................................................................ 9

Young, Dr. Nancy K., Ph.D., director, Children and Family Futures, Inc.,

National Center on Substance Abuse and Child Welfare, Irvine, CA ............. 18

Frank, Kevin T., regional administrator, Department of Public Health and

Human Services, Child and Family Services Division in South Central

Montana, Billings, MT ......................................................................................... 20

Aigner, Rev. Frederick, Ph.D., president and CEO, Lutheran Social Services

of Illinois, Des Plaines, IL ................................................................................... 22

ALPHABETICAL LISTING AND APPENDIX MATERIAL

Aigner, Rev. Frederick, Ph.D.:

Testimony .......................................................................................................... 22

Prepared statement .......................................................................................... 33

Baucus, Hon. Max:

Opening statement ........................................................................................... 2

Prepared statement .......................................................................................... 38

Binkley, Joey:

Testimony .......................................................................................................... 9

Prepared statement with attachment ............................................................. 40

Bruno, Allison:

Testimony .......................................................................................................... 4

Prepared statement .......................................................................................... 44

Frank, Kevin T.:

Testimony .......................................................................................................... 20

Prepared statement .......................................................................................... 47

Grassley, Hon. Charles E.:

Opening statement ........................................................................................... 1

Prepared statement .......................................................................................... 50

Noble, Aaronette:

Testimony .......................................................................................................... 6

Prepared statement .......................................................................................... 52

Noble, Darren:

Testimony .......................................................................................................... 8

Prepared statement .......................................................................................... 55

Rockefeller, Hon. John D., IV:

Prepared statement .......................................................................................... 57

Young, Dr. Nancy K., Ph.D.:

Testimony .......................................................................................................... 18

Prepared statement .......................................................................................... 59

Page

IV

COMMUNICATIONS

Child Welfare League of America ........................................................................... 125

Fight Crime: Invest in Kids .................................................................................... 134

National Indian Child Welfare Association ........................................................... 143

Prevent Child Abuse America ................................................................................. 152

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SOCIAL AND ECONOMIC EFFECTS OF

THE METHAMPHETAMINE EPIDEMIC ON

AMERICA’S CHILD WELFARE SYSTEM

TUESDAY, APRIL 25, 2006

U.S. SENATE,

COMMITTEE ON FINANCE,

Washington, DC.

The hearing was convened, pursuant to notice, at 10:35 a.m. in

room SD–215, Dirksen Senate Office Building, Hon. Charles E.

Grassley (chairman of the committee) presiding.

Also present: Senators Snowe, Smith, Baucus, and Wyden.

OPENING STATEMENT OF HON. CHARLES E. GRASSLEY, A U.S.

SENATOR FROM IOWA, CHAIRMAN, COMMITTEE ON FINANCE

The CHAIRMAN. We will get started. I appreciate everybody’s patience. There is some conflict with other committee meetings, so

maybe all members will not come. I appreciate Senator Baucus.

We have cooperated on these hearings and most every hearing

we do. It is a good working relationship. We come here today to

discuss a very important problem that faces his State, my State,

and a lot of States, particularly west of the Mississippi. That is the

issue of methamphetamine.

The purpose of our hearing is best exemplified by the title of our

hearing, ‘‘The Social and Economic Effects of the Methamphetamine Epidemic on America’s Child Welfare System.’’ It is worth

noting that this is the first hearing that the full committee has had

on this issue relating to child welfare in nearly 10 years.

Discussions of issues relative to child welfare are of course long

overdue. If time permits, I hope to hold another full committee

hearing on child welfare issues, particularly as they relate to Promoting Safe and Stable Families. That is a program that has to be

reauthorized by Congress this year.

Today we will hear about the awful toll that methamphetamine

abuse and addiction is taking on families, communities, and our

Nation’s social services infrastructure, particularly as it relates to

children. Methamphetamine is possibly the fastest-growing drug

threat in America.

According to a survey from the National Association of Counties,

58 percent of the counties report that methamphetamine is their

largest drug problem. Methamphetamine is highly addictive, and

the effects last longer than crack or cocaine. Methamphetamine is

relatively easy to make and cheap compared to other drugs.

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According to the 2003 National Survey on Drug Use and Health,

over 12 million Americans have tried methamphetamine. Methamphetamine-making operations have been uncovered in all 50

States, but the most widespread abuse has been concentrated in

the western/southwestern and Midwestern United States.

Numerous reports indicate that methamphetamine abuse is on

the increase, particularly among women of childbearing age. This

is having an impact on child welfare systems in many States.

Again, referring to a survey of the Association of Counties—and

the title is ‘‘The Impact of Methamphetamine on Children’’—that

report says, ‘‘Methamphetamine is a major cause of child abuse and

neglect.’’ Forty percent of all the child welfare officials in the survey reported increased out-of-home placements just because of

methamphetamine in the last year of that survey.

Many child welfare agencies are struggling to cope with the

unique challenges associated with parental addiction to methamphetamine. Children living with a methamphetamine-addicted

parent are often exposed to toxic chemicals such as ammonia, iodine, hydrochloric acid, starter fluid, and drain cleaner used during

the production of the drug.

Because of the parent’s high lasting for hours, and because the

drug binges can persist for days, children are often left neglected

to fend for themselves. Additionally, one of the effects of methamphetamine is a dramatic increase in user’s sex drive. As a result, children are often exposed to pornography and sexual abuse.

While this hearing today will highlight the strains that the methamphetamine epidemic is perpetuating on the child welfare system,

it is important to note that our Nation’s child welfare system is already overburdened. The system is under-staffed and undertrained. Children linger too long before securing a safe and permanent home.

More funding could be available for adoptive assistance and family reunification services. Administrative funds could be used more

efficiently. Data collection is insufficient. Finally, the child welfare

financing structure is antiquated, inflexible, and prevents States

from responding to a variety of challenges.

So I am hopeful that, working on a bipartisan basis, the Senate

Finance Committee can address additional flaws in our current

child welfare system that impede progress to ensuring every child’s

well-being.

Senator Baucus?

OPENING STATEMENT OF HON. MAX BAUCUS,

A U.S. SENATOR FROM MONTANA

Senator BAUCUS. Thank you, Mr. Chairman, for calling this hearing. I appreciate it very, very much. It is very helpful; it is needed,

frankly. We have to do all that we possibly can to stamp out and

discourage meth use. It is affecting very much of our country.

A medieval poet once wrote, ‘‘When the orphan sets a crying, the

throne of the almighty is rocked from side to side.’’ Today we will

hear that our Nation is being rocked from side to side. We will hear

of the weeping that methamphetamine is bringing to American

children.

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Every year here in America, 900,000 children fall victim to abuse

or neglect, 900,000. That is as many people as live in the entire

State of Montana. A child who suffers abuse is more likely to grow

up to inflict abuse on others. About one quarter of children who

suffer abuse will end up engaging in delinquent behavior.

We have good reason to believe that methamphetamine exacerbates child abuse and neglect. Look at the homes where children

of methamphetamine abusers live. They are eating meals at a stove

with the cooking of the harmful drug. Their toys share a space with

dangerous chemicals. Their forks and spoons share the sink with

pots used to cook methamphetamine. I might say, I have seen children whose enamel is decayed because of passive methamphetamine smoke in a household.

Today we will hear real life stories of what these kids face. We

will hear from victims of methamphetamine abuse, and we will

hear from people trying to protect the children. Methamphetamine

abuse has increased dramatically in recent years. It has reached all

corners of America.

Methamphetamine has become the scourge of many rural communities. Last week when I was home in Montana, I talked to a

lot of kids about meth. I had a couple of assemblies, a couple of

high school assemblies. I have had many of these over the last

year.

In one in particular I was even more struck because, at the end

of the assembly, four separate high school students walked up to

me to tell me that their mom or somebody in their household was

on methamphetamine. In fact, one gal cried on my shoulders because her mom was on methamphetamine, and she was taken

away from her mother, and she could not find her siblings.

It is frightening, it is graphic. I am very impressed, though, with

the series of ads now running in Montana. They are graphic, and

they depict frightening accounts of methamphetamine abuse. They

are a series of ads run by a businessman in Montana named Tom

Siebel. I really appreciate Mr. Siebel’s work. He is fighting methamphetamine with his own money. He has spent about $10 million

in Montana producing the ads, and he is running the ads on television.

In fact, at the high school assemblies, I asked for a show of

hands if they had seen these anti-methamphetamine ads, and man,

they are graphic, they are really graphic. Every hand went up in

the assembly.

I asked, are these ads effective? Are they deterring the first-time

users of methamphetamine? Virtually every hand went up in the

high school. There are about 2,000 kids at one high school, and at

another there are about 700, 800 kids.

So there are people taking steps that are making a difference

here, and I think these are the kinds of steps we have to continue

to take.

Montana kids also tell me that one of the most powerful

motivators for kids not to use methamphetamine is testimony from

those who have been affected by it, by their peers—somebody they

know and can trust who has been on methamphetamine and tells

them what it does to them, what it did to them.

4

We can look forward to exactly that kind of testimony here today.

We are here for people who share their stories of struggle and ultimate victory over methamphetamine addiction.

You will also hear the devastating effect that methamphetamine

is having on the child welfare system. Methamphetamine abuse

has thrown thousands of children into the safety net of child protective services.

Montana’s child protective service agencies are struggling. Kevin

Frank from the Montana Department of Public Health and Human

Services will tell us what Montana case workers face every day as

they try to provide for children from methamphetamine-abusing

homes.

I very much look forward to the testimony. Thank you all for

being here very, very much. I look forward to the day when methamphetamine is no longer what it is, and when methamphetamine

will no longer bring children to cry. Thank you.

The CHAIRMAN. Thank you, Senator Baucus.

We thank our first panel already at the table, because first of all

they have traveled a long way to come here. Secondly, I presume

it is not easy for families to talk about, as they will testify to, personal issues. So we thank you very much for your courage. More

importantly, we thank you for coming so far to share with us.

So I would welcome you. Allison Bruno is from my State of Iowa.

We have Aaronette and Darren Noble and Aaronette’s son, Joseph,

from Missouri. All are here to share with the committee their experiences being in the grip of this terrible drug.

I commend them for their courage in appearing before the committee and for their willingness to share difficult and personal aspects of their problems with addiction. Some have concluded that

methamphetamine addiction is untreatable, and recovery impossible. Allison and the Noble family proved these characterizations

untrue.

As we learn about the wake of destruction that this drug leaves

in its path, we can find hope and solace in their stories. We can

celebrate their recovery, and of course recognize the redemption

available through work, love, and family.

We will hear from them in the way I introduced them, so we will

start with Allison, and then Mrs. Noble, Mr. Noble, and then Mr.

Binkley.

So would you start, please? And make sure the red light is on,

and that you speak in the microphone. Thank you.

STATEMENT OF ALLISON BRUNO, MOTHER IN RECOVERY

FROM METHAMPHETAMINE ADDICTION

Ms. BRUNO. Hello.

The CHAIRMAN. Hello.

Ms. BRUNO. Thank you for your time today. My name is Allison

Bruno, and I am 22 years old. I have two daughters. Alexis is 5,

and Lillian is 22 months. I was born in Waterloo, IA.

My mother and father were both addicts. They got divorced when

I was really young. I did not really see much of my dad as I was

growing up. As I think back on my life right now, I think that I

was predisposed to be an addict.

5

I had all the addict behaviors when I was young, and I did not

know anything else but that. I started drinking, smoking cigarettes, and smoking marijuana regularly when I was 11 years old.

My mom was an active user, so she always had friends over and

they were always doing drugs, and drinking and stuff.

I walked in on them one day smoking methamphetamine, and

my mom offered me some. I was 13 the first time that I did meth,

and I truly believe that I was addicted from that day forward. I did

meth until I was 15. At 15, I found out I was pregnant.

I quit smoking meth and doing drugs when I was pregnant, but

I picked up right where I left off after I had my daughter. It never

crossed my mind that I was not being a good mother, because the

only thing I had ever known was addicted mothers.

As an addicted mother, I really lacked the proper skills that most

people take for granted. I did not learn how to cook, clean, make

money, manage money, or take care of kids. When my daughter

was 8 months old, I met a man who cooked meth, and I started

using IV meth.

I would leave my daughter with her dad, who was not an addict,

for days and weeks at a time without seeing or hearing from her.

I felt like I needed meth to survive. I did not want my daughter

to be exposed to what I was doing, and I was ashamed of my addiction, but I had no idea how to stop.

I was 18 and I got kicked out of my mom’s house. I became

homeless at that time, and I just floated around from house to

house using meth. I was using meth at that time so I did not have

to think or feel. I did not have a place where I could bring my

daughter to for visits, and I felt tremendous guilt and shame for

that.

I got arrested at 18 for possession of a controlled substance and

was released the next day. I went to a single adult treatment facility in Waterloo shortly after my arrest, but the program was not

very comprehensive. There were no therapeutic services that allowed me to understand the underlying reasons for my addiction.

Not having my daughter with me in treatment was especially

hard for me. I thought that, since I could not see her, I might as

well just leave. I did leave, and I continued to use until Christmas

of 2002.

On Christmas Eve, I was granted a visit with my daughter for

Christmas Day. The guilt of not having any gifts for my daughter

and not being there for her got to me so bad that I signed myself

into treatment.

By the grace of God, I ended up at a family-based treatment program, the Heart of Iowa Women and Children’s Treatment Facility

in Cedar Rapids, IA. At the Heart of Iowa, I got to have my little

girl with me again. Finally we were together.

I had groups every day from 8 a.m. to 8 p.m., while my daughter

was in day care or counseling. After 2 weeks, I moved to an apartment owned by the Heart of Iowa. I was taught how to cook, clean,

and raise my little girl.

As part of the Heart of Iowa, I was in residential treatment for

4 months, a halfway house for 4 months, and after-care for 2

months.

6

I now have 3 years and 4 months clean from drugs and alcohol.

I am attending Kirkwood Community College and majoring in

human services. I had another child in recovery, and I am engaged

to be married.

Today I proudly say that my children are the light of my life. My

5-year-old daughter started kindergarten this year, and she is

doing wonderful. I am involved in the PTA, and my children are

involved in sports and gymnastics. I regularly attend 12-step meetings and the support group, Moms Off Meth.

Because of family treatment, I broke the cycle of addiction in my

family. My children will have a different childhood than mine, and

I will continue to be a loving, responsible, and healthy mother to

them.

My life is truly beautiful today, and I have never been as happy

as I am now. Thank you. [Applause.]

The CHAIRMAN. Mrs. Noble?

STATEMENT OF AARONETTE NOBLE, MOTHER IN RECOVERY

FROM METHAMPHETAMINE ADDICTION

Mrs. NOBLE. Good morning, Senators. Thank you for the honor

of speaking with you today. My name is Aaronette Noble. I am

here with my husband and my son, Joey.

I am a wife, a mother, and a recovering addict. I grew up in an

alcoholic home. I smoked marijuana for the first time at the age

of 7. I first drank alcohol at the age of 14, and I began using cocaine and methamphetamine at the ripe age of 17.

No one plans to have this disease of addiction take over their

lives, and no one plans to end up in prison for methamphetamine

abuse, and no one plans to give birth to a tiny baby born with

drugs in her system.

No one plans to have their children tell them they do not want

to have anything to do with their mother. No one plans for these

things. I know I did not.

When I was using meth, I felt dead most of the time. All I did

was breathe in and breathe out. I had no motivation. The world

was a very dark place. I had no hope or faith in anything or anyone.

Every day I would wonder why I just did not die. I was so angry

at God, at the world, and mostly at myself. My teeth and my hair

were falling out, and other people had custody of my children. My

husband and I were homeless and sleeping in our car.

Did I believe that family treatment could help me with all that

was wrong in our lives? How could it? I had tried single adult programs, but I never succeeded in staying clean. The programs were

very short-term. They were only 90 days at most.

I was not helped as a mother who had shame and guilt because

of my addiction. My children were not provided services, and we

could not heal together as a family.

After years of prison and inappropriate single adult treatment

programs, my addiction to meth got worse. I gave birth to a daughter born addicted to meth. She was removed from my custody by

child welfare.

At that point, however, a miracle happened. My children and I

were referred to a comprehensive family treatment program. We

7

entered into Bridgeway Counseling and the Division of Family

Services.

My husband had made a commitment to do the same. Bridgeway

had just opened a men’s residential treatment center next to the

women’s center. We were the first married couple to be in that

treatment center at the same time. It helped to know that we were

doing this apart, but also together.

Our addiction tore our family apart, so we needed to find a solution as a family. I received services I did not even know I needed.

I saw a psychiatrist who helped me with my depression. I could

sleep better and think more clearly. It was like someone turned a

light on in my head. I could see colors, things tasted and smelled

different, my mind was not constantly racing anymore.

At Bridgeway, we started family therapy. I got counseling for domestic violence and for sexual abuse from past relationships. I did

not even think I had issues in these areas until I finally opened

up to my counselors and was truthful with myself.

We took parenting classes, went to meetings, and attended

church. The Division of Family Services brought our baby to

Bridgeway for Darren and I to see. She is a beautiful little girl

with big blue eyes that can see right through you.

I want her to only see good things in me today, and that is what

she does. She gives me strength and courage.

After 30 days of doing Bridgeway’s residential program, my family and I transitioned into Bridgeway’s intensive outpatient program. The beginning of our sobriety was not easy, but maybe it

should not be.

Maybe we needed to work and struggle. We entered into a shelter, and I came to Bridgeway during the day. We then as a whole

family lived in a used trailer that we had bought for $500. I have

to tell you, we love that trailer. It is our first sober home as a family.

My husband and I voluntarily joined a family safety drug court

with the Division of Family Services that has been great. It has

given us more structure and support, and it has given us incentives

to move forward. The Division of Family Services, we are able to

interact with them more often.

We call a drop line every day, so that gives us more structure,

I do believe, in staying sober. It has allowed them to have an even

bigger part of our lives.

We have nothing to hide anymore. We only wanted our family

back together. We only wanted to stay sober. We only wanted to

make our children smile as often as we could. We also continue to

receive the family-based treatment services of therapy, family counseling, and parenting classes at Bridgeway.

My beautiful girl with the big blue eyes has been reunited with

us now. She has been with us for 5 months. I am sure those of you

who are parents can feel the light having all of your children next

to you brings to your life. The light is with me today, it is here with

me today in Washington, DC, and it is with me every moment.

I know that being a parent is not a right, it is a privilege. It is

mine and Darren’s privilege to be parents today. No one plans to

tear their world apart and the world of their children apart.

8

Today, because of available family treatment, I can plan every

day to put their world back together. This is work, but it is the best

kind of work. It is a struggle, but it is the best kind of struggle.

We continue to go to meetings, we continue to meet with the

court, we continue to make sober friends, and we began for the first

time to be sober heroes to our children.

The CHAIRMAN. Thank you very much. [Applause.] Mr. Noble?

STATEMENT OF DARREN NOBLE, FATHER IN RECOVERY

FROM METHAMPHETAMINE ADDICTION

Mr. NOBLE. Good morning, Senators. I would like to thank you

for the chance to speak here. Aaronette and I are proud parents of

two children, Casey, who is 6, and Summer, who is 15 months old.

Summer is here with us today. I am also a proud stepfather of Joey

Binkley.

Aaronette said a lot of my story. I would just like to touch on

meth. Meth struck our family hard. It tore our whole family apart.

I tried to seek recovery. It would not do me any good. I wanted to

be able to focus on myself. I had my family out there. It takes 100

percent to get recovery. When I had family out there, my wife and

my children, I could not focus on that. I could not let go of that

feeling.

It did not work for me. Aaronette would try, and the kids were

suffering, too. I always thought I was being a parent, but I was

not. The children were the ones being the parents. They were

watching over us. They knew what we were doing. Even though we

thought we kept it away from them, they knew.

They always wanted to go places with us, they would not let us

get away alone. They knew what we were going to do, so they

wanted to be there.

I used to get home, and Casey would hide my keys to keep me

from leaving. I thought it was because she wanted to be with me.

She was being my mother, telling me to stay home, that I did not

need to leave, because she knew what I was going to do.

But then the time came when I was arrested for manufacturing

methamphetamine, and I went to prison. While I was in prison—

I was locked up for 3 years and 10 months—I used to talk to Joey

over the phone and tell him how it was going to be different when

I came back. I was away from the drugs.

I actually thought it was going to be different. I thought my life

was different. I did not seek recovery, I was just away from it.

When I came out of prison, I came right back to what I left from.

My same life, it never missed a beat. Everything had changed a little bit, but I came right back to the same situation; I went right

back to the same things.

I stayed away from manufacturing meth because I thought, that

is what sent me to prison, making meth. Not doing meth, but making it sent me to prison, so I stayed away from making it, but continued on my life.

I let Joey down, nothing changed, same old family. Then my

daughter, my daughter was born while I was in prison. I got attached to her, and all that lost time, here I am doing meth. I am

thinking I am spending quality time with her, but I am high and

I am out there.

9

I do not remember that time, first getting out of jail and being

with her. All of that time is lost. I thought those were precious moments of getting back to my daughter, but it is lost.

Aaronette had gotten pregnant with Summer, and we could not

get away from it. We tried and tried, but we could not. I tried leaving her, because I knew I could not quit, so I would leave her, my

family, to try to get her to quit.

She was not getting any help, so how was that going to keep her

from using? She was going to keep using. So then I would just

come back because she is still using while she is pregnant. We did

not know what to do.

Summer was born, and they took her away from us. I decided I

was going to quit when she got out of the hospital and we got

home. Well, we did not quit. We figured we would quit once we got

to the courts and we had to quit. Well, then we got there. They

could see right through us. We were not quitting.

So we ended up getting kicked out of the program, and she was

getting put up for adoption. We talked to people, and they allowed

us back in. They allowed us to get back in this program.

They put us into a family treatment center where we all went

together. We all got healthy together. Our family could not be broken up and made healthy. Our family had to go get healthy together. Once we were all safe, we were able to focus on ourselves

and get better.

For us, where we are today, it has been a process. It just did not

happen overnight.

The CHAIRMAN. Thank you very much. [Applause.] Mr. Binkley?

STATEMENT OF JOEY BINKLEY, SON OF A MOTHER IN

RECOVERY FROM METHAMPHETAMINE ADDICTION

Mr. BINKLEY. Hello. As you know, I am Joseph Binkley. I am the

son of Aaronette Noble. I am 18 years old, and I am a senior at

Ritenour High School in St. Louis, MO. For most of my life, I had

no idea that my mother was addicted to drugs and alcohol. But

looking back now, I can see some points in which things were not

right.

I had no idea until about the end of elementary school, beginning

of middle school, that there was a problem. I kind of noticed whenever I would go to friend’s houses and see how their mother would

act, how their mother was, and mine was not the same.

She had gone into treatment, she had gone to jail, and things

were not changing. One time when she went into jail, I stopped

talking to her. I completely broke away because I did not want anything to do with that. I had no trust in her anymore.

Up until about a year ago, whenever Summer, as I am sure you

guys hear her screaming in the back, until she was going to go into

a foster home, I knew at that point, that was when I needed to step

in and help do something for the family. I know that if I were to

ever get taken away, then I could not have been the normal, upright citizen, student as I am right now.

I know that the family treatment at Bridgeway really helped

bring us together and solve our problems. I know that you had

some statistics about how kids who live in these families do so bad.

I would just like to say that I am not one of them.

10

At this point right now, I have a high grade point average of 3.8.

I have perfect attendance for the last 4 years of high school. I am

involved with many groups, such as Leadership. I am a DJ for our

school radio station. I am involved with RCO, I play varsity baseball, I am with the school’s big brother/big sister program. I am a

teenage health consultant. I’m in Mu Alpha Theta. I was even on

the homecoming court earlier in the year.

[Applause.]

Mr. BINKLEY. Even at work, I have excelled. I worked at, it is

a little diner called Chuck-O-Burger on St. Charles Rock Road. I

was working there for less than a year, and my responsibility and

my hard work allowed me to be a manager there. So now I am a

part-time worker, and I manage.

At the beginning of the year, I applied to Southeast Missouri

State University, and was accepted. So I plan to go there. Well,

they only gave me two scholarships, so I am trying to find some

more funding for that. But my plans are to become a teacher in

some field of science. Right now I am thinking physics. [Applause.]

The CHAIRMAN. Thank you. Did you finish?

Mr. BINKLEY. Yes.

The CHAIRMAN. All right. Good. Well, it is a nice story. All of

your stories are nice in the ending. Getting to where you are today

is not so nice, but you are helpful to other people by coming here

to explain.

Now, let me tell you, we have a period of time for members to

ask you questions. You do not need to feel intimidated. Just answer

as best you can. If there are any problems that you have in answering of questions, we can provide a process by where you can answer

questions in writing, and our staff will help you with that.

Let me say to you on the second panel, because members have

conflicts and cannot all come, sometimes you do get questions in

writing, but since you have not been involved with that process, we

will be helpful to you in responding to members who cannot come.

So I will take 5 minutes, then Senator Baucus, then Senator

Smith, and then Senator Snowe, and if others come, we will have

further questions.

I am going to start with you, Allison, and thank you for your

honesty, your courage, all of you. Let me say up front, thank you

for your honesty and courage.

In regard to your testimony, you mentioned, I believe, Moms Off

Meth.

Ms. BRUNO. Yes.

The CHAIRMAN. And I hear that this is a support group and has

been very helpful to you. Maybe describe just a little bit for the

committee how that support group works. But if you could give us

some idea of how many women participated, at least while you

were there, and then if there is any indication you can give us, how

many mothers maybe tried to seek the same sort of family-based

treatment that you did, and whether or not you consider this successful. I assume from your standpoint you do see it as successful.

But just some sort of general comments along those lines.

Ms. BRUNO. Okay. Moms Off Meth is a support group for women

who are mothers. It is not really just for methamphetamine; it is

for any sort of addiction that mothers have.

11

It is basically we sit around a table and we just help each other

get through our issues and our problems. We help each other learn

how to advocate for ourselves.

Like with the social service system, people who have been

through it can help the other mothers go through the steps to get

through the DHS system. There are like 20 to 30 people in the

group that I attend. It is just a loving group of women that can get

together and help each other work out their problems.

We do a lot of great things there. That is why I am here today,

is through them. I love that group.

The CHAIRMAN. Well, along the lines of describing, for instance,

did you run into people on the staff saying that they are able to

take care of the needs of mothers like you? Or is there just a long

waiting list? Is there a lot of interest in getting into the program?

Ms. BRUNO. The treatment center?

The CHAIRMAN. Yes.

Ms. BRUNO. Oh, yes. There are three family treatment centers in

Iowa, and only one of them is actually residential treatment where

families can get treatment all day and get counseling and therapy.

There is a tremendous amount of women who need to get in that

program. There are 30 to 40 beds there, and that is all the women

they can have at one time. There are people who come into Moms

Off Meth who are trying to get into these programs, and there are

waiting lists that are so long, 2 weeks, 3 weeks, a month.

They need this. I cannot say that I would be clean if I did not

get into that program right away. If I had to go back out on the

street and wait for the bed to open up, I probably would not have

made it.

The CHAIRMAN. I will go to Mrs. Noble now. You told us about

a treatment experience you had that was earlier than the one that

was successful for you.

Why do you believe that that first treatment that you sought did

not work for you and your family?

Mrs. NOBLE. Because the single treatment, a lot of it was just for

today, keep it simple, one day at a time. At that point in time, I

knew all that. I knew all the just for today’s. I had to find out what

kept me using.

It was not like I used for a year. I had been using most of my

life. I needed to find out within myself what kept me using. So with

this family-based treatment program, they had services.

My mom and dad were alcoholics, too, and I came from a very

dysfunctional family, so I did not know how to be a parent. They

had a parenting class. Like I said, domestic violence, domestic sexual abuse. I mean, I did not even know I had problems in most of

these areas.

Right before the hour was up talking to a counselor, I was in

tears. So I had to go deal with me, what made me keep using, or

I could apply the just for today’s and keep it simple and all that

in my life. My family was there. That burden was off of me.

I could look out the window and see my husband at the man’s

place. So I knew that he was okay. I knew my kids were okay, because they were there. That way I could focus more on me and my

issue.

12

It is an individual problem, but you turn it into a family problem

that is a community problem. So that is why.

The CHAIRMAN. Senator Baucus now. We just had a vote start.

I will go vote now, and then Senator Baucus goes to vote after I

get back.

Senator BAUCUS. Yes, I will ask questions now.

The CHAIRMAN. Yes. Go ahead. So I will just be temporarily gone.

If Senator Baucus gets done, Senator Smith then Senator Snowe.

Senator BAUCUS. Thank you very much, Mr. Chairman. It is

those blue eyes, they look right through you, you are right.

I would like to know, and I will start with you, Ms. Bruno. What

works best in prevention? Looking back on your experience, is

there a time when, I am thinking of these ads. You have not seen

these ads, I am sure. There are some TV ads running in Montana.

They are on billboards, they are radio ads, they are really graphic,

high shock effect.

Ms. BRUNO. Yes.

Senator BAUCUS. I am wondering if you, when you were younger—you said I think you were born into a dysfunctional family—

had seen those ads, do you think that might have made a difference, or not? What kind of prevention works?

Ms. BRUNO. I think for me if I would have seen, I mean, I never

really saw any. I did not know what methamphetamine was. I just

was from a dysfunctional family. People just did things that were

not normal.

I think that if there were more people who came out and talked

about their addiction and talked about the things that were going

on, to let me know that the things that were going on in my home

were not normal, they were not the things that were supposed to

go on.

Senator BAUCUS. At what age did you start doing methamphetamine?

Ms. BRUNO. I started doing methamphetamine at 13.

Senator BAUCUS. So what if in school there had been lots of discussions about what methamphetamine is, and the problems that

it causes? Would that have helped, do you think?

Ms. BRUNO. I think it would have. We have the DARE program.

Senator BAUCUS. Right.

Ms. BRUNO. All I can remember is the DARE song. I do not really remember anything that we learned. I think if there was a little

more explanation on what the drug could do to you, I think that

would have helped me.

Senator BAUCUS. Let me ask you, Mr. and Mrs. Noble. What

might have worked in your lives to prevent you from doing methamphetamine, deterring you from doing methamphetamine in the

first place.

Is there anything when you look back in your lives? Ms. Bruno

mentioned something may have worked for her, perhaps.

Mr. NOBLE. For me, I believe I was born an addict.

Senator BAUCUS. And you were born an addict why?

Mr. NOBLE. From my genes.

Senator BAUCUS. All right.

Mr. NOBLE. From my family. It was passed onto me from my

family. I was an addict without the drug. All you had to do was

13

apply the drug to me, and I was going to be an addictive person,

unlike some people who can experiment with drugs and not use,

can go out and do methamphetamine one time and never touch it

again in their lives.

Me, I go out and do methamphetamine one time, I’m going to do

it every day, and I’m going to be an addict. But for me, to publicize

methamphetamine, like you say, is a good way. Today I feel recovery is out there a lot more.

The first time I went through treatment was in 1987 when I was

15. It was not very popular back then; it was just starting to get

started. Very few young people were involved in it, so I did not stay

involved in it. That was before I started getting into harder drugs,

into methamphetamine.

I think the way the world is going today, treatment just needs

to be more accessible to people. Just like she said.

Senator BAUCUS. Let me ask that question, then. What kinds of

treatment work? You are all clean?

Mr. NOBLE. Yes.

Senator BAUCUS. How tempted are you when you see drug paraphernalia?

Mr. NOBLE. Oh, not at all. I have no cravings. When I think

about drugs, or what I used to use or any situation that has to do

with that, I think of the negatives. The negatives pop in my head.

Senator BAUCUS. And the treatment really worked?

Mr. NOBLE. Yes.

Senator BAUCUS. It helped create that situation?

Mr. NOBLE. Yes.

Senator BAUCUS. You do not want to go back to that at all?

Mr. NOBLE. Yes.

Senator BAUCUS. All right.

Mr. NOBLE. We changed our whole lives around. Our whole lives

are different today than what they were before we went into that

treatment center. We do not associate with anybody. If they use,

they are not part of our lives anymore.

We changed, we did a complete process of our whole lives. When

we came out of treatment, we did not have a home. We did not find

a place to stay where we knew people. We went and found a place

where we did not know people.

Senator BAUCUS. Right.

Mr. NOBLE. We started going to meetings in that area. We met

new people, met new friends, started going to church. It took our

kids being behind us, supporting us.

Senator BAUCUS. Mrs. Noble, you wanted to say something about

what treatment really works. Or what prevention.

Mrs. NOBLE. I was going to say that, you know, maybe if the

family treatment was available for me when I was younger, you

know, my mom was involved in it once, like my son, I believe that

will break the cycle of addiction, that will prevent it. By having my

kids involved in the family treatment at such an early age that will

educate them.

When I first started doing methamphetamine, I did not know

that it was batteries, ephedrine, all the stuff that it was, ammonia.

I mean, any one of those chemicals would kill you.

14

Senator BAUCUS. Right. Mr. Binkley, you were able to stay away

from it, is that right?

Mr. BINKLEY. Yes.

Senator BAUCUS. How? Why?

Mr. BINKLEY. Well, I would have to believe I stay away from it

because I had an example at home that showed me what not to do.

Having the police around, people going to jail, that kind of negative

feeling, people around the neighborhood talking about it. That kind

of thing—I did not want to be anything like that.

That is why I have never smoked, I have never drank anything.

I just do not think that those are the right things to do. I have

learned a little bit at school what it can do to you. Though I was

never really shown much, I always thought that I do not want to

have those kind of, not just physical ailments, but more the emotional ailments also.

Senator BAUCUS. Great. Thank you. Senator Snowe may have

something that she wants to say here, too.

Senator Snowe?

Senator SNOWE. Thank you. I want to thank all of you for your

moving and courageous stories and your willingness and courage to

be here to describe your personal experiences and the long road

back.

Clearly it is an indication to us that we should not abandon help

in any way in terms of the resources that can be provided that can

make a difference. I think that is really the key for us, what works

in the final analysis, and starting early.

Obviously this started early in your own lives and became

generational. So starting with you, Ms. Bruno, what education prevention services could have helped to intercede at any point in your

young life? Again, you started taking methamphetamine at the age

of 11?

Ms. BRUNO. Thirteen.

Senator SNOWE. Thirteen. So what could have happened in the

school systems, for example, that could have made a difference?

Anything?

Ms. BRUNO. Within the school system, like there were days

where I would dress myself in kindergarten and stuff like that, and

would not eat breakfast and stuff like that.

I think that if some type of intervention would have happened

when I was young that involved my mother, maybe things would

be different. Maybe if the child welfare system got involved when

I was a kid, when I was young, things would be different. My mom

could have gotten clean maybe.

As far as the school system, I think they should have recognized,

or they could have recognized. Maybe it was not so recognizable

back then, the things that could happen.

Senator SNOWE. The child welfare system did not recognize it in

your own family?

Ms. BRUNO. Oh, no, no. The child welfare system got involved in

my family after I had my daughter. I have a little sister who is 9

now, and they got involved with my mom there.

She was still an active user and alcoholic, and still nothing happened with my little sister. She did not get removed either until

15

I went to treatment. Then my mom gave her to my aunt. My mom

actually got clean 6 months after I did.

Senator SNOWE. Was that a motivating factor? The whole custody

question, do you think with your mother, for example?

Ms. BRUNO. Oh, yes.

Senator SNOWE. Yes.

Ms. BRUNO. Yes. She saw me going through family treatment,

and she saw that things were working for me. I think she did not

think there was any hope for her since she has been addicted so

long. She felt so much guilt.

But she ended up going to a family treatment center, too, and

that is where she recovered.

Senator SNOWE. All right. Mrs. Noble, you mentioned the fact

that it is residential treatment because you did not have to worry

about your husband and your son and so on.

What could have happened earlier for you in your life do you

think? Where could it have all started where you could have benefitted from some assistance in the system?

Mrs. NOBLE. DFS did get involved in my life when Joey was

probably like 9 or 10, but they did not follow up or anything. So

I think I even had signs of using on my body from IV using. They

totally ignored it.

I go back again on family treatment. Having the family involved

at as early an age as possible I believe is a big factor in that.

Senator SNOWE. So we have to intervene early?

Mrs. NOBLE. Early.

Senator SNOWE. Early on.

Mrs. NOBLE. Like I said, most people do not even know. You can

say oh, well, methamphetamine has ammonia in it. But if you do

not see it, you do not see these things that people are making

methamphetamine with. You do not associate with it.

Senator SNOWE. So it is key obviously to start early in breaking

the cycle.

Mrs. NOBLE. With family treatment, I do believe that if my mom

had been involved, and my mom went to rehab a few times, but

it never involved the family.

Actually, like Joey said, he did not talk to me for like 4 years

besides yes and no. With the family treatment, it brings the family

back together, and that is what this country needs, more family

back together.

Methamphetamine is breaking up families, and that is what we

need.

Senator SNOWE. So if we provided more support in that respect

in maybe grants——

Mrs. NOBLE. Yes, ma’am.

Senator SNOWE [continuing]. Because that is one of the bills that

Senator Rockefeller and I have introduced in providing more grants

for substance abuse to help families.

Mrs. NOBLE. Because like I said, it is an individual problem, but

then it becomes the family problem, which becomes a social problem in the community as well.

If we could get more education, more treatment, family treatment centers.

16

Senator SNOWE. To bring the family together. And you would

agree, Mr. Noble, on that question?

Mr. NOBLE. Yes.

Senator SNOWE. As a family. Does that make a difference?

Mr. NOBLE. Yes. It made a difference in my family.

Senator SNOWE. All right.

Mr. NOBLE. One thing I would like to add to that is to prevent

it, for me, I would be able to notice the signs with my children. I

am healthy now, so I will be able to take the right steps, which I

know the steps myself.

But also people who are not addicts and do not have this problem

in their lives, they need to be educated because they think they are

smart. But when their child goes out and becomes this, when it

gets into his life, he also gets that ability to snow over his parents

on what they are seeing and telling them different stories.

They can really put it off on somebody who does not know anything about it for a long time. So families need to be educated before it comes into their lives, too.

Senator SNOWE. Thank you. And Mr. Binkley, you are an inspiring story. We really congratulate you.

Mr. BINKLEY. Thank you.

Senator SNOWE. It is very moving, all of you, to be here today

to share that, and to tell us what works, what does not work, and

what we need to do to help make a difference in other people’s

lives. You are certainly helping to make a difference by telling your

stories. Thank you for the courage of being here. Thank you.

The CHAIRMAN. Thank you, Senator Snowe, for taking over. I appreciate it.

Senator SNOWE. Any time.

The CHAIRMAN. Is Senator Smith coming back? All right. So then

I will go ahead. I had a couple of questions, and then if Senator

Baucus does not have any more questions, we will go on to the second panel.

I will go to Mr. Noble. From your perspective as a father, and

also as a person who is addicted, in your seeking support in the

support system, do you believe that the intervention of the child

welfare services was an effective intervention in your family?

Mr. NOBLE. Oh, yes. It changed my life. They open up doors in

all areas, getting us into the Bridgeway Family treatment, the parenting classes, telling us things. We are trying to get our daughter

back, and they would give us a goal. When we did our part, they

backed that up. What they said, they backed up.

So we got from 4-hour visits to 8-hour visits to overnights to

weekends. Before you knew it, we had her with us by doing our

part, and them keeping their word. That meant a lot to us.

When we would do this, something which was actually small, it

would mean so much to us from what they were doing back to us,

and they kept their word.

The CHAIRMAN. Did the criminal justice system coordinate with

the child welfare system? The services system? Child welfare services system?

Mr. NOBLE. I am not understanding.

17

The CHAIRMAN. Well, in other words, you coming out of the

criminal justice system, was there an effort there to work with you

in the child welfare systems? Or was it entirely separate?

Mr. NOBLE. No. Actually it was totally separate.

The CHAIRMAN. Okay.

Mr. NOBLE. Can I explain that to you?

The CHAIRMAN. Yes.

Mr. NOBLE. At the time of trying to get into the family services,

into the family treatment center, I was getting a lot of grief from

my parole officer. She wanted to send me back to prison.

I told her, I am trying to get into this treatment center, this family thing. She was like, she did not care. I guess when she wrote

to the board to send me back, they replied back that it would be

suitable for me to go into this family treatment before I got sent

back to see how I would do.

The CHAIRMAN. And Mr. Binkley, could you tell us how long you

and your family spent at the Bridgeway Treatment Center, and

what made it such a successful experience for your family as you

saw it as a son within the family?

Mr. BINKLEY. I am not really good with time. I would say it was

almost a year, about, dealing with the Bridgeway program, and

just seeing that everyone was together and everyone was working

together to gain a goal to get clean, to have a healthy family. I

think that is what made it work.

The CHAIRMAN. Let me ask, does anybody know if Senator Baucus has any more questions? Okay. Well, we are going to thank you

very much for your appearance. I cannot say anything more than

thank you for being brave.

Also, I cannot speak for other people, but I would see from the

standpoint of other people seeing what you have gone through,

both to raise questions about the use of drugs, and more importantly, to see that help as you received it can be very successful.

Thank you for being a good example. Thank you.

[Applause.]

The CHAIRMAN. Now, can we have the second panel, please? Our

first witness is Kevin Frank. Senator Baucus would like to introduce Mr. Frank, so I am going to start with Dr. Nancy Young. She

is the director of Children and Family Futures at the National

Center for Substance Abuse and Child Welfare. Then Rev. Fred

Aigner will speak as a practitioner on the meth crisis and options

available to ensure the well-being of children.

So Mr. Frank, I am going to start with your testimony. Then

when Mr. Baucus comes, I will allow him to speak about you. Go

ahead.

Mr. FRANK. Thank you, Mr. Chairman. You kind of threw me a

curve ball there, I thought you were going to start with hers.

The CHAIRMAN. Well, maybe I should. Yes, let us do that. Can

you start off, Dr. Young, please?

Dr. YOUNG. Absolutely, yes.

18

STATEMENT OF DR. NANCY K. YOUNG, Ph.D., DIRECTOR, CHILDREN AND FAMILY FUTURES, INC., NATIONAL CENTER ON

SUBSTANCE ABUSE AND CHILD WELFARE, IRVINE, CA

Dr. YOUNG. Thank you for the opportunity to share some information with the committee. If you have the hard copy of my written testimony, I want to walk through a couple of charts that I put

in the front of that.

First is a table that shows the number of new users by specific

substances in our country. You will see that there has been a similar rate of increase in new methamphetamine users and new cocaine users over the past decade.

The second chart then shows that same data of the new users,

which are kind of a leading indicator of drug use problems in our

country.

The second chart then also has that bold triangle that shows the

foster care caseload in the country. You see that, while there are

variations by State and by community, overall in our country since

1999 there has been an ongoing decrease in the number of kids

who are living in out-of-home care.

I think that paints a picture of how complex the issue of substance use disorders are with the child welfare system. It is not a

single drug kind of issue. It is not something that just happened

when methamphetamine came along. It is something that we have

been working on in the country for quite some time, and certainly

had a lot of efforts during the cocaine and crack epidemics of the

late 80s and early 90s.

I think some of the lessons from that era are things that we need

to be able to apply to this era of methamphetamine use.

The next chart then shows those numbers of people that are

using methamphetamine that have increasingly been diagnosed or

met criteria for substance abuse or dependence. That is one of

those alarming kinds of statistics that over just the last 2 years,

the methamphetamine abuse and dependence have doubled among

those who are using methamphetamine.

So if you go back to that leading indicator of who is using, and

then this next set of data about when do folks start to have problems related to that use, you see what is happening with our country, which brings up then the need for treatment and the need for

services based on meeting that criteria for abuse and dependence.

I want to point out also that there is a very big difference between the cocaine and crack epidemic from the late 80s and 90s

and what we are seeing today. The percentage of individuals who

are using, current users of methamphetamine by race and ethnicity, shows our native populations in our country are more impacted by methamphetamine—our native Hawaiians and our native Americans. We need to pay attention to that as we are thinking about what happens for children in the child welfare system.

But particularly alarming, if you look then at a lagging indicator,

if you will, those who actually get into treatment, you see that the

rate of pregnant women who are entering treatment with primarily

methamphetamine problems has greatly increased over the last 5

or 6 years.

That is the good news. We want women who have substance use

disorders who are pregnant to be in treatment, but it also calls into

19

question what is happening for the children. Perhaps those who

may have been prenatally exposed during that period, knowing

how many, what kinds of services is really one of the critical issues

for the country about that issue.

Next I want to point out what the overall treatment gap is in the

country. If you look at the 19 States that are represented by senators on this finance committee, they represent 6.5 million people

who needed treatment for substance use disorders and did not get

it. That is in the 19 States represented on this committee.

Overall, there are about 17 million people who needed and did

not get treatment for alcohol addiction, and another 6.5 million

who needed treatment for drug addiction and did not get it.

So what is the good news here? There are communities around

our country that have put programs together. They have been

working on it for quite some time and have addressed the substance use disorder problem in their child welfare system.

I want to point out the data that are on the graph from Sacramento County. Over the last decade, they have put in place several different system reforms so that parents at the very first interaction with the child welfare system get access to comprehensive

services.

They get recovery management services, they immediately get

access to the kinds of supports that are needed by families. It is

unique in Sacramento, and it has taken awhile for them to get

there. But half of the parents whom they are working with in the

child welfare system who are in the evaluation data have primary

methamphetamine problems. But if you look at the reunification

rates, if you look at the treatment completion rates, there are not

significant differences between those who have methamphetamine

problems and those who are addicted to other substances.

So again, it calls into question some of the media in terms of

methamphetamine being untreatable. That is not what the scientific literature would support, it is not what the evidence supports. Thank you very much for your invitation today.

The CHAIRMAN. Thank you. I want to introduce Mr. Frank, and

then we will have Mr. Frank’s testimony, and then Rev. Aigner.

Senator BAUCUS. Thank you, Mr. Chairman. Kevin Frank is the

Regional Administrator of the Department of Health and Human

Services at Child and Family Services in the State of Montana, supervising all child protective services and activities in 11 counties

in Montana.

In those 11 counties, and I might say, Mr. Chairman, here in

Washington, DC, they think they know what rural America is.

They do not know what rural America is, frankly, Mr. Chairman,

until they come out to those 11 counties that Kevin is involved

with. That is really rural.

I might say, just in passing here, it is kind of interesting, back

more than 10 years ago, President Clinton came up with his health

care plan. Hillary, now Senator Clinton, came to Montana, and,

when she got off the airplane in Montana, her first words were,

this is not rural, this is hyper-rural, this is mega-rural.

That is the kind of territory that Kevin supervises. He has been

working for the State for 15 years, and he knows his subject very

20

well. He is extremely able. We are very proud of him. He is a third

generation Montanan, so he knows what he is doing. Kevin Frank.

STATEMENT OF KEVIN T. FRANK, REGIONAL ADMINISTRATOR,

DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES,

CHILD AND FAMILY SERVICES DIVISION IN SOUTH CENTRAL

MONTANA, BILLINGS, MT

Mr. FRANK. Thank you very much. Good morning, Mr. Chairman;

and Senator Baucus, thank you for that introduction. Members of

the committee, it is my great pleasure to be here today.

By now nearly everyone in America has at least heard of methamphetamine, and over time, many communities have come to the

sobering realization that methamphetamine affects everybody, and

in a big way. From farmers to law enforcement officials, landlords

to social service professionals, victims of methamphetamine-related

crimes exist in families across the entire socioeconomic spectrum.

No other illicit drug in recent history has garnered such attention, and unfortunately many have discovered the nearly limitless

capacity of methamphetamine’s authentic reputation for rampant

personal destruction.

In Montana, we were once able to point to the large urban areas

of the country as having the most drug-associated ills for which we

were proudly immune. We are no longer able to make such claims.

As Senator Baucus mentioned, I grew up in Montana, as did my

parents and grandparents, and things have changed.

Methamphetamine affects nearly all aspects of the citizens and

systems in our society, but nowhere are the immediate and residual effects of methamphetamine more brutally visible than through

the eyes of child protective services social workers.

Social workers entering the child welfare field today can fully expect to be exposed to toxic chemicals, expected to know how to

physically handle a contaminated child, must have a heightened

awareness of their own physical safety, and through it all are expected to withstand rigorous cross-examination from defense counsel in court proceedings.

A social worker can also fully expect to be confronted by an adult

whose behaviors may range from maniacal to near comatose, and

verbal and physical threats of assault against case workers are

common.

With regard to older youth, in the past when we received reports

of incorrigible adolescents or teenagers contributing to what could

lead to reciprocated violence between the parents and youth, we

might suggest family counseling combined with the mental health

assessment. Today it is increasingly common for both the parent

and the youth to be experimenting with or addicted to methamphetamine.

In questioning parents, some will immediately confess to drug

use, along with the desire to get clean. Others will deny use, even

when confronted with drug test results, and still others will flatly

tell us or a police officer, just take the kids.

Child welfare workers get into this business to help families, but

methamphetamine is a multiplier that exponentially increases all

things bad that may have otherwise been preventable or manageable in families showing more traditional signs of risk.

21

Caseworkers are accustomed to fast-paced, near-chaotic work environments where the rewards are few, and the personal demands

great. Methamphetamine poses unprecedented challenges to child

welfare agencies given the risk factors involved. Over 65 percent of

all foster care placements in Montana are directly attributable to

drug use, and of those, methamphetamine is a primary factor 57

percent of the time.

Sadly, 80 percent of all foster care cases involving methamphetamine in Billings will result in termination of parental rights. Hundreds more children who are not directly involved in the child welfare system are living with grandparents or other relatives due to

methamphetamine-related incarceration or absenteeism of their

parents, and methamphetamine use among residents of the seven

Indian tribes in Montana far exceeds epidemic proportion.

There is hope. The first being through education and awareness.

Montana has been blessed with responsible local media outlets that

consistently and accurately report on all aspects of the meth issue,

and we enjoy a great deal of partnering and collaboration with

many diverse organizations from all levels of the public and private

sectors to get the word out about methamphetamine.

Also there are a handful of family drug treatment courts in Montana, the first in Billings which started taking clients in June of

2001. The significance of the drug court model is very simple, but

also very powerful. It invokes the historically recognized and revered institutional authority of the District Court to both punish

and praise.

It custom-tailors that to one individual at a time. For most of the

parents whom we see, it is the first time they have ever had a conversation or any type of a positive relationship with a judge. Most

of our clients are in need of a total person transformation due to

multigenerational dysfunction.

Drug court participants are subject to high-level personal accountability while treated with respect and dignity in a holistic and

practical approach designed to reintegrate them back into society,

and, in my opinion, it is one of the most honorable applications of

the court system.

For those who complete the year-long commitment, it is often the

most life-changing year of their lives, marked with graduation celebrations that are so packed with emotion, they are enough to keep

child welfare workers motivated for months when they go back to

the grind.

So in closing, let me say that any successful approach to combating methamphetamine must involve authentic, cooperative,

working relationships between community players and a holistic

approach with individual clients.

Thank you very much for this opportunity to address the committee. This concludes my testimony, and I welcome your questions.

The CHAIRMAN. We thank you, Mr. Frank. Now, Rev. Aigner.

22

STATEMENT OF REV. FREDERICK AIGNER, Ph.D., PRESIDENT

AND CEO, LUTHERAN SOCIAL SERVICES OF ILLINOIS, DES

PLAINES, IL

Rev. AIGNER. Good morning. Good morning, Mr. Chairman. Just

by way of reference, I am grateful for your relationship with Roger

Goodman.

The CHAIRMAN. Oh, yes.

Rev. AIGNER. Who prized his relationship with you. Thank you

for your accessibility. We are grateful. Member Baucus, good morning.

Senator BAUCUS. Good morning. How are you?

Rev. AIGNER. I serve in the President’s Office at Lutheran Social

Services of Illinois. It is a 140-year old institution. Last year we

served 65,637 people, 16 lines of service. Two of the most predominant ones are child welfare, child issues, and then also drug abuse.

Methamphetamine first came to our attention in Illinois through

our southern offices. The region down there is rural. I do not know

if it is hyper-rural, but it is rural. Fourteen counties the size of

Connecticut and Rhode Island together with not a lot of people.

That is where in 2002 we had no methamphetamine abuse indicators, and now 3, 4 years later, we have a 260-percent increase in

it, and most of it is attributable to methamphetamine.

A Statewide agency, we track it across the State and we see it

moving up freeways, so it is Peoria and Champaign, and now

Galesburg and the quad cities and Rock Island. I was over there

the other day and I saw an ad maybe comparable to the one that

Senator Baucus mentioned. It was a policeman. It said, ‘‘If you cook

it, we will come.’’

There is such a widespread understanding now, that is what is

at stake. You do not have to, cook what? Cook up your methamphetamine at home. It turns out that in the southern part of the

State, unlike other places, it is virtually all home labs, virtually all

home labs, so we do not have an import issue. That is a non-issue

down there.

But as a consequence, children are exposed then in the homes

down there to all of the toxicities around that. You heard them portrayed variously by other members of the panel, the previous panel,

and also by this panel.

There is this danger that Mr. Frank identified to first responders, which include child welfare specialists. People are very erratic.

Whatever their predispositions in the world, they are now amped

up on the stimulant, and they are going to be more so. If they keep

high for long enough, they are going to be perfectly dysfunctional

psychologically, as in fact yours and the other Senator’s portrayals

suggested at the very beginning.

So domestic violence, child abuse, not to mention of course, neglect, as well as sexual abuse are all very, very common and are

pretty much on the minds of our folks as they now go out with a

sense of threat to themselves.

I want to tell one story, and then make three suggestions, and

then answer your questions if I may, sir.

A young mother left her child with a babysitter. The babysitter

called the hotline because mom did not pick up the child, and was

given to us to care for her. We tried diligently for 21⁄2 weeks to find

23

the mom. Finally after approaching 3 weeks, she showed up. She

had been on a methamphetamine binge.

What is remarkable in her personal testimony is to me, she forgot she had a baby. That is so remarkable clinically. That is actually unprecedented in our experience, and we work with people

with drugs all the time. She forgot she had a baby. When she finally stopped binging and she remembered, of course she was horribly ashamed.

This is a happy story; it had a good ending. She got herself

straightened out, and now months later there is a high likelihood

of reunification, which is of course what we are always shooting

for.

But the fact of the matter is that, in most of our experiences with

methamphetamine, it does not have a happy ending, at least 60

percent. It is that difficult.

The people who were here before us—I was in town a couple of

weeks ago for the Horatio Alger awards—these were the Horatio

Algers of America here, undaunted spirit and optimism in the face

of adversity. What is the difference between the Nobles and Allison

and Mr. Binkley? All of them have very bright eyes, and all of

them had lovely childhoods, and they had adversity, but they were

not broken internally, and they were not addicted.

They were not singly, dually, or multiply diagnosed, as most of

the people now coming into the system, not these folks, but most

of the people coming in now, these are the Horatio Algers. Theirs

is the story of America that needs now to be told, and resources

have to be found to free them up.

I think that if we do think positively, lots of good things can happen. The fact of the matter is that because it is rural, it very often

happens in places where there are not sophisticated drug interventions, drug treatment programs. So the first recommendation I

would like to make: we run drug programs in Chicago, but we do

not have them in the southern part of the State. I do not know how

complete access is in Iowa. It sounded very good from some of the

testimony, and Missouri now too, I would assume, as well as California sounds wonderful. Oregon of course has been wrestling with

it for a long time.

I would suggest that resources have to be deployed to add drug

abuse counselors to the child welfare teams within the offices. They

cannot be extrinsic to it. They not only have to be within the offices

and working in tandem—and we do not do residential work in the

south—but when they go out, they need to actually go out in twos,

because the impact of a child welfare specialist on a methamphetamine parent or someone who is trying to clean up, it is so aversive, they immediately want to get high again. They almost have

to have a drug counselor there with them on the visit. Well, that

doubles the cost for every one of those visits right there.

Furthermore, drug counselors have to be sophisticated about the

Federal mandates regarding permanency and the fact that the time

lines are inordinately short. Not inappropriately, but relative to

methamphetamine, inordinately short. So 9 months and 17 months,

they have to be working and intensifying their activities on behalf

of our clients in order to bring them along in such a way that famiVerDate 11-MAY-2000 15:58 Apr 16, 2007 Jkt 095484 PO 00000 Frm 00027 Fmt 6633 Sfmt 6633 34207.000 SFIN1 PsN: SFIN1
24

lies can be reunified, which would be the ideal situation. So there

was that.

I wanted to mention training. It is for us in our area a relatively

new phenomenon. It clearly is not with Dr. Young or with Mr.

Frank in your areas. We need lots of training. We have spoken in

the past and would lift up again title IV–E.

Title IV–E dollars are largely used for training pretty much

through State agencies. The fact of the matter is with 80 percent

outsourced to private agencies, it seems a shame that the training

dollars that are available to train people are not made available

also to the private agencies who are doing the burden of the work

in the field. So we would lift that up for your consideration as well.

Finally, even though the number of children in foster care has

fallen nationally, the fact is that the children in foster care are increasingly more difficult to serve. As a consequence, I would recommend that case loads drop from—currently in Illinois—15 per

worker, to 10. That set of recommendations and the resourcing of

it would be hugely helpful for us.

A great opportunity for me and for Lutheran Social Services of

Illinois, part of Lutheran Services of America—which by the way

delivers $8 billion worth of services and touches the lives of 1 out

of 50 people every year—to come and to present to you this day.

Thank you for your interest in the methamphetamine crisis.

The CHAIRMAN. Thank you very much. I will start with Mr.

Frank.

From your experience with interacting with Federal money, do

you believe that there is enough flexibility in the current Federal

financing structure for child welfare to allow States to respond to

the methamphetamine epidemic?

Then I suppose I ought to start with the reality of the fiscal constraints that we face now. How would you balance the State’s need

for flexibility with a concern for a more flexible block grant approach, and would reducing or eliminating the entitlement status

for various vulnerable children be a good thing, or not?

Mr. FRANK. Well, Mr. Chairman, I think I got most of that. Some

of that I can comment on, and some is up to my superiors to formulate a response.

As far as flexibility, the first part of your question, grants certainly offer far more flexibility to the extent that they last, the size

of them, than does IV–E. IV–E is an antiquated system. Welfare

was reformed, IV–E was not. It is designed to take care of kids who

otherwise would meet that traditional financial category and places

them in foster care. It is just not a progressive type funding source.

Montana though has tens of millions of dollars wrapped up in

IV–E, as its current entitlement program. So if it were to go to a

block grant, we would want to definitely have comment on what

would that look like. There are experts who know a whole lot more

about this than I who would need to weigh in on that.

The CHAIRMAN. All right. Dr. Young, in your testimony you discuss the characteristics of female methamphetamine users. Could

you review these characteristics for the committee and discuss the

implications, particularly on children.

Dr. YOUNG. Well, I think the thing that comes to mind most profoundly without looking at my notes is the intergenerational issues

25

of abuse and neglect. The vast majority of women who come to

treatment were abused or neglected as children themselves.

So we are addressing two parts. First, the whole family in terms

of the parent who comes to treatment, and the needs of the children, but also recognizing that for women, the mental health, the

trauma, the domestic violence components that make up her world

as she enters this new life of sobriety have to be put in place to

be able to deal with that.

We know that there are some unique characteristics of women in

terms of methamphetamine itself and using. They tend to begin

using younger, they use with a different kind of pattern, a certain

number of days. That would mean that if the effects of methamphetamine last over a longer period of time, the risk of neglect—

and predominantly who comes to the child welfare system are kids

who have been neglected—that risk obviously is increased when a

parent is using methamphetamine compared to some of the other

drugs.

I think, again, most importantly is looking at that intergenerational piece as a woman who comes to treatment and what

else needs to go on in her life in terms of comprehensive services

and really looking at the trauma issues that got her there in the

first place.

The CHAIRMAN. You speak about two-thirds of the women who

are methamphetamine users having been physically abused, and

nearly one-third sexually abused.

What is it about the nature of this drug that makes it so attractive to women who have been victims of domestic or sexual abuse?

Dr. YOUNG. Well, I think if we look at the young girls and the

data on the young girls that are starting, the media messages and

what they tell us about why they are starting to use, it is a pretty

effective weight control piece in the very beginning.

Girls get into methamphetamine for a variety of reasons that

would not necessarily attract boys for those same kinds of things.

I am not sure that it is the methamphetamine that draws a population that also has childhood abuse going on in their family. I

think that that is there regardless of what kind of substance.

We know of women who are addicted to alcohol, to cocaine, to

other substances, and the amount of childhood abuse and neglect

in their lives is similar. It is not just methamphetamine that that

comes out in.

The CHAIRMAN. Senator Baucus?

Senator BAUCUS. Thank you, Mr. Chairman. I would just like to

explore a little bit the relative value of, say, drug courts and other

programs like Bridgeway that came up in the last panel.

I assume that some work better, some situations, than others.

But could you talk, both of you, Mr. Frank, a little bit about the

drug court. In your experience it is working pretty well. I am just

trying to see where we put our resources, because they are not infinite.

Mr. FRANK. Thank you, Senator Baucus. The drug court does

work well for a certain population. It does not work for others. It

is the best thing that we have going in the way of treatment combined with what we were calling shared family care, what Allison

on the first panel referred to as a family treatment program.

26

Senator BAUCUS. Right. Right.

Mr. FRANK. That is something I am going to go back and talk to

my peers and superiors about. I am very interested in that twist

on adding that to drug court.

The families we see are at the end of their rope. I mean, they

have tried every kind of preventative thing and intervention that

may have been tried earlier, short of going to court. So it is just

a very difficult population. But drug court is from the treatment

standpoint, and it does address the whole family. As the youth, I

guess that he is 18 now, down on the end said, drug court will encompass all of the juvenile probation activities.

I think one of you asked about the criminal aspects, and the gentleman replied, that is done separately. There are different evidentiary standards and so forth, but drug court does treat the

whole family in court.

Senator BAUCUS. Dr. Young, do you want to talk about that,

please?

Dr. YOUNG. Yes. I think the thing that we have to think about

in terms of the family treatment courts and developing family

treatment courts is it allows us to have accountability in two ways.

Accountability for families that have substance use disorders, but

it also makes the systems more accountable.

The court then is looking at what is happening in the child welfare case, what is happening in treatment. The models that have

been developed that provide those services for all of the families in

that particular jurisdiction have been very, very effective in terms

of increasing reunifications, increasing treatment completions, getting parents to treatment faster.

There is lots of evidence about what works in family treatment

court. However, we have to remember that that is really the back

end of the system, if you will. Most of the families that are in child

welfare are in those services that are family support services, Promoting Safe and Stable Families, the flexibility about being able to

serve families before children are removed.

Once the court comes into a jurisdiction where a child has been

removed, that is where most of the family treatment court practice

is happening. That is not to say that there are not court-involved

families in which the kids are still at home.

Senator BAUCUS. I appreciate that.

Dr. YOUNG. But they are on the back end.

Senator BAUCUS. Reverend, do you have any thoughts, among

these various ways, but in terms of treatment, what works?

Rev. AIGNER. It does have to be comprehensive. Actually I apologize, I actually want to speak to this, but my immediate thought

has fled as I was following Dr. Young’s response. It is escaping me.

Senator BAUCUS. We can come back to you.

Rev. AIGNER. Would you please come back to me?

Senator BAUCUS. Yes, sure.

Rev. AIGNER. Thank you.

Senator BAUCUS. I will tell you, in my very limited experience,

the family treatment centers work, and foster programs work.

About a year ago, I was in an assembly at a middle school in Billings.

27

The whole program was fighting methamphetamine. We had

some various resource people, law enforcement and others, trying

to get kids to understand the problems with methamphetamine.

Afterwards, a bunch of kids walked up to me and we chatted a little bit, this and that.

I could tell there was one little fellow standing off on the side.

In the corner of my eye, I saw him. I sensed that he had something

pretty serious that he wanted to talk to me about.

Sure enough, he was the last person to talk to me. He walked

up to me and blurted out, he said, ‘‘My mom is on methamphetamine.’’ He started crying. We talked about his grades and how he

is doing, the situation. It was rough. He kind of pulled himself together a little bit, but it was tough. He really bawled when he

walked away.

But right then at that moment, I decided I am going to mentor

this kid, and I have. We correspond a lot, we see each other. I have

to tell you, he was placed not too long ago into a family. His mom

was taken away from him. He only had really himself. He had no

idea where his dad was, but he knew his mom and he loved his

mom, but he was taken away from his mom because she was doing

methamphetamine.

Anyway, he went to a foster home. A month ago, his mom died

of an aneurysm, methamphetamine-related disease. I saw him. I

had dinner with him at a Pizza Hut last week. He is really doing

well. It is just wonderful to see.

The foster home environment has been really helpful to him. You

just see the confidence he is now getting. He has also grown a bit

in the last year. He is talking that he might go live with his brother who is overseas in Okinawa. He is on the Internet learning

about Japan and other countries.

From my experience, the foster program in Montana is working,

at least in this fella’s situation. So I just wanted to thank you for

all that you do very much.

I do not have any more questions here. Just thank you so much

for what you do. Obviously you all care, you care a lot. Based upon

the experiences there were up there, there are good results. Just

keep at it. Again, thank you very much for taking the time and

coming here. Thank you.

The CHAIRMAN. Rev. Aigner, if you think of what you were going

to say to Senator Baucus, break in at any time.

Rev. AIGNER. Yes. Thank you. Yes, actually I did think about it.

I do not know if I said it exactly as precisely as I wanted the first

time around with this young woman.

Yes, it is 7 percent in the country. Other drugs seem to be comparable in many ways, and maybe the treatment patterns will be

the same. This drug is so disruptive of the natural order of creation

for people, so profoundly disruptive that that is what I was trying

to suggest with my example. I had three or four, if you read the

written testimony again.

That is often as even the threat of having a child removed does

incite and incent a parent to engage it. Our experience is equally

often, it does not. That is why we need a lot of help here in the

State of Illinois. If you are doing better other places, I commend

you. We are actually pretty good at this. Proprietaries want to buy

28

our drug and alcohol continuum from detox all the way through.

We are actually pretty good at this.

I am saying that around methamphetamine, it is new territory

for us. It has not been easy for us to engage as fully as we should.

So in the example of the courts, the later part is more where we

find ourselves than the earlier part. We engage, but as many times

as not in one family, the other example, the father commits suicide,

the mother regains her health.

That is about it for us so far. So we need the attention, we need

the resources. I know we can do better, we are very good at it. But

methamphetamine is a pernicious drug.

The CHAIRMAN. Senator Wyden?

Senator WYDEN. Thank you, Mr. Chairman. Mr. Chairman,

thank you for holding this hearing. I think it is an important discussion and long overdue. You and Senator Baucus have long been

leaders in the anti-methamphetamine effort.

Dr. Young, I especially appreciate what you have done. Oregon

has taken a huge pounding in terms of the methamphetamine

problem. I would like to put it I think a little bit differently.

The skeptics, particularly in this kind of budget environment,

often come to me and say, Ron, can we really afford these kind of

treatment programs? It seems to me the question is really different. That is, can we afford not to have these programs?

My judgment is just from the standpoint, I mean, a really coldhearted budgetary analysis, the kind of treatment work you advocate makes sense from a dollars and cents standpoint.

Let me tell you how I get to that point, and I would be interested

in your reaction. I think the country has a choice. You can spend

a boatload of money constantly paying for jails, constantly paying

for hospital emergency room visits, constantly paying for this huge

array of costs that methamphetamine addicts can incur, or you can

have the kind of well-targeted treatment programs you are talking

about and break the cycle of methamphetamine addiction all together.

That way, the kids and parents can be back together in a drugfree environment. So my question to you is, even if you do not have

a warm heart, and I am not saying that anybody approaches that

way, but just from a cold dollars and cents standpoint, doesn’t it

make sense to look at some of these targeted treatment approaches

and say, it sure looks like the costs here are not going to be close

to the dollars that you rack up constantly paying for people, a revolving door in and out of a jail cell?

Dr. YOUNG. That is absolutely correct. Time and time again, cost

offset studies, cost effectiveness studies have shown that treatment

pays for itself a few times over, most recently out of California and

their Prop 36.

Again, the treatment effectiveness data as well as the cost effectiveness data are there. But Oregon is a very unique situation. In

fact, one of the staff from the Oregon State child welfare agency

has said recently that if you look at the case load data of Oregon

of the kids coming into out-of-home care, during the time when the

methamphetamine epidemic was really exploding there, they had

treatment resources.

29

Mr. Wersher would say we really were getting a handle on what

was happening with methamphetamine, and their case loads were

coming down. Then they had a cut in funding in substance abuse

treatment in Oregon. He says, and you will see in the data and the

graphs that were provided, Oregon’s case load has gone back up.

He attributes that to not being able to get access to services for

families in the State of Oregon.

Senator WYDEN. Well, I am going to do everything I can to kind

of take your message and sort of proselytize for your cause. If you

can get us some more information to that effect, that would be

helpful.

I think the way this has really broken down in terms of a debate

with citizens is, are you tough on methamphetamine? And of course

I want to be. I want to come down with hobnail boots on these

kinds of sophisticated criminals that are dealing in methamphetamine.

We have seen some very sophisticated people. When Senator

Smith and I were in Asia, for example, recently we talked to them

about the link between Asia and the methamphetamine problem.

Apart from the morality of helping families get back together, the

data you have in terms of just plain dollars and cents impact show

that treatment is smarter from a dollar standpoint than the alternative.

So if you can get us a summary of those studies, I would like to

take that message far and wide, because I think it is something

that needs to be heard. I thank you all. We are all juggling today.

There have been a lot of hearings and demands on our time, but

I just thank you for all the work you are doing.

Especially, Mr. Chairman, for calling this hearing. I think a lot

of people would look at the topic and say, what is the Senate Finance Committee, this enormously prestigious committee doing

looking at the methamphetamine issue? You have laid out exactly

why we are, and the costs to our country both in terms of social

services, which we do have jurisdiction over, and the costs to our

families are compelling.

So I look forward to having more hearings like this and to working with you and Senator Baucus.

The CHAIRMAN. Along that line, if we can work it in, we may

have another hearing dealing specifically with the reauthorization.

I am going to just ask a couple of questions, and then we will

be done, unless other members come. I am going to ask Rev.

Aigner.

On this issue of what is best for the kid, whether it is with the

family that gave birth to that child, or whether it is outside the

family, in working with these children and families, how do agencies such as yours, Lutheran Social Services, determine whether or

not family reunification is possible?

Let me ask three questions. Whether or not family reunification

is possible, how do you determine that, and then secondly, in your

experience, how often is family reunification successful when a parent is addicted to methamphetamine, and that might be as opposed

to being addicted to other things, and do you have suggestions for

Federal lawmakers on ways that we can facilitate positive outcomes when family reunification is advisable?

30

Rev. AIGNER. I take note of the latter. With all clients, you have

a treatment plan. It is the participation of your client in that treatment plan that determines whether or not you are going to move

back toward family reunification.

It would be participation in the full range of counseling services,

parenting services, management of the cravings, and all of that

side. It would be engagement in a job and the ability to support,

it would be all the normal indicators from the treatment plan.

If they are moving along, then they can appear before the judge

and they can be reunified.

The CHAIRMAN. In most cases, are they reunified, or not so?

Rev. AIGNER. In other parts of the State, and with other issues,

we have great luck. We have less luck at this point in Illinois with

the methamphetamine-related cases.

The CHAIRMAN. Go ahead.

Rev. AIGNER. Yes. So that is the first part of it, if that is helpful.

I forgot your second question. Could you just quickly remind me of

it?

The CHAIRMAN. The second one, how often is family reunification

successful when a parent is addicted to methamphetamine? That

might also be in relationship to success or in relation to other addictions other than methamphetamine.

Rev. AIGNER. Yes.

The CHAIRMAN. And you may not have any statistics on that in

your own mind. If you do not, it is okay.

Rev. AIGNER. Thanks. We are talking about a spike in a very precise part of Illinois, rural Illinois, in the south, generally outside

Chicago, downstate generally.

It seems in the early days to be worse. We are very mindful of

Oregon’s work. We are very impressed by that, by Dr. Young and

her colleagues there, and mindful of the States that have gone before us, Missouri and Iowa, and their engagement of it, and we are

trying to learn as fast as we can.

At this juncture, I would still say because it is so early, we do

not have a lot of evidence to suggest we can be enormously successful with it at the current level of resources. I guess that is how I

would like to phrase it.

The CHAIRMAN. All right.

Rev. AIGNER. We have pretty good success with the rest of them,

although it takes a long time. In our culture, the problem is everyone wants shorter, more intensive quick fixes. The fact of the matter is most addictions require years of behavioral management before you have integrated all that has to happen.

The CHAIRMAN. Well, then did you just tell me that the chances

of recovery and family reunification are better with addictions

other than methamphetamine than with methamphetamine?

Rev. AIGNER. Yes, and perhaps this is in support then of Dr.

Young’s point. We know those other drugs better. We understand

how they work better. We seem to have better luck with those. Yes.

The CHAIRMAN. Okay. Then as we consider reauthorization or

any policies here, any suggestions on ways that we as Federal lawmakers can help facilitate positive outcomes when family reunification is advisable, as opposed to adoption or foster care?

31

Rev. AIGNER. Well, it is a beautiful thought to think that you

could take a whole family to a residence and have them all there

in proximity and everyone would know that they were there and

could be engaged in it as a corporate act.

That seems very much beyond our ability to achieve in the State

of Illinois, at least to date. We have women’s residences, we have

men’s residences. We have programs for families, but they are all

outpatient programs. They are not inpatient like that.

Part of the problem always, it seems to me in dealing with the

Federal Government, has been the decision to not fund any kind

of facility. Fund a program, but not a facility.

Well, for us who live with no margin at all, or a negative margin

on a yearly basis, we cannot capitalize the creation of a facility. So

I can imagine running the residence if we had the capitalization for

it, but we do not have that.

It sounds like that would be a really effective way to go. In facilities, you see them every day. It is that kind of intensive treatment

that makes the difference. As it is, in a rural area they are spread

out. You have to go, and it should be two now, two counselors, the

drug-abuse and child-welfare specialists, they have to go these long

miles to that home. That is what we have to do where we currently

are.

The CHAIRMAN. Oh.

Rev. AIGNER. So anything that you, sir, would understand that

you could do I guess to fix that would be helpful.

The CHAIRMAN. Dr. Young, my last question is for you. Describe

how methamphetamine works differently in the body and the brain

than other addictive drugs. Then for my part, if I could tell you,

I make a very short statement about methamphetamine because

obviously even though it is a major problem in my State, I do not

understand what I just asked you in the sense of what that answer

might be.

I describe it as probably more mind altering than any other drug.

Now, that may not be true. So if I am wrong, correct me so that

I cannot make that statement in the future.

Dr. YOUNG. Well, remember I am a social worker, not a

neuroscientist. But I will help you with that if I can from my understanding of what that means.

We know from, if you will, animal models, that they are able to

measure the Dopamine, which is a neurotransmitter that gives us

pleasure in our brain. We get Dopamine from all kinds of activities

that give us pleasure as human beings, and rats get that also.

So when they measure what the Dopamine levels are from eating, from sex, from using particular kinds of chemicals, they can

then measure how much of that is there. The amount of Dopamine

for methamphetamine far exceeds any of the other substances of

abuse.

So it increases the amount of Dopamine that is happening between the neurons in the brain, and it lasts for a longer period of

time. That half-life, about how long it will last, creates some of

those risks to kids. There is no question about that.

So that is part of the reason that it becomes so immediately such

a huge issue for families.

32

Could I turn to your previous question about the reunification

numbers?

The CHAIRMAN. Yes.

Dr. YOUNG. I mentioned Sacramento County because we have

been looking at their data for quite some time. They have had

about a dozen years now to work on the comprehensive services

that need to be put in place between the substance abuse agency,

the child welfare agency, and the court.

They now have a coordinated system for the last 2 or 3 years

that just works beautifully. It works on time, it works to meet the

needs of families.

They have gone from before they put their system in place, they

had a reunification rate among families with substance use disorders of about 22 percent. After they put this system in place, that

includes recovery management, access to services at the first court

date, accountability for the families through the family treatment

court, the reunification rates are about 47 percent.

So they have essentially doubled the percentage of families that

are reunifying in their county. They have cut the time of kids in

out-of-home care dramatically. They estimate that they have saved

about $3 million a year in services that would have been expended

had they not put this in place.

But what is really important is when we look at that data by primary substance of the parent, there are no differences in the reunification rates among parents with methamphetamine problems

than there are from alcohol problems, marijuana problems, cocaine

problems.

The only family groups that reunify at a lower rate, at least in

that particular county, are heroin addicts. More recently with the

2-year data looking over 24 months of what is happening for children, we have begun to see that there is a difference with heroin

and opiate addicts.

The CHAIRMAN. All right. As Senator Baucus said, you have been

very helpful. We appreciate it very much. Not only this panel, but

the previous panel, and I repeat that for the previous panel because I think that they were brave in coming forward.

But it helps us very much as we think of this issue, particularly

its impact upon our social services. Thank you very much, and the

committee is adjourned.

[Whereupon, at 12:20 p.m., the hearing was concluded.]

(33)

A P P E N D I X

ADDITIONAL MATERIAL SUBMITTED FOR THE RECORD

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