Opioid overdoses have claimed more than 300,000 lives in the past 15 years, including some 33,000 in 2015 alone. But those numbers do not tell the full horror of this epidemic, which has devastated the lives of countless children whose parents have succumbed to addiction to prescription painkillers and other opiates. In one terrible case last month, a Pennsylvania couple died of apparent overdoses, and their baby perished from starvation a few days later.
More commonly, children are rescued or removed from the custody of their parents by local child welfare officials or relatives. After declining for several years, the number of children in foster care jumped 8 percent nationally, to 428,000, between fiscal years 2012 and 2015, the most recent data available. Experts say opioid abuse accounts for a lot of that increase. Officials cited parental substance abuse as a reason for removing children from families in 32.2 percent of cases in 2015, up from 28.5 percent in 2012. But these numbers very likely understate the problem, because local officials often fail to report drug and alcohol abuse and list most cases under the broad category of "parental neglect." One group, Generations United, estimates that 2.5 million children now live with relatives or family friends rather than their parents.
Yet federal, state and local officials have done far too little to address the problem. Years of budget cutbacks have left many states with too few caseworkers and too few foster families to deal with the crisis. Total federal and state child welfare spending fell by 5 percent between 2004 and 2014, according to a report published in October by Child Trends, a research organization. In Texas, conditions have gotten so bad that officials have assigned dozens of foster care children to sleep in state offices and other temporary shelters. Two court-appointed monitors proposed an overhaul of the Texas system in November.
A bipartisan bill that would have given states matching funds for mental health, addiction treatment and other assistance to parents didn't make it through the Senate, though it had passed the House. The measure was supported by groups like the Children's Defense Fund and the American Academy of Pediatrics. It would have reduced funding for foster care in group homes, settings that many experts say are far worse for children than placements in foster families. But some senators who were worried about the concerns of group home operators opposed that cut and prevented a vote on the bill.
Another major threat to children of the opioid epidemic is the Republican plan to repeal the Affordable Care Act. More than 20 million people have gained access to mental health and substance abuse treatment because the 2010 law expanded Medicaid and provided subsidies to help people buy insurance policies on health exchanges. If repeal isn't followed by a replacement law that provides equivalent coverage, many parents with drug and alcohol problems won't get access to addiction treatment. President-elect Donald Trump pledged during the campaign to end the opioid epidemic. But repealing the health care law is likely to exacerbate the crisis.
There was a big spike in foster care cases during the crack cocaine epidemic of the 1980s and 1990s. The government was far too slow to act then, and it is in danger of being dangerously behind the curve again.