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1 Substance Use and Child Welfare { An examination of outreach and barriers Introduction The following presentation is intended to provide the_audience with knowledge and resources to assist them better understand the occurrence ~f substance use within the CPS client population and what efforts are made to address the issue. Th~ presentation will be broken up into three topic areas : 1'. Prevalence of substance use in CPS client population 1'. Explain current testing methods used 1'. Discuss challenges and trends noted in the work being done Number of CPS investigations - with Substance Use - eom...-.lm~ Dr1t91Ak...i1t... %DrWWNc!MWt~....., l is.,.,, l.1134 "" IUllJ "'' ""... "".,.. 11.IW, ,llO ' "' ' '"'..,5_,'11, , 7,15a7.., 22,529 l4.lm ,1173 lo!ll 10. ll 30.1'!1. -H.5'! % Hi'!I. '"... um,.,. 17, <ll.7'11, "' 40,J'II, """ " " Total 171,H <lo.i% Impact of Substance Use cases across CPS program areas Investization , % Family Based Safetv Services 25,681 34, % Substitute Care % 1

2 The impact of substance use on families Impact of substance use on community resources 1,. The loss of trust among family members 1,. Emotional strains on the family 1,. Finandal strain 1,. Invites a criminal element into a place that should be safe for children 1,. Creates a shift in family value system over timefamily togetherness and education give way to the need to get high and seek money to continue to get high 1,. Increased referrals for treatment and intervention from CPS and law enforcement agencies to local substance use community resources.,. Increased strain on already limited budgets of these community resources 1,. Some areas are faced with wait-listing referrals due to the high demand for services Testing Types Drug Testing Basics { What you need to know CPS caseworkers have several drug testing types available to assist them in making a more informed assessments of a situation that may involve drug use. We will explore the different testing types, the periods of detection for each drug test type, what these drug tests detect, and when to appropriately use them. 2

3 11 Oral Swabs i,. Oral swabs typically refer to the instant-react tests thatwe have available for use out in the field. ts Oral swabs have a window of detection of beiween hours i,, Oral swabs detect IBC, cocaine, opiates, amphetamine, methamphetamine, and PCP ts Instant-read oral swabs provide an instant result. Any positive finding should be confirmed by a lab confirmed urinalysis test Urinalysis Testing i,, Urinalysis tests are lab confirmed tests that are admissible in court. i,, With the exception of marijuana, the drug detection period is 3-5 days {marijuana can remain in urine days) ts Our standard contracted urinalysis testing will detect : THC, cocaine, opiates, amphetamines, methamphetamines, PCP, methadone, benzodiazepines, barbiturates, propoxyphene, oxycodone, and methaqualone. i,, Positive finding are verified by a Medical Review Officer Hair Strand Testing ii Hair strand iests are also lab confirmed tests that are admissible in court. Any positive finding as are verified by a Medical Review Officer. i,, Hair strand tests capture historical use-meaning use from at least 10 days ago to 100 days agogiving you a 90 day sample of history. ts Standard hair strand tests detect: THC, cocaine, opiates, amphetamines, methamphetamines, and PCP. Specialty Tests In addition to the substances already discussed in the previous slides, we have the ability to test for a select number of other substances when needed. These additional substances include: ts Alcohol {ETG/ETS) i,, Bath salts (synthetic cathinones) ts K2/Spice/Synthetic marijuana {synthetic cannabinoids) ts D/L confirmation testing {used only to confirm a positive methamphetamine urinalysis or hair strand test) 3

4 Example 1: Allegations that mother and father are using methamphetamine daily. Case Related Examples { A quick review of appropriate drug tests At a minimum, a urinalysis for each parent should be requested. The urinalysis will go back 3-5 days and capture the daily use. If there is previous CPS and /or criminal history related to drug use or if there is concern hat the family is a flight risk a hair strand test may also be a consideration to better establish a pattern of ongoing use. 1, Example 2: A case has been reassigned after being open 110 days. The initial allegations included drug use. There is no record of lab confirmed drug tests on file. The dot:umentation does mention an oral swab and the results were inconclusive. The parent reported it was due io an allergy medication. Given the lack of confirmed drug tests following the invalid swab and the length of time the case has been open, a hair strand test is the most appropriate tool to help determine if any use has occurred during the open case. Example 3: I! An allegation has been made that a mother and her paramour are abusing Xanax. The worker received the intake at 5:20 pm on Friday night. Although it is after hours, an oral swab will not detect Xanax (a benzodiazepine) and therefore a urinalysis test must be requested. The case Worker will need to staff with the supervisor to address any observable concerns and make arrangements to have the parenis test at a lab during the weekend if available or submit to a test promptly on the next business day. 4

5 Questions about Drug Testing? Challenges { Barriers to recovery Common barriers 111. Parent's readiness lor change 'fl Do they recognize that their use impacts their ability to parent safely 111. Appropriate support systems,r Arc there supportive friends and family, co-workers, faith community 111. Available resources within the community Fl Are there treatment facillties, recovery coaches, AA/NA groups, peer recovery groups within easy access 111. Funding i: Does the person have insurance or wiu they have to access state funding 111. knowledge P' Do people understand the extent of the substance use issue. Do supports and systems involved (including CPS) understand the most appropriate treatments and supports for the individual. to. Stigma Barriers,r Substance use often carries with it a stigma which leads the individual who uses to not open up about the frequency, amount, or type of use to avoid judgment. fzf Certain interventions such as the use of methadone or Suboxone to treat opioid addiction are themselves stigmatized and misunderstood 5

6 Resources In addition to our DFPS resources, there are several external resources that are worth bookmarking for easy access. Resources { Uscrul links for working with substance abuse The Texas Department of State Health Services Mental Health and Substance Abuse page has an abundance of resources about ireatment locations, guidance on referrals, and other helpful information. The Substance Abuse and Mental Health Services Administration (SAMSHA) website has numerous resources and links to articles on drug trends and treatment practices Substance Abuse Specialist Contact If you have general questions about drug testing or treatment or casespecific questions about what test or services are most appropriate please contact the Substance Abuse Program specialist at: substanceabusespecialist@dfps.state.tx.us 6