The Silent Victims
When mom and dad are using meth, the whole family suffers.
by Audrey Ticknor, RDH, MA

When discussing the abuse of methamphetamines (meth), the obvious focus for the dental hygienist is the dramatic consequences the substance can have on the oral cavity. Once we know or suspect that a patient is using meth, our thoughts center on the user: getting him or her help, involving the police, protecting ourselves and our practice. The truth is, that as a healthcare professional, our role can and should go beyond the immediate needs of the user, taking into account the people in his or her life that also are impacted by the drug abuse, especially children.

    According to the report, The Meth Epidemic in America: Two Surveys of U.S. Counties, the effects of the production, distribution, and use of the drug are hitting communities across the country. Meth abuse is not a victimless crime as some would like to believe. Legal, medical, environmental, and social issues are creating a complex problem that can no longer be denied.1 One of the most heartbreaking societal consequences involves the children that suffer from neglect and abuse while living in a drug environment.

About 30-35% of meth labs found in homes raided by law enforcement have children present. Many states consider this child endangerment because of the dangers of toxic chemicals/fumes which, being combustible and highly flammable, often lead to fires and/or explosions during the cooking process.

Whether meth is manufactured in a home or simply used, toxic residues settle on the carpet, furniture and walls, and can contaminate food the children might ingest. According to Dr. Kathy Wells, Medical Director for the Denver Family Crisis Center, children living in a meth lab enviornment are at an increased physiological and behavioral risk. Children experience higher metabolism, development, and growth rates as well as increased respiration rates. And, due to the hand-to-mouth habits common among small children, significant contact with a meth enviornment means that some of the drug may be entering the child’s system. According to Dr. Wells, “at least two reports have demonstrated that 35 to 70% of children removed from labs have a urine drug screen that is positive for meth at the time of removal from the home.”

With some types of substance abuse, parents are still able to function, offering protection and a livable environment for their children. With meth, the ability to parent is severely impacted. Judgment is impaired and adults are no longer able to act in a consistent, nurturing manner. Substance abuse is believed to cause or exacerbate seven out of 10 cases of child abuse and neglect. In fact, children whose parents abuse drugs and alcohol are three times more likely to be abused and four times more likely to be neglected.

Meth abusers are often irritable, paranoid, and violent. Because of this, children often experience physical abuse through severe corporal punishment or becoming involved in domestic violence episodes. Deliberate, intentional assaults can include biting, burning, cutting, poking, twisting limbs, or other types of torture. Children subjected to this type of treatment learn to resolve future conflicts through physical power rather than reason. It also is important to note that, as part of their paranoia, many meth users keep vicious animals or weapons—including knives and loaded guns—within easy reach, a dangerous situation for inquisitive youngsters.

Emotional abuse can be just as damaging to a child as physical abuse. Children who live in drug homes often exhibit attachment disorder. This occurs when an infant’s basic needs are not responded to or are done so unpredictably. These children usually won’t show emotion or cry if separated from their parents. Long term consequences include an inability to trust, form relationships, and adapt to change. This can lead to a greater risk of criminal activity and substance abuse as they mature.

A frequently described effect of meth is an increase in libido. This heightened sexuality often places children in inappropriate situations where they witness sexual acts, encounter pornography, or become victims themselves. The Department of Justice, Office for Victims of Crime, report that children living in meth lab homes are more likely to be victims of physical and sexual abuse by members of their own family and by other individuals who may visit the site. Sexual abuse/incest affects the child’s physical and mental health and may manifest itself by low self-esteem, aggressive behavior, or inappropriate knowledge about sexual acts for their age.

Neglect can take many different forms. Abandonment—leaving a child unattended or inadequately supervised—occurs when the drug abuser crashes after binging on meth, falling into a deep sleep for up to 24 hours at a time. Lack of supervision often leaves toddlers in harm's way since no one is around to monitor the child's actions or whereabouts. In April 2006, a 5-year-old California boy was weaving his bicycle through heavy traffic, unaware of the danger he was in. When a police officer brought him home, the child's father panicked and ran because he had a meth lab in the house.

    Appetite suppression occurs in users because meth is a stimulan; it was used as a diet aid in the 1960s. Since the adult doesn't feel hungry, they often forget the children must eat, or, the parent may have spent the family's money for drugs, leaving little to buy food. In either case, the nutritional needs of the children are not considered and there are frequent anecdotes of kids being forced to eat spoiled food or food out of the garbage can.

Medical and dental neglect are the result of lack of funds or failure to recognize and seek appropriate treatment. You may see a young child with chronic pain and/or abscesses of the primary dentition because the parent thought the baby teeth would just fall out. In September 2006, a mother was charged with endangerment after her 5-year-old boy had to have 12 infected teeth extracted, including all his molars. He had been complaining of pain and headaches for over a year.

Often, children of meth addicts are forced to fend for themselves, so you may see them wearing inappropriate or insufficient clothing for the season. Their living environments can be chaotic, incredibly messy and dirty, even rodent-infested. The home may lack heating, electricity, or running water. For example, in June 2006 two young children were removed from their Washington home from which their mother was producing and selling meth. When police entered the home, they found the sink and bathtub were dirty, unused, and the faucets didn’t work. The women told the authorities she had never bathed the children, but did occasionally clean them with baby wipes. The Child Protection workers noted the children had crusted skin around the crevices of their bodies. Cockroaches fled when the oven door was opened and the stench from a bag of moldy, wet clothes caused one officer to retreat outside for fresh air.

These stories may be hard for you to believe but, unfortunately, incidence just like them happen every day all across the country. Are you wondering what you can do?

    Medical providers are considered mandatory reporters. A mandatory reporter is an individual or agency who is required by state law to report any instance where he or she has reasonable cause to suspect that a child under 18 has been abused or neglected. Dental professionals are mandatory reporters of suspected child neglect or abuse.

    Mandatory reporters must report the instance to the state's attorney of the county in which the child resides or is present, the Department of Social Services (DSS) or law enforcement officers. Any person or party participating in good faith in making a report or submitting copies of medical examination, treatment or hospitalization records is immune from any liability, civil or criminal, that might other wise be incurred or imposed, and has the same immunity for participation in any judicial proceeding resulting from the report. A report can be made by telephone, in person, or in writing.8 While you may be legally and morally required to report, the most important reasons to report child abuse and neglect are to protect the child and get help for the family.

    Some states have expanded their laws of the definition of an abused or neglected child to include exposing children to an environment being used for the manufacturing, use or distribution of meth or any unlawfully manufactured controlled drug or substance. Such drug-oriented environments place children at great risk for abuse and neglect.

    A study in California indicated that 92% of child protection cases were drug related. In South Dakota, Child Protection Services has started to identify cases with alleged meth involvement. In the first six months of FY05, 145 reports of alleged meth involvement have been assigned for further investigation. There should be no doubt that knowingly exposing children to this type of environment is within the definition of abuse and neglect and must be reported. Persons reporting in good faith are immune from any civil or criminal liability.

Meth is a major cause of child abuse and neglect and can hurt children and families in the long-run.9 Become familiar with the signs of meth exposure in children. Remember that Meth knows no social class – anyone can be a user. You may see a child in need in your neighborhood, community, at work, in the park, or at school. Trust your instincts and if something doesn't seem right, investigate. If you suspect or know of a child living in a meth environment, help alleviate their stress and trauma by reporting the situation to the authorities.