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Community opioid abuse and student trauma: New challenges for educators

May 21, 2018

SRI International
   Betsy Davies-Mercier, REL Appalachia

The dramatic increase in opioid addiction and its devastating consequences have sparked nationwide concern about the epidemic's impact on children and youth. National data indicate that between 2009 and 2014, about 1 in 8 of U.S. children under age 18 lived with at least one parent who had a substance abuse disorder and about 2.1 million lived with at least one parent who specifically had a prescription drug or illicit drug use disorder. ¹

The states the Regional Educational Laboratory Appalachia (REL AP) serves are among the most severely impacted areas of the country. Prescription opioid rates in Kentucky, Tennessee, and West Virginia are among the highest in the country, and for at least two years in a row (2015 and 2016) West Virginia had the highest drug overdose rate in the nation. In recent years, all four states in the REL AP region have experienced statistically significant increases in deaths from drug overdoses, and in 2015 opioid abuse caused most of the overdose deaths in Appalachia. ²

Effects on children and youth

The effects of the opioid crisis on the region are far reaching, from community-wide economic losses to the dissolution of families. Children of opioid-abusing parents face a host of risks and traumatic experiences, which include neglect and maltreatment, loss of family income, separation from family members, having to move and change schools, increased risk for personal addiction (prenatally and later in life) and mental health disorders, and loss of a parent to overdose. ¹, ³

The pervasiveness of the epidemic has put additional demands on institutions that support children and families. For example, in 2016 the foster care system saw a large increase in the number of children needing placement, and authorities removed 92,000 children across the nation from their homes because at least one parent had a drug abuse issue. More than a third of children in the foster care system qualified on the basis of a parent's drug abuse. ⁴

The effects of the epidemic also extend to the classroom, where educators must deal with behavioral, academic, and practical issues among the growing number of children affected by opioid abuse in their homes and communities. These children may demonstrate chronic absenteeism and tardiness (because of parental intoxication or incarceration), behavioral and academic difficulties, and symptoms of trauma associated with relocation and needing to change schools. The trauma these students experience may override their ability to be engaged and successful learners.

How can REL Appalachia help?

At a recent meeting members of the REL Appalachia governing board and the REL AP leadership team discussed the challenges in the region's schools due to widespread opioid abuse. The board members said that educators throughout Appalachia lack resources and strategies to support the mental health and behavioral needs of students affected by the crisis.

To respond to these needs, the REL Appalachia team can identify and share tools and resources with educators to support students who are living with family or community opioid addiction and to articulate gaps in resources and knowledge of the topic. The REL Appalachia staff can share information with educators and other stakeholders about evidence-based and promising practices for addressing the effects of student trauma associated with the crisis. This includes identifying similar work being done in other regions and assessing practices relevant to this population that have not yet been applied to the opioid crisis, such as interventions for child welfare-involved children and families and trauma-informed approaches to treatment. The REL Appalachia team looks forward to ongoing conversations with educators and others about how to work together to address this high-priority concern.

Below are some preliminary resources that offer background information about the opioid crisis in the Appalachia region and some examples of federal and regional programs that support children living with trauma, especially those affected by substance abuse. Data from the federal programs in particular may offer insights into effective and innovative approaches that communities REL AP serves could adopt.

Background information on the opioid epidemic

• The documentary “Understanding the Opioid Epidemic” from the Public Broadcasting Service addresses the causes and effects of the current national crisis. Educators also can download several accompanying lesson plans from a curriculum for middle and high school students focusing on opioids.
  http://www.pbs.org/wned/opioid-epidemic/for-educators/

Resources on opioid addiction in the Appalachia region

• With funding from the Centers for Disease Control and Prevention, the Appalachian Regional Commission commissioned researchers at ORAU (Oak Ridge Associated Universities) to study “Communication about Opioids in Appalachia—Challenges, Opportunities, and Best Practices,” which included interviews and focus groups with experts and community members on prescription drug abuse.
  https://www.orau.org/health-communication/success-stories/report-communicating-about-opioids-in-appalachia.aspx
• West Virginia Public Broadcasting's podcast Inside Appalachia addresses the impact of opioid addiction on the region's young children in “Across Appalachia, Thousands of Children are Affected by Opioid Addiction: Who's Helping Them?”
  http://wvpublic.org/post/across-appalachia-thousands-children-are-affected-opioid-addiction-who-s-helping-them#stream/0
• This interview of a school superintendent in western Maryland describes how the opioid crisis has affected one school system and the steps educators are taking to combat it.
  https://www.edweek.org/ew/articles/2017/11/20/absences-trauma-and-orphaned-children-how-the.html

Federal and regional programs addressing trauma in children and youth

• The Substance Abuse and Mental Health Services Administration (SAMSHA) Regional Partnership Grant Program established regional partnerships of stakeholders working to improve outcomes of children placed out of their home because of a parents' substance abuse.
  https://ncsacw.samhsa.gov/technical/rpg-i.aspx
• SAMHSA's Children Affected by Methamphetamine Program (CAM) provides grants for programs to expand services to children and families affected by methamphetamine use and abuse.
  https://ncsacw.samhsa.gov/technical/cam.aspx
• The West Virginia Center for Children's Justice provides general information about drug- endangered children in the region.
  http://handlewithcarewv.org/index.php
• The Trauma-Informed Elementary Schools (TIES) program serves children in preschool through grade 1 who have trauma symptoms.
  http://wellspringwv.com/ties/

Practical resources

• Supporting Students Experiencing Trauma During the COVID-19 Pandemic. This blog post from REL Appalachia provides a variety of resources including the common symptoms of trauma, practical strategies for educators to leverage in virtual settings, and a resource to support school leaders in selecting interventions that align with their students' needs and contexts.
• Trauma Support for Schools. This website from REL Appalachia's Cross-State Collaborative to Support Schools in the Opioid Crisis (CCSSOC) includes extensive resources including mindfulness videos, training modules, factsheets, blogposts and much more for diverse stakeholders committed to supporting students and educators experiencing trauma.

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Footnotes:

¹Lipari, R. N., & Van Horn, S. L. (2017). Children living with parents who have a substance use disorder. The CBHSQ Report: August 24, 2017. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, http://www.samhsa.gov/data/population-data-nsduh

²Centers for Disease Control and Prevention, National Center for Health Statistics, as reported by Meit, M., Heffernan, M., Tanenbaum, E., & Hoffmann, T. (2017). Appalachian diseases of despair. Accessed at http://wonder.cdc.gov/mcd-icd10.html.

³Child Welfare Information Gateway. (n.d) The Relationship Between Substance Use Disorders and Child Maltreatment. https://www.childwelfare.gov/pubs/factsheets/parentalsubabuse.cfm.

⁴ https://www.acf.hhs.gov/media/press/2017/number-of-children-in-foster-care-continues-to-increase