Emerging evidence suggests that violence perpetrated against women who use and inject drugs may be worse than previously expected. In our recent investigation, “Violence Against Women Who Inject Drugs,” published in JAMA Network Open in March, my colleagues and I found that experiencing violence was nearly universal for women who inject drugs in Melbourne, Australia. Eighty-two percent had been assaulted at some time. Nearly 2 in 5 women had been sexually assaulted. 

Australia is often seen as a world leader in harm reduction, with strong systems to reduce drug-related harm and social supports that can help people access income, housing, and services for domestic and family violence. However, as with many high-income countries, women who use drugs are invisibilized in policies to end violence against women. Despite facing much higher risk of abuse than other marginalized groups, they are not recognized as a key priority population in Australia’s 10-year plan to end violence against women and children.

Women described major barriers to engaging in care. They feared stigma from their health care provider—or, more frightening still, that their children would be put at risk of removal.

While much violence is suffered alone and women are often reluctant to access medical care in the aftermath, nearly one in four women who inject drugs, according to our paper, presented to the emergency department due to assault over a 10-year period. Most of these women had severe enough injuries to be admitted to hospital. 

Only one in three women reported accessing medical health care after an assault, however, and this was typically contact with a counselor. In in-depth interviews, women described major barriers to engaging in care for their assault. They feared stigma from their health care provider about their drug use, for example—or, more frightening still, that their children would be put at risk of removal. 

Women who inject drugs are also often marginalized in other ways, and sometimes lack access to a phone or money for transport to engage with violence services that they need. 

This all heightens vulnerability when drug acquisition in unregulated markets and use under prohibition can be weaponized against women as a method of control. In these circumstances, control of access to methamphetamine, which is commonly smoked in Australia, may play a particularly sinister role in sexual coercion, according to past research.

My colleagues and I have been following up on these issues. In research examining violence against people who smoke meth, which has not yet been published, we found that two in three women reported recent assault over an 8.5-year period—at an average of six separate occasions of recent violence. Nearly one-third of women reported that the person who used violence against them was a current or ex-partner. One in six of the women had presented to an emergency department after being assaulted.  

Women who use substances rarely conform to society’s perspective of the “perfect victim.” Public and institutional ideals about who is believable, deserving of sympathy or worthy of protection are often shaped by entrenched stigma towards people who use drugs. 

In many countries, responses to violence against women still fail to account for how stigma, substance use, and gendered power intersect.

When a woman is known to use drugs, signs of abuse can be dismissed, minimized or interpreted through criminality and disorder, rather than vulnerability. Consequently, violence towards this population is somehow seen as expected or even deserved. Alternatively, women are at risk of being misidentified as the primary aggressor in an abusive situation.

For many women, children become a powerful tool of coercive control. Partners can threaten to report drug use and manipulate child protection or custody fears. Women may stay in dangerous relationships, avoid health care or withdraw from support services not because they do not need help, but because seeking it, or disclosing the complete context of their situation, can be too high-risk.

The invisibilization of women who use drugs is also reflected in drug and violence policy. Resourcing and attention are more likely to be paid to those groups identifiable within formal policy documents and commitments. In Australia, harm reduction policy does not adequately address the issue of violence and ending-violence policy does not adequately identify people who use substances. And Australia is unlikely to be unique. 

In many countries, responses to violence against women still fail to account for how stigma, substance use and gendered power intersect, leaving some of the most vulnerable women outside of public discourse, unsupported and alone.

Photograph (adapted) via the CDC

The post We Need to Focus on Violence Against Women Who Use Drugs appeared first on Filter.

For decades, the Motherisk Drug Testing Laboratory at Toronto’s Hospital for Sick Children ran hair-strand drug tests to assess whether pregnant people and parents—mostly mothers—were fit to care for their children. These tests were later found to be unreliable and far below forensics standards, lacking basic safeguards like proper validation, quality control and independent oversight.

Motherisk was no marginal operation. Between 2005 and 2015 alone, the lab tested more than 16,000 people for “child protection” purposes. More than 100 child welfare agencies across five provinces relied on its results. Millions of public dollars were spent on inadequate testing that shaped decisions with lifelong consequences. 

My youngest child was apprehended from the hospital at just two days old, based on compromised and unreliable drug tests.

I became involved with the Children’s Aid Society, Toronto’s primary child welfare organization, due to allegations related to marijuana use while breastfeeding, resulting in years of drug testing and restricted access to my children. In 2008, my youngest child was apprehended from the hospital at just two days old, based on compromised and unreliable drug tests from the Motherisk program.

These faulty results were used to justify decisions that led to me losing custody of my children for more than a decade. Even after the testing failures were acknowledged and apologies were offered, the stigmatizing narratives in court records and case notes were never corrected. I continued to be portrayed as an unfit parent.

A 2018 review largely focused on “fixing” flawed testing methods and oversight. But by framing the problem as a technical failure, we avoided a harder conversation about the deep-seated biases—the moral judgments about drug use and parenting—that made this junk science so easy to believe in the first place.

Motherisk thrived because it replaced human uncertainty with apparent objectivity. It allowed drug use to become a shortcut to judge parental fitness, equating abstinence with good parenting and any drug use with so-called abuse. This was despite decades of medical experts saying that drug testing cannot assess parenting capacity, and Ontario law not even listing drug use on its own as a reason for children’s aid involvement. 

This impulse to “catch” parents rather than support families remains institutionalized today.

Nevertheless, biases and racism of social workers and other professionals continue to drive the reporting of families for drug use, scaring parents and their children away from seeking the very care and support they need. 

This impulse to “catch” parents rather than support families remains institutionalized today through “duty to report” rules. In shelters and other social and health services, staff often feel pressured to call children’s aid even when there is no imminent risk, simply because they are not trained in alternatives and fear legal penalties. 

In Ontario, there were roughly 125,000 calls to children’s aid in 2024-2025, leading to over 63,000 investigations. This surveillance disproportionately targets Indigenous and racialized families.

Framing drug use as a proxy for parenting capacity shields decision-makers from many of the real issues harming families: poverty, inadequate housing, and structural inequality. 

The lesson is not that we need “better” tests. It is that we must end our over-reliance on the child welfare system.

I have experienced the trauma that comes from this firsthand, which caused lasting psychological harm and permanently damaged my sense of safety within health care and child protection systems. Even now that my children are young adults, this painful chapter remains central to my family history.

The lesson of Motherisk is not that we need “better” tests. It is that we must end our over-reliance on the child welfare system as a primary response for ensuring family safety. Families are safer when they are supported with housing, health care, and trusted community-based support—not torn apart by systems that surveil, punish and separate. Skilling up social service and health care workers to learn about alternative responses to mandated reporting should be a first-line prevention strategy.

The science is settled. The unresolved question is why our institutions continue to cling to the same moral judgments that allowed junk science to shatter so many families in the first place.

Anne-Rachelle Boulanger, a lawyer and policy analyst at the HIV Legal Network, and Kathleen Kenny, a postdoctoral research fellow at the College of Global and Community Health at the University of Manitoba, contributed to this article.

Photograph (cropped) via PickPik

The post Ten Years After Motherisk, Parents Who Use Drugs Still Punished appeared first on Filter.

I rested my arms on the ledge of the fogged window, swiping at it so I could make out every detail of what was inside.

My mother was much skinnier than when I’d last seen her, over six months previously. Her favorite band shirt used to sit snug against her skin. Now, she was drowning in it. Her belly showed no hint of having carried life. It was hard to believe the newborn nestled in her arms had just come out of her frail body.

My sister’s fingers wiggled toward our mother, almost mimicking the slow rhythm of the beeping monitors that watched over them. IV drips poked into her arms, tubes pushed oxygen into her nose, and patches pressed into her chubbed skin. She blew bubbles and looked right up at our mother. Their eyes met in a silent union, passing something somber back and forth—perhaps a goodbye.

That was in the spring of 2018. I was 14. I never saw them together again. 

***

My father’s two-bed apartment was cramped. His pregnant sister, her boyfriend, and their toddler were staying with our family after losing their home. We lived off my father’s welfare check, barely making rent. Food stamps never seemed to cover enough to feed us all. We couldn’t afford heat. Most of the time, I’d stay with friends so I could get fed, shower and clean my clothes.

When I was home, I’d often find my father in his recliner, lost in his high, the floor littered with wrappers, cigarette butts and empty pill bottles, and the fridge empty aside from dried condiment crusts and molds.

I was doing what I could to get by, and I knew my father was too. He tried to find work, but nowhere would take someone on methadone. He loved me and took care of me in the ways he could.

She was silent for days, until I caught her whispering to my father, “I’m pregnant.”

My mother walked out in early 2017. This wasn’t unusual; it had happened on and off since I was a toddler. When she was around, it never felt that she was. I’d pester her for attention, to try to win her love. But even winning a smile or hug was hard. Her distance hurt, but I understood. I’d seen her emotionally torn apart and physically abused by every man she’d thought would be the one to finally save her.

Her return in December that year, from another man who’d hurt her I presumed, was different. She was skin and bones, with bruises up her body. Her eyes were dim. She was silent for days—until I caught her whispering to my father, as I watched from between the rails at the top of the staircase, “I’m pregnant.”

That was my tipping point. I couldn’t bear the thought of another child living through all of this—in fact, I couldn’t bear to live through it anymore, either. That night, I called some relatives and begged them to let me stay. Days later I left, cutting off communication with my parents.

I ended up living with those relatives for years. Perhaps they took me in out of the goodness of their hearts, but they sought to convince me to resent my parents, for getting high instead of taking care of me. They surveilled and controlled my every move, to turn me away from becoming like my “welfare-leeching, druggie parents.”

I still don’t know why they let me see my mother and newborn sister in the hospital. Perhaps they knew, like my grandmother who insisted I come, that this might be my only chance to meet my sister.

When I got back, I brought them piles of questions. They made clear to me that my mother’s feeble state, my sister’s long stay in the hospital and their impending separation were the result of my mother “relapsing”—that she cared more about “scoring drugs” than protecting her unborn child.

And this is what I assumed to be the truth, until a few months ago.

***

Five years after my youngest sister was born—five years of confusion, anger and fear after 14-year-old me watched their final tender moment together—I finally grew the courage to ask my mother what happened.

Getting to this point wasn’t easy for either of us.

After arriving at Stanford, having wealth and privilege shoved in my face, I felt worse than ever about what I’d been through. I longed for answers and for resolution with my parents, particularly my mother. I started calling, making slow efforts to have her be a part of my life. And after a while, it became routine for us to talk over the phone, often about the past.

“The clinic made me go through withdrawal throughout my entire pregnancy.”

One day, I asked her about the pregnancy, recalling how our relatives thought she was using.

“It never had anything to do with me using drugs,” my mother told me. “I was sick, which made the baby sick. And that’s because the clinic made me go through withdrawal throughout my entire pregnancy.”

By the time she was pregnant with my sister, she had been at the same methadone clinic for around 15 years. She’d been one of the first patients to walk through the doors the day it opened.

In her eyes, and to clinic staff, she’d been the perfect patient. She made it to all her counseling sessions. She had clean urines. She was friendly with the dosing nurses and the clinic director, and built a strong relationship with her counselor. She’d had her take-homes for years and never had a problem keeping them.

When her random monthly drug screening came back indicating that she was pregnant, her counselor was very sweet about it and congratulated her. But the counselor said nothing about what the methadone stabilization process would look like during the pregnancy.

At the time, she was at 49 milligrams, much lower than the dose she’d long been on. About five years earlier, an ex-boyfriend made her try to get off; she was at 3 mg by the end of their relationship. Getting back up to a dose that made her feel well took years; the clinic only allowed patients to go up a maximum of 5 mg at a time—if their request was approved by the doctor.

At 49 mg, she was still on a low dose compared to what most other people she knew at the clinic were receiving.

“If you go up, you know what’s gonna happen. You’re gonna have to come every day again.”

Considering all this, when my mother came back to her counselor a few weeks after learning she was pregnant, expressing her need for a higher dose because she was starting to experience symptoms of withdrawal, she expected they would raise her dose right away.

Her counselor wouldn’t allow her to go up by even 1 milligram.

“Right away,” my mother recalled, “my counselor’s like, ‘Well, if you go up, you know what’s gonna happen.’”

“And I’m like, ‘What do you mean?’”

“And she tells me, ‘Well, you’re gonna have to come every day again.’”

The threat shocked my mother. She began to explain that she couldn’t get to the clinic every day. It was two hours away from where she lived, and she had neither a car nor the income to afford other transportation. Just getting there every Monday to pick up her weekly take-homes was extremely burdensome.

But the counselor knew all of this already.

“My counselor told me that if I wanted to go up, I’d lose my take-homes because I’d be considered ‘unstable,’” my mother said. “But I was pregnant, and I knew I was going to get super-sick. They shouldn’t have been worried about me being ‘unstable’; they should have been worried about my baby inside me being unstable.”

She’d been through withdrawal plenty of times, and that wasn’t her main concern. It was about the baby, and the fact that she was going to go through withdrawal too. “How is it fair,” she asked me, “that the baby inside me has to suffer because the clinic wouldn’t let me up my dose?”

As the pregnancy progressed, she began losing a lot of weight. Her belly shrank. She was severely dehydrated and vomiting nonstop. Severe anxiety prevented her from being able to sleep.

“It got to the point where the baby inside me was kicking as if she was in pain and trying to get out,” she said. “The kicks were violent. It was terrifying. I was so sick that when I’d go to my baby-doctor appointments they’d send me to the ER, where I’d be hooked up to an IV all day—or for even two days. The clinic knew that I was being put in the ER for that, and they still didn’t care. It didn’t register that they were causing this harm.”

She kept going back to the clinic, asking for a higher dose, but they always denied her requests. Eventually she stopped asking, afraid they’d see this as “drug-seeking behavior” and take away her existing take-homes.

“It’s like they were making me go through withdrawal to pressure me into coming in every day, so they could make more money off me.”

Her pregnancy with me, while attending the same clinic, had been nothing like this. Before, she’d been able to go up in her dosage as much as she needed. And clinic staff had been extra cautious, she said, to make sure she wasn’t experiencing any withdrawal symptoms.

Back then, my mother and father had a car and an apartment together. She’d been working evenings cutting hair, and he was in school. Somehow they managed to make the two-hour drive to the clinic every morning.

They were determined to do everything they could to set up a good life for me. But the exhaustion cultivated by the clinic set in, and it all slowly began to fall apart. Their car: gone. Her job: gone. His college degree: gone. Their hopes and dreams for the future: gone.

Years later, the weekly take-homes they’d “earned” could not undo this.

“This pregnancy was so unique because of my take-home status,” my mother explained. “When I was going every day, they didn’t care how high they’d dose me. They treated me like gold when they could charge Medicaid every time I dosed in front of them. It’s like I had more freedom when I didn’t have take-homes.”

Being able to make that comparison informed her understanding of why things were different this time around. “I started to realize it wasn’t about them caring that being on too much methadone would hurt me or my baby,” she said. “It’s like they were making me go through withdrawal to pressure me into coming in every day, so they could make more money off me.”

I approached Dr. Bruce Trigg, an experienced clinician and former medical director of a methadone clinic in Tucson, Arizona, with my mother’s story, asking him how methadone providers should handle pregnancies.

He was shocked at how low a dose she’d been on at the start of her pregnancy.

Dr. Trigg made clear that dose increases during pregnancy are the medical standard.

“Forty-nine milligrams of methadone is nothing,” he said. “The therapeutic dose is 80-120 mg … So why would someone be stuck at 49 mg for a long time like that? It makes no sense—that’s only half the therapeutic dose.”

Trigg also made clear that dose increases during pregnancy are the medical standard. “Throughout pregnancy, especially in the third trimester, the body’s fluid volume increases, and there is no question that women need higher doses.”

During pregnancy, the person “should not be experiencing withdrawal, because if they’re in withdrawal, the fetus is in withdrawal,” he said. “And that’s exactly what you want to avoid and that’s exactly why you want them to be on an adequate dose.”

There is no rule for methadone clinics, Trigg said, that stipulates you must dose daily at the clinic in order to get your dose increased during pregnancy. What was really happening, he believes, was stigma.

“The assumption [among clinic staff] is often that the patient is trying to ‘get something out of us’—trying to get high or trying to get more methadone than they need,” he said. “But anyone with experience, who’s picked up any book about methadone and pregnancy, [should know that pregnant people] need more methadone.”

Taking patients’ requests seriously and communicating with other providers throughout a pregnancy are critical to ensuring best outcomes, he added.

“Ideally, your mom would have had an OB-GYN, who had some experience working with women [on methadone], and would have been in communication with the doctor at the methadone clinic,” he said. “But, the reality is, that is super-rare [because] methadone is a complete standalone system.”

***

Eight months into her pregnancy, my mother had her yearly exam at the clinic, and that’s where she met the new doctor. He was unable to tell that she was pregnant, and she had to explain the whole situation again. But when she did, he increased her dose without hesitation—raising it from 49 to 59 milligrams during the last month of her pregnancy at 5 mg intervals, as confirmed by the dose history provided by my mother’s current clinic counselor.

“And that’s all it took,” she told me. “So if their line the whole time was that I couldn’t go up without losing my take-homes because ‘It’s the rules,’ then how was that newer doctor at the end able to up me by 10 milligrams without taking my take-homes from me? They flat-out lied to me, and nobody took responsibility. The damage was done.”

Despite this increase, she still experienced symptoms of withdrawal. And just before she was due to give birth, a sonogram revealed she had only a quarter of the amniotic fluid that would normally be present. Because of this, she underwent an emergency C-section.

My sister was immediately put in the NICU, on constant watch for 20 days until her condition stabilized. My mother came to the hospital everyday to bathe her, change her diapers, feed her and spend as much time with her as she could.

She told me how hard it was to see her baby have to deal with these health problems. She cried out to me over the phone how badly she’d wished for a better life for my sisters and me, how she’d give her life for us.

I did everything I could to not break down in that moment, knowing how much she already gave up for us when she never should have had to.

“My body was so beaten down because of the withdrawal,” she told me. “I had no job, because I’d lose my insurance and wouldn’t be able to afford to stay at the clinic if I did [get one]. And even if I did, how was I supposed to bring a newborn baby to the clinic by myself?”

“So I decided to give her up for adoption,” she whispered, “so she could have a normal family that could actually take care of her. It hurt me to have to do that, but her wellbeing was more important than anything to me.”

Until recently, my mother heard nothing of her daughter. Then, a little over two years ago, she received a call.

At the last minute, a family friend had offered to take her baby in, so that my mother would still be able to see her. My mother went to court to sign over custody, thinking she could stay connected to her child. This didn’t end up being the case. And up until recently, my mother heard nothing of her daughter.

Then, a little over two years ago, she received a call from child services. Over the phone, the person assigned to the case told my mother that her daughter had been taken into custody by the state, after they’d deemed her previous living situation unfit. Then, without informing my mother, they had placed my sister with another family.

After that phone call, she felt helpless. Fighting for custody, to her, seems like a battle she could never win. The harm done by the clinic cannot be undone.

“I was furious that I wasn’t the first person they’d call in making the decision,” she said. “They’d called my ex-boyfriends, who weren’t even related to the baby, and asked them if they’d be willing to take her in before they even tried calling me.”

“I’d expressed that I wasn’t comfortable with the placement they’d decided on because I wanted her to be in a drug-free environment,” she said of that phone call. “And he made a sarcastic comment, asking me if I was trying to say that I was sober too. He knew from the case file that I was on methadone. So, it felt like he was saying that I was unfit to take care of her either, because I was on methadone.”

“It’s really hard on me thinking back and knowing that if it would have been different, my baby’s life, my life and your life could have been so much better,” she said.

One person’s decision to stabilize my mother on methadone properly during her pregnancy with me might have been what allowed me to arrive with no complications, to stay with my parents and away from foster care, and to have the honor of knowing my mother, her story, her bravery and her love.

But one person’s decision to not up her dose, to force my mother through withdrawal while she was pregnant, afforded my sister a much different reality, with consequences unforeseeable.

My mother lost her child. My sister lost her mother. And I lost my sister.

“I really hope I live to see the day that this system ends.”

“I’m trapped at the clinic like I’m a prisoner, and I have to just sit here and watch silently as the people that run this whole system do everything they can to make my life miserable, to line their own pockets with cash because they know I need my medicine,” my mother said.

“Imagine I didn’t have to be there every day and could just get my medicine at a pharmacy like everyone else; that I didn’t have to have a nurse watch me take my medicine because I’m seen as being untrustable; that I didn’t have to be watched while I peed in a cup every month to prove my worth to live with ‘clean’ piss.”

“Imagine I didn’t have to go through withdrawal for nine months and be told by everyone that I was a bad mother because of it—when all along it has always been the clinic’s fault.”

The thing is, she didn’t have to tell me to imagine it. I imagine it all the time. I imagine my mother sitting in the same position with my newborn sister—but instead of monitors, IVs, oxygen tubes and patches, they’re surrounded by bright pink balloons, bouquets of flowers and a pile of stuffed animals.

I imagine myself in that room. I imagine my mother telling me, “Isn’t she so beautiful?” I imagine her putting her in my arms, looking up at me and then down at her, cupping her cheek, and whispering, “Look, that’s your big sister. She’ll always be by your side—just like me.”

This could have been our reality, and maybe it still can be for someone else.

“I know so many parents who have suffered and continue to suffer because of how awful the clinic is to them,” my mother said. “It can’t stay this way. I hope I don’t spend the rest of my life stuck at the clinic. I really hope I live to see the day that this system ends—where methadone clinics are a thing of the past.” 

Photograph of the author’s mother with another sister, courtesy of the author

The post Pregnancy in Withdrawal: Methadone Clinic Tore My Family Apart appeared first on Filter.

I tucked my face into my chest and rolled in the yellowed sheet. Crisp edges of cigarette burns scraped against my skin.

“C’mon, please get up.”

I peeled my eyes open, only to be blinded by the digital alarm clock flashing, in fluorescent green numbers, “03:00 AM” over and over again, as it did every Monday morning. It continued to buzz, vibrating violently against the wooden dresser.

“Dad, turn it off,” I whispered, afraid that chips of wood would fly at my face.

“Can you pee for me, buddy?”

“I really don’t wanna.”

“I can’t come back hot, buddy, you know that. I’ll lose everything. If I don’t get my medicine, you know I’ll get super-sick.” He paused and grabbed my hand. “They’ll take me away from you.”

“Dad, I just don’t get it.” I tugged nervously at a loose thread on my pajama pants.

“Buddy, I need my other meds. They help me get moving in the day. They help me feel good, so I’m able to take care of you and Mom.”

“Well, why don’t you just tell your doctor that you need them?”

“He won’t listen. They just don’t understand. They think they’re bad—that we shouldn’t be on anything but what they give us. But they don’t know what it’s really like. They don’t know how hard it all is.”

I filled it up the whole way, just to be safe. “Here, Dad.”

I sat quietly.

He pulled out an empty pill bottle from his back pocket and put it on the bed. “Can you please just do this for me?”

“Okay, okay.” I took the pill bottle and started walking down the hall and into the bathroom. He followed close behind.

“You think you can fill it up about half-way for me?”

I filled it up the whole way, just to be safe. “Here, Dad.”

He twisted a cap on, put it back in his pocket, grabbed my hand and walked me downstairs.

My mother was kneeling on the floor, smearing brown eyeliner on the outer corners of each eye into little wings. She was dressed in her nicest clothes: her embellished Miss Me jeans, a striped Old Navy sweater and a large, faux fur-lined coat. Her curls were full, cascading down her back. She turned toward us, revealing perfectly lined lips and bronzed eyelids.

“I think Mark’s here. Everyone ready to go?”

We zipped up our coats, stepped out into the cold, made our way to the car, and began our two-hour journey upstate to one of the only clinics in Blair County, Pennsylvania. We’d done this each and every Monday for what felt like my entire life—all seven years of it.

It was hard to believe there was a time when we had to go up there every single day.

The author holding methadone bottles as a baby

I sprawled across the back seat and watched the snow fall into the valley off of I-99. I nodded in and out of sleep, picking up chuckles, soft melodies of Nirvana and 311, and stories of high school parties and drunken campfire accidents—of the “good old days” before Oxy, prison, probation and clinics.

I knew we’d made it when the car began to rock, as the tires fought against the gravel of the parking lot. I groaned as I stepped out and was met with fierce gusts of wind. My Spiderman PJs did their best to protect me against the cold.

I followed behind my parents as they made their way to the end of the line, near the bottom of the metal ramp that wrapped the exterior of the building. Dim overhead lights revealed foggy breaths and sharp, anxious movements.

The wait was long. I stared at folk in line until they’d begin to stare back. Voices and stories melted into one another.

“Isn’t it funny that this is supposed to make me normal—going to this place.”

“I can’t stand waiting in this fucking line any longer. It’s too damn cold to be out here like this. It’s like they don’t even see us as human,” one older man muttered.

“Why ain’t anybody movin’ up?”

“Please tell me you got you some xannies. They cut my dose.” The plastic from a small sandwich baggie reflected light into my eyes.

“C’mon let’s go!”

“This shit’s killing me, and they know it. They just want the fucking money. But I guess I’m the idiot who’s waiting in line at the slaughterhouse, huh.” Nervous chuckles followed.

“Isn’t it funny that this is supposed to make me normal—going to this place,” a woman said. “How am I supposed to be normal when I’m standing out here in the freezing fucking cold every day—and I’m missing work most of the time to do it! If I lose my job, I’m gonna lose the kids. This is a fuckin’ nightmare.”

“I’m never getting out of this. I’m gonna keep coming back to this line until I die.”

Once we made it indoors, I ran over to the play area with the other kids. I fought to grab any toy I could, then sat on the matted carpet and watched my mother and father continue to file through the line.

Eventually, my father reached the plastic, bulletproof border, where he was greeted by the nurse on the other side. He handed over his take-home box.

“Okay, looks like you have your urine today, so let’s go test ya.”

My father turned back. But he had forgotten to tuck the empty pill bottle back in his pants.

The nurse stepped into the main lobby, handed my father a large cylinder cup, and waved his hand toward the bathroom. “Just follow me into here.”

My father stepped inside, positioning himself, as he later told me, to avoid the direct gaze of the nurse. He carefully pulled the pill bottle out of where it was tucked in his pants, and began to pour out my urine, trying to mimic the flow of urination into the test cup.

My father turned back. But he had forgotten to tuck the empty pill bottle back in his pants.

The nurse looked down at the bottle, then back up at my father, with a disapproving glare.

My father handed the urine test back, fearful of what the nurse would say.

“I saw your kid out there. Don’t let me catch you again.”

The nurse waved him out of the bathroom, walked back behind the plastic border, pulled out his dose and handed it over.

After he swallowed it, the nurse signaled him to open his mouth, carefully checking to see that he swallowed every last drop. The nurse then filled his take-homes and slid his box across the counter.

“Next!”

My father walked over to me. He picked me up and pinched my cheek. He grinned as he whispered, “Thanks, buddy. I love you.”

I hugged him back. “I love you, too.”

Photographs courtesy of Aden McCracken

The post “Can You Pee for Me?” A Childhood Under the Methadone Clinic System  appeared first on Filter.

Researchers found that 8,986 children and adolescents under 20 died of opioid-involved overdose in the United States between 1999 and 2016, with the mortality rate increasing almost three-fold over that period. Of the total, almost 20 percent were classified as “intentional” deaths, such as suicide or murder.

In contrast to today’s overdose crisis in the general population, prescription opioids, which may be more accessible to minors, were involved in over 70 percent of those teenage deaths. Heroin, a drug frequently involved in drug-induced homicide cases, was involved in 1,872 deaths of 15- to 19-year-olds between 1999 and 2016. Despite a steep increase over the period, such deaths remained relatively low by 2016, in a national context of over 42,000 opioid-involved deaths and over 15,000 heroin-involved deaths that year.

When local media in Arizona last year reported that teens are overdosing at “alarming rates,” and that “teens as young as 14 years old have overdosed and died” after taking fentanyl, it may not have been wrong—any such deaths are alarming—but it omitted this context of relative rarity.

At the end of 2021, a handful of state lawmakers filed House Bill 2021—a drug-induced homicide bill with a twist.

It would classify the charge as a “dangerous crime against children” when the person who died is under 15, increasing the mandatory minimum to 35 years without parole.

If passed, it would make drug-induced homicide (with the legal moniker “drug trafficking homicide”) a felony, with a mandatory minimum prison sentence of 10 years. Such laws have long been condemned by harm reduction advocates.

But what’s more, this bill would classify the charge as a “dangerous crime against children” when the person who died is under 15. That would increase the mandatory minimum sentence to 35 years in prison without a chance at parole. Virtually all of the 41 crimes that currently qualify as dangerous crimes against children under Arizona law involve rape or sexual abuse.

In practice, this enhancement would almost never apply. But this supposed “child protection” element—in fact, drug-induced homicide laws do nothing to reduce overdose—was arguably included to make it even more politically difficult for any legislator concerned with re-election to vote against it. HB 2021 is also named the Ashley Dunn Act—after a young woman who recently overdosed and died, at age 26.

The bill has also exposed growing fault lines in the ranks of Arizona’s top local prosecutors. Yavapai County Attorney Sheila Polk helped Ashley Dunn’s mother through the process of getting legislators to pick up the issue, according to a segment on KYCA Radio.

On the other hand, Laura Conover, the newly elected prosecutor of Pima County (Tucson), the second largest in the state, testified against the bill. Her Twitter account argued that it would “fail to mitigate the tragedies of fentanyl, like other failed drug policies have done little to nothing to address substance use disorder.”

The Arizona legislature is conservative and carceral, so it would be surprising if Conover’s opposition to HB 2021 prevailed. However, it displays one of the less-appreciated aspects of the movement to elect reform-minded prosecutors. Conover’s testimony shows lawmakers that law enforcement officials do not represent a unified cabal against smart drug policies. That gives lawmakers more political cover to do the right thing.

Traditionally, elected prosecutors have formed lobbies to perpetually demand more and harsher punishment, despite those policies’ failure to drive increases in public safety. Breaking from that mold has a tendency to provoke backlash from “tough on crime” interests.

However, Conover treads a line that makes her difficult to pin down as a “progressive” prosecutor. She does not shy away from certain criminal justice reform positions, describing arrests for drug possession and paraphernalia, for example, as leaving her community “unhealthy and less safe,” and declaring, “The death penalty is over.” In late 2021, Conover announced her intent to no longer prosecute drug possession due to COVID-19 risks.

But neither does she pitch herself as radical. Indeed, local grassroots organizations like Mass Liberation have sharply critiqued Conover for her relationship with the police; on the campaign trail, she frequently referred to lessons she said she’d learned from her brother, a sergeant with the Tucson Police Department, and she has done “ride-alongs” in office.

That said, when influential writers and organizations smack “progressive prosecutors” down, her name is hardly ever included. State lawmakers are not demanding that Conover resign, like they are doing with Philadelphia DA Larry Krasner in Pennsylvania, and she is likely to stay in office longer than her higher-profile counterparts in Baltimore and Boston. In a conservative political landscape, that could be of significant help to people who use drugs.

Photograph of Arizona state capitol by Wars via Wikimedia Commons/Creative Commons 3.0

The post Arizona May Enact 35-Year Mandatory Minimum for “Drug Trafficking Homicide” of Kids appeared first on Filter.

The legislation is intended to address the city’s skyrocketing rates of homelessness amid the pandemic. An estimated 122,926 people were in the city’s municipal shelter system each night in 2020. In March 2021 alone, more than 50,000 people slept in the shelter system, including nearly 17,000 children. 

“[This is] absolutely a victory that was won through blood, sweat, and tears of homeless people who never gave up the fight,” Amy Blumsack, director of organizing and policy of the Community Action Program at Neighbors Together, told Filter. 

Obtaining housing vouchers through CityFHEPs, the main housing subsidy program, is a key pathway for low-income New Yorkers to find an apartment, single room or other home. If people meet the criteria, including having a gross income at or below 200 percent of the federal poverty level, they can apply for the vouchers in person or online. But the vouchers are worth just $1,265 per month for a single occupant, or $1,580 per month for a family of four. These values do not meet the median rent in any New York City neighborhood. 

Intro. 146 will remove the time limits on the vouchers’ eligibility and increase their value to Section 8 levels, as designated by the federal government. This translates to immediate, direct increases: up to $1,900 for individuals, and $2,217 for a family of four. This puts the vouchers closer to median rents and could make an estimated 70,000 more units accessible to voucher holders. 

“We need to first and foremost give credit to the many directly impacted people who have led the charge,” Jacquelyn Simone, senior policy analyst at the Coalition for the Homeless, told Filter. “[The] passage wouldn’t have happened without relentless advocacy led by people who are homeless or were formerly homeless and pushed for this bill to pass.” 

“We cannot begin to address systemic racism unless we’re ensuring that all of our neighbors have access to the safe, affordable housing they need.” 

Insufficient value has not been the only issue with rental vouchers. People who attempt to use them are often discriminated against; many landlords will reject vouchers outright, despite it being illegal to do so. And Black and Brown New Yorkers are disproportionately impacted both by homelessness and by such discrimination.

“We talk about housing in a silo, but housing justice is racial justice,” Simone said. “We cannot actually begin to address systemic racism unless we’re also ensuring that all of our neighbors have access to the safe, affordable housing they need to thrive.” 

Advocates have long pushed to increase the value of the vouchers, but Mayor Bill de Blasio’s office had openly opposed it in previous years. Although the bill has finally passed, last-minute changes to the language could still perpetuate re-cycling through the shelter system.

For someone to be eligible for the vouchers now, they must earn under 250 percent of the federal poverty level. That threshold currently stands at $32,200 for a single adult. Earning even a dollar more than that would end a person’s eligibility. Previous versions of the bill required that voucher eligibility ended when rent was 30 percent of income.

“This will force [people] to choose between a living wage and housing,” Blumsack said. “It doesn’t set anyone up for success. In NYC, you can’t magically raise your income enough to be able to afford market rent when you lose your voucher.”

Blumsack stressed that this requirement shows the importance of continuing advocacy and community organizing. “It’s unfortunate that this was the end result,” she continued. “We’re disappointed—and we don’t want to lose sight of the victory we have won. It’s a big step forward for the homeless, but the work is not done.”

Photograph by Warren LeMay via Flickr/Public Domain

The post NYC Raises Value of Rental Assistance Vouchers, Expands Eligibility appeared first on Filter.

“I’m ugly,” she added. “I’m dumb.”

These aren’t things that she or her 6-year-old sister have been told at home—at least not that I’ve heard. Since the moment she was born and placed on my breast, where she immediately latched on and nursed contentedly for almost an hour, she’s been showered with love and affection. Neither child has ever experienced anything resembling abuse or neglect.

But in early 2018, a little over a month after I hauled my family from our home in Seattle to my in-laws’ home in Broward County, Florida so their father could recuperate from mental illness, he and I were removed from the home—and our daughters from our custody—by child services.

This followed an argument I had with my in-laws, after which they made allegations of abandonment and drug use against me. The abandonment charges would eventually be dismissed, and the claims of drug use negated by slews of tests. But by that point, my daughters were already living with them, I was already homeless in a strange state without resources, and we were ordered to complete numerous requirements within 15 months. When their father and I did not complete those mandates in time and to the court’s satisfaction, our parental rights were permanently severed. Our daughters were adopted out to their paternal grandparents.

When the removal first happened, my youngest had just been weaned from my breast; my sudden abduction from her daily life broke an unspoken covenant of love and trust between us. She has never received an explanation that she can understand. It’s become clear to me that she is doing what so many children in this painful situation do: blaming herself, and transmuting the pain into self-harm.

Traumatic Separations Within Our Borders

Sadly, what my babies are experiencing is not uncommon.

“I hated myself. There’s a lot of self-loathing because you feel like there’s something wrong with you. It’s like trying to fit a puzzle piece into a puzzle where it doesn’t belong,” recounted Pennie, who asked that she be identified by her first name only. Now 51, she was adopted out of the foster system by a Mormon couple at the age of 11, while her mother was undergoing psychiatric care.

“I don’t think [the adoption] was right. I feel my mother was vulnerable and they just kind of redistributed me to a wealthier [family] … [but] you need more than clothes and food as human beings and human children.”

The public is familiar with the concept that wrenching children from their families is harmful and wrong. When news broke about the Trump administration policy to separate children and parents at the Mexico-US border as a de facto punishment for seeking asylum, media responded with a flood of stories describing the extreme trauma inflicted.

These articles widely failed to address the parallels between the separations at the border and the separations within our borders.

The Associated Press reported children’s symptoms ranging from inconsolable crying, to chest pains, to delusions and night terrors, with the possibility of growing into depression or cancer in adulthood. Child psychiatrist Dr. Gilbert Kliman told the AP that he predicted, “an epidemic of physical, psychosomatic health problems that are costly to society as well as to the individual child grown up. I call it a vast, cruel experiment on the backs of children.”

Dr. Colleen Kraft, president of the American Academy of Pediatrics, was quoted in an article published by the University of Michigan School of Public Health: “We know very young children who are exposed to this type of trauma go on to not develop their speech, not develop their language, not develop their gross and fine motor skills, and wind up with developmental delays.”

But these articles widely failed to address the parallels between the separations at the border and the separations within our borders. Through the so-called child welfare system, children are not only wrenched from their families suddenly and without regard to their needs and desires; they are also funneled through an expedited adoption scheme that leaves children forever wanting their parents. These adoptions are often conducted in less than two years, even when the only issue facing a family was poverty or substance use.

“A huge problem in our field … is that in our obsession to achieve ‘permanency,’ we are often forcing families into arrangements they don’t want,” Vivek Sankaran, clinical professor of law at the University of Michigan Law School and director of the Child Advocacy Law Clinic and the Child Welfare Appellate Clinic, told Filter. “This is particularly acute in situations involving substance use, where it does take, as we all know, time for folks to heal and to recover and to address the trauma that might be contributing to an addiction.”

As Sankaran observed, this timeline realistically leaves very little space for recovery from substance use disorder.

Enormous monetary boons, built into the foster system via the Clinton administration’s Adoption and Safe Families Act (ASFA), require agencies to file for termination of parental rights once a child has been out of home-care for 15 out of 22 months, or else risk losing funding. Exceptions exist, including when a child is in kinship care, like mine were; or when it is not in the best interests of the child to sever ties to their parents, which some argue constitutes the majority of cases. But agencies are not obliged to make those exceptions.

The severing of children from their families takes place in a whirlwind procedure paraded as an act of necessary saviorism. “To me, adoption is ownership … Your birth certificate is like a title to your car, a deed to your house. I feel like I was literally signed over like a product. It turns children into commodities,” said Pennie.

And, as Sankaran observed, this timeline realistically leaves very little space for recovery from substance use disorder, which often involves the need to address co-occurring or pre-existing trauma and mental illness, and rarely results in total abstinence right away (if at all).

In fact, recent research out of Canada found that the act of separating mothers who use drugs from their children increased the incidence of chaotic substance use and non-fatal overdose. This was compounded for Indigenous mothers, whose overdose rates were doubled within the study’s cohort.

Pennie’s story offers another example of the extreme harm imposed by child services on parents who use drugs; although her mother previously struggled with mental health concerns and used substances, it was only after losing her child that she became addicted to heroin.

They were silent for a moment. What do you say to someone who is telling you that they would prefer to endure rape again, rather than what you’re doing to them?

Having undergone the violence of child removal and rapid, forced adoption, I know intimately how damaging the adoption system is to parents, particularly those struggling with trauma or substance use. During my required mediation prior to the termination filing, I looked the attorneys in the eye and told them that this was the worst thing that had ever happened to me. Worse than the sexual and physical violence that caused the post-traumatic stress disorder (PTSD) that they had trotted out as proof of my parental unfitness.

They were silent for a moment. What do you say to someone who is telling you that they would prefer to endure rape again, rather than what you’re doing to them?

Then, in a rather sheepish tone, the attorney for the state, a stand-in from the drug court system due to staffing issues, admitted that before the ASFA timeline, parents with addiction had “a chance.” But not anymore.

“Kids want their parents, they want their mother … This system has been allowed to develop to be a hammer and treat every case like a nail,” said Tracie Gardner, vice president of public policy at Legal Action Center and a mother who has been directly impacted by this system. “There is no subtlety, no assessment, preventative services that are weak, and there are few tools to deal with families where there is a parent struggling with their drug use. It’s zero-tolerance, it’s abstinence-only, it’s punitive and it’s scorched-earth.”

Widening Circles of Lasting Harm

Of course, the harms of these forced adoptions extend well beyond the child’s youth, and hurt other people besides the child and parent. When children are adopted outside of their family, they lose contact with their ancestry.

Pennie describes her birth certificate, which still bears the names of her now-estranged adopters, as a forgery. Though she’s been able to reconnect with her family as an adult, she was raised apart from her sister and extended relatives; people who may not fulfill the role of a parent or primary caregiver, but still make up an important part of one’s identity and growth.

Their adoption was committed with no thought to the network of love it would sever.

“When children’s rights are terminated as to their parents, and parent’s rights terminated as to them, we put the memories and history of a child in the hands of a system that knows nothing about that family and compiles a scrapbook through government records,” said Erin Miles Cloud, a former parent attorney and one of the co-founders of Movement for Family Power, a parent advocacy organization that did some pro bono work on my case. She described these physical scrapbooks, such as those created by workers in the New York City system, as an issue that is “enormously under-discussed.”

“I have always wondered what memories they create about [the child’s] family member, their parent, and how they navigated the War on Drugs,” she continued. “It perpetuates this insidious pathology with no actual healing and also no actual agency in the reckoning of memory, especially for young children who then become incredibly reliant on these other people to help them sift through some of their memories.”

When children are forcibly adopted within families, as with my daughters, it permanently alters the topography of that family. My daughters often discuss missing their Aba, my mother, and their elder half-brother; both live across the country, where we had planned to return once their father stabilized. My aunts constantly mourn their inability to see them, and my daughters have virtually no relationship with my father, who also lives across the country. Their adoption was committed with no thought to the network of love it would sever.

Dinah Ortiz is a grassroots harm reductionist and parent advocate in New York City, who has written for Filter about the structural racism of the child welfare system, which includes disproportionate targeting of Black, Indigenous and Latinx families for surveillance and removal. Ortiz lost her own daughter to forced adoption in Florida 18 years ago. She had planned to place her newborn daughter with her brother and his wife while briefly incarcerated. But child services removed Ortiz’ baby immediately after birth due to concerns about her substance use, and ultimately mandated adoption by her brother against her will.

Ortiz described returning to drug use after her baby was taken as a means to numb the pain.

“We were really, really close. That’s why I made the arrangement with them because we were very close, me and him and his wife,” Ortiz recalled. Now, however, she no longer considers him family, opting to call him simply “my daughter’s adopter.” She has not spoken with the couple in almost two decades, since they cut off contact with her child.

Fortunately, her daughter sought her out at the age of 16 and they are working to rebuild their relationship. But nothing can undo the trauma and wreckage of those lost years. Ortiz described returning to drug use after her baby was taken as a means to numb the pain.

The foster system “destroys families, destroys lives, destroys the very children they claim to be protecting,” said Joyce McMillan, a directly impacted mother, activist and founder of JmacForFamilies—an advocacy organization geared toward the abolition of the child welfare system.

“The violence of snatching a child from their parent as they scream mommy; the trauma of that gets forever sketched in their souls,” she said. “We talk about when people get shot and the hole it leaves; when a child gets removed from families it doesn’t just leave a hole in the heart, it leaves shrapnel… [in the form of] depression, in some cases mental breakdown, fear, loneliness [and] isolation.”

For my family, this gruesome violation hangs over everything, all the time. When I am apart from my daughters, my life feels like a small, windowless room. When I am with them, I feel like a ghost, haunting a life that is no longer mine. I can look at them, hold them, smell them, play with them, but nothing I say or do really matters, because their lives are now dictated by someone else, someone whose values are completely at odds with my own.

I can also see the hurt of my absence, how they try to reckon with it quickly so they can squeeze as much enjoyment as possible from our few hours together—but it still spills out in declarations of self-hatred, or accusations that I don’t love them.

Now my daughters have been given the same message: If you, too, struggle, you won’t be worthy of parenthood, agency or a full life.

On the morning after a rare holiday sleepover, my elder daughter woke up crying relentlessly. Her eyes were wild with fear and pain. For nearly half an hour, no amount of comforting could quell her loud, frantic tears.

Finally, I was able to calm her enough so that she could croak out a single explanatory sentence: “I don’t want a new mommy.” A few minutes of hugs and reassurances later, she finally revealed that she’d dreamed her father and I were taken away, and I was replaced by a stranger.

When the state took my daughters, they confirmed my worst fears as an abuse survivor: that I was made lesser by having been the victim of sexual and physical violence, and am no longer worthy of participation in regular society because of it.

Now my daughters have been given the same message: If you, too, struggle, you won’t be worthy of parenthood, agency or a full life.

What if, instead, they had been allowed to share in my recovery, to watch me struggle and work and overcome? This could have been an opportunity to teach them about resilience, resolve and recovery. Instead, it has become a powerful lesson in self-loathing. The state chased permanency—but the only permanency achieved is the grief that now permeates all of our lives.

Photograph courtesy of Elizabeth Brico

The post Forced, Rapid Adoptions Are a Weapon of the Drug War appeared first on Filter.

But while one outcome will certainly offer greater hope for positive change, neither is poised to do enough to assuage one of the biggest issues faced by the drug-user population: the confusion of punishment and coercion with addiction treatment.

Such measures might sound like progress when touted in a campaign speech, but those of us who’ve lived through them know otherwise.

During his term, Trump has thoroughly demonstrated his commitment to a heavy-handed, supply-targeted approach that defies the recommendations of research and has fostered increasingly dangerous, often lethal instability in the illicit market. Biden’s plan to address the “opioid crisis” includes promising measures such as universalizing access to medications for opioid use disorder, but more supply-side actions, too—and, just as concerning, emphasizes replacing incarceration with forced treatment and social-services interventions. Such measures might sound like progress when touted in a campaign speech, but those of us who’ve lived through them know otherwise.

I don’t remember what my husband and I were arguing about two years ago on a day weighted by the thick wet heat of South Florida. What I do remember is the agitation it incited in me that I could feel spiraling in my chest. It’s a discomfort I know well, anger mixed with helplessness. Since eighth grade, when I began coping with negative feelings by using substances, that feeling has been one of my strongest triggers. But instead of rushing out to score drugs that day, I went for a jog.

My two young daughters had been removed from my custody by the state of Florida in April 2018, a few months before that fight. After my daughters were taken, I was angry. Really angry. I was a good mom, and even the investigator who filed for the removal admitted under oath that my girls appeared well bonded to me and their father, and showed no signs of abuse or neglect. All of my drug tests had come back negative, including the hair test that was able to detect use up to three months prior.

It was totally unfair, but I still had hope. Various delays by the people in charge of my case meant I was unable to access formal trauma or addiction support for more than six months, but I was determined to get my daughters back, which meant remaining abstinent. I designed a personal support system that included writing, utilizing online supports and rigorous exercise.

When I got home from the run that day, drenched in sweat but buzzing from the endorphins and no longer angry over the argument, it hit me just how effective exercise was for my recovery. But the state of Florida would find a way to take even that from me.

At my next case review hearing, the judge decided that my low creatinine levels meant I was intentionally diluting my urine to hide drug use. I explained that I was hydrating due to exercise, and that I ate a vegan diet (which is sometimes associated with lower creatinine levels), but she didn’t care. She marked my slew of negative tests as positive, stated that I was noncompliant with my case plan, and refused to move my case forward, keeping me on once-weekly supervised visits with my daughters.

I felt as though everything had been taken from me, and then when there was nothing left to have taken, the state still managed to take more. It was not long after that hearing that I finally did what they had been accusing me of the whole time—I relapsed.

Negative reinforcement as a recovery motivator has become such a staple that it often goes unchallenged.

“When we look at individuals who are involved with, perhaps the criminal justice system or whatever… instead of actually putting more involvement with community support, we do the opposite. We isolate them and punish them and those are actually more detrimental,” said Nelson Perez, an addiction counseling instructor at Minneapolis Community and Technical College. “We continue to utilize those things when it comes to criminal justice-involved individuals … Those things are not evidence-based, and people know that, but they continue to utilize those punitive measures.”

Negative reinforcement as a recovery motivator has become such a staple in mainstream treatment and recovery circles that it often goes unchallenged, despite the fact that it defies best practice—and common sense. In my case, there was a clear (if unarticulated) belief among everyone, from the state to my and my husband’s families, that taking away my kids would throw me into the condition of rock-bottom despair that would serve as that final motivator to never, ever take a drug again.

Instead, it broke my heart, robbed my life of purpose, and eventually sent me seeking some sense of peace and pleasure elsewhere, through the opioids that had filled that role before my elder daughter was born.

“The concept that as a condition or illness or disorder that you know is a behavioral health condition, that it’s best addressed through aversion and punishment and isolation to me feels one: unethical, and two is not scientifically grounded,” said Mishka Terplan, an OB/GYN and addiction medicine physician who consulted on my case. “Then somewhere in all of this too is this idea that you can’t trust people with addiction. They lie, they manipulate, that sort of stuff. I think that’s also really common currency amongst those who endorse those punitive things.”

“The idea that someone with substance use disorder must reach rock bottom in order to recover: It’s an assumption that is not accurate,” he continued. “For what other human condition is the solution withdrawing love and support?”

The harms of this approach are exemplified by the various systems that intersect with drug use in the United States, all of which punish and disempower, and have become so normalized that punishment has become, for many, an expected part of an addiction trajectory.

“The criminal justice system and the [addiction] treatment world are even becoming more connected.”

Dinah Ortiz, a harm reduction and parent advocate, drug user and mother with prior child protective services involvement, described her own version of the ensuing helplessness in her recent account in Filter of the day her son, who used drugs, was sentenced to federal prison during the pandemic. “My hands and legs were shaking. The tears were already streaming down my cheeks … I just saw my son as a six-year-old boy, surrounded by adults who were there to scold him.”

“People don’t realize using punitive measures doesn’t work,” Ortiz said over the phone. “It’s kind of like the definition of insanity: doing the same thing over and over again expecting different results. We’ve been doing this for years and it hasn’t worked. Whenever they terminate your rights due to drug use, whenever they break up a family, whenever they put you in prison for drug use, they don’t realize they are doing more damage and more harm than good.”

“The criminal justice system and the [addiction] treatment world are even becoming more connected,” observed Perez. So-called treatment programs are “becoming more ingrained and joined up with the criminal justice system. It has a lot to do with that they still don’t want to get rid of the same type of mentality that has been going on since forever.”

For me, the impact has been a long, slow decline in my and my family’s quality of life. It has been over a year since my daughters saw their elder brother, my son from a different relationship, who lives in Seattle. He has nonverbal autism and attention deficit disorder, which make communication by phone or video extremely difficult. The last time I saw him was during a brief work visit to Seattle in January, just before the pandemic impeded transnational travel.

My parental rights to my daughters were terminated in March and they were forcibly adopted to the paternal grandparents who initiated the case against me, one of whom suffered an alcohol-induced injury a few months into the case that has left him without executive function, including the ability to consent to the adoption. Although I am seeking signatures for a petition requesting their return and/or a third-party investigation and reopening of the case, the termination is technically and legally final.

Their paternal grandmother is their sole caretaker. As such, she decides when and if we are allowed contact. Recently, when she found out that I referred to her as “ignorant” in an online thread, she cut off all contact between me and my daughters for several weeks without any explanation to them. I only recently regained my three-days-per-week visitation allotment.

“I’ve probably never had a patient who had child welfare involvement who didn’t think about suicide at some point in time.”

A new study out of Canada found that mothers who lost custody of their children were at heightened risk of fatal overdose, and that this risk was especially high for Indigenous mothers. Erin Miles Cloud, a former parent attorney in New York City and the co-founder of Movement for Family Power, an abolitionist-centered advocacy organization that provided pro bono consulting on my case, described the study as “tragic and also an awful truth that we all know to be true.”

“I’ve probably never had a patient who had child welfare involvement who didn’t think about suicide at some point in time, or didn’t think about using, many of whom did use or engage in some kind of self destructive behavior,” observed Terplan.

Last year, the obituary of a mother named Megan Webbley went viral after she overdosed following the loss of her child to the system. This year, on August 29, Dylan Stanley, Harm Reduction Ohio’s illustrious director of community outreach, also fatally overdosed following the custody loss of her beloved daughter.

During our last few correspondences, Dylan and I discussed plans to co-produce a podcast with another harm reductionist mama. She was hurting, but she had plans and goals for the future. We also commiserated about our shared loss; hers was especially painful because her child is medically fragile, which meant COVID concerns limited Dylan’s ability to even visit with her.

The last time we spoke, Dylan was trying to escape an unsafe housing situation, and faced the loss of her belongings due to the cost of storage. She had also been dealing with criminal-justice involvement and high barriers to accessing evidence-based opioid addiction treatment, despite her deep desire to find help.

Megan Webbley and Dylan Stanley are two examples of the insidious, often terminal impact these punitive systems have on people who use drugs, particularly if addiction is a factor. There are many, many more like them—and many, many more to come if nothing changes.

The final outcome of the election will not in itself remove the cloud of misery hanging over millions of us impacted by these systems.

During a recent conversation with my husband, whose parental rights were also terminated, I described my life as a small dark room—one with a small window that is occasionally opened to a view of a sun-drenched idyll that is no longer mine. Every day, I have to decide whether or not I want to continue my life in the small dark room, or take my final exit. Every day that I decide to keep going for one more lunar rotation, I also have to decide whether sobriety has any benefits anymore.

When my rights were terminated, it certainly didn’t seem to. I spent months after the termination injecting fentanyl until my supplier unexpectedly ran out due to a major bust in Florida. If that dry spell hadn’t happened—and if I hadn’t had buprenorphine to help me through the physical withdrawals—I could very well have met the same fate as my friend Dylan. I still could.

The final outcome of the election, even if it’s the one we hope for, will not in itself remove the cloud of misery hanging over millions of us impacted by these systems. It’s vital to remember that.

“It’s tearing me apart,” Ortiz told me of having her 26-year-old son, a father to five children, incarcerated in federal prison for almost three years over a nonviolent offense. “Every day I wake up and try to say ‘today is a new day, today is a day that’s gone by, that is another day off the calendar. But he’s my… son. It’s horrible. When I speak to him, there are times I just sit on my bed after the call and my tears just come down.”

Photo by Monty Allen on Unsplash

The post The Waiting Game: A Powerlessness That’s Long Harmed Drug Users appeared first on Filter.

Having the wrong information about drugs can be annoying at best and deadly at worst. Imagine a child who is told to “just say no” to heroin and benzodiazepines. What would happen if this child one day found themself at a party, being offered Percocet and Xanax by friends? How would they know that combining these two drugs heightens the risk of a fatal overdose?

Jen Sarduy considered such risks after seeing problematic drug use in her family and community growing up. Based in Fort Worth, Texas, she now works as the communications manager for the National Harm Reduction Coalition. As a mother of three children aged 6, 8 and 13, she is having constant conversations with them about drugs, safety and harm reduction.

“I became a parent very young, and I knew I wanted to parent my children in a way that was more open than how I grew up,” she told Filter. “I knew when my parents were lying to me and it left gaps. I wanted to create more space with my kids about what a conversation on drugs could look like.”

Sarduy’s children often ask her questions about drug users they see in the media and on television. For her, these are opportunities to talk about the negative ways society perceives people who use drugs.

“It’s important for us to combat representations first,” she said. “These conversations in our home usually start with our kids seeing a portrayal of someone on the news that’s inaccurate or stigmatizing, so we have to explain what’s wrong with that.”

“Conversations in our lives stem from questions like, ‘Why was this person adopted?’ So we have to talk about how the War on Drugs took that child away from their family,” she continued. “It’s all tied up in how the world works.”

Working directly with people who inject drugs, homeless people and formerly incarcerated people, Sarduy has plenty of opportunities to educate her children about the ways in which these groups are discriminated against. “Kids learn from us,” she said. “We just talk to people like people. We model how we can offer support instead of stigma.”

“It just made me look elsewhere, to my peers—who were also not well educated about drugs.”

The need to help parents communicate better about drugs inspired Angela Rabbitt to co-create a webinar series, titled: How To Have The Drug Talk. She is a social worker with experience in harm reduction, and also the mother of a 10-year-old child.

“I knew that my parents had experimented with drugs, so I thought they were very hypocritical,” she told Filter. “My dad was very anti-marijuana and didn’t talk about anything with us. That, combined with my school education on drugs, made me mistrustful of what I was told. It just made me look elsewhere, to my peers—who were also not well educated about drugs.”

Her weekly webinar series focuses on addiction and overdose prevention for families. Rabbitt is already having conversations with her daughter about drugs—though she hopes it will be several more years before she starts experimenting.

“Our culture sees drugs and sex as inherently bad and taboo, but I’d rather present her with facts,” Rabbitt said. “We talk about what different drugs are and their effects, and opioid overdose and how that works. My daughter also doesn’t get easily afraid of things.”

“What helps me is having an air of curiosity and non-judgement, and allowing her to ask questions. And being honest and willing to answer all her questions—unlike for many parents, where the response is, ‘All I’m going to say about drugs is they’re bad.'”

For some parents, personal tragedy has pushed them to want to teach other parents. Carol Katz Beyer, a mother from New Jersey, lost two of her sons to fentanyl-involved overdose in their late 20s. Through her advocacy with Families for Sensible Drug Policy, she now helps share information about safer drug use while advocating to end the War on Drugs. On October 2, her organization debuted a virtual Family Drug Support Listening Session for caregivers to share knowledge and experience.

“Unfortunately my approach to drugs was very different from what they were taught in schools and in rehab,” Katz Beyer told Filter. “My sons were labeled as ‘powerless’ and ‘addicts,’ and I don’t see any other health condition being treated in that way.” She urges parents to see problematic drug use as health problem rather than a moral issue, and to approach it with love and support.

Of course, parents aren’t raising their children in a vacuum. Kids will grow up receiving conflicting and confusing information about drugs—from their teachers, from the media, from popular culture and their peers.

Rabbit acknowledges the challenges this adds to parenting. “I assume my daughter’s drug education in school will be quite inaccurate,” she said. “But I hope she is the one who can talk to her friends and share her knowledge in class. That’s why I focus on giving her the right information, so she can then help others.”

Katz Beyer stresses that even with all the right information and education, living within the drug war inherently creates risks for people using drugs. She experienced this firsthand when her son Bryan went through the addiction treatment system in Florida. He was prescribed Suboxone by a doctor to taper his heroin use.

But when he went to a sober living facility, he was banned from using Suboxone. “Children who likely are only experimenting with drugs are being funneled into abstinence-only programs,” she said. “Stopping use and then returning to use, especially if fentanyl is involved, can lead to a fatal overdose.”

“We know that risk-taking is part of their wonder years. But when you feel like you’re being judged, often you won’t express what you need.”

She encourages parents to approach their children’s drug use within the context of comparable behaviors. “We tell our children to eat right, and wear a helmet when they ride their bike. We know that risk-taking is part of their wonder years. But when you feel like you’re being judged, often you won’t express what you need.”

Rabbitt echoed this. “Telling your children they can’t do something just pushes them to do it secretly. Let your child know they can call you if they’re in trouble, without punishing them.”

And if your child shows signs of problematic use, she suggests using questions to help them discover whether their behavior aligns with their own values and goals.

“Have a conversation with your kid about their drinking or drug use,” she said. “If your goal is to go to college but you’re not getting good grades, how is your use impacting that? How is it affecting your safety and those around you? That can help kids see if their behavior is getting in their own way.”

Sarduy emphasized personal autonomy and consent when having “the drug talk.” She makes sure her own kids are well-versed in the harm reduction techniques in which she specializes. They are each trained in naloxone administration and how to spot an overdose, and are familiar with syringe issues and HIV tests.

Avoiding hypocrisy is important to her. “I try not to set boundaries that are not for my own body,” she said. “So we talk about world traditions and how people use substances, and legality. We want to equip our child to make an informed decision, and not make choices that make them unsafe when they want to experiment.”

Photo by Annie Spratt on Unsplash

The post How Will You Talk to Your Kids About Drug Safety? appeared first on Filter.

“I wish I could live with you, Mommy,” says my littlest.

“Me too,” says her sister. “Is that natural?”

I say nothing, wanting to gather her in my arms, and Littlest answers instead. “Yes. That’s normal, living with Mommy and visiting Grandma. That’s normal.”

“I want to be with you always, I love you both so much,” I tell them. I don’t know how to make them know, to really know and feel, that I am leaving because I have to, not because I want to.

My elder daughter pulls her little blankie—the one she’s had since she was a baby—close to her chest and pops her thumb in her mouth.

This is their home, their life, as assigned by Broward County and Florida Department of Children and Families (DCF). It’s the home of their paternal grandparents, who initiated the child welfare case against me. Their grandfather, who has since become completely paralyzed and unable to speak, requires their grandmother’s constant care.

I have written about my case for Filter and other publications in the past. About how my daughters’ paternal grandparents called a child abuse hotline to accuse me of drug use and abandonment while I was staying with them in Florida, and testified against me in family court in 2018. About the barriers the authorities placed in my way—like failing to facilitate or allow my access to evidence-based opioid use disorder treatment—before proceeding, on the basis of misconceptions about drug use and addiction, to deem me an incurable failure and place my case on an adoption track.

Now, I’m writing about the predictable outcome of that: how they permanently terminated my rights to my two little girls, who still beg to come home to me.

Sometimes, the agency arranges a final meeting, where the parent must explain to their child that this is the last time they will see each other.

Termination of parental rights is termed the “civil death penalty.” It permanently severs the legal bond between parent and child. The parents’ names are removed from the birth certificate, erasing any record of the relationship, no matter how long the family was together prior, or how bonded they are. For many, that means the sudden and total cessation of contact. Sometimes, the agency arranges a final meeting, where the parent must try to explain to their child that this is the last time they will see each other, and why. Sometimes, they don’t get even that.

“My clinic worked with a father who had been visiting his son in foster care for years,” said Chris Gottlieb, co-director of the Family Defense Clinic at the New York University School of Law. “The child knew that was his father and was very attached to him. The boy was going to be adopted by a single mother. We asked—begged, really—for the father to be able to at least stay in his son’s life through continued visits after the adoption, but the agency refused. They wouldn’t even let the father say goodbye. Who could think that’s actually good for a kid?”

For me, I am still able to have continued contact because they are with their paternal grandmother—but she could rescind that privilege at any time. Once the adoption is finalized and the case closed, she could also, if she chose, give the girls back to me. In other words, the agency has given total power over my daughters to the very woman who made the allegations that triggered this case. The allegations which were found to be untrue at the trial, but had by then entangled me in a system that judged and misjudged my substance use disorder, PTSD and lack of financial resources.

The termination means that if my daughters are seriously injured, I can be barred from visiting them in the hospital. I have no say over their medical or educational decisions. I can’t travel with them without permission; I am forced every day to choose between staying with them in Florida, isolated from all my support systems; or returning to Seattle, Washington, where their older half-brother lives.

They call me “mommy” and “mama” and “mom,” but I am no longer their mother—not legally. The decision leaves them to build their personalities, attachments and aspirations atop a constantly shifting foundation embedded in grief and confusion—the opposite of what this system purports to secure for children. It leaves me navigating a lifetime of unending trauma and loss.

Perhaps worst of all is the knowledge that this outcome was arbitrary—an automatic reaction to a timed financial incentive set at the federal level.

Perhaps worst of all is the knowledge that this outcome was arbitrary. The decision to terminate my rights was not based upon any actualized threats to my daughters’ safety; rather, it was an automatic reaction to a timed financial incentive set at the federal level by the Adoption and Safe Families Act (ASFA).

Under ASFA, if states want to receive the funding that allows them to finance child protective programs, agencies must either return children home, or move to terminate parental rights once a child has been in out-of-home care for 15 of the past 22 months.

“ASFA has exceptions,” Gottlieb noted. “They don’t have to file a termination of parental rights on the [15/22] time-frame if there’s one of these exceptions, which include if kids are in kinship foster homes, or if for any reason it’s not in the child’s best interest to do the termination.” Since my daughters were in kinship care, the first of those exceptions applied in our case. I would argue the second does too.

“But,” Gottlieb continued, “the only message that gets emphasized is the simplistic rule that you have to file. People are not doing the case-by-case analyses they’re supposed to do to apply these exceptions.”

In my case, when we sat down for a required mediation session in March, the guardian ad litem attorney acknowledged my daughters’ bond to me, but felt that the financial benefits of adoption, including payments to their grandmother and funding for college, were important enough to warrant severing our legal bond.

Misunderstandings of Drug Use and Addiction

Another major issue throughout the case has been the misunderstanding and mistreatment of drug use and addiction. It began with the initial investigation, when an inexperienced member of the Broward County Sheriff’s Office came by the home while I was away and did not attempt to contact me, instead choosing to file for an emergency removal because she felt my history of engaging in methadone treatment was proof enough that any allegations against me were true.

It continued at the deposition, when the judge charged me with neglect and imminent risk of harm. She cited my “skill with language,” which apparently made me a less credible witness, and a discussion about marijuana with a family member that my in-laws testified about at trial as her reasons for the decision, in lieu of any actual instances of harm or near-harm to my daughters.

“Everyone is so focused on the substance use that often they don’t see, or refuse to acknowledge, a mother’s positive behaviors.”

It continued as the agency not only failed to provide me with referrals to the trauma and addiction treatment I was mandated to complete, but also barred me for months from accessing them myself—in part by forcing me to undergo a psychological evaluation, which they repeatedly delayed, before engaging in any other state-sponsored services. Throughout the life of the case, they never referred me to evidence-based treatment.

“Everyone is so focused on the substance use as this negative behavior that often they don’t see, or refuse to acknowledge, a mother’s positive behaviors,” said Mishka Terplan, an OB/GYN and addiction medicine physician who was retained by advocacy organization Movement for Family Power to provide expert testimony during my case.

“For you, the positive behaviors were, you … sought treatment on your own and you demonstrated motivation,” Terplan described. “You understood the importance of treatment; nobody had to tell you treatment was important, you actually had to tell them you wanted this. You actively sought it and when the program was not adhering to standards of care, you sought another program that would be better for you. That seems to be completely correct.”

But at the mediation, the representative for the state attorney’s office—a worker from the drug court division who was standing in because the case was undergoing yet another of many instances of staff turnover—summarized all of that as, “too little, too late.”

Then she leaned across the table and told me that before ASFA, parents with substance use disorders had an actual chance to get their kids back, but now with the timeline, it just didn’t work.

As Jerry Milner, the associate commissioner at the Children’s Bureau, co-wrote in an article published about a month after my rights to my daughters were terminated:

“The timelines in the [ASFA] … do not reflect what we know about treatment and recovery and do not reflect the contextual factors that are directly relevant to successful reunification, such as the availability of quality services and treatment and a family’s ability to access services timely and effectively. The decades that have passed and research lessons learned have revealed the timelines as lacking alignment with what many children and families need.”

Despite acknowledgments at both the state and federal level that the ASFA timeline does not make sense in the context of substance use, and despite admonishments from the medical and legal advocacy communities, agencies across the nation continue to file for termination of parental rights at the 15/22 mark, so that they can continue to receive the millions of dollars in funding it affords them.

They continue to do this even in cases like mine where they don’t have to. And in cases like mine where everyone is in agreement—at least behind the closed doors of the mediation room, where any statements made can’t be applied as evidence at trial—that the act of termination will, in fact, cause harm to the children.

If nothing is done, the consequences will continue to echo through my life, my children’s, and generations of my family to come.

And it has. It has caused my children harm. Not a day goes by that I don’t hear my daughters ask to come home to me, tell me they love me and miss me, muse about how much they miss Seattle, their brother, and their other friends and family back home. Their questions about the situation, their acknowledgment that it’s not normal and doesn’t feel good, are accumulating urgency with each passing day.

If nothing is done, the consequences of this travesty will continue to echo through my life, my children’s, and generations of my family to come. I started a petition requesting the immediate return of my daughters and/or an independent third-party review of my case and appropriate remedial action. It’s a small hope, one that rests upon the world taking notice and deciding to care, but it’s what I have left.

For all the families impacted by such systems, we can listen to the experts, and stop applying this irrational timeline. Our federal government can reform or repeal ASFA, and in the meantime, states have the choice to take a stand and say no—to take the hit instead of forcing their families to.

As Gottlieb explained, “Just as some states opt out of certain aspects of Obamacare, they could opt out of ASFA. They could turn down federal money rather than buying into a system that incentivizes severing parent-child relationships.” But so far, none have.

It’s millions of dollars, and it would cripple their child welfare system, but the other choice is continuing to tear apart hundreds of thousands of families each year for no real reason.

Yesterday I hung on my walls in Hollywood, Florida the sequined monsters and Dr. Seuss landscapes the girls and I crafted together over the holiday weekend. I was reminded of the conversation we had while we glued down those pom-poms and plastic gems, one about the strangeness of memory, and how we forget the memories we don’t use.

“Will I forget you, Mama?” asked my elder girl.

“Do you think about me?” I asked.

“I think about you sometimes,” she replied.

Then my littlest one chimed in. “I think about you. I think about you all the time. I think about you all the time because I’m always missing you so much.”

Photograph courtesy of Elizabeth Brico.

The post “The Civil Death Penalty”—My Motherhood Is Legally Terminated appeared first on Filter.