Chil­dren also feel the pain of opi­oids

Baltimore Sun Sunday - - NEWS -

The lit­tle boy had run out of food, and he was hun­gry, so he started knock­ing on doors. That’s when the neigh­bors re­al­ized some­thing was ter­ri­bly wrong.

The boy was 5 years old, a kinder­gart­ner and the son of a man who now lay dead from an over­dose of fen­tanyl in his girl­friend’s house in Al­le­gany County. The girl­friend was dead, too, also from an over­dose. It is be­lieved the cou­ple had died some 48 hours be­fore their bod­ies were dis­cov­ered on that Mon­day last year, when the boy went look­ing for food.

David Cox, su­per­in­ten­dent of schools in Al­le­gany County, told Congress this story on Wed­nes­day in Wash­ing­ton. He wore a gray suit, a white shirt and bow tie for an ap­pear­ance be­fore a House ed­u­ca­tion sub­com­mit­tee. He sat next to Dr. Leana Wen, the Baltimore health com­mis­sioner, who was also there to tes­tify about the opi­oid cri­sis.

While Wen spoke of the epi­demic in the city — over­dose deaths at a rate of two per day; ad­dicts dy­ing while they wait too long for treat­ment; no funds for new pur­chases of Nalox­one, the over­dose an­ti­dote — Cox gave a glimpse of how opi­oid ad­dic­tion has af­fected his ru­ral com­mu­nity in west­ern Mary­land, 140 miles from Baltimore. He did not spare de­tails.

The county, Cox said, as­sesses the learn­ing needs of chil­dren be­fore they en­ter the Al­le­gany schools. Twice dur­ing vis­its to the homes of pre-school­ers, Cox’s staff mem­bers en­coun­tered small chil­dren an­swer­ing doors be­cause, they said, their moth­ers were asleep. In fact, in both in­stances, the women had over­dosed. One was dead, Cox said. One was “brought back” with the an­ti­dote.

“There are more sto­ries,” Cox told me on Fri­day, “but I only had five min­utes to [tes­tify]. Of course, these are not sto­ries I’m happy to tell. It’s an aw­ful thing to have to tell. But mem­bers of Congress need to know the deep im­pact this [cri­sis] is hav­ing, and not just on those who over­dose. Ad­dic­tion hurts chil­dren, too.”

It leaves them with deep emo­tional scars. It leaves some with­out par­ents.

Grand­par­ents — and, in at least one case, a great-grand­par­ent — have taken guardian­ship of chil­dren whose par­ents died of over­doses in Al­le­gany County, Cox said. Some chil­dren have ended up in fos­ter care. In some in­stances, older sib­lings have be­come the pri­mary care­givers.

Cox is a na­tive of Ten­nessee. His ca­reer in ed­u­ca­tion took him to Kansas and Vir­ginia be­fore he was ap­pointed Al­le­gany County su­per­in­ten­dent in 2009. He was named Mary­land School Su­per­in­ten­dent of the Year for 2016 by the Pub­lic School Su­per­in­ten­dents’ As­so­ci­a­tion. There are about 8,700 chil­dren in his school sys­tem.

The opi­oid epi­demic, which claimed 59 lives in Al­le­gany County (pop­u­la­tion 72,000) last year — and an­other 27 so far this year — has be­come a grim new chal­lenge for the county’s prin­ci­pals, teach­ers, school nurses and sup­port staff.

Cox was asked when he and his prin­ci­pals first sensed the reach of the opi­oid epi­demic.

“I would say about five years ago,” he said. “Our district has had a 95 per­cent [stu­dent] at­ten­dance rate most of the time. But we started notic­ing a drop.”

More el­e­men­tary school stu­dents were ar­riv­ing at school late, or not at all. In as­sess­ing preschool­ers, Cox’s staff no­ticed a sharp in­crease in the num­ber who re­quired spe­cial ser­vices for be­hav­ioral is­sues. In an ef­fort to ex­plain that in­crease, or at least sug­gest a cause, Cox noted this dis­turb­ing statis­tic: Eigh­teen per­cent of new­borns in Al­le­gany County are in some way drug-af­fected. And that does not in­clude, Cox noted, chil­dren who might have ex­pe­ri­enced pro­longed, pre­na­tal ex­po­sure to al­co­hol.

Add those trau­ma­tized by the over­dose or over­dose death of a par­ent, and you have a lot of small chil­dren in need of spe­cial care.

There are 13 el­e­men­tary schools in Al­le­gany County, and only one be­hav­ioral spe­cial­ist for all of them. “I could keep three more busy,” Cox said. Two weeks ago, the pres­i­dent de­clared the opi­oid cri­sis a pub­lic health emer­gency. But, of course, the Trump ad­min­is­tra­tion com­mit­ted no ad­di­tional funds to fight the epi­demic.

In Wen’s tes­ti­mony, pointed as ever, she said it was “un­con­scionable” that pub­lic health of­fi­cials are be­ing lim­ited in their ef­forts to save lives. More funds are “des­per­ately needed” to pro­vide on-de­mand treat­ment for ad­dicts, she said, and Congress should ex­pand in­surance for men­tal health ser­vices.

Cox had a spe­cific re­quest of Congress: Give him and other su­per­in­ten­dents more flex­i­bil­ity in how they can al­lo­cate fed­eral funds for dis­ad­van­taged chil­dren. “Their pub­lic school,” Cox said, “is the place where they are most loved, best cared for, where they re­ceive the best nutrition, where they’re the warm­est, and are shown the most kind­ness.” The chil­dren of the opi­oid epi­demic are go­ing to need help, and schools might be the best place to start to deal with all the col­lat­eral dam­age.

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