By Amy Silverman
By Olivia LaVecchia
By Monica Alonzo and Stephen Lemons
By Chris Parker
By Michael Lacey
By Weston Phippen
But the judge in her case, with the help of her family, did see hope. He gave her a choice -- long-term residential treatment that she had to complete successfully, or prison. If she succeeded at treatment, she could be reunited with her children. If not, they were gone.
A giant stick. A giant carrot.
She went into the Harbor Light program of the Salvation Army, a yearlong inpatient drug treatment program that most closely modeled what national meth-abuse experts say is the most effective treatment protocol for meth-addicted parents.
Voss was one of the last to graduate from the program, which -- as is common with treatment programs in Arizona -- was shut down in 2000 because of lack of funding.
Also, when her baby was born, she was allowed to keep the infant with her at Harbor Light. The center had its own child-care facility.
It takes months for meth to clear the system and for brain chemicals to begin flowing normally again. During the first stages of withdrawal, addicts are alternately lethargic and jittery, their brains craving the drug that, as addiction set in, provided equilibrium.
After a few months, Voss began learning how to function in the real world again. The whole time, too, she was learning to mother again.
Any time she considered getting high, she had to consider losing the baby in her arms.
"You don't know how powerful a deterrent that is until you've been there," she says. "It's hell fighting this addiction. But it was worth it because I could see the rewards. These beautiful children. I had to be there for them."
Once the overwhelming mothering instinct could again be discerned, meth addiction was beatable.
After 12 months essentially locked up at the Salvation Army, Voss began her return to society. But again, as the top research shows, this foray into the real world needs to be supervised. Voss was in a halfway-house setting, with constant counseling at hand, for six more months.
The trick here, treatment experts say, is to help the recovering addict build new friendships and life patterns free of chemicals.
Voss began working again. In time, her older children returned to her. She cleaned up her credit. She bought a car, she bought a house.
Now it's Voss and her four kids taking on the world.
She has her two oldest boys, Brandon, who has graduated high school, and Donnie, who is excelling in high school, both of whom spent much of their childhood living with Maggie's sister.
She has Megan, who is a star student despite spending her early years catering to Maggie's drug friends, and later, running for her life from her mother's violent boyfriend.
And, of course, Ryan, conceived in a meth haze but born drug-free, a born leader at school who has only known his mother as the rock of the family.
"We're a team," she says. "I'm so proud of them, it's crazy. And we're proof that it can be done and that a little extra work from the community is worth it.
"What scares me is the thought of how many women there are who won't get the kind of help I got," she says. "What, thousands of mothers, thousands of children? They can be saved. The community just has to come together to do it the right way."
In their February assessment of Arizona Families F.I.R.S.T., the statewide program for families entering the child-welfare system with substance-abuse problems, University of Arizona researchers made several recommendations for making the program more effective.
They were heartened by the fact that 48 percent of the parents entering the program received at least six months of treatment, mostly on an outpatient basis, an improvement over past years.
"The patterns are promising," researchers said, "given that research on substance-abuse treatment emphasizes that the longer a client remains in treatment, the more likely it is that treatment will result in long-term behavior change."
But that six months of outpatient care is far from reaching a standard of treatment proven effective in households in which meth has taken hold.
In 2004, Dr. Lester's team at Brown finished the most comprehensive analysis yet of drug treatment programs for pregnant women and women with children.
Their first discovery: that women are underserved by treatment programs compared to men, and that pregnant women are grossly underserved.
They also discovered that scarcely little analysis has been done of the effectiveness of the treatment programs that do exist.
That said, though, in limited studies of comprehensive female treatment programs in Hawaii and Los Angeles, it became clear that inpatient programs that allowed mothers to remain in contact with their children provided the greatest chances for success.
"Mothers admitted to the programs with their children had better treatment retention and higher rates of successful treatment completion than women admitted without their children," Lester wrote.
"The authors also suggest that the inclusion of children could strengthen mother self-esteem and mother-child bonds while also improving post-treatment outcomes."
And, he wrote, "results suggest that an intensive day treatment model is more effective than a standard outpatient treatment model for a variety of reasons."