Ice, Ice, Baby
Maggie Voss cried as her 7-year-old son, Ryan, received a Student of the Month award from his school's principal recently. The weeping was a little weird, but the other parents didn't seem to notice. Some suburban moms tend to overreact to their babies' accomplishments. That's a given. It's better than the alternative.
The reason Maggie Voss was crying, though, was precisely because she used to be the alternative; the scourge, the blight, the problem, the drain on our resources, the decay of our society.
Think crank whore, and Voss was it.
A pistol-packin', trash-mouthed meth mama who kept getting knocked up by the next guy who knocked her around. Three dads, four kids, even more felonies. (See "Meth and Sex" about the relationship between meth addiction and sex addiction.) In most people's eyes, she was hopeless, irredeemable, evil.
And that kid up at the podium? He's a "meth baby," the modern equivalent of the dreaded "crack baby," born to a meth-addicted mother, stigmatized by our culture at birth as messed up, hopeless, sure to be a lifelong drain on the public coffers.
But the truth is, Maggie and Ryan are living proof that methamphetamine addiction can be overcome. They also prove that meth-addicted moms can be good moms again, that kids are more resilient than we think, and that kids, in general, are better off with mom than with a foster mom.
And much better off with mom than with an institution acting as mom.
Right now, though, some Arizona policymakers are working in the opposite direction. Maricopa County Attorney Andrew Thomas is working with legislators to craft a bill to give mandatory minimums and lengthen prison time for mothers who use meth while pregnant. Governor Janet Napolitano's well-meaning and often successful "Protect Children First" mandate to Child Protective Services workers is succeeding at getting children out of dangerous situations, but doing far less to help remove the drug problem from the home torn apart by drugs.
Essentially, the program Napolitano started as attorney general in 1999, the Arizona Drug Endangered Children program, has done well at getting drug-abusing parents and their children into the system. It's just not doing a very good job of getting them out.
At the same time, the state Attorney General's Office, as well as certain Valley governments, including Phoenix's, are releasing sometimes erroneous and sensationalized information regarding the effects of methamphetamine on the children of meth-addicted mothers or meth households. It is, many health officials say, a replay of the "crack-baby scare," the politically motivated, short-on-science hysteria of the late 1980s and early 1990s that damaged the lives of children much more than the crack cocaine ingested by their mothers.
The stakes of bad meth policy are extremely high for Arizona.
According to a February 2005 report, methamphetamine is the most common drug abused by individuals entering the Arizona Families F.I.R.S.T. program, the five-year-old state-run program for substance-abusing families entering the child welfare system.
Of the 1,763 individuals referred to the program, 40 percent reported methamphetamine use, beating out pot (26 percent), cocaine (13 percent), and even alcohol (32 percent) for the most-abused drug.
These are stunning numbers that suggest methamphetamine is hitting Arizona like no other state in the country.
Consider these national statistics: According to a report by the U.S. Substance Abuse and Mental Health Services Administration, meth was the drug of choice for 7 percent of those who sought treatment, while alcohol abusers made up 42 percent, marijuana users 16 percent, and cocaine abusers 14 percent.
The problem, experts say: Only 10 percent of those parents with drug problems in Arizona were given residential drug treatment. And of those, fewer than 1 percent received residential drug treatment in which they had full access to their children.
In the case of methamphetamine -- arguably the toughest addition to kick -- research shows that mothers placed in long-term residential treatment along with their young child or children have the highest rate of recovery.
Under intense and often yearlong supervision, often with the threat of serious prison time hanging over them, mothers learn to be, and learn to take pride in being, sober and responsible parents again.
Look at Maggie Voss.
Voss is clean, seven years now. She owns her home, has a good job, has all four kids living with her. The kids are successful. And from all appearances, they're happy as hell and getting along great.
Voss got clean in a Salvation Army long-term residential care facility, where her children could be with her during treatment. The treatment center has since been shut down for lack of funds.
Voss went through what national experts say is the rehabilitation protocol most likely to be successful.
Right now, there is only one such program operating in the Valley of the Sun for indigent meth-addicted mothers, with a total of 24 beds.
One Phoenix Rescue Mission official estimated that those 24 beds are all that exists for an estimated 10,000 Arizona women with children who could benefit from such a program.
Under current policies, and even under proposed new ones, Voss likely would have gone to prison for years, and her ties with her children would have been severed.
One more prison inmate to pay for in a critically bloated prison system. Four more kids to support in a critically bloated foster-care system. Research suggests that when Voss would have gotten out, she quickly would have used again. (Why not? What would she have had to live for?) Research also suggests that her children would languish in foster or institutional care, likely ending up in the same life cycle as their mother.
A California study posited that it costs seven times more to imprison a mother and take away her kids than it does to break her of her addiction with long-term residential treatment.
And to be blunt, that cost just spirals over generations. Because drug moms may be really bad mothers, but they are really good at making more babies.
This, then, is a cycle begat by strictly punitive measures based on politics and bad science.
"People like me are really tough for a community," Voss admits. "Hell, they had every right to throw me in prison and take away my kids. I was a disaster.
"But I was incredibly lucky to be given a real shot at recovery and redemption. That's rare here, trust me. But the payoff is huge. There are thousands more out there like me. What's the potential savings there?
"For me, what was saved was my life. For my kids, their mother and their home were saved."
According to the Arizona Attorney General's Office, 362 Arizona children have been "rescued from meth labs" in the past four years.
Of the meth-lab busts in Arizona since 2000, children were present in about a third of the cases.
Since 2000, 218 children have been taken into temporary custody by Child Protective Services at the scenes of meth-related busts.
To be sure, there are real horror stories.
Earlier this year, the Phoenix Police Department busted a house with a meth lab in which the air was so toxic it took six hours of airing the place out to make it safe enough for investigators to enter without oxygen tanks. Living in the house was an 18-month-old baby, who now lives with relatives in another state.
Last year, Phoenix police had trouble entering a meth-lab home because a mountain of trash blocked the door. Inside, they found seven years' worth of garbage. The home had no electricity or water; the owner was stealing water from a neighbor's garden hose.
Two children lived in the house. Their father had set up a mattress in front of the television set in the living room. The kids slept and ate and spent their days on that mattress. They only left the mattress to urinate in bottles and defecate in buckets that were strewn throughout the house.
Since 2000, two children have died in the Valley from ingesting waste from the meth labs their parents operated.
Nobody is saying mixing methamphetamine and children isn't a degrading, dangerous and sometimes lethal combination.
What is wrong, many drug-addiction researchers and treatment experts say, is that police, prosecutors and political leaders often use horror stories to make sweeping arguments that parents must be dealt with punitively, which lands their kids in foster care.
Attorney General Terry Goddard, in the "Methamphetamine Fact Sheet" on his office's Web site, lists "facts" that many researchers argue are not facts at all.
For example, the AG states: "Prenatal exposure to meth causes infants to be six times more likely to be born with birth defects such as spina bifida, club foot, intestinal abnormalities and skeletal abnormalities."
Also: "Children found in meth labs often suffer from developmental delays and have likely been abused or neglected."
That line is followed with: "Justice Department statistics show that neglected or abused children are 50 percent more likely to be arrested as juveniles, 40 percent more likely to be arrested for a violent crime as adults and 33 percent more likely to be substance abusers."
Ergo, meth-exposed kids can end up as drug-addicted criminals who resemble the Elephant Man.
"That stuff about the children being more likely to have defects is just absolutely not true," Dr. Barry Lester, probably the nation's leading researcher on the effects of meth and crack cocaine on children, tells New Times. "That statement comes from some early, early research done on animals. Nothing in any human tests shows anything like that."
And the attorney general's other claims?
"There are no published studies of children in meth-lab homes," he says. "The jump from meth to general research on abuse and neglect? None of that is valid.
"It's just like what we saw in the 1980s with crack cocaine," he says. "It's not science. It's politics."
Lester, the director of Brown University's Center for the Study of Children at Risk, who heads a massive National Institute of Health study on drug-addicted parents and children, knows the science better than anyone.
In the course of his research, though, he's also had to learn the politics of addiction, of which there are two basic camps.
The liberal persuasion looks at drug use as a public-health problem requiring compassion and understanding. From this perspective, he says, drug use during pregnancy, or in the presence of young children, must be treated in the same manner as depression or mental illness.
The conservative view of drug use during pregnancy is that the mother is committing a voluntary and illegal act against the rights of the fetus. From this view, women who use drugs when pregnant are willfully hurting their children, a crime that deserves significant punishment. The same goes for a parent who uses or manufactures the drug in the presence of their children.
Throughout history, American voters have generally liked the idea of punishing drug users better than the idea of treating them.
And to be honest, punishment is just about as effective at changing behavior as the average short-term outpatient treatment program.
The problem is, in meth-afflicted families, punishment of the parents usually ends up punishing the children while doing nothing to solve the core problem.
Especially damaging was the political response in the late 1980s to the rise in the use of crack cocaine, particularly among women with children.
"So many lives were ruined during that time based on bad science or no science," Lester says. "We can't let that repeat itself with the response to methamphetamine."
Lester conducted the nation's most comprehensive long-term study on the effects of crack cocaine on mothers and their children.
"For cocaine, we now know that early scientific reports were exaggerated and portrayed children who were exposed to cocaine in utero as irreparably doomed and damaged."
In fact, Lester's research showed that crack-cocaine-exposed children did have deficits in intelligence and language skills, but those deficits were minor and often easily overcome in special-educational settings. Also, crack-exposed children did show increased difficulty paying attention and handling abstract thinking problems. Again, though, the problems were minor and conquerable.
They were nothing close to problems experienced by children with fetal alcohol syndrome.
In addition, University of Florida researchers studied two groups of infants born with cocaine in their systems. One group was placed in foster care, the other with birth mothers able to care for them. After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out.
Consistently, the children placed with their birth mothers did better.
"For the foster children, being taken from their mothers was more toxic than the cocaine," says Richard Wexler, executive director of the National Coalition for Child Protection Reform.
But that was exactly what most policymakers in the 1980s and early 1990s wanted to do: Immediately separate mother from child. Also, throughout the crack scare, increasingly popular across the country were laws greatly increasing prison time for crack-addicted mothers.
At the same time, Lester says, children exposed to crack as babies were stigmatized within the educational system. Often, these children were "expected to fail," he says, "and when you're expected to fail, you usually do."
While everyone focused on crack cocaine, Lester says, they ignored the reality of the average substance-abusing household. Typically, in such a family setting, more than one drug was getting abused. And beyond those drugs, there were often myriad other forms of neglect and abuse coming from directions other than the crack-addicted mother.
Now, Lester says he is seeing the same sort of political storm brewing around methamphetamine, creating the same sort of erroneous information and damaging legislation.
And so far, Lester's research on in utero methamphetamine use shows it has nearly identical long-term effects as its first cousin, crack cocaine.
"If the meth effect is anything like the cocaine effect, which in the early stages it appears to be, it is mild and treatable," Lester says. "I just don't want us to make the same mistake with meth that we made with crack."
Which is why Lester and 90 other physicians, scientists and treatment experts released a statement in July imploring the nation's policymakers to address the methamphetamine problem with great care.
"We are concerned that policies based on false assumptions will result in punitive civil and child-welfare interventions that are harmful to women, children and families," the group's statement read.
The physicians called for policymakers to base their decisions on "the best research" and to focus on promoting the proven solutions -- "ongoing research and improvement and provision of treatment services."
Whether that will happen -- especially in regions of the country like Arizona, where law-and-order demagoguery wins elections -- is anyone's guess.
"You get these 'tough-on-crime' guys who have no idea how to actually be tough on crime," Lester says. "What they end up doing is just ruining lives and perpetuating crime over generations."
Detective Tim Ahumada is tough on crime. Has been for a quarter of a century.
He's still working on being smarter on crime, though. That is a lifelong process. And that is the only way you ever win any ground in the drug war.
"I know we need to do something more as a community, but I'm still not exactly sure what it is," admits Ahumada, who works with the Phoenix Police Department's Crimes Against Children Detail, a job that increasingly takes him into the homes of meth abusers with young children.
"As a police officer, I'm the intervention. I'm the quick fix. But I'm not the answer."
Ahumada, like a lot of veteran cops in the drug wars, is a dichotomy of hope and cynicism. He doesn't see that his 25 years have put a dent in drug use. In fact, he has plugged away as a new and bigger scourge has grown exponentially around him.
"Meth is the worst drug I've seen on the family." he says. "If you're on it, all you want is the drug -- period. The idea of taking care of kids goes right out the window."
He has charged into the worst of houses, babies lying in days' worth of their own feces next to explosive meth-lab chemicals, 5-year-olds running households because mom has been in bed for three days. In a recent home, the child's main chore was to get the meth pipes for the adults.
And Ahumada doesn't mind stacking charges on parents. In the chain of law enforcement, judicial and health-care officials involved in the attorney general's Drug Endangered Children program, it is his job to give those down the road in the system the biggest stick possible.
So he's tough on crime.
But his great hope, he says, is that the case he builds on parents ultimately leads to the rebuilding of that family. No doubt, some of the people he busts are just plain scumbags. But very often, he says, he finds hope for the future in the oddest places.
For example, he often comes across parents who say they only smoke meth once their kids are in bed. One dad would only cook when his children were at school. If they came home and the batch wasn't cooked, "mom would take the kids to the mall."
Maggie Voss insists she never let her kids go into the room in which "the hard-core users" were shooting meth into their veins.
While it's true, Ahumada says, "that tweakers don't parent their kids at all, it's also true that many of these people, if you can get the drug out of the house, have a good chance at rebuilding the home."
"This may sound weird, but I can often see the parenting values still there buried under the horrors of the addiction," he says. "What that is is a glimmer of hope. If we can do the job right after I'm done, there's a chance I won't have to come back."
And the children?
Yes, there's damage, but kids are also resilient, and "in some cases, they've learned to take care of themselves in ways most kids of today can't even imagine," he says. "If you can just get the drug out of the family setting, there's hope. And in many cases I've seen, there's plenty of hope not just that these kids can get by, but that they can thrive."
What that means for a community, Ahumada says, is providing the proper carrot to go along with the stick provided by police.
It was 7 a.m., and here was this rough-looking guy cruising around on a motorcycle with a rough-looking woman hanging on. You can see why the cop pulled over Maggie Voss and her boyfriend. They screamed methamphetamine.
When the cop ran Maggie's name through the system, it came back that she had an outstanding warrant for failure to appear.
Well, of course she didn't get to court that day. Her previous boyfriend had locked her up in a bedroom of his house. He boarded the door and told Maggie that if she and her daughter tried to leave, he would kill them.
But she did leave. And the guy did stalk her. And then she found this new guy. And he was pretty nice to her, and he did not lock her up for days on end and did not beat her and threaten to kill her every day.
"You know, he didn't pulverize me," Voss says. "So I was hooked."
Unbeknown to her, in her belly that morning was her fourth child by the third different guy.
Her other three kids were with her parents and sister.
She had taken them to her sister's years before. Voss told her sister she was hard up for money and needed a few weeks to get back on her feet.
The weeks turned to months, the months to years, and pretty soon, her sister and other family members stopped bringing the kids by for visits.
Her family wasn't exactly sure what was happening -- they did not know about meth. Voss had been raised in a healthy, happy home -- "no cycle perpetuating itself there," she says. "But that meant they weren't exactly sure what I was up to. They just knew it was bad."
Throughout the late 1990s, she bounced from meth house to meth house. Back then, it was pretty much only a white-trash drug, lots of biker dudes, lots of tattoos, a few Aryan Brotherhood members.
In time, Voss was dealing. At first she was bad at it. Her volume was not only too low to support her habit, but she lost her house and everything else.
So she took her kids to her sister's and moved in with a new guy. She started dealing more and getting ripped off less. She always carried a pistol and was known around town as a ferocious bitch to cross.
"If you met me then," she says in the cafeteria of the hospital where she now works as an administrator, "you would not have seen hope. You would have wanted to put me away for life."
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."
Some other findings:
The more intense the penalties for drug-addicted mothers, the less likely they are to enter themselves into intensive treatment for fear of losing their children.
It is imperative that programs are modeled specifically to meet the needs of females, and especially, females with babies or young children.
That the best programs offer comprehensive care in one location -- "one-stop shopping," as Lester called it. This, research shows, allows mothers to develop a relationship with a consistent team of providers, which has shown to reduce dropout rates.
Offering parenting classes is a must.
Family members should be included in treatment whenever possible.
"Most professionals agree that a comprehensive program is best for mothers," Lester wrote. "Services should be family-centered, community-based, multi-disciplinary, individually tailored and promote competency of the individual."
Again, while Arizona has succeeded at creating a multi-disciplinary, cross-jurisdictional approach to getting drug-addicted parents into the system and drug-affected children to safety, the state's leaders have generally failed at building the infrastructure needed to get the drug out of the household and get the family functioning again.
"I'm definitely the exception right now," Maggie Voss says. "The vast majority of women in Arizona aren't given a realistic shot at recovering from this drug."
It is hard to argue against Governor Napolitano's "children first" mandate to the child-welfare system. The basic idea: Get children away from dangerous situations.
The mandate was a response to a sickening litany of stories about children who had been returned by CPS to dysfunctional homes and later died at the hands of their abusers.
"It was the right thing to do," says Jeff Taylor, a counselor and program advocate for the Phoenix Rescue Mission. "But there is fallout. It's a policy that goes against the ideas that work best in treating mothers and reuniting families once the drugs are gone."
Taylor came over to the Phoenix Rescue Mission when the Harbor Light program was shut down at the Salvation Army. The closing of Harbor Light, Taylor and several other counselors say, was a sad day for Arizona.
"It just plain worked," he says. "It breaks my heart to think how many mothers have been denied the help they need since it closed."
The only statistics regarding the Harbor Light program are by no means of scientific quality. But they are intriguing.
In the last three years of the program, when Harbor Light offered full-time child care and full-scale residential treatment for pregnant meth-addicted mothers, 27 of the 28 women who came into the program pregnant delivered a drug-free baby.
Also, 60 percent of mothers who went through the intensive yearlong program returned two years later for an annual reunion picnic held for patients.
"Nothing scientific," Taylor says, "but you don't come back and celebrate with your counselors if you're actively using. You just stay away."
Compared with all men or women with or without children who went through the program, the mothers had the highest return rate at the reunions, he says.
Taylor also ran the Harbor Light child-care facility. There, he says, he saw as much hope as in the treatment facility for mothers.
"I don't know where this idea of 'meth kids' comes from," he says. "These kids were bright, engaged, full of love. The child with real emotional or developmental problems was very much the exception."
Once Harbor Light closed, Taylor says, only one program remained in the Valley for long-term residential treatment for indigent mothers in which their children can stay at the facility with them. That program, run by the Center for Hope, has 24 beds available.
"We know there are thousands of mothers out there addicted to meth," Taylor says. "So right now, we're giving about one-tenth of 1 percent the kind of treatment known to work. That's not good at all."
The Phoenix Rescue Mission is in the planning stages of a new facility for residential treatment of drug-addicted mothers, he says.
When that's completed, perhaps 100 women per year will have a shot at the kind of treatment that gave Maggie Voss and her four children their lives back.
Taylor and other advocates around the state will be asking the governor and legislators to work toward expanding these sorts of treatment programs for drug-addicted parents.
"Right now, the direction has been away from getting treatment for the family," Taylor says. "The governor was right to run with the idea of a child's safety first. But now, we need to look at the idea of putting foster care at the end of the line. If the parents fail, then it's foster care. If they succeed, the family is saved."
Support for this sort of reform isn't just coming from the experts in treatment. It's also coming from the experts in incarceration.
"We're still falling short on the treatment end," says Phoenix police Detective Ahumada. "Everything we do is a waste if the cycle continues. I know we can do better. And considering how important this is to so many lives, we absolutely must do better."
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