Ice, Ice, Baby

Page 6 of 7

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."

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Robert Nelson