PREVALENCE AND SYSTEMS PLANNING

Methamphetamine and Children

This webpage identifies the major literature in the field of prevalence and systems planning: methamphetamine and children. The time frame is from January 2000 through December 2014.

Asanbe, C. B., Hall, C., & Bolden, C. D. (2008). The methamphetamine home: Psychological impact on preschoolers in rural Tennessee. Journal of Rural Health, 24(3), pp. 229-235.

The purpose of this study was to examine whether preschoolers who lived in methamphetamine-producing homes are at increased risk for developing psychological problems. The participants were 58 white children between the ages of 4 and 5 years; 31 with a history of living in methamphetamine-producing homes and 27 children who live in non-methamphetamine producing homes in rural Tennessee. Biological or custodian parents completed a rating on their preschoolers that provided information about the children's pattern of behavior and feelings. Findings show that preschoolers from the methamphetamine-producing homes showed more externalizing problems than their peers, but were comparable on internalizing problems. On specific behaviors, the data indicate that preschoolers in the methamphetamine group showed higher aggression symptoms than their peers from non-methamphetamine-producing homes. These findings, if replicated, point to the need for mental health screening when a child is removed from a methamphetamine-producing home.

Bassindale, T. (2012). Quantitative analysis of methamphetamine in hair of children removed from clandestine laboratories – Evidence of passive exposure? Forensic Science International, 219(1-3), pp. 179–182. DOI: 10.1016/j.forsciint.2012.01.003.

This study aims to look at the results of hair analyzed from children ages 2 months to 15 years removed from clandestine methamphetamine laboratories during 2008-2010 in New Zealand. The levels of methamphetamine is then compared with those detected in adult users form the same period to determine the likelihood of external contamination. The results of this study show that there is a low level of evidence of external contamination suggests that the children are exposed to methamphetamine and are incorporating it into the hair through the blood stream.

Carbone-Lopez, K., Owens, J. G., & Miller, J. (2012). Women’s “Storylines” of methamphetamine initiation in the Midwest. Journal of Drug Issues, 42(3), pp. 226– 246. DOI: 10.1177/0022042612456013

The authors present research from 40 interviews with female methamphetamine (meth) users incarcerated in Missouri, a state that has gained national attention for having high numbers of meth lab seizures. This study focuses specifically on the ways in which women articulate their storylines of initiation into meth use. These reveal a number of important findings, including the most common contexts in which women describe first using meth and their motivations for doing so. In particular, the findings highlight the role of family drug use, prior victimization experiences, and methamphetamine’s known pharmacological effects in women’s motivations for initiation.

Carnevale Associates. (2004, October). Children endangered by methamphetamine: Drug endangered children. Darnestown, MD: Author. Available online at: http://www.carnevaleassociates.com/CAPolBriefDEC.pdf#search='Carnevale%20Associates%20and%202004%20and%20Children%20endangered

The growth in methamphetamine production and use has grown significantly over the past decade. As a result significant numbers of children have been endangered due to direct or indirect exposure to methamphetamine or living in a dwelling where methamphetamine is used or manufactured. This policy brief examines the scope of the drug endangered children, damaging effects of methamphetamine lab exposure, the effects on prenatal development, federal help available, State legislative actions, and the National Alliance for Model State Drug Laws. This brief also identifies the need for policies to improve medical protocols, medical research, and awareness and intervention.

Colby, J. B., Smith, L., O’Connor, M. J., Bookheimer, S. Y., VanHorn, J. D., & Sowell, E. R. (2012). White matter microstructural alterations in children with prenatal methamphetamine/polydrug exposure. Psychiatry Research: Neuroimaging, 204(2-3), pp. 140-148.

In this study, whole brain maps of fractional anisotropy (FA) were evaluated using tract-based spatial statistics. Relative to unexposed controls, children with prenatal methamphetamine exposure demonstrated higher FA mainly in left-sided regions. Relative to the methamphetamine-exposed group, children with prenatal alcohol exposure showed lower FA in frontotemporal region. This report demonstrates unique diffusion abnormalities in children with prenatal methamphetamine/polydrug exposure that are distinct from those associated with alcohol exposure alone, and illustrates that these abnormalities in brain microstructure are persistent into childhood and adolescence – long after the polydrug exposure in utero.

Connell-Carrick, K. (2007). Methamphetamine and the changing face of child welfare: Practice principles for child welfare workers. Child Welfare, 86(3), pp. 125.

Methamphetamine use and production is changing child welfare practice. Methamphetamine is a significant public health threat (National Institute of Justice, 1999) reaching epidemic proportions. The manufacturing of methamphetamine is a serious problem for the child welfare system, yet child welfare has not addressed the needs of children living in homes where methamphetamine is manufactured. This article presents key issues for child welfare workers related to the use, production, and effects of methamphetamine on children and families, and identifies practice principles for child welfare workers in order to ensure safety for victims, parents, and workers themselves.

Cunningham, S., & Finlay, K. (2012). Parental substance use and foster care: evidence from two methamphetamine supply shocks. Economic Inquiry, 51(1), pp. 764-782. DOI: 10.1111/j.1465-7295.2012.00481.x

This paper presents the first evidence of a causal effect of meth on foster care admissions using two exogenous supply-side interventions in meth markets from the late 1990s for identification. According to the authors, meth use appears to cause foster care caseloads to increase. These results suggest that child welfare policies should be designed specifically for the children of meth-using parents.

Derauf, C., Lester, B. M., Neyzi, N., Kekatpure, M., Gracia, L., Davis, J., Kallianpur, K…Kofosky, B. (2012). Subcortical and cortical structural central nervous system changes and attention processing deficits in preschool-aged children with prenatal methamphetamine and tobacco exposure. Developmental Neuroscience, 34(4), pp. 327-341. DOI: 10.1159/000341119

The objective of this study is to look at the relationship between prenatal methamphetamine exposure (PME) and inhibitory control at age 66 months in children. Results show that children with PME had significantly reduced caudate nucleus volumes and cortical thickness increases and that PME and PTE may have distinct differential cortical effects on the developing central nervous system. Additionally, PME may be associated with subtle deficits in attention mediated by caudate volume reductions.

Derauf, C., LaGasse, L. L., Smith, L. M., Newman, E., Shah, R., Neal, C. R., Arria, A. M…Lester, B. M. (2012). Prenatal methamphetamine exposure and inhibitory control among young school-age children. The Journal of Pediatrics, 161(3), pp. 452-459.

This study examined the association between prenatal methamphetamine exposure and inhibitory control in 66-month-old children. Analysis of the study reflect that heavy prenatal methamphetamine exposure was related to reduced accuracy in both the incongruent and mixed conditions on the Stroop-like task. Caregiver psychological symptoms and Child Protective Services report of physical or sexual abuse were associated with reduced accuracy in the incongruent and mixed conditions and in the incongruent conditions, respectively. Heavy prenatal methamphetamine exposure, along with caregiver psychological distress and child maltreatment, are related to subtle deficits in inhibitory control during the early school-age years.

Haight, W., Jacobsen, T., Black, J., Gingery, L., Sheridan, K., & Mulder, C. (2005). “In these bleak days": Parent methamphetamine abuse and child welfare in the rural Midwest. Children and Youth Services Review, 27(8), pp. 949-971.

This report describes the impact of parent methamphetamine abuse on the development and wellbeing of school-aged children, and considers implications for culturally appropriate child welfare services. Thirty-five adult informants from several, adjacent rural Midwestern counties in the United States were interviewed as part of a larger ethnographic study. Child welfare workers, other community professionals (educators, counselors, law enforcement personnel, and substance abuse treatment providers), and foster caregivers described their experiences with families involved with methamphetamine. Overall, informants described that children are brought by their methamphetamine-abusing parents into a rural drug culture characterized by distinct, antisocial beliefs and practices. Children's experience of this culture includes environmental danger, chaos, neglect, abuse, loss, and isolation. Informants believed that children develop antisocial beliefs and practices such as lying, stealing, drug use, and violence through direct teaching by their parents and, indirectly, through observing parents' own antisocial behavior. Informants described children as displaying psychological, social, and educational disturbances. They also described individual variation in functioning across children that they attributed, in part, to individual (e.g., temperament, intelligence), familial (e.g., extended family), and community (e.g., school) characteristics. Informants noted a need for effective child mental health services in the area, and for ensuring a positive environment for children's future development through education of the children, foster parents and other community members. The authors discuss four strategies for enhancing the development of school-aged children whose parents abuse methamphetamine: (1) enhancing education in schools and communities; (2) enhancing timely, child welfare involvement with children of methamphetamine abusers; (3) providing timely access to quality mental health services focused on adequate assessment, trauma, and socialization; and (4) employing culturally and developmentally sensitive intervention practices.

Holman, M., Oliver, R., & Wright, W. (2004). Methamphetamine abuse and manufacture: The child welfare response. Social Work, 49(3), pp. 373-381.

This article describes the history of methamphetamine, the effects of methamphetamine use, treatment for methamphetamine abuse, and the effects of exposure to methamphetamine during pregnancy. The authors examine the ways exposure to the manufacture of this drug affects clients and social workers in the course of their work. Because children are frequently found at the scene of a manufacturing laboratory, the child welfare system often becomes involved, and child protective services and other social work agencies need protocols on how to recognize home laboratories and on how to address the needs of these children and their parents. In 1997, California created and implemented Drug-Endangered Children's units in seven counties to address the needs of children from families that manufacture methamphetamine; these units involve collaborative efforts among child protective workers, district attorneys, physicians, and police officers. A case example provides information about the role of social workers and their collaboration with these multiple systems.

LaGasse, L. L., Derauf, C., Smith, L. M., Newman, E., Shah, R., et al. (2012). Prenatal methamphetamine exposure and childhood behavior problems at 3 and 5 years of age. Pediatrics, 129(4), pp. 681-688.

The authors evaluated behavior problems in children who were prenatally exposed to methamphetamine (MA) at ages 3 and 5 years. Results show that MA exposure was associated with increased emotional reactivity and anxious/depressed problems at both ages and externalizing and attention deficit/hyperactivity disorder problems by age 5 years. Heavy exposure was related to attention problems and withdrawn behavior at both ages. There were no effects of MA on the internalizing or total behavior problems scales. This first report of behavior problems in patients as young as 3 years associated with MA exposure identifies an important public health problem. Continued follow-up can inform the development of preventive intervention programs.

Liles, B. D., Newman, E., LaGasse, L. L., Derauf, C., Shah, R., Smith, L. M., Arria, A. M...Lester, B. M. (2012). Perceived child behavior problems, parenting stress, and maternal depressive symptoms among prenatal methamphetamine users. Child Psychiatry of Human Development, 43(6), pp. 943-57. DOI: 10.1007/s10578-012-0305-2

The present study was designed to examine parenting stress, maternal depressive symptoms, and perceived child behavior problems among mothers who used methamphetamine (MA) during pregnancy. Mothers in the study who used MA during pregnancy reported more parenting stress and more depressive symptoms than a matched comparison group. There were no differences between groups on perceived child behavior problems. Screening for potential parenting problems among mothers with a history of substance abuse is warranted. Parenting interventions targeting depressive symptoms, parenting stress, and child behavior problems are needed for this population.

Lloyd, H. M., & Akin, B. A. (2014). The disparate impact of alcohol, methamphetamine, and other drugs on family reunification. Children and Youth Services Review, 44(1), pp. 72-81.

This article presents the findings of a study analyzing the impact of parental use of alcohol, methamphetamine, other drugs, and poly-substances on reunification rates for children in foster care. The author’s analyzed data from a Midwestern state between the years 2007-2012 to evaluate the contribution of each substance use domain, results show that methamphetamine had the most significant impact on the likelihood of reunification, followed by other drugs, and poly-substances. Other findings suggest that children removed due to parental substance use stayed in foster care for an average of 49-156 days longer than other children.

Oster, T., W. Haight, et al. (2007). Case series: Mental health needs and perspectives of rural children reared by parents who abuse methamphetamine. Journal of the American Academy of Child and Adolescent Psychiatry, 46(4), pp. 500.

This case-based, mixed-methods study was undertaken to understand the perspectives and mental health needs of rural children exposed to parental methamphetamine abuse. Participants were 23 children involved with a state child protective agency because of parental methamphetamine abuse. A semi structured interview provided information on children's perspectives of their families. Information on children's mental health needs was obtained from the Child Behavior Checklist and Trauma Symptom Checklist. Case records and caseworker reports provided information on children's family experiences. Children described emotional pain; few social resources for coping with emotions, problem solving, or talking about their experiences; and avoidant or passive coping skills. Sixty-five percent of children evidenced significant dissociative or posttraumatic symptoms on standardized assessments; 57% had other significant emotional and behavioral problems. Challenges to understanding children's perspectives included children's perceptions that talking about methamphetamine abuse was taboo and underreporting of significant symptoms on the Trauma Symptom Checklist. The high rate of mental health problems suggests the need for nontraditional strategies for services delivery in rural areas that are targeted toward these vulnerable children. Early identification and treatment of mental health problems should be a priority. Clinicians should be alert to the complexities in assessing children's mental health needs.

O'Brien, A. M., Brecht, M., & Casey, C. (2008). Narratives of methamphetamine abuse: A qualitative exploration of social, psychological, and emotional experiences. Journal of Social Work Practice in the Addictions, 8(3), pp. 343-366.

Clinicians are increasingly confronted with treating the dramatically growing numbers of methamphetamine (MA) abusers. However, scant research documents the internal experience of MA abuse. This study uses data from ethnographic interviews to describe the development of MA abuse across users' lives. Results show drug initiation emerging from abuse during childhood and parental drug abuse. Respondents entered drug-using peer groups that paradoxically offer both protection from and vulnerability to violence and other problems. Consequences of MA abuse include economic instability and concern with only the acquisition and use of MA, instead of MA-related problems. Understandings of "problematic" drug use emerge as respondents stigmatize users who lack basic resources and hurt others for the sake of money or drugs, and parents whose use interferes with parenting. Respondents describe barriers and alternatives to treatment. Results provide insight into the experience of MA abuse. Theoretical considerations and implications are discussed.

Pennar, A. L., Shapiro, A. F., & Krysik, J. (2012). Drug endangered children: Examining children removed from methamphetamine laboratories. Children and Youth Services Review, 34(9), pp. 1777–1785. DOI: 10.1016/j.childyouth.2012.05.006

The purpose of this article is to describe a sample of children removed from homes with methamphetamine laboratories involved in the Arizona Drug Endangered Children (DEC) Program and examine associations between testing positive for methamphetamine, assessment of risk for abuse, perpetrator of abuse, and placement outcomes. It is the authors’ purpose that the findings from this study will help promote more adequate assessments of the needs of children removed from homes with methamphetamine laboratories. Older children were more likely to be designated low risk for further abuse, test negative for methamphetamine, and have paternal alleged perpetrators of abuse. Results also show that children initially placed in foster care were more likely to remain in foster care at the final assessment than to be living with a parent or kin. These findings have implications for individuals working with children removed from homes with methamphetamine laboratories, and recommendations based on study findings are offered to child and family advocates and interventionists.

Shah, R., Diaz, S. D., Arria, A., LaGasse, L. L., Derauf, C., et al. (2012). prenatal methamphetamine exposure and short-term maternal and infant medical outcomes. American Journal of Perinatology, 29(5), pp. 391-400.

This study’s objective is to examine maternal and infant medical outcomes of prenatal exposure to methamphetamine (MA). According to this study, MA-exposed infants were more likely to exhibit poor suck, to have smaller head circumferences and length, to require neonatal intensive care unit (NICU) admission, and to be referred to child protective services (CPS). Prenatal MA exposure is associated with maternal psychiatric disorder/ emotional illness, poor suck, NICU admission, and CPS involvement, and MA-exposed infants were less likely to be breast-fed; however, the absence of many serious complications, such as fetal distress, chronic hypertension, preeclampsia, placenta previa, abruptio placentae, and cardiac defects, suggests confounding variables influenced prior studies.

Sheridan, K., Haight, W.L., & Cleeland, L. (2011). The role of grandparents in preventing aggressive and other extreme problems in children from rural, methamphetamine-involved families. Children and Youth Services Review, 33(9), pp. 1583-1591. DOI: 10.1016/ j.childyouth.2011.03.023

This mixed method study explored naturally occurring sources of protection and considers the implications for targeted interventions. Participants were 41 children aged six to 14 years from rural families involved with methamphetamine and the public child welfare system, their primary caregivers, and 19 parents recovering from methamphetamine addiction. When invited during semi-structured interviews to talk about their families, 48% of children spontaneously described socially and emotionally supportive relationships with healthy grandparents. Children's and parents' descriptions of grandparent support suggest how grandparents may protect children from the development of aggressive and other externalizing behavior problems. Understanding naturally occurring sources of protection for children can inform the development of interventions by identifying strengths on which to build, and suggesting culturally sensitive approaches when children are struggling.

Smith, L.M., LaGasse, L.L., Derauf, C., Newman, E., Shah, R., Huning, W., Arria, A…Lester, B.M. (2011). Motor and cognitive outcomes through three years of age in children exposed to prenatal methamphetamine. Neurotoxicology and Teratology, 33(1), pp. 176-184. DOI: 10.1016/j.ntt.2010.10.004

To examine the effects of prenatal methamphetamine exposure on motor and cognitive development in children at 1, 2, and 3 years of age. IDEAL enrolled 412 mother–infant pairs at four sites (Tulsa OK, Des Moines IA, Los Angeles CA, and Honolulu HI). The Peabody Developmental Motor Scales (PDMS-2) were administered to the infants at the 1 and 3 year visits. This analysis includes a subsample (n = 350) of the IDEAL study with completed 1 and/or 3 year visits (n = 330 and 281, respectively). At each annual visit we also conducted the Bayley Scales of Infant Development (BSID-II) as a general evaluation of mental and motor development. The BSID-II analysis includes a subsample (n = 356) of the IDEAL study with completed 1, 2, and/or 3 year visits (n = 331, 288, and 278 respectively). GLM analysis conducted on the PDMS-2 and BSID-II examined the effects of MA exposure and heavy MA exposure (≥ 3 days of use/week), with and without covariates. Longitudinal analyses were used to examine the effects of MA exposure on changes in motor and cognitive performance over time. Heavy MA exposure was associated with significantly lower grasping scores than some and no use at 1 year (P = 0.018). In longitudinal analysis, lower grasping scores associated with any MA exposure and heavy exposure persisted to 3 years. There were no effects of MA exposure, including heavy exposure, on the Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) at any or across age. There were no differences in cognition as assessed by the BSID-II between the groups. There was a subtle MA exposure effect on fine motor performance at 1 year with the poorest performance observed in the most heavily exposed children. By 3 years, no differences in fine motor performance were observed. These findings suggest MA exposure has modest motor effects at 1 year that are mostly resolved by 3 years.

Smith, L. M., Paz, M. S., LaGasse, L. L., Derauf, C., Newman, E., et al. (2012). Maternal depression and prenatal exposure to methamphetamine: neurodevelopmental findings from the infant development, environment, and lifestyle (ideal) study. Depression and Anxiety, 29(6), pp. 515-522.

The aim of this study is to help determine the neurobehavioral effects of maternal depression on infants exposed and not exposed to methamphetamine (MA) using the NICU Network Neurobehavioral Scale (NNNS). According to the authors, maternal depression is associated with neurodevelopmental patterns of increased stress and decreased quality of movement, suggesting maternal depression influences neurodevelopment in infants as young as 1 month.

Vandermause, R. K. (2012). Being wholesome: The paradox of methamphetamine addiction and recovery - A hermeneutical phenomenological interpretation within an interdisciplinary, transmethodological study. Qualitative Social Work, 11(3), pp. 299–318. DOI: 10.1177/ 1473325011401470

This article presents a Heideggerian hermeneutic interpretation of findings from an interdisciplinary, transmethodological study addressing the questions, ‘What does it mean to experience methamphetamine addiction? What does it mean to recover?’ Study aims, to: (1) uncover the meaning of addiction and recovery via case intensive analysis, and (2) generate an interdisciplinary, transmethodology for understanding complex Health-care problems, were intended to stimulate a deeper understanding of the experience of addiction and recovery through an innovative methodological approach. Scholars from Nursing, English, Teaching and Learning, and Fine Arts contributed to the analysis. This article presents the hermeneutic interpretation of the transmethodological study.

Wouldes, T. A., LaGasse, L. L., Derauf, C., Newman, E., Shah, R., Smith, L. M., Arria, A. M…Lester, B. M. (2013). Co-morbidity of substance use disorder and psychopathology in women who use methamphetamine during pregnancy in the US and New Zealand. Drug and Alcohol Dependence, 127, pp. 101-107.

This study examined prenatal MA use and the co-morbidity of SUD and psychiatric disorders at 1-month postpartum. In the US and NZ, MA groups had lower SES, increased single parenting, delayed prenatal care, and increased polydrug use, and had lower income than the comparison group. MA users were 10 times more likely to have a SUD and twice as likely to meet BSI criteria for a diagnosable psychiatric disorder. In NZ, but not the US, MA users were five times more likely to have co-morbidity of both. This disparity may be due to higher quantities of prenatal alcohol use associated with increased psychiatric symptoms. These findings suggest that addressing both substance abuse and psychiatric disorders in mothers who use MA may be required to effectively treat maternal MA use.

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