CONTEXT COUNTS IN CARING FOR CHEMICALLY DEPENDENT KIDS AND FAMILIES

By Andrew Malekoff©

Despite feeling blindsided, many of us now know that we are living in the midst of an unprecedented drug epidemic. According to the U.S. Department of Health and Human Services, since 1999, the rate of overdose deaths including prescription pain relievers, heroin and synthetic opioids such as fentanyl, nearly quadrupled.

In the intervening years, many steps have been taken to help save lives. These include improving prescribing practices and expanding access to medication-assisted treatment and the use of Naloxone. 

Medication-assisted treatment combines behavioral therapy and medications such as methadone or buprenorphine to treat opioid addiction. Through affordable, accessible and quality care people can recover and go on to live productive lives.

Naloxone is used to treat a narcotic overdose in an emergency situation by reversing the effects of opioids, including slowed breathing or loss of consciousness.

Notwithstanding the increased attention to lifesaving measures, there is relatively little focus on the devastating impact of addiction on children living in families where a parent is addicted to drugs or alcohol.

There are more than 8 million children under 18 years of age that are growing up in homes with alcohol and other drug-abusing parents. These young people are likely to become alcohol or drug abusers themselves without intervention.

Parental alcoholism and drug addiction influence the use of alcohol and other drugs in several ways. These include increased stress and decreased parental monitoring that contributes to adolescents’ joining peer groups that support drug use.

Children who grow up with an addicted parent learn to distrust to survive. When unpredictability dominates one’s life, he or she is likely to be wary, always sensing disappointment lurking nearby.

Children growing up with an addicted parent become uncomfortably accustomed to living with chaos, uncertainty and unpredictability. When a child grows up under these conditions, they learn to guess at what normal is.

Denial, secrecy, embarrassment and shame are common experiences of children who live with an addicted parent. Even seeking help outside of the family might in itself be seen as an act of betrayal, a step toward revealing the family secret. The stigma of addiction can leave chemically dependent persons and family members feeling utterly alone in the world.

Children who grow up with an addicted parent live with the unspoken mandate - don’t talk, don’t trust, don’t feel.

Growing up with an addicted family member leaves children with little hope that things will ever change. I am reminded of a parable about the small village on the edge of a river.

One day a villager saw a baby floating down the river. He jumped in the river and saved the baby. 

The next day he saw two babies floating down the river. He and another villager dived in and saved them. Each day that followed, more babies were found floating down the river. The villagers organized themselves, training teams of swimmers to rescue the babies. They were soon working around the clock.

Although they could not save all the babies, the rescue squad members felt good and were lauded for saving as many babies as they could. However, one day, one of the villagers asked: "Where are all these babies coming from? Why don't we organize a team to head upstream to find out who's throwing the babies into the river in the first place!"

Mobilizing resources to pull babies from the river, while neglecting the ones left behind makes no sense.

Published in Behavioral Health News, FALL (2) 2017 Issue, Volume 5, Number 2, p. 20

SHORTSIGHTED CUTS TO DRUG TREATMENT

http://www.newsday.com/opinion/letters/letter-shortsighted-cuts-to-drug-treatment-1.4809203

Shortsighted cuts to drug treatment

Andrew Malekoff

March 14, 2013

Regarding the escalating drug problem on Long Island ["Deadly turn to heroin," News, March 11], six months ago, County Executive Edward Mangano held a news conference on the growing heroin and prescription pill problem in Nassau County. He stood with the mothers of children who died from drug overdoses.

To remedy this he announced that Nassau had been certified by the New York State Department of Health to train its employees, as well as families of at-risk individuals, in administering the overdose-reversal agent Narcan to anyone who has ingested large amounts of opioids like heroin.

Any step to save lives is welcome. However, at the news conference there was no mention of $7.3 million in human services funding that was cut on July 5, 2012, which included $1.75 million for outpatient drug treatment.

I am reminded of the parable about the small village on the edge of a river. One day a villager saw a baby floating down the river. He jumped in the river and saved the baby. The next day he saw two babies floating down the river. He and another villager dived in and saved them. Each day that followed, more babies were found floating down the river. The villagers organized themselves, training teams of swimmers to rescue the babies. They were soon working around the clock.

Although they could not save all the babies, the rescue squad members felt good and were lauded for saving as many babies as they could. However, one day, one of the villagers asked: "Where are all these babies coming from? Why don't we organize a team to head upstream to find out who's throwing the babies into the river in the first place!"

Mobilizing county resources to pull babies from the river while simultaneously cutting back on activities to prevent the babies from being tossed into the river in the first place makes no sense.

Andrew Malekoff

Editor's note: The writer is the executive director of the nonprofit North Shore Child and Family Guidance Center in Roslyn Heights.

SAVE OUR SERVICES

SAVE OUR SERVICES
The Olympic games in London have inspired us with the fetes of 15-year-old swimming sensation Katie Ledecky and the diminutive dynamo of gymnastics, 17-year-old Gaby Douglas. At the same time, in Nassau County, there is a game of political cat-and-mouse being played by our elected officials who have put tens of thousands of vulnerable young people in the legislative crosshairs.

The July 6th funding cuts to essential human services provide a chilling insight into the insidious nature of Nassau County politics. The Democratic minority on the Nassau County Legislature chose not to authorize $41 million in borrowing for tax refunds. Republicans claim that the democrats are withholding their votes as a ploy to get new election districts redrawn. Democrats state that the funding cut is a policy decision by Nassau County Executive Edward Mangano.

In an attempt to draw wider attention about the impact of the budget cuts, STRONG Youth, Inc., a gang-prevention program in Hempstead that lost all of its county funding, staged a symbolic funeral for youth services at the Hempstead Pentecostal Church on August 2nd. I attended the funeral and participated in the processional motorcade led by two hearses that traveled past the legislative building in Mineola and concluded in a press conference on the steps of the Supreme Court.

Some critics accused STRONG of being too extreme. Others called the symbolic funeral disrespectful of the dead. Nothing could be farther from the truth. The funeral, procession and press conference were impeccably organized in less than a week by STRONG social workers and volunteers, young and old, who galvanized a complex network of children, teenagers, parents (including parents of murdered children), crime victims, clergy, colleagues, community leaders and local businesses.

The only thing extreme about the “funeral” was in the exceptional orchestration and staging of an event aimed at exposing the gap between what we know and what we are told by government officials. The skills used to organize this event are the same ones that are used by professional social workers to develop and implement an exemplary gang prevention program that aims to engage young people to become successful students and active citizens in community affairs. Nassau County should not be eliminating programs like STRONG, they should be celebrating and promoting it as a best practice in gang prevention.

One of the speakers at the press conference was a young woman, Amory Sepúlveda, who testified, “When I was 19-years-old I was the innocent victim of a drive-by shooting that resulted in [my] never being able to walk again. I was hurt physically, emotionally and thought my life was over. With the help of county youth services I am now a college graduate in pursuit of a master’s degree [in social work]. I’ve shared my story, changing the lives of thousands of youth in Nassau County.”

The shame of Nassau County and its loss of humanity are evident in our elected representatives’ failure to value, respect, uplift, defend and safeguard all of the County's children when having the power to do so. Our elected officials have demonstrated, notwithstanding their ever-present availability for photo ops designed to depict a contrary impression, that they have little respect for our most vulnerable citizens.

When our elected representatives implement politically-motivated cost cutting they miss the human toll and they miss the fiscal consequences of their decisions. Our elected representatives miss that they are cutting cost-effective services that keep people out of jail, emergency rooms and costly psychiatric institutions.

During harsh economic times when all of our best efforts are needed to preserve families and save lives, the recent cuts to human services will not only destroy families but increase the long term burden to the taxpayer. And, it will bear an even greater cost in lives lost, kids plucked from their homes and families splintered and destroyed.

Andrew Malekoff, Long Beach

The author is executive director of North Shore Child and Family Guidance Center in Roslyn Heights.

ENOUGH IS ENOUGH

ENOUGH IS ENOUGH

Andrew Malekoff

Submitted to Long Island Newsday on July 16, 2012

The recent spate of politically-motivated funding cuts to essential human services and the ritual recruitment of our neediest citizens as unpaid lobbyists offers a chilling insight into how far Nassau County leadership has fallen.

The Democratic minority on the Nassau County Legislature voted four times against authorizing $41 million in borrowing for tax refunds. Republicans claimed that the Democrats are using their voting leverage to get new election districts redrawn. Democrats asserted that the cuts represented a policy decision by Nassau County Executive Edward Mangano.

In 2009, then-County Executive Tom Suozzi, whose motto for human services was "No Wrong Door," cut funding from 43 agencies serving over 60,000 people. In so doing, he "enlisted" the county's most vulnerable citizens to become his unpaid lobbyists to advocate for red-light cameras, cigarette taxes and traffic violation reform.

Red-light camera legislation was approved in Albany and local agencies were given bi-partisan assurance of restored and sustainable funding. That “reserved” fund was taken off the table by County Executive Ed Mangano as a consequence of the county legislature’s failure to pass the bonding.

When our elected representatives implement politically-motivated cost cutting they demonstrate a loss of empathy. What’s worse, is that they lose all reason. They miss the human toll and they miss the fiscal consequences of their decisions. They are relegated to finger-pointing, tantruming two-year olds hell-bent on getting what they want at any cost.

Our elected representatives miss that they are cutting cost-effective services that keep people out of jail, emergency rooms and costly addictions and mental health institutions. They discount the lives that will be saved by preventing suicide and drug overdoses. They ignore the human and fiscal benefits that quality services bring in effectively addressing homelessness, hunger, runaways, gangs, unemployment, family crises, eating disorders, sexual abuse, teen pregnancy and much more.

Our elected officials have demonstrated, notwithstanding their ever-present availability for photo ops designed to depict a contrary impression, that they have little respect for our most vulnerable citizens. Too harsh an assessment? Let’s face it, behavior talks.

Our services are referred to as “discretionary,” connoting that they are dispensable; which, we have learned, they surely are. We are reminded of this on a regular basis when our funds are slashed and our people are taken hostage to lobby for bonding or red-light cameras and, I am sure, in time, for gambling.

Moody’s Investors Service offers an opinion about the county’s general creditworthiness, or expected loss. I wonder how Nassau County would stack up if there was Moody’s Vulnerable Citizens Service that judged how we treat our most at-risk teenagers or seniors.

During harsh economic times when all of our best efforts are needed to preserve families, the recent cuts to human services will increase the long term burden to the taxpayer. And, it will bear an even greater cost in lives lost, kids plucked from their homes and families splintered and destroyed.

It is time for the people who we elected to represent us to get real.

Andrew Malekoff

Mr. Malekoff is executive director and chief executive for North Shore Child and Family Guidance Center in Roslyn Heights, New York