The preschooler snuggles close to her mother on the couch, limp like the blanket that covers the two of them. "She’s got a fever," the mother whispers as she strokes her daughter’s hair.
Not such an unusual sight, unless you consider that the mother is a recovering methamphetamine addict, she’s pregnant with her second child, and this little family lives with more than 20 other women and their kids in a residential drug treatment program. The Center for Hope in Mesa is the only place in the East Valley that takes drug-addicted pregnant women and their kids, and one of only a few in the state. But that may change in the coming years as growing support for methamphetamine prevention and treatment takes hold.
Though methamphetamine has been on the scene for decades, federal and local policymakers have focused mainly on busting large labs and reducing access to the drugs used in its manufacture. Meanwhile, politicians, police and others have promulgated several meth myths, making the drug sound impossible to kick and demonizing its users, particularly those who have children.
"The myth that needs to be debunked is that treatment doesn’t work. It works," says Rob Evans, director of the governor’s office of substance abuse policy. "But treatment capacity is always an issue. It’s sort of a constant effort to be able to fill those gaps, and the gaps are pretty big."
Gov. Janet Napolitano recently called for coalitions in every county to devise plans to combat meth in anticipation of a two-day conference on the drug in February. The state’s behavioral health system has put out its first contracts for methspecific treatment, and state Child Protective Services is working with treatment experts to find ways to keep families together or at least reunify them sooner.
The Arizona Parents Commission is spending about $1.6 million in state alcohol tax money for the conference and technical support to anti-meth coalitions.
"What we’re trying to do now is educate the population that meth is a serious problem, but you need to look at it differently," says Frank Scarpati, CEO of Community Bridges, a substance-abuse treatment center that opened Center for Hope in January. "People don’t destroy their brain and their body by choice."
Scarpati’s agency has one of the first state contracts to develop meth-specific treatment using a model that includes behavioral therapy, time management, drug testing, family involvement and positive reinforcement.
"I think it’s harder to treat a pot smoker than a meth addict, because it’s
harder to make them see that it’s hurting them. It’s not hard for a meth addict to see that their life is out of control," says Kimberly Craig, who researched meth treatment under a federally funded program in Montana before opening the Center for Hope in January.
"The truth is, many of these women had very successful lives at one point. They were working, they were part of the community, they came from good families," she says. "This is the devastation of drug addiction."
Long in the cross hairs of law enforcement and child welfare agencies, methamphetamine addicts had been given up as lost causes. The hype surrounding the drug and the children of meth users has rivaled that of the 1980s crack cocaine problem and "crack babies." Hospitals are testing mothers for drug use, and CPS has put their newborns into foster care.
In a July letter to national newspapers and network TV stations, more than 90 medical doctors, scientists, psychologists and treatment experts implored the media to stop using terms like "meth babies" and not to rely on non-experts for information about treatment or the effects of prenatal drug exposure, and to stop labeling babies as "addicted" to meth since no symptoms of addiction have been found among babies whose mothers used drugs while pregnant.
"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 rather than in the ongoing research and improvement and provision of treatment services that are so clearly needed," the letter said.
In states such as South Carolina, drug-abusing mothers have been jailed for child abuse. Maricopa County Attorney Andrew Thomas plans to push legislation that would allow his prosecutors to do the same after placing the newborn in state custody.
The bill, sponsored by Rep. Steve Yarbrough, R-Chandler, would make it a crime for a mother to give birth to a baby who tested positive for illegal drugs or showed an injury within a year of birth that resulted from the mother’s drug use. It also would require health care workers to notify police when they believe a baby has been exposed to drugs.
"A condition would most likely be that they have to undergo courtordered treatment," says Yarbrough. "The goal is to change the behavior, so that the next baby is not going to suffer the same harm that this one did."
Yarbrough says he’s met with Scarpati and is impressed with Center for Hope, but believes the law is necessary to force women into such programs. "We have a shared goal," he says. "We may have a different perspective on how to get there."
But critics say such laws prevent women from seeking prenatal care and getting off drugs. At the same time, because few treatment programs accept children or pregnant women, addicted mothers must choose between their children and their addiction.
"There’s no way to protect children without protecting mothers and families," says Lynn Paltrow, a lawyer and director of National Advocates for Pregnant Women, a New York City-based nonprofit organization. "We claim to be a country that cares about families, and yet so many of our policies actually split up families," she says. "The notion that people can just go out and get the drug treatment they need is absurd."
To be sure, methamphetamine packs a powerful combination — highly addictive, cheap, long-lasting and easily accessible — and it has taken its toll on children and families.
Meth was the most popular drug among parents entering Child Protective Services’ substance-abuse program, the vast majority accused of child neglect, not abuse. About 1,200 parents who participated in the Arizona Families FIRST program had more than 2,000 children placed in foster care, according to the most recent evaluation of Arizona Families FIRST.
"The drug and the type of addiction that comes with it does pose a risk to kids, particularly when there’s not another caretaker in the home," says Steve Sparks, who oversees Arizona Families FIRST for the state Department of Economic Security’s Division of Children, Youth and Families. "That’s particularly true with very young children, infants and toddlers, who require 24-hour attention."
But Sparks says that not all parents who use meth are the same, and not all of their children should be taken into foster care. Treatment programs that allow families to stay together have proved effective. "It isn’t just the substance, in and of itself. It’s what is the effect of the drug on the parent’s ability to provide proper care to their children."
Center for Hope’s first graduate made that decision herself, sending her three boys to live with their father in Michigan when she realized her meth addiction had taken over.
The center insists that the women and their families not be identified.
Articulate and attractive, the newly divorced, working mother of three said she started using meth because "it gave me energy. I thought it made me perform better."
But over the next two years, she would lose her job and her apartment, become pregnant and deliver a girl who tested positive for meth, and become pregnant again, this time landing at the Center for Hope in time to kick the addiction and deliver a drug-free boy in April. She left the Mesa treatment center earlier this month, clean, confident, gainfully employed and devoted to her children.
"Life does go on without drugs," she says. "You can be happy. You can be a better mom. You can work and be part of society again, and feel like you’re important and not just an addict."
A total of 24 women, either pregnant or with their new babies, plus up to eight toddlers live and recover together at the center. Roughly three-quarters are addicted to meth. Some are sent by judges, and some are referred from other programs in the community. Their first several days are spent sleeping, eating and getting cleaned up — "we just let her know that she’s safe, that she can take a deep breath," Craig said.
Another of Center for Hope’s residents comes from a close-knit Mormon family in Gilbert and had been using meth for about five years. Her mother brought her to the center in May after she moved back home, pregnant and addicted. The buoyant, artistic 22-year-old brunette is due to deliver a baby boy any day.
"The place is a miracle," says the young woman’s mother. "I really believe it is the length of the program . . . and dealing with every aspect of what these girls have been through."
She visits often and has gotten to know many of the women at the center. Like her daughter, they have lived through much in their short lives. Unlike her daughter, though, most don’t have such solid family support.
"People need to be forgiving and have much more understanding about how this drug works," says the mother. "None of them just went out and wanted to be bad.
"The things that they’ve been through, they really hardly had a chance. And now, they have one."