There is broad agreement among drug counselors and health professionals that more treatment programs must be created for addicted parents and their children. But those working the front lines believe other actions also are critical. Here are some of their suggestions:
* Every agency that comes in contact with women and children--schools, hospitals, social service agencies or welfare programs--must work harder to identify children in substance-abusing families. A 1992 survey of 72 hospitals found that less than half had any protocol to identify children of female patients who abused alcohol and narcotics.
* Women jailed for drug offenses should be allowed to serve their sentences in residential drug treatment programs, preferably with their children. Incarcerating such women, advocates say, does not address the cause of their problem, further harms their children and costs taxpayers more in the long run.
* Drug treatment providers and welfare agencies should offer family planning services. A UCLA study shows that 60% of women who have given birth to one drug-exposed baby go on to have another. Some experts believe that welfare agencies should make payments contingent upon random drug tests.
* Schools must do a better job of cracking down on truancy and of tracking children who leave one school but do not enroll in another--a sign of possible family substance abuse. More support groups and counselors are needed for children living with addicted or alcoholic parents.
* The staffs of child protective services departments must be beefed up and better trained, so people who suspect possible abuse or neglect feel more confident that appropriate actions will be taken.
* All children placed in foster care should automatically receive therapy, which today is rare. Even when such counseling is court-ordered, government health programs pay for only one session every two weeks.
* Child protection agencies should ensure that drug-exposed infants taken away from their mothers at birth are returned only if the mother completes drug treatment. Today, that frequently does not happen.
* Medicaid must liberalize its payments for drug treatment, which have been cut back in recent years as the federal program has moved to managed-care providers.