How Hamilton County is Helping Children Caught in the Opioid Epidemic

A Hamilton County Jobs and Family Services program may offer a solution for addicted parents who want to keep their kids and get clean.
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Hope was born on a Friday in 2019 at Good Samaritan Hospital. Her mother, Faith, remembers the exact moment she first saw her daughter’s face: 12:43 p.m. “It was perfect. She was the most beautiful thing I’d ever seen in my life. Then her skin started turning blue.”

Illustration by Alex Nabaum

The baby had a hole in her lung caused by meconium aspiration syndrome, and she had been exposed to opioids in utero. Faith and Hope are not the pair’s real names; rather, they were chosen to protect their identities and, Faith says, to represent important concepts in her life.

For five years, Faith struggled to overcome an opioid addiction. After she endured eight surgeries over 10 months to treat her Crohn’s disease, a doctor prescribed Percocet, and things started to fall apart. “It’s not like one day I wanted to pick it up,” she says of her addiction. “But I understand I hurt a lot of people along the way.”

Faith told her doctors about her opioid use during the pregnancy. So two agents from Hamilton County’s Jobs and Family Services (JFS) arrived at the hospital to let her know that her child would not be allowed to be in her care for a minimum of 30 days, and then the case would be re-evaluated. “If I stayed clean, she could possibly stay with me,” Faith says. “I made the decision to go into in-patient treatment.” She then began addiction recovery through a program she would later know as START—Sobriety Treatment and Recovery Teams.

In May 2016, the U.S. House of Representatives looked for ways to address the impact the opioid epidemic was having on children. At the time, more than 400,000 minors were in foster care nationwide, with roughly a quarter landing there for drug-abuse related reasons. One program that seemed to be having some success was START. The program represents a relatively new way of thinking about the issue: that parents should be given support through their addiction, instead of being separated from their children.

START began in Cuyahoga County during the 1990s crack epidemic in Cleveland, and it expanded to Kentucky in 2006. There, the program has yielded positive results: Participating mothers in Kentucky have been twice as likely to achieve sobriety than those in the regular Child Protective Services (CPS) system; their children are less likely to enter foster care; and more than 75 percent of kids stay with their families.

The key to START’s success is its focus on familial support. Each family is assigned a START caseworker and a peer mentor, someone who’s gone through treatment to become sober. In 2017, then–Attorney General Mike DeWine announced an expanded version of the program in 17 counties in southern Appalachian Ohio. It quickly grew, and now START currently exists in 46 of the state’s 88 counties. The goal is to add 16 more by the end of 2020, and to eventually reach every corner of the state. Now, as governor, DeWine has continued to support START’s growth with an increase in the state budget for START programs to the tune of $10 million.

While it’s too soon to see how that funding will impact Hamilton County’s START initiatives, Faith has already seen her own positive changes. She recently moved out of the First Step house and into her own apartment. And while she doesn’t have a car, her caseworker has helped by driving her to look at a daycare. She says she’s moved on from just learning how to live; she’s now learning how to be a mom. “When I was real bad, I prayed every day to die, doing gram-shots of dope and being pissed when I woke back up,” Faith says. “Now I’m happy. Genuinely happy. Hope brings so much joy to my life.”

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