[Congressional Record Volume 145, Number 65 (Thursday, May 6, 1999)]
[Senate]
[Pages S4888-S4889]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD (for himself and Mr. Jeffords):
  S. 971. A bill to amend the Public Health Service Act to revise and 
extend the grant program for services for children of substance 
abusers; to the Committee on Health, Education, Labor, and Pensions.


     Services for Children of Substance Abusers Reauthorization Act

 Mr. DODD. Mr. President, I rise to join Senator Jeffords in 
introducing the Children of Substance Abusers Reauthorization Act'' 
(COSA). This legislation represents a vital step in expanding and 
improving early intervention, prevention, and treatment services for 
families confronting substance abuse. In addition, this legislation 
addresses the devastation generated in the wake of parental substance 
abuse--the physical and emotional difficulties faced by children of 
substance abusers, abuse and neglect, and adolescent substance abuse 
and violence.

  Children with substance abusing parents face serious health risks, 
including congenital birth defects and psychological, emotional, and 
developmental problems. For example, fetal exposure to alcohol puts a 
child in danger of fetal alcohol syndrome and other congenital birth 
defects. In addition, each year around 500,000 babies are born 
prenatally exposed to some form of addictive substance including crack, 
alcohol, and tobacco, compromising their long-term ability to thrive 
and to learn.
  We also know that substance abuse plays a major role in child abuse 
and

[[Page S4889]]

neglect--irreparably damaging family bonds and threatening to further 
strain an already over-burdened child welfare system. In fact, over the 
past 10 years, fueled by parental substance abuse, the number of abused 
and neglected children has more than doubled from 1.4 million in 1986 
to more than 3 million in 1997, a rise more than eight times greater 
than the increase in the child population. The disturbing link between 
parental substance abuse and child abuse is irrefutable. It is 
estimated that children whose parents abuse drugs and/or alcohol are 
three times more likely to be abused and four times more likely to be 
neglected than children whose parents are not substance abusers. In a 
1998 report, the General Accounting Office estimated that two-thirds of 
all children in foster-care had substance abusing mothers and that 80% 
of those mothers had been using drugs or alcohol for at least five 
years--many of them for ten years or more.
  Alcohol and drug use exact a huge price tag on both children and 
society at large. Estimates are that parental substance abuse costs the 
nation approximately $20 billion a year. Of that amount, the federal 
government pays 44%, states 44%, and local governments 12% of the cost. 
We also know that the toll that substance abuse takes on families is 
immeasurable. Parents sacrifice the joys of watching their children 
grow and thrive and their children lose the opportunity to learn and 
grow in a safe, supportive home.
  In Connecticut alone, there are an estimated 12-15,000 children of 
substance abusers who are in desperate need of integrated, specialized 
support services. To assist those families and the thousands of others 
across this nation battling substance abuse, this legislation seeks a 
broad-based commitment from schools, social service agencies, health 
providers, community centers, and the other entities serving families 
to join together to promote aggressive outreach, prevention and 
treatment services. Because parental substance abuse impacts so many 
aspects of children's lives, this legislation would also provide 
comprehensive, family-centered services addressing health, mental 
health, violence, child abuse and neglect, HIV and family planning 
services, child care, and transportation. In addition, COSA will 
strengthen the systems which provide these services by funding the 
education and training of providers.
  COSA represents a bipartisan commitment to lessen the terrible toll 
that substance abuse takes on families. I am grateful for Senator 
Jeffords' co-sponsorship and am pleased that Senator Frist and the 
Health, Education, Labor, and Pensions Committee have agreed to include 
COSA within the larger Substance Abuse and Mental Health Services 
Reauthorization legislation that will be introduced today.
  I ask my colleagues to join me in supporting this 
legislation.
 Mr. JEFFORDS. Mr. President, I want to join my colleague from 
Connecticut in introducing the Children of Substance Abusers 
Reauthorization Act (COSA). Senator Dodd is to be saluted for his keen 
ability to identify conditions that place families and children at risk 
and for developing innovative solutions and strategies for alleviating 
those conditions.
  Substance abuse affects us all. Many of us have a close friend or 
family member who is a substance abuser or is in recovery. Even those 
of us not familiar with the personal struggles of substance abuse are 
affected. My office just received a report from General McCaffrey at 
the National Drug Control Policy Office that states that drugs play a 
part in virtually every major social issue in America today, be it 
health care, crime, mental illness, the dissolution of families, or 
child abuse. There is no question that Americans want to do 
``something'' about substance abuse, but 78 percent of Americans think 
that the ``War on Drugs'' has failed. So what options for combating 
substance abuse and addiction should policy makers explore?
  My state of Vermont has an innovative strategy it is eager to employ. 
Vermont has done its research and learned that among its school-aged 
youth a significant portion used illicit drugs; 51% used alcohol, 32% 
used marijuana, and 5% used cocaine. Twenty-nine percent of Vermont 9th 
graders (those are 14-15 year-olds!) used marijuana in the past month. 
About 49% of Vermont students in grades 8 through 12, (almost 19,000 
youth) were in need of substance abuse treatment or intervention in 
1996. Yet only about 10% of the youth in need of treatment or 
intervention indicated having received the services.
  Now the really striking results. Youth in need of alcohol, drug 
treatment, or intervention services were significantly more likely than 
those not in need of services to report an array of other school- and 
health-related problems. Twice as likely to report fighting in the last 
year; twice as likely to report being threatened or injured with a 
weapon at school in the past year; two to three times as likely to 
report having ever had sex; six times more likely to report having ever 
had sex with four or more people; and three to four times as likely to 
report having been pressured or forced into having sex. The Vermont 
report underscored clearly the challenges posed to primary care and 
substance abuse treatment and intervention providers in Vermont and 
indicated the wide range of services that are needed to identify and 
respond to the multiple needs of these kids and their parents. So what 
options for combating substance abuse and addiction should policy 
makers explore?
  We know that prevention is most effective when it is directed at 
impressionable children. Just as adolescents are the most susceptible 
to the allure of illicit drugs, so too is it the most imperative to 
delay or prevent the first use of illicit drugs, alcohol and tobacco. 
Case studies from the national Centers for Substance Abuse Prevention 
demonstrate that prevention programs work, especially when the 
prevention message is reinforced by parents, teachers, clergy, mentors 
and other role models. The options we policy makers explore must 
include a comprehensive strategy that provides the constellation of 
prevention services needed by children of substance abusers and their 
families.
  Vermont is ready to implement just such a strategy. Working with the 
national Center for Substance Abuse Treatment (CSAT), Vermont has 
confirmed that it's adult based substance abuse treatment models are 
not age appropriate, they don't work for adolescents, and they need to 
be redeveloped specifically for youth. Problems with engagement, 
retention in treatment, and relapse have been chronic in our current 
system. The CSAT treatment needs assessment determined that almost 40% 
of youth leave treatment after only one session, or leave against 
medical advice. Vermont has developed and is ready to implement a 
strategy but it needs assistance.
  Vermont would like to build on the demonstrated success of the 
wraparound models of youth services. Adolescents will receive expanded 
case management, a broader array of outpatient options, easy access to 
intensive outpatient care, residential treatment, and encouragement to 
participate in collateral family treatment. The focus would be on ease 
of movement between levels of care, case management and integration of 
community based treatment plans.
  The bill introduced today can provide States like Vermont much needed 
assistance in these areas. COSA will provide grants to nonprofit and 
public entities to provide a constellation of services needed by 
children and affected families to prevent substance abuse and stop the 
devastation it causes. Those services can include chid care, remedial 
education, counseling, therapeutic intervention services, job training. 
The children of substance abusers and their families is a group that 
desperately needs help. If we start now, we can begin to bring a close 
to the endless cycle of inter-generational drug abuse and this measure 
is the start we need to prevent further substance abuse by the next 
generation.
  Mr. President, I would hope that my colleagues will not let this 
opportunity go unheeded.
                                 ______