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1930 Casework Practice for Substance Abuse Cases

1931 Overview of Casework Practice for Substance Abuse Cases

1931.1 The Definition of a Drug

CPS June 2010

The word drug, as used in this policy, refers to:

  •  controlled substances;

  •  prescriptions;

  •  over-the-counter medications; and

  •  alcohol.

1931.2 Obtaining Diagnostic Classifications From Professionals

CPS June 2010

When a client appears to be using drugs, the caseworker refers the client to professionals for in depth screening, assessment, or treatment.

The caseworker does not make any diagnostic classifications regarding the criteria of drug or alcohol use by the client. Classifications are made by licensed professionals.

For a summary of the criteria, see Appendix 1931.2: Criteria for Diagnosing Substance Abuse.

1931.3 Guiding Principles of Drug Testing

CPS June 2010

Administering a drug test does not change the protocols for conducting an investigation or for performing casework. The caseworker does not rely solely on a drug test to arrive at a conclusion or make a decision in a case.

The caseworker considers the entire case, including:

  •  both the negative and positive results of drug tests; and

  •  all other evidence, such as statements from collateral witnesses (such as teachers, neighbors, and family doctors), the effect of any drug use on the children in the case, and the ability of the parent to protect the child.

1931.4 Marijuana Policy

CPS June 2010

In compliance with Texas law and the schedules of controlled substances required by the Department of State Health Services, DFPS considers marijuana a Schedule I Controlled Substance that is illegal.

Medical Marijuana

The State of Texas and DFPS do not recognize the use of medical marijuana, whether taken in pill form or by smoking. DFPS views marijuana as analogous to any other illegal substance or the use of alcohol as it relates to a child's safety.

1931.5 Determining Safety and Risk When Marijuana, Other Substances, or Alcohol Are Present

CPS June 2010

Caseworkers need to determine whether the use of marijuana, other illegal substances, or alcohol:

  •  puts a child in situations of danger or harm; or

  •  places the child at risk for abuse or neglect.

Immediate Safety

In assessing the child's immediate safety, the caseworker assesses the following:

  •  Parental behavior – For instance, erratic behavior that makes the parent appear unable to protect the child, or the inability to separate reality from hallucinations.

  •  Physical signs of impairment – For example, in the case of marijuana use, the physical signs of impairment could include altered perception, dilated pupils, lack of concentration and coordination, craving for sweets, increased hunger, laughter, slowed thinking, slowed reaction time, and respiratory infections (The caseworker may also notice the smell of burned rope. Physical impairment indicates that threats are present, the child is vulnerable, and the parent does not have sufficient protective capacities to deal with the threats to the child's safety. For more information, see, Appendix 1931.1: Physical Signs and Symptoms of Drug or Alcohol Use.

  •  The lack of a sober, protective parent present who possesses sufficient protective capacities to mitigate threats.

  •  A child's age and level of vulnerability as a measure of the extent to which threats or risk of harm are present.

  •  Whether the basic needs of child are being met; for example, determining whether the child is so severely neglected due to the parent's substance use or abuse that the child needs immediate medical attention.

  •  Accessibility to substances – A child's accessibility to marijuana, other substances, prescriptions drugs, or alcohol makes the child vulnerable to threats or dangers.

  •  physical safety – The extent to which the living environment creates the condition for threats or harm to the child; for example, a child living in a home where Methamphetamine is cooked.

Risk in Foreseeable Future

To assess the risk of abuse and neglect in the foreseeable future, if CPS were no longer involved, the following tasks are completed by the caseworker:

  •  Conduct a full risk assessment

  •  Talk to collaterals, especially school officials or child care staff

  •  Assess for prior CPS history, criminal history, and substance abuse history

  •  Assess for prior or current participation in treatment programs

  •  Review mental health, psychiatric history, or both

  •  Determine when the parent last used a substance 

  •  Ask the parent about the friends and family members that visit the home in relationship to their drug use and history

  •  Ask about the presence of a sober protective caregiver who has sufficient protective capacities to manage threats

1932 Screening and Assessing for Substance Abuse

1932.1 Screening for Substance Abuse

CPS June 2010

Questionnaires

Using a simple screening questionnaires, the caseworker determines whether a parent is in need of further screening, assessment, or treatment for substance abuse.

The following questionnaires are easy screenings for the caseworker to administer:

  •  CAGE (Cut Down, Annoyed, Guilty, and Eye-Opener)

  •  UNCOPE (Using, Neglected, Cut Down, Objected, Preoccupied, and Emotional)

Considerations

The caseworker also considers the following as further intervention when a client indicates that he or she is using marijuana or other controlled substances, or is using alcohol in a way that threatens the child's safety:

  •  Observation

  •  Medical, criminal, and substance abuse histories

  •  Collateral reports

  •  Examination of the living environment

  •  Information from the case record

Timeframe

A screening for drug or alcohol use can be conducted in any stage of the case.

1932.2 Fetal Alcohol Spectrum Disorder

CPS June 2010

When appropriate, the caseworker may administer either of the following screening questionnaires when interviewing a pregnant mother who is alleged to be drinking alcohol while pregnant:

  •  T-ACE (Tolerance, Annoyance, Cut Down, and Eye-Opener)

  •  TWEAK (Tolerance, Worry, Eye-Opener, Amnesia, and Cut Down)

The T-ACE and the TWEAK questionnaires help identify the risk of alcohol use during pregnancy. Drinking alcohol during pregnancy can damage the embryo or fetus.

If the questionnaire indicates that a pregnant mother is drinking alcohol, the caseworker refers her to a health clinic or physician.

1932.3 Drug Use Outside of the Home

CPS June 2010

A caseworker considers a parent's drug use as he or she would any other evidence in a case; that is, the caseworker considers it along with all other available evidence when:

  •  making a disposition;

  •  evaluating a parent's need for treatment; or

  •  assessing the safety of a child.

Whether the drug use occurs inside or outside the home must not automatically lead the caseworker to one conclusion or another. Each case must be reviewed and addressed individually; for example, whether the parent tests positive for or admits to using marijuana, other illegal substances, or alcohol either outside of the home or outside of the presence of the children (for example, if the parent smoked marijuana at a party that was held away from the home).

In arriving at a disposition, the caseworker follows the statutory definitions of abuse and neglect. It is the effect that the marijuana smoking, drug use, or alcohol use have on the child and the child's safety that guides the disposition, rather than purely the parent's use of the substance.

To arrive at a disposition, the caseworker takes into account that a child's safety is based on:

  •  the child's vulnerability;

  •  the threats of danger within the family; and

  •  the capacity of a protective caregiver.

1940 Establishing Protective Measures When a Child Is Threatened by Substance Abuse

CPS June 2010

When a child's safety is threatened by a client's use of marijuana, other substances, or alcohol, or when there is a risk that the child's safety could be threatened, the caseworker puts protective measures into place.

The table below lists some of the protective measures the caseworker can consider:

Protective Measure

Interventions

Related Definitions

Ensure the child's immediate safety

  •  Safety assessment

  •  Safety plan

  •  Parental-child safety placement (voluntary placement by the parent, as opposed to by a court order)

  •  Conservatorship removal

Safe child:

Vulnerable children are safe when there are no threats of danger within the family or when the parents possess sufficient capacity to manage threats and protect the child.

Help client achieve and maintain abstinence

  •  Random drug testing

  •  Physician-prescribed medications to treat a drug or alcohol addiction

  •  Detoxification

Refraining from the use of alcohol or other drugs.

(Abstinence from alcohol applies to parents who have endangered a child's safety when drinking)

Develop a relapse safety plan

  •  Network of abstinent and sober friends and family members

  •  Identified friend or family member to protect the child

Plan to provide safety for the child, if the parent contemplates a relapse or experiences a relapse

Seek judicial oversight

  •  Motion to participate

  •  Order in aid of investigation

  •  Family treatment drug court

  •  Petition for temporary managing conservatorship

Involvement of the court to mitigate problems of substance abuse and child safety

Develop reliable sources of support

  •  TANF

  •  Protective day care

  •  Medicaid

  •  Employment or job training

  •  Food stamps

  •  Housing or public housing

Having tangible resources that enable a parent to recover, or to improve enough to meet the parent's and family's financial and basic needs.

Guide parenting and child development

  •  Parenting class

  •  Participation in ECI (Early Childhood Intervention)

Having knowledge about parenting, child development, and alternative forms of discipline

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