Child Welfare & Family Court Opioid Use Disorder Trainings

The Florida Alcohol and Drug Abuse Association in partnership with the Department of Children and Families offers a series of training modules designed for Child Welfare Protective Investigators, Child Welfare Case Managers, Florida Judges, Judiciary Staff and Child Welfare Stakeholders. These comprehensive modules focus on increasing understanding of the opioid crises in Florida, the effects on family systems, and how to engage recovery resources. The trainings were funded by the federal State Targeted Response to the Opioid Crisis (O-STR) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA).

Child Welfare & Family Court Opioid Use Disorder Trainings


Opioid Training Module Menu

Module 1: Understanding Prescription Opioid Misuse

This module reviews the harmful effects of prescription opioid misuse, including counterfeit opioid medications and additives such as fentanyl, and discusses factors that contribute to this growing epidemic. A photo simulation exercise is provided that includes possible signs in the home of prescription opioid medication misuse as well as examples of harms to children.
Module 1 PowerPoint Slides
NIH DrugFacts - Fentanyl
Opioid Patient Education

Module 2: Understanding Heroin Use

This module reviews heroin and factors that contribute to its widespread use. The various methods of heroin use and associated effects are described including through the lens of persons with lived heroin experience. A photo simulation exercise is provided with possible signs in the home of heroin use.
Module 2 PowerPoint Slides
NIH DrugFacts - Fentanyl
NIH DrugFacts - Heroin

Module 3: The Link between Parental Opioid Use Disorders and Neglect: The Impact of Toxic Stress on the Developing Brain

This module reviews the three types of childhood stress and describes specific ways in which parents with opioid use disorder (OUD) can contribute to the development of toxic stress in their children. Some examples of actions that can be taken to identify and ameliorate toxic stress in children are also provided.
Module 3 PowerPoint Slides
Module 3 CDC Childhood Stress Booklet

Module 4: Understanding Opioid Use, Pregnancy, and Neonatal Abstinence Syndrome (NAS)

This module describes neonatal abstinence syndrome (NAS), also referred to as neonatal opioid withdrawal syndrome (NOWS), an expected and treatable consequence of opioid exposure. Data on NAS/NOWS prevalence in Florida is reviewed as well as common treatment barriers for prevent pregnant women who misuse opioids. Two U.S. Food and Drug Administration (FDA)-approved treatment medications for pregnant women with opioid use disorders (OUD) are discussed as well as examples of actions to identify and help this population access treatment.
Module 4 PowerPoint Slides
Module 4 NAS Fact Sheet

Module 5: Understanding Medication-Assisted Treatment and Recovery (MAT-R)

This module describes MAT-R and how opioid use impacts the brain and behavior. The three Food and Drug Administration (FDA)-approved opioid treatment medications are discussed as well as their respective differences. The module ends with an overview of how medication can be used—in conjunction with counseling along with psychosocial and recovery support—as the most effective treatment for OUD and also reviews some common myths.
Module 5 PowerPoint Slides
Module 5 Handout

Module 6: Working Effectively with Opioid Treatment Providers

This module describes the various types of opioid medication-assisted treatment and recovery (MAT-R) providers and elements that can contribute to effective relationships with them. Examples of reasonable efforts to connect a parent with an opioid use disorder (OUD) to care are also reviewed.
Module 6 PowerPoint Slides



Child Welfare System Case Studies Applying Motivational Interviewing

These four training modules demonstrate application of Motivational Interviewing (MI) scripts and learning tools (downloadable from the FADAA.org website) to help child welfare practitioners increase their effectiveness in having hard but necessary conversations about parental opioid use, while also connecting it to child safety in a non-judgmental, collaborative manner. Each case study is opioid-specific and involves applying motivational interviewing (MI) skills with parents with opioid use disorders (OUD):

Motivational Interviewing Module 1

A parent who previously delivered a baby with neonatal abstinence syndrome (NAS).
Module 1 PowerPoint Slides
Module 1 Case Scenario

Motivational Interviewing Module 2

A parent who was leaving their child unattended to pursue opioid procurement.
Module 2 PowerPoint Slides
Module 2 Case Scenario

Motivational Interviewing Module 3

A parent’s opioid use problem interfering with the provision of a clean and safe home for a child.
Module 3 PowerPoint Slides
Module 3 Case Scenario

Motivational Interviewing Module 4

A parent who was reported to have strange people coming in and out of the house at odd hours with a young child in the home who appeared to frequently be in distress.
Module 4 PowerPoint Slides
Module 4 Case Scenario



Other Training Modules for Judicial System Representatives


Opioid Myth Busters

This module provides an overview of a quick reference tool that reviews seven common opioid-related myths and busts these myths with factual information. A few examples of myths covered include: whether pregnant opioid-using women should receive medically-supervised withdrawal to prevent fetal distress; whether a lower dose of methadone or other opioid treatment medication is preferable to a higher dose; and whether treatment programs, and child welfare and judicial systems should consider limiting MAT to 12 months or less to reduce enabling addiction.
Opioid Myth Busters PowerPoint Slides
Myth Buster Quick Reference Tool

Applying Parental Opioid Use Knowledge to Shelter Hearings

This training module (primarily helpful to judicial system representatives) supports an associated shelter hearing case study and helps to identify case facts that are: suggestive of parental opioid-use-disorders; suggestive of child neglect; and recognizes important missing case information.
Applying Parental Opioid Use Knowledge to Shelter Hearings PowerPoint Slides
Bench Guide for Opioid Involved Dependency Cases



Other Training Modules for Child Welfare Representatives


Applying Opioid Knowledge to Dependency Court Process

This module provides an overview of a quick reference tool to apply general knowledge about opioid use and treatment to the dependency court process as well as identify case-specific information that judges need to make well-informed decisions at different points in the dependency court process.
Applying Opioid Knowledge to Dependency Court Process PowerPoint Slides
Bench Guide for Opioid Involved Dependency Cases

Naloxone and Overdose Basics

This module provides an overview of a quick reference tool that lists signs of overdose, a life-threatening emergency, as well as other information such as the purpose of naloxone, common examples of factors that can contribute to a person overdosing, and methods of naloxone administration.
Naloxone and Overdose Basics PowerPoint Slides
Signs of Overdose
Opioid Overdose Card

Chemistry Not Character: Avoiding Stigma

This module provides an overview of a quick reference tool that provides multiple examples of words or phrases that describe individuals with SUDs or their activities in a stigmatizing manner followed by alternative ways to describe individuals with SUDs or their activities in a non-stigmatizing manner and an associated rationale. The supporting module also describes factors that contribute to stigmatizing persons with substance use disorders (SUDs), including opioid use disorders (OUDs).
Chemistry Not Character: Avoiding Stigma PowerPoint Slides
Stigma Free Chart

Recovery Support Basics

This module provides an overview of a quick reference tool that utilizes SAMHSA’s four dimensions of recovery to frame examples of recovery supports relevant to individuals with a opioid use disorder (OUD). Examples of concrete actions they can be taken to provide relevant recovery support are also briefly provided.
Recovery Support Basics PowerPoint Slides
Recovery Support: Quick Reference Tool

Speedballing: Mixing Stimulants and Opioids

Individuals who struggle with substance use often spend time seeking the next high, hoping that it will be bigger and better than the one before. Sometimes, to get it, they combine multiple substances together. “Speedballs”, the combination of opioids and stimulants (commonly heroin and cocaine but also now including fentanyl, meth, and more) is on the rise. Florida is one of 10 states where the Drug Enforcement Administration (DEA) has recently seized various combinations of methamphetamine with fentanyl, carfentanil, heroin, and cocaine. The combination of opioids and stimulants are a potent mix that can lead to severe consequences for those who try it even once. The result can be dangerous situations, such as overdose, or other extreme physical and mental symptoms or effects that can put the individual’s health, safety, and life at risk.
Speedballing PowerPoint Slides
Speedballing: Quick Reference Tool

Applying Stages of Change to Opioid Use

Parental substance use—including misuse of opioids—can have detrimental effects on parents as well as their children, placing all family members at risk. Determining the readiness of parents to change their behaviors, including their willingness to access effective treatment and recovery support, is an important dimension that helping professionals need to address. One approach to working with these parents is the Stages of Change model, which posits that the five stages of change—precontemplation, contemplation, preparation, action, and maintenance—can be an effective aid in understanding the process of how people change their behaviors. People do not typically change behaviors quickly and decisively, and dependence on opioids can be a significant and complicating factor in their efforts to change. This micromodule helps participants understand how to recognize the likely stage of change of a parent who uses opioids and identify appropriate helping responses.
Stages of Change PowerPoint Slides
Stages of Change Reference Guide
Stages of Change Case Study

Beyond the Headlines of the Opioid Epidemic: Issues and Promising Interventions for Children from Zero to Three

The opioid epidemic hasn’t spared infants the and very young children. For children with one or both parents who misuse opioids or other substances, family life often can be chaotic and unpredictable. Past and present adverse experiences may contribute to the inability of caregivers to understand and attend to a young child’s needs thus creating adverse childhood experiences for the child. Children’s basic needs—including nutrition, supervision, and nurturing—may go unmet, which can result in neglect during a period of utmost importance in brain development. Recent developments in the neuroscience of addiction and parenting may help to explain the challenges faced by many caregivers with opioid use disorders (OUD) who are caring for young children, as they transition to a caregiving role.1 This micromodule will provide a brief overview of these issues and identify emerging promising interventions that adopt a developmental perspective, occur concurrently with substance use treatment, and target the parent–infant relationship as early as possible.
PowerPoint Slides
Case Study Handout

Complex Connections: Domestic Violence (DV), Opioid Use, and Trauma

Women who have been diagnosed with opioid use disorder (OUD) are more likely to have experienced DV, sexual violence, and childhood sexual abuse; are more likely to have been prescribed opioids for chronic pain; and are more likely to self-medicate to cope with trauma. While definitive research on whether OUD increases risk for victimization or whether victimization leads to OUD, adverse consequences abound. This micromodule identifies ways DV perpetrators use opioids and other substance use and mental health problems against survivors, including those at risk for or involved with the child welfare system.
PowerPoint Slides
Quick Reference Handout

Opioid Use and Family Dynamics

With all the attention on the opioid use epidemic gripping Florida and the rest of the nation, the rippling effects on other family members and caretakers are not always sufficiently addressed. Family structures in America have become more complex—growing from the traditional nuclear family to single-parent families, stepfamilies, foster families, and multigenerational families. Opioid addiction dramatically alters family roles, rules, rituals, and the family’s internal and external relationships. Its effects are observed across all family subsystems—adult intimacy relationships, parent-child-relationships, sibling relationships, and the relationship between the nuclear family and kinship networks.
PowerPoint Slides
Case Study Handout

Prevention Strategies for Youth Affected by Parents with Opioid Use Disorder

Opioid use disorder (OUD) can impede parents’ abilities to care for their children. Societal responses are often guided by a belief that unless the parent receives substance use treatment, there is little help for the child. A significant body of research, however, demonstrates the importance of not only addressing the immediate wellbeing of the children of caregivers with substance use disorder but also preventing the continuing cycle of drug use. Opioid and other substance abuse prevention programs for children are often delivered to groups of students in general settings such as school classrooms. This module describes why these universal programs are often minimally effective for children affected by parents with OUD and provide suggestions for a more effective cumulative strategies approach for children of parents with substance use disorders.
PowerPoint Slides
Quick Reference Handout

A Transformative and Evidence-based System Response for Parents with Opioid Misuse and their Children: Challenges and Opportunities in Your Community

Collateral impacts of the opioid epidemic such as overdoses, neonatal abstinence syndrome (NAS), and higher rates of child maltreatment reports and foster care placements are creating significant challenges in Florida communities. From early identification, screening and assessment, medication-assisted treatment, recovery support, and continuing care, this workshop will review what we know about evidence-based and other effective practices for system responses with parents with opioid misuse involved in the child welfare system. Through material presented and interactive discussions, participants will collectively identify opportunities for their communities to address these challenges through existing resources, new resources including the federal opioid resources and Family First Prevention Services Act, and emerging approaches. Participants will leave prepared to do their part in developing a transformative and evidence-based local system response to parental opioid misuse to foster safe and stable homes in which children can thrive.
PowerPoint Slides
Handout

 


FADAA Resource Center

Explore the Resource Center to learn more about emerging trends, the latest studies, and training opportunities regarding Child Welfare and other behavioral health issues.




These training are offered by the Florida Alcohol and Drug Abuse Association and supported by funding from the Florida Department of Children and Families, Office of Substance Abuse and Mental Health (Contract #LD987).