Dianova organized a virtual round table to discuss how to effectively include a children’s perspective in the field of addiction
Editorial team – World Children’s Day is held on 20 November annually. The event’s focus this year was the inclusion of all children. This implies that the needs of all people should be addressed equally, however there is one area where the children’s perspective is not reckoned with… The addiction field.
Historically, the field of addictions has been largely focused on adults through an androcentric viewpoint, while the needs of children and young people were often put on the back burner. In order to address the rights of children and adolescents in relation to substance use and dependence, it is essential to focus on preventing addiction during childhood and adolescence, reinforcing adolescents’ coping mechanisms when confronted with substance use, and addressing the needs of children whose parents have a problematic substance use or substance use disorders.
A wide-ranging panel
To address these issues in more detail and to celebrate the World Children’s Day, Dianova organized a virtual roundtable on “Children’s rights and addictions: where do we stand now?” on 21 November 2022.
Experts from different fields and experiences participated in the event in order to offer a wide range of perspectives on these issues, including:
- Monica Barzanti – Responsible for International Relations in San Patrignano, Italy
- Agnes Chen – Registered nurse and founder and executive director of Starlings Community, Canada
- Calixta De Balmaceda – Project coordinator, Cruz Blanca Panameña, Panama
- Berenice Gomez – Social psychologist, Universidad Autónoma de Barcelona, Fundación Salud y Comunidad, Spain
- María José Vera – Director of the therapeutic community “Las Torrecillas” for minors with addictions, Asociación Dianova, Spain.
The panel was moderated by Gisela Hansen Ph.D, clinical psychologist, director of Dianova Spain. The event was professionally interpreted in English and Spanish.
Children as subjects of rights
One of the major problems in public policies on addiction issues is that children are not considered as subjects of full rights. Not only are we referring to children’s rights to education and safety, but also to their rights to be heard and to participate in the decision-making processes that are likely to affect them.
Adult-centred programmes for minors
In the field of addiction treatment, programmes are clearly designed with the needs of adults as a basic point of reference. The programmes that are specifically designed to address the needs of children with problematic drug use and/or risk taking behaviours are dramatically scarce. Most programmes residential programmes in particular are simply grounded in models of care for adults, and then implemented with children with no modification whatsoever. It obviously follows that such programmes include no child perspective, nor will to respect children’s rights. This represents a clear adult-centred vision in the design as well as a lack of a gender perspective that would allow for the different needs of boys and girls.
A holistic view of a public health problem that goes beyond drug use
We should keep in mind that, for those concerned, be they adults or minors, problematic substance use is but the tip of the iceberg of a larger problem that usually encompasses such issues as poverty, racism, and gender-based violence. As a result, responses shouldn’t focus on abstinence from substances as the sole goal of treatment programmes, but also promote emotional wellbeing, among other issues. With regard to children, one of the possible actions to be developed is to promote programmes that help to train young people in developing coping mechanisms when confronted with stressful situations. This would help them avoid such problematic situations as substance use and risk taking behaviour. Emotional education is an essential tool and an effective way to support children and prevent potential addictive behaviours.
Offering a range of responses
All the panelists stressed that each individual requires a different type of support, depending on the moment they are in. That is why, offering a single type of treatment is not very effective. Treatment options available should be tailored to each people’s needs and circumstances, and range from abstinence-based to harm reduction programmes. In addition, we shouldn’t lose sight of the role played by non-substance related addiction. All programmes should focus on supporting people and their families, in the manner they need it.
Stigma, a huge barrier to accessing public services
If stigma for people who use drugs is a big problem, it is magnified when it comes to the reality of the children of people who use drugs. Parents who are in need of support for problematic substance use do not seek treatment services because of stigma-related barriers that impact them and their families, and for fear of losing their children’s custody – and more so when they are females.
In addition, based on a child’s rights perspective, we are also seeing children and adolescents who cannot access support services without fear, either because they are not being considered in the design of treatment, or because they do not perceive the spaces as their own to address their problems or ask for help. It is therefore key to strengthen programmes that provide support to young people, in order for these tools to be considered as available and accessible to all.
In addition, we cannot ignore the reality faced by women with addiction problems, and the compelling need to promote gender mainstreaming in addiction services, because it is also a way to promote the perspective of children’s rights.
Lastly, we are aware that public service professionals may also perpetuate stigma (especially in children’s services), this is why providing these professionals with ongoing, adequate training is considered an important part of the development of the children’s rights perspective.
The role of families
Having custody of children withdrawn or being deprived of parental authority because of parental drug use can have a dramatic impact on parents, children, and the whole community. Children have emotional needs that are crucial to their development, and separation from their parents (and especially from their mothers) has negative emotional and developmental consequences that directly impact on their own identity and experience. Although children of people with substance use disorders may be more vulnerable to problematic substance use and risky behaviours later in their life, they shouldn’t be considered as potential drug users, but as children with equal rights to have access to adequate health care, a dignified life, and to achieve their full potential. In the words of Agnes Chen, “Children love their mothers no matter what”.
In the United States for example, an estimated 9 million children are presently in the care of social services and placed in foster care because of parental drug use. This can help us understand the scale of the reality we are dealing with here.
While it is true that children whose parents have problematic drug use also have a higher risk of developing problematic drug use and risk taking behaviours, the affective component is also very important. Richard Vellman, in numerous investigations, has highlighted the need to work on parenting skills with people with addiction issues and to heal relationships by providing strategies, and as a last resort (or in situations of risk) to separate children from their parents, given that the impact of separation generates such a large emotional scar, that multiple resources must be utilized before resorting to this extreme measure.
The key, then, is to incorporate families into programmes and offer services where they feel safe and supported. One way, for example, is to offer treatment services that are capable of addressing the women and their children on site. And of course, to work on parenting aspects in addiction programmes.
However, it should be noted that, in many cases, families do not play a positive role in the lives of people with problematic drug use. Many women in treatment have lost contact with their families, for example. Or many children with drug use problems have begun using drugs at the hands of their parents. Therefore, it is essential that all programmes be adapted to the needs and characteristics of the people who require them.
Inclusion of all children
The roundtable addressed very complex issues, offering perspectives from professionals working in the field of prevention, treatment, direct care with young people, as well as advocates for people’s rights and against stigma, and academic experts who provide many examples and experiences from various countries, including Panama, Spain, Italy and Canada.
Dianova would like to thank the speakers for their time and the knowledge they shared during this dynamic and interesting roundtable. And let’s remember the UN slogan for this year’s World Children’s Day, “For the inclusion of all girls and boys” and let us all work to make it happen, especially in the addiction field.