Dangers for children in the care of drug users

I commend Jane Buxton and Naomi Dove for their brief summary of an important public health issue, crystal methamphetamine (crystal meth) use.¹ Unfortunately, the authors did not mention a very important concern associated with the use and production of crystal meth: child protection.

Methamphetamine use is associated with unique child protection concerns that are not seen with other drugs of abuse.^2–4 Children who live in methamphetamine laboratories can be poisoned as a result of exposure to the lethal chemicals used to manufacture methamphetamine and their toxic biproducts. In addition, because of the volatility of the compounds used to manufacture methamphetamine in a clandestine manner, it is not uncommon for methamphetamine laboratories to explode, injuring or killing resident children. Methamphetamine-addicted caregivers who are on a run or tweaking may neglect to feed their children or may fail to provide for their developmental, medical or emotional needs. In addition, they may fail to supervise their children and may expose them to a wide range of strangers and drug users. Booby traps are used to protect many methamphetamine laboratories because of the paranoia that often characterizes crystal meth use, and children are in danger of physical harm if they inadvertently trigger these traps. Finally, the hypersexuality and drug-seeking behaviours of adult methamphetamine users may lead to sexual abuse of children, who may be prostituted for money or drugs or used as sexual objects by users on a run.

Although children in the care of drug users are not all in need of protection, physicians who are aware of children living with or around caregivers who are addicted to methamphetamine should seriously consider whether child protection concerns exist. If they have a reasonable reason to believe that a child is in need of protection, physicians have a legal and moral duty to report their suspicions to child welfare authorities.