Morning Edition is taking a look at how the opioid epidemic is affecting children – and the people and programs who support them – in New Hampshire.
It's part of NHPR's Crossroad series, examining the impacts of addiction in New Hampshire.
Tim Lena works for the Timberlane Regional School District, where he coordinates student assistance programs that can help identify students who are showing signs of needing help with substance use issues.
(Editor's note: this transcript has been edited lightly for clarity.)
Their grades may be slipping. They may be getting into discipline issues. They can be referred to the program. Once they apply to the program, they are protected by the federal confidentiality law governing substance abuse records. So we can begin to do a screening around mental health issues and other substance use issues, and begin to find resources for those students, and then eventually try to intervene with the family and get them the resources that they need.
And this might be if a student themselves has a substance use problem, or if someone else in the family has a problem and that is affecting the student?
Absolutely, yes. You know, we'll deal with students just who have like peer conflicts all the way up to students that are very harmfully involved with alcohol, or other substances or prescription drugs.
Is it hard to get some students though to interact with you and talk about going into a program, or kind of open up a little bit about what is going on in their lives? I mean, I imagine you get a lot of pushback.
We sometimes get a little pushback. But for the most part actually, kids [know] the reputation of the program. It's a very safe place, especially given the federal confidentiality guidelines of privacy. They know that we're not going to immediately pick up the phone and talk to the parents or talk to school administrators about behaviors they're engaged in. So they know it's a safe place to begin to talk, and they find it very supportive and they tend to like to come.
Are they worried at all about the ramifications for their family?
When it comes to children with substance use disorders in their family, they tend to be very guarded. Because children in substance use disordered families tend to not talk about the problem at all. They learn that rule. There are three rules that they learn to survive – don't talk, don't trust and don't feel. So the first thing is you learn to be somewhat ashamed and somewhat embarrassed about what's happening in the family. You tend to be very closed off. You don't even share that necessarily with your close friends. And the family gives that message that you don't talk about family business outside of the family. So they learn from a very young age to kind of keep that close to the chest.
Don't trust. Certainly they learn not to trust a person with a substance use disorder because they promised many, many times that they're going to quit. 'I'm so sorry I didn't show up to that game of yours or to that recital. I promise I'm going to quit tomorrow and I'll show up.' And those are clearly the best of intentions, but because of their disease they are unable to fulfill those promises. So this student learns not to trust.
And lastly they learn not to feel. If they have any strong emotions and they express, ‘Dad I'm really scared when you're kind of nodding off to sleep at the wheel.' You know they're liable to get a very defensive angry reaction. And they learn to kind of bottle up all those feelings inside and keep very isolated. And unfortunately with the bottling up of those feelings that can lead to many other kinds of difficulties.
It's going to come out somewhere or somehow.
Right, if they don't find the right kind of support. So part of our role in the student assistance program is provide educational support groups for these youth to get together -- to first of all, know that they're not alone walking the halls of the school [when they go] home to a parent or parents that are misusing substances.
Obviously this takes resources and this takes time and labor. How many schools have access to these types of programs?
We have in New Hampshire been expanding the number of student assistance programs dramatically. There's a big federal block grant called Partnership for Success. And so the Bureau of Alcohol and Drug Services has awarded grants to many school districts. We probably have about 40 student assistance people now across the state.
Forty assistance [people] across the entire state. I mean that's a lot of school systems that probably aren't getting those grants. I imagine there's going to be a gap for rural school districts in many areas.
Yeah, the grants have targeted some of the rural areas, because again there are major gaps in services in the community. So having student assistance in the North Country for instance, we have some wonderful programs up there. Unfortunately, many of those personnel are stretched pretty thin because they have to be itinerant and traveled between many different schools in the district.
Are you finding that there's enough outside assistance to help these students?
No. I think there's a severe lack, especially for children from substance use disorder [homes] ultimately across the state. I think that schools need to become more sensitive to the needs of students that are dealing with this trauma. There does seem to be a lot more public education now and public awareness around adverse childhood experiences, and how the effects of trauma can impact on student performance and the choices they make later in life. So I do think schools are starting to become much more aware of what these youth are bringing into the school and trying to be more sensitive to those needs. But we've got a long way to go. We still have teachers who are very much into just teaching the subject and not really thinking about social emotional needs of the students in the classroom.
Whose responsibility is it to fill this gap then? Do you think it is on schools to do to do more, the state, service providers? Is there a magic elixir here?
Well, New Hampshire is very independent. Every school district and every school frankly kind of has their own culture and their own way of operating. There's not a standard that's required across the state.
Do you think that has to change?
Well, I think that we certainly could be better educating the school districts about what are best practices and invite them to take part in it. I don't think that there necessarily needs to be a mandate, but I think that as schools begin to see the benefits of doing social emotional learning, and wrapping around students and meeting their emotional needs, that those are students who are much better able and ready to learn. And the performance and the test scores are going to improve as a result of that and everybody wins.