In the medical community, we talk about cultivating resiliency — working with our patients to strengthen their positive attributes so that they are able to recover and cope with challenging and traumatic experiences. Resiliency happens at an interpersonal level, but also it happens at the societal level. The laws and policies that affect the lives of my patients and their families can foster resiliency, or they can compound trauma.

Fostering resiliency at a policy level would ensure children and their families do not have to endure traumatic experiences in the first place, such as poverty, health inequities, mass incarceration and discrimination. But for decades, our drug laws have compounded harm — punishing traumatized young people for behaviors they use to cope with difficult life circumstances or separating children from parents and caregivers who have substance use disorder.

Promoting resiliency so that young people and their families can thrive is a core reason the Maine Chapter of the American Academy of Pediatrics, of which I am the president, supports L.D. 967. This bill would remove criminal penalties for minor drug possession and offer people the option of taking a health assessment for substance use disorder.

The medical literature finds that some young people who use drugs and alcohol may do so to cope with adverse childhood experiences (ACEs), such as abuse, neglect, the incarceration of a parent or caregiver, and chronic stress from social factors such as poverty and discrimination. The more of these adverse childhood experiences a young person has, the more likely they are to engage in risky behaviors that are often criminalized, such as substance use, vandalism and petty theft. For those young people who are arrested and criminalized from an early age, criminal punishment derails their life and contributes to worse health outcomes as adults, including chronic illness, mental illness, early death, and ongoing involvement with the justice system.

The solution isn’t to continue traumatizing these young people with criminal punishment, but to intervene in ways that we know work. Appropriate assessment and interventions with therapies such as trauma focused cognitive behavioral therapy and therapies that incorporate the family and community, enhance communication skills, develop strengths, and foster positive relationships, building self-esteem and resilience.

The incarceration of a parent or caregiver is among the adverse childhood experiences that can traumatize a child. Severing the parent-child bond is only appropriate in the most extreme cases, precisely because it is so devastating to a child. What works better and has the potential to improve long term well-being of the child is offering non-criminal interventions to the parent and other family members, such as access to treatment and intensive parenting support.

For a parent with substance use disorder that makes parenting very difficult, the solution is not jail or prison-which can impact future housing and employment opportunities. In such situations family foster care can support the child, allow visitation, and maintain a child parent bond while a parent receives treatment until the parent gets better. In some cases, this non-criminal solution teaches a young person an important lesson in resiliency: their parent can fall and still pick themselves back up.

A comprehensive study by the CDC and Kaiser Permanente found two out of five adults reported experiencing at least one adverse childhood experience, and one in six adults reported experiencing four or more ACEs — disproportionately these were women and people of color. Not all children who have these experiences end up using drugs or engaging in problematic behaviors as young adults and adults. Some kids are better able to cope and demonstrate resiliency because they and their families have access to strong social supports, health care, quality education and financial security.

We want this to be the outcome for as many children as possible. We can’t do it on an individual basis. It needs to happen at the policy level. Maine can take an important step at fostering resiliency at a policy level by passing L.D. 967.

Deborah Hagler, M.D., is a resident of Harpswell.


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