Maine's child welfare agency received twice as many reports last year of children who ingested drugs, which experts said is likely attributable in part to the availability of edible marijuana products.
The number of children who ingested drugs often owned by the parents had been trending downward in Maine since 2017. But that figure ticked up two years ago and then more than doubled from 2021 to 2022, according to a newly released report from Maine's Child Death and Serious Injury Review Panel. The 34-member panel is charged with reviewing child fatalities and injuries as well as reporting on trends.
Seven of the 90 ingestions tracked by the DHHS Office of Child and Family Services involved fentanyl, the synthetic opioid largely responsible for Maine’s record-setting drug overdose death rate as well as surging drug-related fatalities nationwide. It was unclear whether any of those children died as a result, although there have been child fatalities in Maine tied to children accidentally exposed to fentanyl in recent years.
Mark Moran (MORE-ANN), who chairs the panel and oversees social services at Northern Light Eastern Maine Medical Center in Bangor, said fentanyl is now everywhere in Maine's drug supply. But many hospitals and labs, particularly in rural areas, can't screen for it. So addressing that lack of capacity is one of the report’s primary recommendations.
"I think a lot of people are surprised to hear that, particularly physicians, frankly,” Moran said in an interview. “They are not always aware, in my experience, that the tests they are ordering don't include fentanyl."
Marijuana accounted for 42 of the 90 child ingestion reports. Moran said he and other panel members weren’t necessarily surprised by the surge.
"I think other states that have legalized adult-use marijuana have seen similar kinds of consequences: increased visits to the emergency room, increased hospital admissions, increased ingestion report calls to their poison control centers and those sorts of things,” he said. “So from that perspective, it's not really shocking."
The report stated that children were exposed to marijuana after ingesting brownies, chocolate bars, gummy bears, drinks and other edibles.
Moran said the sharp increase highlights the need for safer storage and handling of marijuana and other drugs. And the report’s recommendations include that DHHS should continue to provide “lockboxes” to families with which the agency works if there is risk of exposure.
But the report also raised concerns that a "fragmented" tracking network means many child exposures to drugs are not reported to DHHS. It also recommends a series of systemic changes within the Office of Child and Family Services, including hiring more caseworkers whose job it is to handle after-hours investigations and developing a protocol for in-depth reviews of “chronically maltreating families who repeatedly come to the attention of OCFS over a long period of time.”
The report was also critical of what it said were tendencies within DHHS of looking repeated risky behavior – such as leaving fentanyl or other drugs in places accessible to children – “not simply from an intent perspective but also from a negligence perspective.”
Responding to the latter recommendation, DHHS said: “Through the use of the OCFS Structured Decision Making tools, staff are guided to make comprehensive, factually supported decisions that consider safety factors, risk factors, and the totality of the information obtained from parents, children, extended family, and other collateral sources of information. As new caseworkers join the agency, they receive training and coaching support through the Foundations curriculum delivered collaboratively by OCFS and the Catherine Cutler School of Public Policy at USM, as well as from their supervisors throughout their employment.”
