Acting Associate Attorney General Jesse Panuccio Delivers Remarks at the National Children’s Advocacy Center’s 34th National Symposium on Child Abuse

Remarks as prepared for delivery.

Thank you, Alan, for that introduction.  I am so pleased to be here in Huntsville with you, and with Chris Newlin, and with First Lady Hutchison of Arkansas—each of you dedicated community servants. 

I am also delighted to join this distinguished group of children’s advocates and professionals.  Flying down here from Washington, I was thinking about your jobs—about what your day-to-day responsibilities must be like.  The kind of work that you do, the things that you see and hear, the horrors you confront on a daily basis—I am sure there are times it leaves you feeling fairly pessimistic about the world, and perhaps thinking that evil that lurks in every corner. 

But to that I would say: look around you.  Here this morning is an army of good—of men and women who have dedicated their careers and lives to helping the most vulnerable among us.  Men and women who get up every morning just so they can stand eye-to-eye with evil and say: “today, I will fight for the life and future of this child.”  It is remarkable to see so many people from across the country and from around the world—from big cities, and suburbs, and rural hamlets—who work so tirelessly to protect our children.  Thank you for the incredible work you do.

I want to specifically recognize Chris, his executive team, and all of the staff of the National Children’s Advocacy Center for their hospitality and for their work, each and every day, on behalf of our nation’s children.  Alan Hanson and I had the pleasure of touring the center yesterday, and we were both so impressed by the wealth of resources available on the NCAC campus.  With its combination of child-friendly surroundings, state-of-the-art forensic and treatment services, and expert staff members this is an extraordinary place, making a real difference for children and families in northern Alabama and throughout the United States.

Perhaps the best way to appreciate the value of this center, and the need for it and for the more than 950 children’s advocacy centers across the country, is to put yourself in the shoes of a child who uses the services offered here.  Everyone can think back to some difficulty in childhood—some personal or family struggle, something that made you feel alone or frightened or worried about the future.  But for the average person, I would wager that you could take his or her worst day as a child, multiply it by some significant factor, and it still would not approximate what some of the children who come here have faced.  They have been physically, or sexually, or emotionally abused—often repeatedly.  Their thoughts may be dominated by how to make it through the day without suffering some new trauma.  Some of them wonder whether they will be fed.  Some of them, when they go to sleep each night, wonder what new horror the morning will bring.  No one, no matter how old or how experienced, is fully equipped to absorb the physical, emotional, and psychological blows of such victimization. 

While we are always learning more about the damage caused by child maltreatment, we already know that, beyond the immediate harms, it sets up a lifetime of adverse consequences.  It can impair mental and emotional development.  It can negatively affect school performance.  It can influence future relationships, often in very destructive ways.  It can cause both short- and long-term medical problems, and possibly a lifetime of poor health.  When we think of child maltreatment, we think of immediate cuts and bruises and tears.  We don’t always think of the life and the potential that is slowly, tragically slipping away.

And that is why your work is so vitally important, and why we should be especially grateful for the network of children’s advocacy centers across our country and across the globe—centers in communities large and small, serving kids from every background and facing every conceivable, sometimes unspeakable hardship.

In 2016, advocacy centers served more than 320,000 children, providing them services that run the gamut of needs in the criminal-justice and human-services systems. Advocacy center staff make their encounters as painless as possible.  They give comfort and refuge in a time of great need and terrible crisis.  And while they cannot erase the damage completely, they can and do help heal wounds—physical and psychological, seen and unseen.  They help create a new future for these children, restoring hope and the potential for a full life.

I wish that I could report that the steady march of human progress means the need for these services has peaked and is now on the decline.  Sadly, as we know all too well, the opposite is true.  The threats faced by our children seem graver and more pervasive than ever, with cyberspace and its underbelly seemingly exacerbating every problem and creeping into every facet of their lives.

In recent years, one particular menace has been devastating American communities, with an outsized impact on our kids.  Drug abuse, and in particular opioid abuse, is destroying families across the nation.  Opioid abuse has become one of country’s most pressing public health and safety crises. 

In 2016, an estimated 64,000 Americans lost their lives to drug overdoses, with about 750 deaths here in Alabama alone.  That follows a record increase in fatal overdoses from 2015, and preliminary data suggest that 2017 was even worse.  For Americans under 50, drug overdoses are now the leading cause of death.  And the vast majority of overdose deaths, some 42,000 in 2016, were the result of opioids—prescription painkillers, heroin, and deadly synthetic drugs like fentanyl.

These toxic substances threaten everyone in their path—users, their families, first responders.  And especially children. 

About half of opioid overdose deaths occur in people between the ages of 22 and 44; in other words, opioid abuse is significant among the cohort most likely to be parents of minor children.  Opioid addiction thwarts even the most basic parental instincts, as the unquenchable thirst for the drug displaces all other desires and responsibilities.  Children are left to fend for themselves—and, worse still, to care for their parents or to watch in horror as their parents’ lives slip away to a ruthless master. 

Imagine coming home from school one day to find your mother or father unconscious from an overdose, making the tearful 911 call, waiting in terror and helplessness for aid to arrive, watching as your parent is whisked away in an ambulance, and being left behind in the care of police and social services.  Sometimes, these parents never return. 

Here is how a December 2016 Washington Post story by Eli Saslow, reporting on the plight of so-called “opiate orphans,” described one West Virginia teenager’s experience on Easter morning 2015:

It had been so quiet in his parents’ room that morning, even though his father always snored.  He had knocked on the door and gotten no answer.  He had sent his sisters to wait in the car and then walked around the back of the house to look through a window into his parents’ room.  They were both lying on the floor.  He thought they were passed out.  He opened the window and leaned into the room to push over a fan, but his parents still didn’t startle.  He ran back into the house, called 911 and slammed into the locked door.  He knew CPR.  Maybe he could save them.  He busted through the lock and fell into the room, landing on his father, whose body felt cold.

Because of a drug, two people were dead and three children were left without parents.  It’s a chilling and heart-wrenching tale.  And it’s playing out over and over again across this country.

The result of the opioid crisis is that the children of addicts are being removed from parental custody at alarming rates, and with the skyrocketing deaths comes skyrocketing and permanent additions to the foster-care system.   According to a recent story in The New York Times, the number of children in foster care since 2010 has doubled in Montana, and has increased by eighty percent in Georgia and forty-five percent in West Virginia.

These numbers highlight some of the devastating derivative effects visited upon the children of opioid addicts.  But opioids, tragically, are also directly affecting children.  According to a study released earlier this month in the journal Pediatrics, the number of children admitted to hospitals for opioid overdoses nearly doubled between 2004 and 2015.  A substantial percentage of these patients are ending up in the pediatric ICU—that is, they are admitted as severe, life-threatening cases.

And hospital emergency rooms are now regularly seeing opioid-addicted newborns.  The number of babies with a condition called neonatal abstinence syndrome—which describes newborns born as opiate addicts—increased a whopping 383 percent from 2000 to 2012.  For an infant affected by NAS, the average length of a hospital stay is almost three-and-a-half times as long, and the costs are more than three times greater, than for a non-affected infant.

And, of course, even if children of addicts aren’t born addicted, if they enter the foster care system they face the stark reality that children in that system are five times more likely to abuse drugs—creating a vicious cycle of drug abuse, child neglect, drug abuse by the child, and on and on.

The line between drug abuse and child maltreatment is short and direct.  It has always been the case that in homes where there are drugs, children suffer.  But with opioids, the problem seems particularly pervasive and menacing—and like an aggressive malignancy it is metastasizing across the nation. 

Some of you, perhaps many of you, know exactly what I’m talking about, because you have seen it first-hand.  Children’s advocacy centers are seeing this crisis up close and with far too much regularity.  Let me tell you about one.  Lily’s Place is a children’s advocacy center in Marion, North Carolina—a community that has seen a surge in the number of children devastated by the opioid crisis.  The center offers social services and a therapy dog, and their staff is doing heroic work to help the kids who come to their attention.  But with many of these children already testing positive for drugs themselves, sometimes for multiple substances, the challenges are daunting.

Closer to home, Chris tells me that not a week goes by without at least one child being brought to the NCAC because a parent or caregiver has overdosed on opioids in the Huntsville area.  Think about that.  Every week, right here in this city, one new child has to watch a parent lose all control to a merciless, deadly drug.  A monster destroying children’s lives is supposed to be the stuff of horror fiction—of Pennywise in Stephen King’s IT—but for so many children in America today, the monster is very real, and it is the opioid.

We cannot overstate the urgency of this deadly and growing crisis.  That is why President Trump and Attorney General Sessions have made fighting the opioid crisis a foremost priority for the federal government.  Yesterday, they were both in New Hampshire, where the President outlined the pillars of this Administration’s initiative to combat the opioid crisis. 

One of these pillars is to cut off the supply of illicit drugs, and the Department of Justice is committed to being a leader in that fight.  Across the country, our U.S. Attorneys have been tasked with aggressively prosecuting traffickers of fentanyl and other opioids.  In 2017, our prosecutors charged more than 3,000 defendants with opioid-related crimes.  

The Department’s new Joint Criminal Opioid Darknet Enforcement team, or J-CODE team, has been scaling up efforts to prosecute illicit online sales of opioids.  Last summer, the Department announced the largest ever takedown of a dark net marketplace—the notorious AlphaBay, which hosted some 220,000 drug listings and led to countless overdoses from synthetic drugs.

In still another major effort, the Department’s new Prescription Interdiction and Litigation, or PIL, Task Force will focus on targeting opioid manufacturers and distributors who have illegally contributed to this epidemic.  It doesn’t matter where someone is on the supply chain; if they broke the law, then we will hold them accountable.  We will use every criminal and civil tool available to the Department.  Whether someone is a drug trafficker, a corrupt doctor or pharmacist, or a manufacturer using illegal marketing, the Department is determined to bring them to justice.  We want them to hear this message: if you break the law and contribute to the opioid crisis, we are coming for you.

In addition, from those who have broken the law, the Department will seek to recover the high costs that federal healthcare programs have borne as a result of the opioid crisis.  To that end, for example, we recently filed a statement of interest in the ongoing, multi-district litigation against opioid manufacturers and distributors, alerting the court that the federal government may have a substantial recovery interest in those actions.

I mentioned that the President’s initiative has several pillars, and supply-side interdiction is just one.  The Administration is also committed to reducing demand and over-prescription.  And we are determined to help those struggling with addiction.

At the Department of Justice, our grant programs help with these other pillars.  The Office of Justice Programs, led by Alan Hanson, awarded almost $59 million last fiscal year to support a range of programs, including drug courts and programs designed to prevent the misuse of prescription opioids.  A substantial portion of that funding went to state, local, and tribal jurisdictions under our new Comprehensive Opioid Abuse Program.  We’re also funding training and technical assistance and an online resource center.

Some jurisdictions are making real progress.  One of our grantees in Oregon set up a tri-county opioid safety coalition that monitors and tracks overdoses and other related problems.  The goal is to use this to determine how to reach high-risk populations.  We’re also supporting special opiate courts, including one in Buffalo, New York, which has shown promising results.

The Administration is focused on multiple fronts because the opioid crisis is more than a criminal-justice problem.  It is more than a substance-abuse problem.  It is more than an economic problem, or a healthcare problem.  It is more than a child-welfare problem.  It is all of these things at once, and it must be tackled through a multidisciplinary approach—the kind that children’s advocacy centers use every day—by bringing together our law-enforcement professionals, our medical and mental-health experts, and our child-welfare specialists. 

And that is why everyone here today, and everyone in the children’s services community, should know that you are an important part of this fight.  We are looking to you, as we have so many times before, to bring your expertise, your conviction, and your courage to address the specific problems faced by youth caught up in this latest crisis.

And the Department of Justice will support and embrace you in this work.  Last year, through our Office of Juvenile Justice and Delinquency Prevention, DOJ awarded nearly $2.1 million to the National Children’s Advocacy Center to support nationwide operations and to provide training and technical assistance that strengthens the multidisciplinary response to child maltreatment.  Part of that assistance is tailored to children who experience multiple forms of trauma, or polyvictimization, which is so often the case with young people caught up in the opioid epidemic.

We’re also exploring a program through our Office for Victims of Crime designed specifically to help children who become crime victims as result of parents’ drug use.

We’re committed, administration-wide, to fighting this epidemic from all sides.  We know it won’t be easy.  Opioids have taken a firm hold in far too many communities, tearing apart families and leaving children hurt, traumatized, and alone. The need for comprehensive services, spanning all systems, is urgent.

Children’s advocacy centers have proven time and again that there is a way to handle violence, victimization, and abuse so that these traumas don’t leave an incurable mark on the children subjected to them. With collaboration and compassion, by seeing the pain and experience through a child’s eyes, we can work to help make it right for our kids.

You are doing heroes’ work, and we are grateful.  Keep up the fight.

Thank you for your service to our children, to your communities, and to our country.