TALLAHASSEE, Fla. – Ciara sobs as she recounts how, as a middle schooler, she helplessly witnessed her mother's downward spiral into drug addiction, an affliction that left Ciara at times wishing her mother would simply die to end their suffering.
Ciara, now 20, is one of the countless child casualties of an opioid epidemic Florida lawmakers are struggling to curb.
With a 35 percent jump in opioid-related deaths in 2016, legislators are considering a variety of options to stop the spread of drug addiction and to keep patients from getting hooked on prescription medicines that can lead to the use of even more lethal street drugs, such as heroin and fentanyl.
Policymakers are focusing their attention on drug users, dealers and doctors.
But child-welfare advocates want to make sure that the needs of wounded children and other family members --- the collateral damage in the life of an active addict --- aren't forgotten.
On the surface, what Ciara experienced growing up with an addict for a mother pales in comparison with the tales of children discovered in the backseats of cars with their parents passed out from drug overdoses in the front, or toddlers left alone in fetid apartments for days while drug-addled mothers or fathers scour the streets for a fix.
But after her mother, Elizabeth, became hooked on pain pills due to back pain, life as Ciara once knew it rapidly changed. The electricity would be disconnected. The water was shut off. Money would disappear. The family --- Elizabeth, her boyfriend, Ciara and Ciara's younger sister --- began to move from place to place.
Ciara finally realized her mother had a drug problem.
“It got worse and worse and worse, so it's kind of unhideable after a certain point,” she told The News Service of Florida.
At age 15, Ciara went to live with her father, a situation she said wasn't much better because he was an emotionally abusive alcoholic.
The pain she experienced during the six years of her mother's addiction lingers, six months after Elizabeth entered a residential treatment program near Tallahassee. Several years before Elizabeth decided to get clean, Ciara learned that her mother's live-in boyfriend overdosed and died.
“I went into full panic mode after that because I was so scared that my mom would overdose. I couldn't imagine what it would be like to lose my mom,” she said.
But, as a teenager, Ciara said she was also angry and hurt.
“It felt like I wasn't as important as the drugs were,” she said.
For weeks, Ciara would hear nothing from her mother. Then she would get a phone call from Elizabeth, saying she needed money for a hotel room or she would have to sleep outside.
Her mother's lies and disappearing act and the constant anxiety took its toll.
“It hurt so bad that honestly there was a long period of time I just wished she would have died, because it seemed like that would have been easier for me. It just would have been done. No more suffering,” Ciara said, sobbing. “Or just walked out of my life. I couldn't do the constant worrying and the manipulation.”
Ciara, who graduated from high school with honors, did not receive counseling, but she now participates in weekly family sessions with a therapist at her mother's treatment center. She said now realizes she probably should have sought help for herself earlier.
Ciara and her mother requested that their last names not be published.
Teenagers and tweens with drug-addicted parents may not have to enter the child-welfare system because they are not as vulnerable as younger children, who are dependent on others to provide basic necessities, like preparing meals or bathing.
As the numbers of addicts escalate, the numbers of children placed in out-of-home care because of parental drug abuse is increasing, according to data captured by the Department of Children and Families.
“We've definitely seen a significant increase in the number of kids who are coming in the child welfare system as a result of parental substance use,” said Jenn Petion, director of administration and external affairs for FamiliesFirst Network of Lakeview in Pensacola, an agency that provides foster care and other services.
The statistics are staggering across the state.
More than 4,000 babies were born addicted to opioids in Florida in 2016, an increase of over 1,000 percent from a decade ago.
Substance abuse played a role in two-thirds of the cases where children were removed from their homes within 30 days of birth last year.
And there's been a 38 percent increase in the number of children under the age of 5 who have been removed from homes because of substance abuse in the past four years.
In the first half of 2017, more than 60 percent of all removals were due to drug abuse --- nearly double the percentage just four years ago.
The influx of children has resulted in a shortage of foster-care beds, Petion said, prompting her agency to hire an additional foster-care recruiter.
Gov. Rick Scott wants to spend $53 million --- more than half of which comes from federal funds --- to address the opioid issue. Much of the governor's proposed spending is focused on substance-abuse treatment, including medication-assisted treatment that pairs prescription drugs with counseling and other services.
The Legislature, which begins it annual session Jan. 9, is moving forward with another Scott proposal that would limit doctors to prescribing seven days' worth of opioids for patients with acute pain. Research shows a direct correlation between the length of a first prescription for pain medications and the chances of becoming hooked on the drugs.
But focusing solely on addicts or would-be users is only a partial solution, child-welfare experts agree.
“The hidden piece is the cost that the family endures,” said Mike Watkins, CEO of Big Bend Community Based Care, a Northwest Florida agency that provides child-welfare services. “The individual can use all they want. They can blow through resources and damage themselves, but in the wake of that are parents and children and brothers and so on. And then, unfortunately, we end up holding the bag with the kids and trying to put that back together.”
While child-welfare advocates support increased spending on substance-abuse and mental-health treatment services, Petion also stressed that drug abuse “doesn't happen in a vacuum.”
“We have to be able to provide those wrap-around supports when there are children involved. Every time we increase the number of children in foster care, it doesn't just affect one thing,” she said, pointing out that the costs include additional caseworkers and transportation. “We have to provide those children with trauma with services so when the parent gets clean and goes back home, that the child is also healed from the trauma that they've experienced as a result of their parent being an addict.”
Elizabeth, who's been clean for six months, and Ciara are on a path of healing.
“I broke my daughter's heart,” Elizabeth acknowledged in a recent interview.
But the two women also offer inspiration for other families.
“What I would like people to understand about addiction is none of us woke up one day and said we want to throw everything and everyone precious away because getting high or getting drunk is more important. That's not how it happens,” Elizabeth said. “Nobody did this to themselves on purpose. Addiction really is a disease. Once it has you, it has you. But there is hope. You just can't give in.”