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General FAQ
What is the National Alliance for Drug Endangered Children (National DEC)?
What is a drug endangered child?
Are you just about removing kids from meth labs?
Do you provide substance abuse treatment services or counseling?
Who are the practitioners and partners you work with?
I’ve heard of “DEC Teams" before. Is that the same thing you promote?
How can I help with the challenges faced by drug endangered children?
What should I do if I suspect that a child I have contact with in my neighborhood, school, or place of employment is a drug endangered child?
Whom do I call if I need legal/medical/treatment advice on my case?

Clandestine Lab FAQ
General Clandestine Lab Information
Medical Evaluation of Children Removed from Clandestine Labs
How to Care for Children Removed from a Drug Endangered Environment


General FAQ

What is the National Alliance for Drug Endangered Children (National DEC)?
The National Alliance for Drug Endangered Children (National DEC) is a nationwide collaboration of individuals and entities dedicated to helping children endangered by substance abuse. Based in Westminster, Colorado, we are proud to work alongside law enforcement, prosecutors, social services, medical personnel, treatment providers, prevention experts, probation and corrections, first responders, and many more. We believe that all of the professionals who have the opportunity to save a child from neglect and abuse should be trained to work collaboratively. With support from individuals, corporate partners, foundations, and governmental agencies, National DEC provides training and technical assistance to enhance collaborations, develops and promotes best practices, and establishes child-centered approaches to help children caught up in the destructive cycle inherent in the abuse, manufacture, and distribution of illicit drugs. Since our inception as a national nonprofit in 2006, we have provided support and assistance to thousands of professionals and community members, and dozens of statewide drug endangered children (DEC) alliances across the country.

We are funded by grants from the U.S. Department of Justice’s Community Oriented Policing Office (COPS) and Bureau of Justice Assistance (BJA), private foundations, and gifts from individuals and corporate partners.
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What is a drug endangered child?
National DEC defines drug endangered children as children who are at risk of suffering physical or emotional harm as a result of illegal drug use, possession, manufacturing, cultivation, or distribution. They may also be children whose caretaker’s substance misuse interferes with the caretaker’s ability to parent and provide a safe and nurturing environment.
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Are you just about removing kids from meth labs?
Drug endangered children efforts originated out of concerns about the extreme dangers faced by children living in meth lab homes. However, because any type of drug abuse may create dangerous environments for children – not just the manufacture of meth – the efforts quickly expanded to include all drugs of abuse, including legal substances such as alcohol and prescription drugs.  

Our goal at National DEC is for all children to live in safe and nurturing environments. While it is sometimes necessary for children to be separated from their parents or caregivers so those parents or caregivers may receive the treatment and/or counseling they need to get healthy, our efforts at National DEC are aimed at strengthening families and breaking the cycle of substance abuse that puts children at risk.
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Do you provide substance abuse treatment services or counseling?
We do not provide any direct treatment services to families or children. However, through our network of partners, we may be able to help identify appropriate state agencies that can provide treatment referrals. We also link practitioners and community members with research and the latest best practices information.  In return, they inform us about issues and trends showing up in the field.
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Who are the practitioners and partners you work with?
We work with practitioners who are engaged in all aspects of substance abuse and child well-being, including prevention specialists and educators, law enforcement and other criminal justice professionals, drug courts, child protection and social services, medical professionals, treatment providers, public health workers, and crime victim advocates. We work in partnership with tribal governments and federal agencies as well as members of Congress, state legislators, and other policymakers to craft policies and strategies aimed at rescuing and protecting children endangered by substance abuse. This website contains information for practitioners and policymakers in all aspects of substance abuse and drug endangered children and includes a link to ask experts for assistance and information.

We also provide national leadership, information, education, and training to state DEC alliances all across the country. Click here to see if there’s a DEC alliance in your state.
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I’ve heard of “DEC Teams" before. Is that the same thing you promote?
The goal of all drug endangered children efforts – whether at the state, regional or community level – is to rescue and protect children exposed to and endangered by the abuse, sale or manufacture of drugs. National DEC understands that succeeding at this requires the cooperation of many different disciplines and jurisdictions and we support DEC teams at all levels. We also believe that this comprehensive, multi-disciplinary approach is essential for instigating the broad social and policy changes necessary to reduce the number of children who suffer as a result of substance abuse.
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How can I help with the challenges faced by drug endangered children?
We can all help break the cycle of abuse and neglect. It begins with identifying drug endangered children and recognizing the dangers they face. Drug endangered children are victims who need intervention from caring adults for their survival and well-being. Social service and child welfare experts can help provide referrals to services and programs. Law enforcement can intervene when there is evidence of neglect or abuse.

Also, children who have been exposed to drugs prenatally may suffer damage to their developing brains. Getting professional help from someone that understands the effects of drug exposure on a child’s physical and mental health is imperative to ensure that the child receives the services they need. Click here for a fact sheet that lists some of the most common emotional, behavioral and cognitive problems exhibited by drug endangered children and for more about what you can do.
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What should I do if I suspect that a child I have contact with in my neighborhood, school, or place of employment is a drug endangered child?
Drug endangered children need the help of caring adults and appropriate services. Contacting your local child protection agency is a good place to start so that the situation can be investigated by trained professionals. If you suspect abuse or neglect or criminal activity, contact your local police.
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Whom do I call if I need legal/medical/treatment advice on my case?
Call 2-1-1 or 1-800-4A-CHILD. Or, if your state has a state DEC alliance, they may be able to connect you to your local resources.
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Clandestine Lab FAQ

General Clandestine Lab Information - DOWNLOAD PDF (39KB) 

What is a clandestine lab?
A clandestine laboratory is simply defined as a place where preparation of illegal substances takes place. These ‘labs’ are used to manufacture drugs, explosives and even biological or chemical weapons. Most often, the labs are used to manufacture methamphetamine, a potent illegal stimulant drug.
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What hazards exist in a clandestine lab?
Since the activity in these labs is illegal, they are usually designed for ease of concealment of the activity and not for safety. Often, the persons running the lab have little or no formal education in chemistry. Numerous hazards exist in this environment including potential toxicities from the chemicals and gases produced, fires, explosions and chemical and thermal burns. Children living in a lab are at heightened risk for physical, psychological and sexual abuse, neglect, as well as possible exposure to methamphetamine or dangerous chemicals, booby traps, violence, weapons and pornography.
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What chemicals are likely to be present in a clandestine lab?
This question must be answered with some caution. The chemicals commonly used to manufacture methamphetamine are well known. However, this does not mean that only these chemicals are present in a clandestine lab. Since the activity of making methamphetamine is illegal, the chemicals and equipment may be obtained through theft from legitimate scientific laboratories or suppliers. In these circumstances, the manufacturer may steal many things not required in the actual manufacture of methamphetamine. A great deal of misinformation is available, particularly on the internet, which may mislead a cook into thinking a given chemical compound may be useful. Additionally, the cook may lack the scientific sophistication to distinguish between similar sounding chemical names. Finally, there may be more than one clandestine activity taking place in the lab in addition to the preparation of methamphetamine. That said, a wide variety of caustics / corrosives (e.g. NaOH and HCl), solvents (e.g. naphtha and ether), and respiratory irritants (e.g. ammonia) are commonly present in illicit methamphetamine labs.
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What are the potential acute toxicities of these chemicals?
The answer to this question depends on the specific agent to which the individual was exposed, the route of exposure, the concentration of toxin and the duration of the exposure. Most reported acute effects include nausea, headache, and irritation affecting the skin eyes and mucous membranes as well as wheezing and coughing. Other hydrocarbon solvents can cause CNS depression (e.g. lethargy, irritability, etc.) if inhaled in high concentrations. The more concentrated and longer duration exposures are generally more serious, though brief exposures to some highly toxic agents (e.g. phosphine) may also be life-threatening. Low chronic exposure may result in very subtle symptoms.
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What data is available regarding the long-term health effects of these chemicals?
Though long-term effects of some chemicals are known primarily from industrial settings, many other chemicals are not as well studied. Within the specific context of clandestine methamphetamine labs, chemicals may be mixed or stored inappropriately. A limited number of reports have been published examining acute health effects of chemical exposure in methamphetamine laboratories in emergency response personnel. No studies involving long-term effects of continuous clandestine laboratory exposure exist. Currently, no prospectively collected data exist describing the effects of acute or chronic exposure of children to illicit methamphetamine labs.
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What is meant by the term “decontamination” in reference to persons removed from a clandestine laboratory? Why is it necessary and when should decontamination be performed?
“Decontamination” simply means thoroughly washing in order to remove any potentially harmful residue from persons removed from a hazardous site. Decontamination is necessary to protect the individual from continued exposure as well as to prevent possible secondary contamination of other persons, equipment and facilities with which a contaminated individual might come in contact. All persons removed from a clandestine lab should be properly decontaminated and dressed in clean clothing prior to any additional questioning or evaluation. Decontamination is necessary regardless of the age of the person removed from the lab and whether or not the lab was in use at the time of removal. Decontamination should be performed by washing with running water. Wetting the skin without running water or using wipes may result in increased uptake of methamphetamine.
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How should a person removed from a clandestine laboratory be decontaminated?
The answer to this question depends entirely upon the exposure history of the involved persons. For example, a police officer involved in warrant service in a lab may only need decontamination of his/her boots with a soap and water solution. An adult suspect removed from a lab must have all clothing removed and be thoroughly washed with soap and running water, typically using portable warm water and then dried and dressed in clean clothing. The best recommendation for a child is to have a facility such as a tent or camper available at the scene in which the child can be given a warm shower and then dressed in age and gender appropriate clothing to minimize the psychological impact of the decontamination process. Regardless of other decontamination procedures, children should have their clothing removed and be provided clean clothing by the responding agencies or an acceptable outside source. Decisions regarding specifics of decontamination are most appropriately made by trained HAZMAT personnel.
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When should someone removed from a clandestine laboratory be medically evaluated?
All symptomatic persons, both adults and children, should be evaluated by medical personnel immediately upon decontamination. Victims in sites with fire, explosion or chemical exposures should be evaluated immediately. Asymptomatic adults may not require medical intervention. It is recommended that children removed from clandestine labs be further evaluated by a qualified practitioner that can do a complete pediatric evaluation within 24 to 72 hours. This includes children who were previously medically cleared by an Emergency Department. Medical evaluation of children removed from illicit labs is described in greater
detail in the "Medical Evaluation of Children Removed from Clandestine Labs" FAQs.
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Medical Evaluation of Children Removed from Clandestine Labs - DOWNLOAD PDF (39KB)

When should someone removed from a clandestine laboratory be medically evaluated?
All symptomatic persons, both children and adults, should be evaluated by medical personnel immediately upon decontamination. Victims in sites with fire, explosion or chemical exposures should be evaluated immediately. Asymptomatic adults may not require additional medical intervention. It is recommended that all children removed from clandestine labs be evaluated by a practitioner qualified to perform a complete pediatric evaluation within 24 to 72 hours of removal from the lab, if feasible.
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What signs and symptoms would a child likely display after being exposed to the environment in a clandestine laboratory?
There is no single, well-defined expected presentation for a child with a history of potential chemical exposure in a methamphetamine laboratory. Recent exposure to methamphetamine itself will likely cause a picture of sympathetic excess (tachycardia, hypertension, hyperthermia, and irritability/agitation). A child with a more distant serious exposure to methamphetamine may present with CNS depression, neurological deficit or coma due to catecholamine depletion. It is important, however, not to focus only on the toxicity of the finished drug product. In point of fact, there are an untold number of potentially harmful chemicals with which a child could come in contact in a clandestine laboratory. The most common complaints are irritation of the eyes, skin, mucous membranes, gastrointestinal (nausea and vomiting), and headache. Evidence of irritation such as caustic burns, redness, swelling, etc. may or may not be apparent. Respiratory compromise, ranging from wheezing due to irritation to pneumonitis from aspiration of hydrocarbon solvents to respiratory arrest from inhalation of gases such as phosphine or cyanide, is possible in a clandestine laboratory. Finally, the child should be evaluated for signs or symptoms of abuse, neglect and nutritional deficit and, if present, further evaluation as deemed necessary should be completed.
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Does an asymptomatic child removed from a clandestine laboratory require urgent evaluation in a hospital emergency department (ED)?
Pre-hospital care providers (EMT’s or paramedics) should evaluate all children removed from a clandestine laboratory immediately to determine if they are truly asymptomatic. A truly asymptomatic child will likely not require immediate evaluation in the ED, but should see a primary care provider within 24 to 72 hours of removal, if feasible, from the laboratory for a complete assessment of health and developmental status. All symptomatic children and children not evaluated on scene by emergency medical personnel who are removed from a clandestine laboratory should be evaluated in the closest appropriate hospital ED. All children should receive continuing care in a medical home within 1 month.
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What clinical laboratory assessments should be performed on a symptomatic child removed from a clandestine lab?
All symptomatic children should be managed supportively as there is no specific antidote for an unknown chemical exposure. Usual clinical laboratory assessments should be made in order to manage such a child. With appropriate clinical and historic situations, additional analyses such as carboxyhemoglobin or whole blood lead may be indicated.
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What clinical laboratory assessments should be performed on an asymptomatic child removed from a clandestine lab?
It is important to understand that it seems highly unlikely a truly asymptomatic child will become ill at a later time as a result of a toxic exposure in a clandestine laboratory. However, since there are no closely controlled studies proving this each child must be closely examined for the presence of symptoms. There are two levels of clinical laboratory assessment in an asymptomatic child removed from a clandestine laboratory. These include (1), acute exposure assessment and (2) general assessment of health and developmental status, primarily secondary to the high probability of neglect. With respect to the acute exposure issue, some jurisdictions request urine drug testing be performed on children removed from clandestine laboratories in order to assist in prosecution of the case. The topic of urine drug screens is addressed in greater detail in the next question. Current clinical laboratory test recommendations for the general assessment of health and developmental status include a CBC and a chemistry panel, which has electrolytes, liver function tests, kidney function tests and total protein and albumin.
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When is it appropriate to order a urine drug screen on a child removed from a clandestine lab?
The window of collection for the urine sample for a drug screen should be as short as possible after exposure within 8 to 12 hours of removal. Cases exist in which children in clandestine labs have been exposed either deliberately or inadvertently to drugs and medications other than methamphetamine. A urine drug of abuse screen detects some classes of commonly abused drugs. However, many harmful chemicals with which a child may come in contact in a clandestine lab will not be detected by such a screening tool. Urine drug screening may be performed at the discretion of the treating medical providers who understand its strengths and limitations. However, in cases of unresolving tachycardia or signs of sympathetic excess of unclear etiology, a drug screen might be useful. In completely asymptomatic children, a urine drug screen may be beneficial for prosecutorial efforts. Given the fact that some studies have shown greater that 50% of these children test positive for methamphetamine, the current recommendation is for urine drug screening to be performed. False positive results for amphetamines on screening tests are common and any positive screening result should be confirmed prior to legal action being initiated. Medical care should not be delayed while waiting for confirmation of screening results as confirmatory testing may take several days.

It should be emphasized, however, that all children should be considered exposed to methamphetamine or other drugs of abuse if found in a clandestine laboratory regardless of the urine drug screen results. All urine drug screens must be followed by confirmatory testing using GCMS. If performed, hair and skin-patch testing should be performed in consultation with a knowledgeable authority who understands the methodology strengths and limitations. Legal chain of custody procedures must be followed at all times for specimens obtained for drug testing.
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How to Care for Children Removed from a Drug Endangered Environment - DOWNLOAD PDF (41KB)

How should a child removed from a drug endangered environment be cared for?
All children removed from drug endangered environments need predictability, structure, and nurturance. Regardless of age, many children may have mental health, medical and developmental concerns which need to be addressed. Often children in drug endangered environments are witnesses to violence and may even be victims of neglect and abuse. Therefore, they need an environment that ensures as much stability, consistency and safety as possible. Children removed from an environment where illegal substances are used or manufactured may have some special needs.
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What physical signs and symptoms would a child likely display after being exposed to the environment containing a clandestine laboratory?
These children are usually asymptomatic. Children removed from homes where illegal drugs are being manufactured should be evaluated medically before being placed in care. If this has not occurred, they need to undergo an initial medical evaluation, followed by a complete physical (if not done at the time of the initial evaluation) within 24 to 72 hours of placement. Most of the children removed from these homes have normal initial medical evaluations. However, because of the potential chemical exposure the child may have had in the home from which they were removed, the caretaker should pay special attention to any respiratory symptoms (difficulty breathing, excessive cough, shortness of breath) as well as changes in mental status (confusion, excessive sleepiness, excessive hyperactivity). Although unlikely related to the drug, if present these symptoms should be evaluated urgently by a medical provider. If the onset of symptoms occurs greater than 24 hours after the exposure, it unlikely to be related to the clandestine laboratory. However, the child should still be medically evaluated.
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Should I have concerns about a child that was removed from a drug endangered home that did not contain a clandestine lab?
These children should be cared for in the same manner as any child that is removed from their biologic home for any reason. All of these children need complete medical evaluations as required by the Department of Social Services. If the child exhibits any abnormal signs or symptoms prior to or following that evaluation, they need to be reevaluated by a medical provider. Again, homes in which there is drug or alcohol use are often lacking the consistency which children need to thrive. Therefore, providing these children with an environment where there is predictability, structure, and nurturance is critical for optimal development.
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What should I do with the clothing of children removed from drug endangered environments?
All children that have been removed from homes containing clandestine labs should be decontaminated and dressed in clean clothing prior to placement. Therefore, their clothing is safe. If they have not been decontaminated, all clothing should be removed and washed separately from other clothing. The child should shower with soap and warm running water as soon as possible, not placed in a bath. Also, they should not come into your care with any personal items from their homes (e.g. toys, blankets, etc.) other than those provided by responders on scene or by medical professionals at evaluation. There may be an exception depending on local clean up requirements, for certain personal items. If allowed by the local jurisdiction, clothing, blankets and other washable items, such as backpacks, may be laundered separately and safely returned to the child. All clothing and personal items, including toys, contained in a home in which there was a clandestine lab are to be considered contaminated. There may be an exception for certain personal items (such as eyeglasses, but not contact lenses!) that may have been cleaned by the professionals on scene. These exceptions would need to be approved by the HAZMAT commander at the scene. Also, be aware that there have been many cases in which the child’s caregiver has placed drugs and possibly needles/syringes in the child’s toys, diaper bag, or other
personal belongings in an effort to hide them. If you find anything suspicious, do not touch the item and call your local law enforcement agency or caseworker immediately.
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Under what conditions are children addicted to methamphetamine? What are the symptoms? Will a child experience withdrawal?
Children cannot become addicted from passive exposure. Addiction refers to a complex set of behaviors around physiological and psychological dependence. Active use with dependency can occur in children even at a very young age in drug using households. However, a positive drug screen does not equate with addiction, which is very hard to define in this setting. Symptoms of drug exposure may be rapid heart rate, high blood pressure, high body temperature, and agitation. All of these symptoms should have been assessed for during the initial medical evaluation and may be related to a serious medical condition unrelated to drug exposure. If the child was not evaluated medically before placement and is displaying these symptoms, they should be medically evaluated as soon as possible. There have been no adequately documented cases of true withdrawal in children environmentally exposed to drugs, unless the child actually ingested the drug, was clinically ill, and was evaluated at a medical facility. However, in cases of heavy use, methamphetamine is known to deplete dopamine levels in the brain, ultimately causing the user to become very sleepy and lethargic. If the child displays these symptoms, they should also be evaluated medically. It is possible that mood swings and unusual behavior may be related to the child’s previous living conditions or underlying psychological or psychiatric illness and not drug exposure. Finally, there have been reports of caregivers giving children other drugs or medications such as sedatives or antihistamines in an effort to get them to sleep. Therefore, any child that begins to behave unusually or have unexplained symptoms should be evaluated medically. The physical manifestations of withdrawal in an infant are similar to those in an adult.

Symptoms of addiction and withdrawal are variable, non-specific and may be related to the trauma experienced by the child with the exception of drug seeking behavior. Behavioral concerns should be evaluated by a qualified mental health or substance abuse treatment provider. Unexplained physical signs or symptoms must be evaluated by a medical provider.
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What behaviors would one expect to see in a child removed from a methamphetamine lab?
The behaviors displayed by these children vary greatly. Some behaviors that might be been seen are similar to those seen by children with a trauma history and include: Post-traumatic stress disorder, aggression, attachment difficulties, sensory disorders and sexualized behaviors.
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What symptoms would one expect to see in an infant that was exposed to methamphetamine before birth?
Symptoms from a prenatal exposure depends upon the underlying medical factors, the combination of the drugs used, as well as the timing, frequency and quantity of drug use during pregnancy. If infants are affected, the effects are subtle and may include lethargy, feeding difficulties, poor state regulation, low threshold for stimulation, and irritability. These infants may also be small for gestational age.
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How would one care for an infant that is exposed to methamphetamine before birth?
Caring for prenatal meth exposed infants is similar to normal newborn care. However, those infants experiencing signs or symptoms suggestive of prenatal methamphetamine exposure should be cared for in a calming environment. Level of stimulation should be appropriate to the infant’s tolerance. Medication is not necessary unless there is evidence of neonatal abstinence syndrome to narcotics.
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Does a child from a clandestine lab pose a toxic risk to me, my children or to other members of my family?
Absolutely not. Once the child removed from the lab has been decontaminated, he or she poses no toxic risk to other persons whatsoever.
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