Parental Substance Use as Child Maltreatment - Tennessee

Substance-Exposed Newborns 
Citation: Admin. Pol. & Proc. # 14.1 (Work Aid # 1); #14.9

In policy: Drug-exposed child: This allegation pertains to a person under age 18 who has a diagnosis of fetal alcohol syndrome.

Drug-exposed child (severe): Severe forms of this allegation include, but are not limited to, the following: 

• Infants born with a diagnosis of fetal alcohol spectrum disorder (FASD)
• Infants born with a diagnosis of neonatal abstinence syndrome (NAS) where the diagnosis is not based on the mother's prescribed and appropriately followed medication-assisted treatment

The Department of Children's Services shall intervene and respond timely to allegations involving drug-exposed children (DEC) by screening and assigning reports made to the child abuse hotline to child protection services based on the severity of or potential for physical, mental, or emotional harm to the child.

A referral meets the criteria for the investigation track when one or more of the following applies: 

• The alleged child victim (ACV) is aged 0 through 3 months old.
• The ACV is diagnosed with NAS.
• The ACV is diagnosed with FASD.

For investigation cases, a positive drug screen for a newborn infant or the infant is born drug dependent because of the mother's use of illegal drugs or misuse of legally prescribed medication during her pregnancy is considered when substantiating allegations of DEC. This includes, but is not limited to, a validated diagnosis of FASD and/or NAS.

Children Exposed to Parental Substance Use
Citation: Ann. Code § 37-1-102(27)(D)–(F); Admin. Pol. & Proc. # 14.1 (Work Aid # 1); #14.9  

Effective January 1, 2025: The term 'severe child abuse' includes any of the following:

• The presence of a child within a structure where the act of creating methamphetamine is occurring
• The ingestion of an illegal substance or a controlled substance by a child younger than age 8 that results in the child testing positively on a drug screen, except as legally prescribed to the child
• The presence of a child within a structure where any of the following controlled substances are present and accessible to the child:
  • A schedule I controlled substance listed in § 39-17-406
  • Cocaine
  • Methamphetamine
  • Fentanyl

In policy: Drug-exposed child: This allegation pertains to a person to a person under age 18 to whom any of the following apply: 

• Has been exposed to or is experiencing withdrawal from the use, sale, or manufacture of a drug or chemical substance (including, but not limited to, alcohol, cannabis, hallucinogens, stimulants, sedatives, narcotics, methamphetamines, heroin, or inhalants) that could adversely affect the child's physical, mental, or emotional functioning because of the actions or behaviors of the parent or caregiver
• Has a parent or caregiver that uses drugs or chemical substances that impact their ability to adequately care for the child
• Has a parent or caregiver that has current addiction issues that could adversely affect the child's physical, mental, or emotional functioning 

Drug-exposed child (severe): Severe forms of this allegation include, but are not limited to, the following: 

• The manufacturing of methamphetamine where children are present or in close proximity
• Knowingly or with gross negligence allowing a child under age 8 to ingest an illegal substance or a controlled substance that results in the child testing positive on a drug screen, except as legally prescribed to the child
• Knowingly allowing a child to be within a structure where a Schedule I controlled substance, cocaine, methamphetamine, and/or fentanyl are present and accessible by the child

For investigation cases, the following information is considered when substantiating allegations of DEC: 

• A positive drug screen for the parent or caregiver and other evidence indicates that the parent or caregiver is unable to function in a manner that is adequate to meet the ACV's basic needs (e.g., there is a lack of food, housing, medical care, supervision, or proper hygiene).
• Evidence collected, such as a positive drug screen, indicates the ACV was administered or ingested illegal drugs or prescription medications that were not prescribed to the ACV or used in a manner other than as directed and caused or was likely to cause physical, mental, or emotional harm.
• Evidence shows that the ACV was living in or exposed to an environment where the use, manufacture, or sale of drugs took place. The manufacturing of methamphetamine in the same structure as an ACV is always considered severe abuse.
• An admission is made that the use, manufacture, or sale of illegal drugs or the misuse or sale of legal prescription medication occurred when the ACV is present or placed in a dangerous environment as the result of the activity.
• Assessments or evaluations indicate that as a result of the use, manufacture, or sale of drugs or misuse of prescription medication by a parent or caregiver, the ACV has experienced physical, mental, or emotional harm.