Crime and Punishment, minus crime.
 

The segregation of children from their parents as a Federal response to illegal immigration has generated an extraordinary public reaction. Several national professional associations have been among the respondents; indignation and even anger are expected responses to any maltreatment of children.  The pertinence of this to the field of addictions has obvious examples.  Children are of course especially vulnerable to exploitation as a result of being defense-deficient, both psychologically and physically, when compared to adults. The upshot is that they may be used as mules for carrying drugs, or be inducted into addiction in conjunction with servitude, domestic, industrial, or sexual. Two links to the popular press follow, which interestingly make reference to Great Britain's recent enactment of a statute that includes the possibility of life imprisonment for child slavery. Slavery is, if course, imprisonment or restraint in service to the wishes of the enslavers, and does not require that the persons so enslaved be compelled to physical work.  It can be sufficient to use them as hostages in obtaining demands placed on others: 

Drug mules:  https://www.reuters.com/article/us-britain-slavery-drugtrafficking-child/uk-targets-gangs-who-use-child-drug-mules-with-tough-anti-slavery-laws-idUSKBN1DS2K3

Drug mules 2:  https://www.reuters.com/article/us-britain-slavery/from-child-drug-mules-to-migrant-smuggling-reports-of-slavery-soar-in-britain-idUSKBN1H21G7

As those involved in the identification and treatment of addiction, we are equally if not more familiar with the nexus between childhood trauma and subsequent drug and alcohol use. Isolation and segregation are simply specific types of neglect, neglect that emerges later in self-soothing through the use of drugs.  The astonishing thing is how many children evolve healthily in spite of childhood neglect and trauma, a demonstration of human resilience; but we recognize how effectively that resilience is sabotaged if drugs or alcohol are introduced.  Two examples of pertinent literature follow, on childhood experiences contributing to later drug use: 

1. Lamya Khoury et al.,  Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population in 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/
2. Hannah Carliner & associates in the Journal of Child and Adolescent Psychiatry, in a study drawn from the National Comorbidity Survey:  https://www.jaacap.org/article/S0890-8567(16)30212-X/pdf

Our clinical response to addiction is clear; what is sometimes more difficult is identifying prophylactic public health interventions.  Yet here is one: the abolition of isolation and segregation of children from their parents is an obvious intervention.  So we circle back to that word, "indignation," because I find it difficult to write these words - evinced by my regression to a stilted style - without growing angry over the thousands who will be damaged and at explicit risk for addiction.

- W. Haning, MD