The little ones feel the biggest impact. That is true no matter what causes a family to fall apart, and children are the most vulnerable when it comes to the growing use of methamphetamine in Napa County.

For children, living with a parent addicted to meth can be like walking in a mine field.

"Many of these kids live in dangerous, dirty homes. Many suffer from neglect," said Nancy Schulz, behavioral health manager for the Napa County's Child Protective Services department. Schulz said CPS often gets calls from concerned family members or neighbors who suspect drug abuse is ravaging the home of someone they know.

"We have seen some very filthy homes -- disgusting. There is garbage on the floor, sometimes feces. There is very little food in the cupboards and refrigerator, and often what is in there has gone bad. We have come upon homes where the parent is passed out and there are toddlers and even infants in the home."

It all boils down to priorities, Schulz said. Parents who use meth are apt to neglect the needs of their children.

"Like getting them off to school or properly dressing them for the weather. We have assisted police in taking a child who has been reported wandering outside in just a diaper in cold weather," Schulz said.

When a child is taken from a home, CPS has 48 hours to place that child with a relative or in foster care. CPS representatives must appear before a judge within 72 hours and present evidence to show the court why the youngster should be removed from the home, Schulz said. "If the judge agrees with us, a court order is made."

The goal of CPS is to reunite children with the parents. In order to do that, the court orders parents to attend programs that will get them off drugs and learn to be responsible parents.

"Having their children taken away from them is a wake-up call for some parents who seek help themselves," Schulz said. "But unfortunately, that is rare."

CPS offers programs to help parents get their kids back. "We help more moms than dads, because dads are not always in the picture," she said.

From the time a child over 3 is taken from the home, the parents have 12 months to complete the court-ordered drug programs and get drug free. They are given another six months if they haven't quite got there yet, but are making progress. Parents of children under 3 are given six months, and then another six months if they are making progress.

"The problem with meth is it is so addictive and so hard to kick. Many of the parents have relapses and meeting the court orders takes a long time," Schulz said. "But our clock starts ticking the minute we take the child from the home. If time runs out for the parents, their parental rights are terminated and we start looking for permanent living arrangements for the child. The addiction to meth can be so powerful that parents will give up their family."

Often it is hard to reunite children with meth-addicted parents. Because of their addiction, many have lost their jobs, homes and sold their possessions to buy drugs.

Schulz said psychological damage to children can result from living in a meth home.

"These kids have little stability. They learn not to trust adults because they come and go out of their lives. The very people who are supposed to be taking care of them let them down," Schulz said. "I have had some kids say the best day of their lives was when we came and took them away. Other kids really worry about their parents. Because of their parents' addiction, some of these kids have ended up taking care of their parents and their younger siblings."

Schulz said drug abuse by parents has increased in the past few years, but she cannot detail how much is related to meth.

"We don't track our cases for specific drug use," she said. "Our statistics based on the referrals for different types of child abuse, which often stems from the parent using drugs."

Meth mouth

CPS isn't the only county entity dealing with the costs of meth use. Because many meth users end up doing a stint in county jail -- and because the majority of those people do not have health insurance -- the county ends up footing the bill to treat them.

The biggest hit on the county jail health care system over the past few years is the treatment of meth mouth -- rapid decay of teeth. The caustic materials used to make meth, such as brake fluid, drain cleaner and lye, attack the enamel of the teeth, causing them to rot at the gums.

"By the time we see them, there isn't too much of their teeth that are salvageable. We usually end up pulling the rotten teeth," said Diana Antonio, a registered nurse. Antonio is the medical program manager for California Forensic Medical Group, which has the county contract to provide medical services for inmates.

"Those who have chronic cases of meth mouth -- and I have seen them here at the jail -- can end up losing almost all of their teeth. We don't do dentures in jail. They do in prison where inmates stay much longer. Most of people with meth mouth have been suffering from it for so long that even with rotting teeth and no teeth, they learn to manage to eat."

Elaine Hustedt, vice president of operations and personnel for CFMG, said the company allots eight hours a month for dental care for the inmates. "However, if we need to see more patients in that time, we would arrange to have the dentist there at the jail," she said.

Antonio has been program manager at the jail since July 2000. The dentist treats inmates every other Saturday.

"When I first came we treated maybe eight to 10 patients on a Saturday. Now it's more like 12 to 20. Meth mouth is not the only thing we treat, but I do believe it is responsible for the increase in tooth decay in the inmates," Antonio said. "We see it on a regular basis. It wasn't like that five or six years ago. You know a meth mouth when you see it."

Antonio pointed out that most meth users don't have dental insurance, making it all the less likely they are cared for properly. "The only time they see a dentist is when they are incarcerated. So often meth mouth doesn't get treated until it's in the advanced stage," she said.

Inmates suffering from meth mouth ask to see the jail dentist because they are in pain, Antonio said. "When they are on the outside doing meth, they don't feel the pain. They are in jail with no drugs, and the pain sets in," Antonio said. Meth mouth can be found in people of all ages, and both men and women. "I think we are seeing more often in younger people."

Meth use can also cause bizarre psychological behavior, and a person arrested who is on a meth high can be a handful for jail staff.

"Some of them haven't slept in days. Others are paranoid. Others are violent and aggressive. They are taken to booking, and all of a sudden, they go berserk and have to be put in a safety cell. Some end up so out of control that have to be put in a body wrap," Antonio said. "All of this takes a lot work by the staff and can be dangerous to the inmate and staff."