The number of Minnesota children being removed from drug-addicted parents has reached crisis levels, flooding a state child welfare system that was already operating under heavy strains.

As the opioid epidemic has tightened its grip on the Upper Midwest, drug abuse by parents has emerged as the leading reason why children are taken from their parents. Children have been removed from their families because of parental drug abuse on more than 6,000 occasions from 2015 to 2017, according to new data from the Minnesota Department of Human Services (DHS).

Parents' substance abuse now accounts for nearly one of three children being removed from their homes statewide, compared to just over one in 10 a decade ago.

The trend has also produced an alarming increase in newborns exposed to opioids in utero. More than 1,600 Minnesota children were exposed prenatally to alcohol or illegal substances in 2017 — more than double the number in 2013.

"We are absolutely drowning in [parental] drug abuse cases," said Paul Fleissner, Olmsted County deputy administrator of health, housing and human services. "We need to figure out ways to get to these families sooner because far too many of our kids are being put at risk."

In response, state and county child protection agencies are summoning new resources in an attempt to help struggling parents keep their children.

Those efforts rely in part on broad new federal legislation, signed into law by President Donald Trump early this year, that overhauls the way child welfare services are funded. For the first time, states can use federal funds to pay for residential drug treatment programs that serve parents and children in the same facility. In Minnesota, federal money for these child-parent programs finally became available in October, and state officials hope they will help keep families together by expanding treatment options.

"This could be a game changer," Nikki Farago, assistant commissioner of children and family services at DHS, said of the law, known as the Family First Prevention Services Act. "All signs are pointing toward the use of this new funding and the creation of new pathways for treatment. It's incredibly timely."

The effort, however, is complicated by the fact that child welfare cases involving parental drug addiction are particularly difficult to resolve.

Because addiction often afflicts extended families, child welfare workers say it can be impossible to find temporary caregivers among a child's relatives. In addition, demand for substance-abuse treatment outstrips supply, so that many parents struggle to achieve sobriety under rigorous court timetables. Many drug-addicted parents resist getting help and disappear for weeks or months at a time while they are using, as their children languish in the system, officials said.

As a result, children entering Minnesota's child welfare system are staying in foster care much longer, extending the separation from their birth parents and producing larger caseloads for county and tribal child protection agencies. Statewide, the median length of time that children spend in foster care has swelled from 175 days in 2013 to 297 days in 2017, according to DHS data.

"We have parents abandoning their children at record rates," said Dennis Frazier, a child protection worker in St. Louis County in northeast Minnesota. "The addiction is so overpowering and the drugs are so strong that they simply fall off the grid and stop taking care of their kids."

Dr. Lisa Hollensteiner, an emergency room physician at Fairview Southdale Hospital in Edina, has experienced the crisis firsthand.

Hollensteiner said when she sees patients who have overdosed on heroin or other drugs, she routinely questions them on the whereabouts of their children. Increasingly, she said, the parents respond by saying they don't know or have difficulty recollecting.

In one recent case, a drug-addicted mother had left four children, ages 2 to 10, alone in a hotel room before she was found on the streets, Hollensteiner said. Another mother abandoned her two young children at a park in Richfield before she was found passed out on prescription sedatives at the Mall of America. Hollensteiner said she immediately reported the cases to child protection agencies and law enforcement, who were able to find the children.

"We see tremendous amounts of drug use in the ER and we always, always have to ask about the kids," Hollensteiner said. "Parents who are chemically impaired are not always thinking about them."

Still, child welfare advocates warn that removing children from their families — even when it's necessary — can cause deep psychological wounds for both parents and children. A growing body of research has found that children placed in foster care suffer from higher rates of depression, anxiety and behavioral health problems.

Megan Bjork, 38, said she hit "many lows" during her two-decade battle with drug addiction. But nothing compares to the morning in May 2014 when police raided her home in Columbia Heights and took her away in handcuffs as her 10-year-old son watched. Bjork said that as she climbed into the police car, she repeatedly cried "I love you!" to her son, who was later removed from her home.

"The worst part is, a child can't go back and unsee what's been seen," Bjork said. "That memory will last for a lifetime."

Bjork said it took another 15 months before she mustered the courage to throw her meth pipe in the garbage, break away from her drug-using friends and stay in treatment. She has been sober for more than three years and is reunited with her son at her new home. Bjork now advises other mothers on how to get treatment and navigate the child welfare system.

Still, she said, she and her son are both struggling to recover emotionally.

"I made some bad decisions, but taking my child made it worse by ripping my family apart," Bjork said. "It created a sense of hopelessness and anxiety that pervaded my entire life."

Child welfare advocates hope the new federal law will help prevent these traumatic removals by addressing the extreme shortage of family-based treatment programs.

In Minnesota, only a half-dozen residential treatment programs allow parents to stay with their children during therapy. Many parents forgo getting help because they don't want to be separated from their kids, say child welfare workers.

"That's a huge disincentive" to seeking help, said Traci LaLiberte, executive director of the University of Minnesota's Center for Advanced Studies in Child Welfare.

Karina Forrest-Perkins, chief executive of Wayside Recovery Center, a St. Louis Park-based nonprofit that operates a 35-person treatment center in Minneapolis for mothers and their children, said she expects family-based treatment programs will expand as awareness of the new law and funding model grows.

"For too long, women did not seek treatment because they were terrified they would be separated from their children," she said. "The system never worked. Now we have a chance to fix it."