ELLIJAY, Georgia (AP) — The First Baptist Church auditorium was filling with an expectant crowd, friends and family who had been through so much. Kim Silvers' three young daughters were there, all dressed up and eager for the graduation, hoping to mark the end of years of heartache visited on them all by their mother's addiction.
They had begged her to stop using opioids and heard her promise to do so, only to break that vow over and over. They'd cried when she abandoned them, and again when they were split apart and sent to three different foster homes. Then their mother signed on for a rigorous court-run treatment program — her best, last chance to avoid the permanent loss of her children.
On this Tuesday evening, the program's culmination was at hand. The would-be graduates just had one final duty: providing another batch of urine samples to be drug-tested. "We hold them accountable to the end," case manager Jackie Bramlett said.
Across the United States, the opioid epidemic has caused tragedies too numerous to count. One bitter way to quantify the scourge is the documented spike in the number of children removed from the custody of addicted parents. One of the most dramatic increases has been in Georgia, where the foster care population soared from about 7,600 in September 2013 to more than 13,700 as of August. Parental substance abuse of all kinds, the state says, now accounts for about 40 percent of foster care entries.
In response, family drug courts like the program Silvers entered have been spreading nationwide. There are hundreds of them across the U.S., though they still only reach a small fraction of parents with addiction.
Looking back, Silvers says drugs had so taken over her life that she'd likely be dead without this type of help — the constant monitoring and testing, mandatory classes in parenting, curfews and court appearances, jail time for infractions. There were times when she desperately wanted to quit the program.
"I never thought I would have 30 days clean, you know?" the 34-year-old mother confides. "And once I had 30 days, and six months, it wasn't an option. ... I knew I had to do this for my girls. I knew there was a better purpose for my life."
Substance abuse cast a shadow on Silvers' life from her girlhood in this mountainous area of north Georgia; both her parents were alcoholics. By the time she turned 22, Silvers and a boyfriend were parents to three little girls: Emily, Kelsey and Allison. She started drinking heavily herself after Allie, her youngest, was born in 2005, and intoxication led to drug addiction. After Silvers took a drunken plunge from a second-story window and shattered her pelvis, a doctor prescribed the painkiller Percocet, which contains the opioid oxycodone.
"My body grew so dependent on it," Silvers recalls. "I had to have as much of it as I thought I could."
She tried other drugs, often in a fruitless quest to replicate "that first high." Several times a week, her daughters would find her passed out.
Emily, the oldest, remembers a mother who often seemed drowsy, sometimes drooling. "I didn't want to see her like that," she says, "and to see my sisters, how they were sad."
On school days, Silvers would often rouse herself from bed to find that Emily, then about 11, had woken the younger girls, organized breakfast, and gotten everyone on the bus to school. Laundry chores often fell to Emily, too. "I just wanted to be a kid," says the daughter, who is 16 now and whose mother allowed her to be interviewed.
Silvers would promise to stop using, break that promise, then lie and tell her daughters that doctors had instructed her to keep taking medication. Eventually, Silvers wrecked her car and split with the children's father. She went to live with a relative who kept her supplied with painkillers — leaving her daughters with their paternal grandmother, who called child welfare officials when Silvers failed to return.
In November 2013, the girls were removed from Silvers' custody and at first taken in by a cousin, then placed by the state in different homes. Allie wound up having to move around 14 times, and saw her mother only about once a month. Emily and Kelsey, who also were separated, visited with Silvers maybe once a week.
"Every night," Emily remembers, "I'd cry."
Months into the separation, Silvers was told by child welfare officials that Allie was in a hospital after an altercation with another girl at her group home. Then came a greater shock: The state threatened to terminate her parental rights. Silvers entered the Appalachian Judicial Circuit's treatment program that very day — March 17, 2014.
The goal of the two-year program is simple to summarize but not easy to achieve: to stop substance abuse by parents at risk of losing permanent custody of their kids.
"We call it a voluntary program, but if the state has your children, it's not completely voluntary," says Judge Jan Wheeler, who oversees the effort. "The incentive is to get back your children."
There are now roughly 450 such programs across the U.S., up from about 330 in 2012, according to Phil Breitenbucher of Children and Family Futures, a research and consultancy organization. But he said those programs reach less than 20 percent of the population that needs them.
In the Georgia program, participants sign a contract binding them to 32 commitments. Early on, there's a 7 p.m. curfew. Random drug tests occur five or six times a week. Meetings of Narcotics Anonymous or similar groups are mandatory. Court appearances come every two weeks.
Participants must get a job and attend classes on topics like relapse prevention and "moral recognition therapy."
Failing to meet requirements brings sanctions, up to possible expulsion. Along with its 93 graduates over the years, the Appalachian circuit program has had 98 cases where participants quit or were expelled.
"It kind of breaks your heart," says Jennifer Farmer, who heads the child welfare agency's Ellijay office, recalling one couple who were abusing methamphetamine while living with their children in a tent in the woods. After repeatedly violating program rules, they were expelled and lost parental rights for the two youngest kids.
Kristen Gaddis works for the judicial district, guiding troubled participants after herself graduating from the program in 2014. An addiction to the anti-anxiety drug Xanax led her husband to report her to authorities. She had wrecked her car three times in a single year, including once when her son, then 4, was with her. They were both unhurt but, Gaddis says, "Every time I took my kids in the car and I was high, they were in danger. It's hard for a mother to own something like that."
There was a lot that was hard for Silvers to own. "I had made so many broken promises, told so many lies," she says.
She didn't miss any of her visitations, though, and after a year she regained custody of her daughters while remaining in the program. It took longer for them to begin trusting her again.
"They stayed on me," Silvers says. "'Mom, you're not going to the meeting tonight?' Or, 'Mom, you better make sure you're home by curfew.' It was them encouraging me along the way."
There were setbacks. Silvers reunited with the girls' father, but they feuded and she had him arrested. When he got out of jail, he kicked them all out of his house. They moved into a shelter, but it and Silvers' job were in one county and the girls' school in another. Unable to handle those logistics, she missed work and lost her job.
Some friends suggested Silvers try kratom to feel better. The herb, which can activate opioid receptors in the brain, is legal but forbidden along with other substances under the drug court rules. When a lab test discovered it, Silvers confessed and was allowed to stay in the program while taking an extra "relapse" class for six weeks.
She got an apartment with help from a state program and found work nearer the girls' school, but as she neared the final phase of the program, Silvers relapsed again with kratom. The trigger, she says, was discovering that Allison had been mistreated in her last foster home.
Silvers penned a remorseful letter to Judge Wheeler — "I was angry with myself and felt guilty this happened to Allie," she wrote — but the court ordered a third year in the program with more classes and 15 weekends in jail.
While behind bars, Silvers realized she'd come too far to quit. She went to a doctor for treatment of depression, and she and the girls did therapy together. Allie also had individual sessions.
And this past spring, when graduation time came, Silvers took the stage. She thanked her daughters and friends for their love and support. She talked of pride in regaining her self-esteem and of hope that the darkness was past.
"This is the first day of the rest of my life," Silvers told the crowd.
Though nervous, Emily said some words, too. "I wanted to speak for my mom because she deserves it," says the teen. "She's a mom now. I love waking up and she's always, like, 'Get up! Go to school!' I don't want to get up, but I love hearing her voice."
Seven months after the graduation, the family is prospering. Silvers was recently promoted to branch manager at a credit union. She met someone new and is engaged. All three daughters are earning good grades in school.
"Every day is not perfect, but we are grateful for how far that we've all come," Silvers says. "We're just doing the best we can when problems arise — hitting it head on and dealing with it instead of avoiding it."
Emily says she never gave way to despair.
"Even though those were the toughest days of my life, I always knew there was hope," she said by email. "I knew my mom could do it because she had always been a strong person."
Associated Press reporter Alex Sanz contributed to this report from Ellijay and Jasper, Georgia.