RENEE MONTAGNE, HOST:
And in Massachusetts, drug deaths are down slightly for the first time in years. But the number of children being raised by someone other than their parents is up. That's put new pressure on schools as they try to educate a generation of kids whose lives have been upended by the opioid crisis.
As Rachel Gotbaum reports, districts on Cape Cod are using addiction counselors on site to help kids and their teachers cope with the chaos and the trauma of the epidemic.
RACHEL GOTBAUM, BYLINE: The hallways of Lawrence Middle School in Falmouth, Mass., are packed with students rushing to their next class. In this language arts class, kids are talking about their most recent projects.
UNIDENTIFIED STUDENT: A person can stop feeling when they're traumatized or have been through a lot.
GOTBAUM: There are students here who have lost a parent to a fatal drug overdose. And that's becoming a lot more common.
CAROLYN ALVES: I find myself crying more when I go home at the end of the day. And it's hard. You know they need something but that what they need is a lot bigger than what you can give to them as their teacher.
GOTBAUM: Carolyn Alves has been teaching for 17 years. She says an increasing number of her students are living in foster care or have moved in with family members because their parents are dead, in jail or struggling with active addiction.
ALVES: It's a lot because you're dealing with the trauma. You're dealing with loss. And that's what they're - you know, they're up against, a lot of these kids.
GOTBAUM: And that all makes it difficult for them to focus during school.
ALVES: The biggest thing we see is shutting down, just the absolute refusal to do work, the inability to see long term. There's a lot of, also, testing. How far can I push you? How many times can I get thrown out of class before you just give up on me?
GOTBAUM: With a growing number of her students' lives now consumed by the opioid epidemic, Alves and the other teachers here say they are re-evaluating their priorities.
ALVES: You know, it would be easy to say they just don't do their homework. But the reality of what their life is like at home is it's a ridiculous expectation that they're then going to hold it together all day long and then go home and do homework in that environment.
GOTBAUM: Right down the hall from Alves' classroom, Maddy Nadeau (ph) is meeting with her counselor.
CAYENNE KELLY: Can you tell me about that? I don't know much about it.
MADDY: There's a lot of, like, work in progress. This is a horse I've been trying, working on.
GOTBAUM: Both of Maddy's parents are battling heroin addiction. And she has memories of being left alone a lot.
MADDY: I remember Mom was always locking herself in her room and didn't take care of me. And my sister had to go to school during the day. And so I was home - like, a little child all by myself. My mom just wasn't around at the time.
GOTBAUM: Maddy and her sister Devon (ph) ended up with relatives and then a series of foster homes, eventually ending up with Sarah Nadeau (ph).
SARAH NADEAU: Both of the girls felt like maybe Mom will get better, maybe she won't. Maybe Dad will improve. Maybe he won't. And it's up and down with drug addiction. So they didn't know for two and a half years of their life whether or not they were going home.
GOTBAUM: Both of the girls struggled with anxiety and depression. Maddy had the hardest time.
MADDY: I was kind of, like, burying everything inside. And it kind of just made me freak out sometimes. And, like, now I'm not really burying that much inside. I'm able to talk about it. I'm able to focus a little bit better.
GOTBAUM: She says she's able to talk about it now because every week she leaves class to come see her counselor, Cayenne Kelly (ph). Kelly is based at the school but works for Cape Cod's largest drug addiction treatment center, called Gosnold.
KELLY: If you've seen a family member OD, how can you really concentrate in class?
GOTBAUM: Cayenne used to work one day a week but has increased her time here, so she can offer more students counseling sessions at school.
KELLY: It's really neat when you know they started this session hurting, and they finish a session stable and focused enough to do well.
GOTBAUM: Two years ago, Lawrence Middle School joined a growing number of schools where counselors, specifically trained in addiction treatment, work on site to help students whose families are in the grips of the opioid epidemic. Each school pays Gosnold a fee. And most students get their counseling sessions paid for by insurance. When they don't, the treatment center covers them. Last year, Sarah Nadeau adopted Maddy and Devon. She says both of the girls still struggle socially and academically because of all they've been through, especially Maddy, who was exposed to drugs in utero.
NADEAU: That makes it very difficult for her brain to settle down enough to do more than one task at a time. The second part to that is she's got the confidence issues and the trust issues and the abandonment issues. So not only does she have to work harder than a lot of kids to do the exact same thing, but she lacks the confidence to put her best foot forward. Both of those hit a lot of these kids who are growing up in homes where there's drug abuse.
GOTBAUM: But she says now Maddy and her sister are doing much better in their classes and are leading more normal lives because they have the support of a counselor at school who understands what they're going through.
NADEAU: For a lot of these kids, school is the only place that's stable. They get their lunch here. They get their education here. Why not give them their support while they're here in the school?
GOTBAUM: Last year, Gosnold counselors were in 17 schools from elementary to high school. This year, that number has tripled and now includes districts throughout Massachusetts. For NPR News, I'm Rachel Gotbaum in Boston.
MONTAGNE: And our story was produced in collaboration with The Hechinger Report. Transcript provided by NPR, Copyright NPR.