When a little boy reportedly fell off the deck of a house in Lincoln County in July 2009 and hit his head, his mother and her boyfriend were drunk, according to a report by a state child-protection worker.
There was no food in the filthy house, but there were pill bottles, beer cans and needles lying around, and blood on the child's bed.
The mother, who allegedly had tested positive for painkillers and cocaine in late 2004 and March 2005, went missing for three days while the boy lay gravely injured with a fractured skull.
When caseworkers found her, she was drunk and apparently lied about where she was when her son was hurt, the report said.
The boy died July 31, 2009. An autopsy showed he had bruises and bite marks that happened before his fatal injury.
"It was apparent that the child had been abused over a long period of time," the report concluded.
The case points to a troubling reality: When children are abused or neglected in Kentucky, substance abuse often plays a role.
A Lexington Herald-Leader review of files released this week on children killed or nearly killed because of abuse or neglect over a two-year period found that more than half mentioned suspected or confirmed substance abuse by parents or caregivers.
The newspaper analyzed internal reviews that the Cabinet for Health and Family Services is required by law to complete.
There were 85 such cases in 2009 and 2010. The cabinet released the files Monday under order from Franklin Circuit Judge Phillip Shepherd after the Herald-Leader and The (Louisville) Courier-Journal sued to get access to them. However, the state redacted the names of many children and their caregivers before releasing the documents.
About 59 percent of the cabinet's internal reviews mention substance abuse by parents or caregivers.
The substance abuse allegedly happened before the incident under review in some cases, but in at least 19 of the 85 deaths and near-deaths, drug or alcohol use was mentioned in connection with the incident.
The number was even higher in the 35 death cases. Of those, 29 included information about drug or alcohol use by parents or caregivers.
Read the complete story at kentucky.com