Heavy Cannabis Use, Special Medical Needs, and Parental Stagnation in Vermont CHINS Cases: Commentary on In re N.S.

Heavy Cannabis Use, Special Medical Needs, and Parental Stagnation in Vermont CHINS Cases:
Commentary on In re N.S. (Vt. Dec. 5, 2025)

Note on precedential value: This decision is an entry order of a three-justice panel of the Vermont Supreme Court. As the Court itself states, “Decisions of a three-justice panel are not to be considered as precedent before any tribunal.” It therefore has no formal precedential force, but it is still useful as a window into how the Court is currently applying existing precedent, especially on parental stagnation, cannabis use, and the “reasonable time” standard in cases involving children with complex medical needs.

I. Introduction

This commentary examines the Vermont Supreme Court’s entry order in In re N.S., Juvenile, Case No. 25-AP-253 (Dec. 5, 2025), affirming the termination of the parental rights of C.S. (father) and A.B. (mother) to their child, N.S., born in August 2022.

The case arises out of a Child in Need of Care or Supervision (CHINS) proceeding and centers on:

  • Parental stagnation as a “change of circumstances” justifying modification of a disposition order under 33 V.S.A. § 5113(b);
  • The relevance of heavy daily cannabis use to parental capacity, especially where substance use was part of the original CHINS concerns and the child has extensive special medical needs;
  • The “constructive role” factor in the best-interests analysis under 33 V.S.A. § 5114;
  • Whether a young parent’s age (here, mother was seventeen when CHINS was filed) can render a termination decision “premature;” and
  • The centrality of the “reasonable time” standard from the child’s perspective in termination-of-parental-rights (TPR) decisions.

Mother argued that more time would have allowed reunification and that the court insufficiently accounted for her youth. Father argued that there was no sufficient showing of stagnation and that his ongoing cannabis use was both unrelated to the original CHINS basis and not shown to impair his parenting or relationship with N.S. The Supreme Court rejected all of these arguments and affirmed.

II. Summary of the Opinion

A. Factual Background

  • N.S. was born in August 2022.
  • DCF became involved when N.S. was about five months old due to:
    • Domestic violence concerns between mother and father;
    • Mother’s mental-health issues;
    • Subsequently-identified concerns regarding both parents’ substance use.
  • In March 2023, the State filed a CHINS petition.
  • N.S. was first placed with maternal grandparents under a Conditional Custody Order (CCO); the CCO was revoked in July 2023, and custody was transferred to DCF. N.S. then moved to a foster home, where he remained and was described as “happy and thriving.”
  • In August 2023, both parents stipulated that N.S. was CHINS based on their mental-health struggles and illicit substance use.

N.S. has very significant, complex medical and developmental needs:

  • A condition affecting swallowing, throat, and airway; choking is a serious risk;
  • Droopy eyelids and very few teeth;
  • Difficulty regulating body temperature;
  • Severe egg allergy, requiring ability to use an Epi-Pen;
  • Autism and need for psychological support, routine, and stability;
  • Ongoing medical follow-up in multiple specialties: dermatology, endocrinology, ophthalmology, digestive issues, gastroenterology, audiology, speech pathology, and ENT.

Caregivers must be trained in Basic Life-Saving measures and Epi-Pen administration and must reliably attend frequent medical appointments.

B. Parents’ Progress and Stagnation Findings

1. Mother

The family division found that mother stagnated in her progress toward addressing the case plan. Key findings included:

  • Some engagement in substance-use treatment but relapses in 2025 and positive screens for substances;
  • Declined inpatient substance-use treatment when it was offered;
  • Did not engage in recommended mental-health treatment and failed to take prescribed medication consistently;
  • Involved in a violent altercation with her grandparents where she brandished a knife;
  • Lacked stable housing;
  • Did not demonstrate an ability to prioritize N.S.’s needs over her own;
  • Did not visit N.S. at all from summer 2024 until roughly one month before the TPR hearing in June 2025;
  • Attended few of N.S.’s medical appointments;
  • Did not complete the required safety course to care for N.S.;
  • Did not sufficiently engage with providers or demonstrate real understanding of N.S.’s complex medical needs.

2. Father

The court likewise found stagnation as to father, while acknowledging some steps forward:

  • Positives:
    • Completed a parenting class;
    • Completed Basic Life-Saving and Epi-Pen training.
  • However, father:
    • Maintained heavy daily cannabis use, did not view it as problematic even in the context of parenting N.S.;
    • Did not engage in any substantive substance-use evaluation, education, or treatment despite case-plan requirements;
    • Failed to show insight into how his use could impair his ability to safely care for a medically fragile young child;
    • Did not take concrete steps to taper or reduce use;
    • Lacked suitable housing;
    • Demonstrated limited understanding of N.S.’s specialized medical needs;
    • Attended few medical appointments;
    • Had only one hour of contact with N.S. per week and, during visits, sometimes focused on his own frustration (e.g., being unable to feed N.S. food or liquids) rather than on N.S.’s safety needs.

C. Best-Interests Determination

Applying the best-interests factors in 33 V.S.A. § 5114, the family division found:

  • Parents had a positive but minimal relationship with N.S.;
  • N.S. was well-adjusted to his foster placement, with a loving relationship with foster parents and other children in the home;
  • His extensive medical needs were consistently being met in that placement; he was “happy and thriving;”
  • Neither parent could resume parenting within a reasonable time from N.S.’s perspective, given:
    • Mother’s minimal progress over two years;
    • Father’s ongoing heavy marijuana use, lack of housing, and limited understanding of N.S.’s needs.
  • Parents did not play a constructive role in N.S.’s life, particularly in light of:
    • Limited contact;
    • Infrequent attendance at critical medical appointments;
    • Insufficient understanding of N.S.’s special needs.

The court therefore terminated both parents’ rights, and both appealed.

D. Supreme Court’s Holdings

  1. Change of Circumstances / Stagnation (Father’s Appeal)
    • The Court held that there was sufficient evidence of change of circumstances, demonstrated by father’s stagnation in relation to the case plan.
    • Father’s heavy cannabis use was directly relevant:
      • Substance use was one of the concerns that led to the CHINS petition;
      • Father had case-plan obligations addressing substance use;
      • He did not make the expected progress.
    • Additional stagnation findings—lack of suitable housing and limited understanding/engagement with N.S.’s medical needs—independently supported the change-of-circumstances conclusion.
  2. Constructive Role (Father’s Appeal)
    • The Court upheld the finding that father did not play a constructive role in N.S.’s life.
    • While he visited one hour a week and behaved appropriately in that limited context, the court was entitled to weigh more heavily:
      • Failure to attend medical appointments;
      • Failure to understand or engage with N.S.’s significant special needs.
  3. Prematurity and Youth (Mother’s Appeal)
    • Mother’s argument that termination was “premature” because she was only seventeen at the outset was deemed unpreserved and, in any event, unpersuasive on the merits.
    • She did not object to the case plan or request different services at the trial level, nor did she clearly argue that lack of access to adult services explained her limited progress.
    • The evidence supported the finding that stagnation resulted from factors within her control:
      • Declining inpatient treatment;
      • Noncompliance with mental-health treatment and medication;
      • Violent altercation with a weapon;
      • Lack of visits and minimal engagement with N.S.’s medical needs.
  4. Best Interests (Both Parents’ Appeals)
    • Consistent with precedent, the Court emphasized that the core question is whether the parent can resume parenting “within a reasonable time from the child’s perspective.”
    • Given N.S.’s age, substantial time in DCF custody, and extraordinary need for stability and medical oversight, the record supported the finding that neither parent could resume parenting within such a timeframe.
    • The termination of parental rights was therefore affirmed.

III. Legal Analysis

A. Precedents and Authorities Cited

The decision relies on, and is framed by, a series of Vermont Supreme Court precedents interpreting the CHINS and TPR provisions of Title 33.

1. In re K.F., 2004 VT 40, 176 Vt. 636 (mem.)

K.F. articulates the two-step analysis when the State seeks termination of parental rights after an initial disposition order:

  1. There must be a change of circumstances under 33 V.S.A. § 5113(b); and
  2. Termination must be in the child’s best interests under 33 V.S.A. § 5114.

In re N.S. explicitly follows this framework. The Court focuses especially on “parental stagnation” as the principal form of change of circumstances and then applies the § 5114 factors with emphasis on the reasonable time standard.

2. In re J.B., 167 Vt. 637 (1998) (mem.)

J.B. stands for the proposition that the most important statutory best-interests factor is whether a parent can resume parental duties within a reasonable time. In In re N.S., the Court cites J.B. to emphasize that this factor is paramount when assessing termination.

3. In re D.M., 2004 VT 41, 176 Vt. 639 (mem.)

D.M. is the leading Vermont case on “parental stagnation” as a change of circumstances. It defines stagnation as arising when a parent “has not made the progress expected in the plan of services for the family despite the passage of time,” and clarifies that the central concern is whether the parent has made the improvement contemplated at the time of removal.

In re N.S. directly quotes D.M. and applies its definition of stagnation to both parents, focusing on their lack of progress on enumerated case-plan “action steps” over roughly two years.

4. In re T.M., 2016 VT 23, 201 Vt. 358

T.M. is a critical comparator case because it addresses marijuana use in the context of a TPR.

In T.M., the Court held that the State had not shown parental stagnation where:

  • The parent was in treatment for opioid use and had ceased using opioids;
  • The parent used some undetermined amount of marijuana;
  • The parent nonetheless played a constructive role in the children’s lives; and
  • The State failed to link the marijuana use to any specific parenting deficiency or harm.

Father in In re N.S. invoked T.M. to argue that his cannabis use could not justify a stagnation finding. The Court distinguished T.M. on several grounds:

  • Here, heavy daily cannabis use while caring for N.S. was explicitly identified as a risk factor in the CHINS affidavit;
  • Parents stipulated that N.S. was CHINS due in part to their “illicit substance use,” bringing substance use squarely within the basis for State intervention;
  • The case plan included express action steps for father related to substance use (obtaining help to support sobriety, undergoing substance-use evaluation), which he did not meaningfully pursue;
  • Unlike in T.M., father:
    • Did not engage in substance-use treatment;
    • Did not abstain or reduce use;
    • Lacked insight into how his heavy use might impair his ability to parent a medically fragile child.

This distinction is legally significant: T.M. does not stand for the proposition that marijuana use is irrelevant to TPR proceedings; rather, it requires the State to connect the use to parenting deficiencies. In re N.S. shows how that connection can be sufficiently established when heavy use is contemporaneous with caregiving, explicitly identified as a risk, embedded in the merits stipulation, and left unaddressed in the face of case-plan mandates.

5. In re A.M., 2015 VT 109, 200 Vt. 189

A.M. addresses the doctrine of issue preservation. To preserve an issue for appeal, a party must present it to the trial court with sufficient “specificity and clarity” to give the trial court a meaningful opportunity to rule on it.

The Court cites A.M. to reject mother’s appellate argument that her youth and limited access to “adult” services justified her slower progress. She had not raised that theory below, had not objected to the case plan as unrealistic or inappropriate for a minor parent, and had not requested alternative services. Therefore, the argument was not preserved and could not form a basis for reversal.

6. In re N.L., 2019 VT 10, 209 Vt. 450

N.L. reiterates that the “reasonable time” inquiry under § 5114 is measured from the child’s perspective. Parents’ developmental trajectories, however sympathetic, are subordinate to the child’s need for stability, especially for young children or those with special needs.

The Court invokes N.L. to rebut mother’s argument that the court should have assessed “reasonable time” from her own developmental stage. The law remains clear: the relevant lens is the child’s, not the parent’s.

B. Legal Reasoning in Detail

1. Change of Circumstances and Parental Stagnation

Under 33 V.S.A. § 5113(b), a previously issued disposition order may be modified only upon a showing of a change of circumstances. Vermont case law, especially In re D.M., recognizes parental stagnation as the paradigmatic change.

The reasoning in In re N.S. proceeds as follows:

  1. Case Plan as Benchmark: The court uses the original disposition case plan, and particularly its “action steps,” as the yardstick for assessing progress. For father, these steps explicitly included substance-use evaluation and support for sobriety, in addition to housing and engagement with N.S.’s medical care. For mother, they similarly encompassed substance-use treatment, mental-health treatment, medication compliance, stabilizing housing, and engagement with N.S.’s medical and developmental needs.
  2. Passage of Time: N.S. has been in custody roughly two years by the time of the June 2025 TPR hearing. The Court places clear weight on this timeframe: stagnation is not a snap judgment but a failure to progress “despite the passage of time.”
  3. Comparison of Expected vs. Actual Progress:
    • Mother: The Court notes her relapses, refusal of inpatient services, non-engagement with mental-health treatment, serious violent behavior, prolonged absence from visits, and lack of participation in N.S.’s medical care. These are not partial steps that fell just short; they indicate failure to substantially begin several core action steps.
    • Father: Despite some positive steps (classes, life-saving training), he did not address substance use, did not secure suitable housing, and did not meaningfully engage with N.S.’s specialized medical regimen. These deficits remained largely unchanged by the time of the TPR hearing.
  4. Substance Use as Integral, Not Incidental: The Court rejects father’s attempt to compartmentalize cannabis use as unrelated to why N.S. entered custody. The CHINS affidavit and merits stipulation both tied “illicit substance use” to endangerment of N.S., including specific mention of father’s heavy daily marijuana use while caring for the infant.
  5. Link to Parenting Capacity: Especially given N.S.’s fragility and medical complexity, heavy daily cannabis use that is uncontrolled and unexamined can reasonably be viewed as undermining a parent’s capacity to respond quickly and appropriately to emergencies and complex regimens. Father’s failure even to appreciate this risk was itself evidence of stagnation.

Thus, stagnation is not reduced to one factor (such as marijuana use) in isolation. The Court looks holistically at whether, over time, each parent has achieved the intended rehabilitative gains the case plan envisioned. The answer was no.

2. The Constructive Role Factor and Specialized Needs

Under § 5114, one of the best-interests factors is the quality of the child’s relationship with the parent and whether the parent has played a constructive role in the child’s life.

Father argued that he did play such a role because he visited N.S. one hour per week and behaved appropriately during those visits. The Supreme Court acknowledges this positive aspect but affirms the lower court’s contrary conclusion, based on:

  • Father’s failure to attend most medical appointments;
  • His limited understanding or engagement concerning N.S.’s special medical needs (e.g., because of swallowing risks, N.S. could not safely eat or drink in ways father desired during visits);
  • His tendency to center his own frustration rather than N.S.’s safety during visitation.

In doing so, the Court clarifies—at least at the persuasive level—that “constructive role” is not restricted to affection or basic play during short visits. Where a child has extensive special needs, a constructive role also entails:

  • Consistent involvement in critical medical care;
  • Demonstrated understanding of the child’s conditions and safety needs;
  • Actions that support, rather than undermine, the child’s therapeutic and medical plan.

3. Mother’s Youth, Service Availability, and Preservation

Mother framed her appeal around the claim that TPR was “premature” given her initial age (seventeen) and the limited access to some adult services. The Court’s analysis proceeds on two tracks:

  1. Procedural Track – Preservation:
    • Mother never objected to the dispositional case plan below as unrealistic or inappropriate for someone of her age;
    • She did not request alternative or youth-targeted services;
    • She did not argue at the trial level that any lack of progress was due to age-related barriers rather than her own choices.

    Under In re A.M., that failure to raise the issue with “clarity and specificity” means the issue is not preserved for appeal.

  2. Substantive Track – Control vs. Constraint:
    • Even if the Court considers the merits, the record shows mother declined available services (e.g., inpatient substance-use treatment), did not engage in treatment that was accessible, and acted in ways (violent altercation, non-visitation) that directly harmed reunification prospects.
    • These are all factors within her own control, not purely structural barriers arising from being under eighteen.

The Court therefore concludes that, both procedurally and substantively, mother’s argument fails. Youth alone does not insulate a parent from the consequences of stagnation where the record reflects choices that impede progress rather than unavoidable external barriers.

4. The Best-Interests Standard and “Reasonable Time”

Finally, the Court applies the best-interests criteria in § 5114, giving particular weight to the likelihood that the parents can resume parenting within a reasonable time.

Consistent with In re J.B. and In re N.L., the Court underscores that:

  • “Reasonable time” is measured from the child’s perspective, considering age, evidentiary needs, psychological development, and, here, serious medical fragility;
  • Even if further time might theoretically allow parental improvement, the law does not require the child to wait indefinitely in limbo, especially when already in a stable, thriving placement.

With N.S. being extremely young and having:

  • Severe allergy risks;
  • Swallowing and airway complications;
  • Autism and need for routine;
  • Multiple continuing specialist appointments;

the Court finds it within the family division’s discretion to conclude that neither parent could become a safe, consistently available, and medically informed caregiver in time to meet N.S.’s urgent need for permanency.

IV. Simplifying Key Legal Concepts

1. CHINS (Child in Need of Care or Supervision)

A CHINS case begins when the State alleges that a child’s health or welfare is seriously threatened by abuse, neglect, or other specified conditions. If the court finds the child is CHINS, it can order services, supervision, and changes in custody—to relatives, DCF, or others.

2. Disposition Order and Case Plan

  • Once the child is adjudicated CHINS, the court issues a disposition order setting out where the child will live and what conditions must be met for reunification.
  • A case plan outlines specific steps each parent must take—e.g., substance-use treatment, counseling, parenting classes, stable housing.
  • Progress, or lack of it, is later measured against these “action steps.”

3. Change of Circumstances and Parental Stagnation

  • A disposition order is not modified lightly. The State must show a change of circumstances.
  • This is often demonstrated through parental stagnation—when the parent has not made the progress the case plan contemplated, despite having had time and opportunity to do so.
  • Evidence can include:
    • Failure to engage in required treatment or testing;
    • Continued substance use in ways that endanger the child;
    • Unchanged or worsening housing, relationships, or behavior patterns.

4. Best Interests of the Child (33 V.S.A. § 5114)

When deciding whether to terminate parental rights, the court must consider statutory “best interests” factors, including:

  • The child’s relationship with parents, siblings, and caregivers;
  • The parent’s ability and disposition to provide love, guidance, and material needs;
  • The child’s adjustment to current home, school, and community;
  • The likelihood that the parent can resume parenting within a reasonable time from the child’s perspective.

In practice, the “reasonable time” factor often becomes decisive.

5. Constructive Role

Whether a parent plays a constructive role in the child’s life looks beyond mere biological bonds or occasional visits. The court asks:

  • Does the parent’s involvement promote the child’s wellbeing, safety, and stability?
  • Is the parent consistently engaged with the child’s daily needs, especially medical or special needs?
  • Does the parent attend crucial appointments and follow safety plans?

6. Issue Preservation

Issue preservation is a procedural rule requiring parties to raise arguments in the trial court before relying on them in an appeal.

  • If a parent believes a case plan is unrealistic, discriminatory, or impossible due to age or disability, they must raise that issue then, not for the first time on appeal.
  • This allows the trial court to correct or adjust the plan if warranted, and creates a record for review.

V. Impact and Broader Significance

A. Substance Use, Especially Cannabis, in Vermont TPR Cases

Although not formally precedential, In re N.S. provides concrete guidance on how Vermont courts may treat cannabis use in the CHINS/TPR context:

  • Context Matters: Cannabis use is neither automatically disqualifying nor automatically irrelevant.
  • Link to Parenting: Courts will look for evidence tying substance use to:
    • Risk of harm;
    • Impaired judgment or responsiveness; and
    • Failure to comply with safety-sensitive regimens, especially for medically fragile children.
  • Case-Plan Integration: Where parents have stipulated that substance use contributed to CHINS status and agreed to substance-related action steps, non-compliance supports a stagnation finding.
  • Distinguishing T.M.: The opinion reinforces that T.M. does not immunize marijuana use; it simply requires a demonstrable link between the use and parenting deficits. Heavy daily use amid caregiving, with no insight or treatment and in the face of a medical-fragility case plan, satisfies that link.

B. Special-Needs Children and the Constructive-Role Analysis

This case illustrates that for children with complex medical and developmental needs, a “constructive role” requires more than warmth and affection during short visits. It requires:

  • Regular attendance at multi-specialist appointments;
  • Mastery of specialized safety trainings (life-saving, Epi-Pen, choking risks);
  • Ability and willingness to adhere to strict dietary and feeding requirements;
  • Emotional regulation and stability sufficient to manage the stress of caregiving.

Foster parents or other caregivers who can reliably meet these demands may be heavily favored in best-interests analyses where biological parents remain unstable or disengaged from the medical regimen.

C. Youthful Parents and Timing of Termination

The Court acknowledges, implicitly, that mother’s youth is a sympathetic factor, but it does not change the core legal standards:

  • Youth does not suspend or soften the reasonable time from the child’s perspective rule.
  • Where a young parent repeatedly declines offered services and fails to engage, courts may find stagnation regardless of age.
  • To argue that services were age-inappropriate, a young parent (or counsel) must raise that contention at the case-planning stage, not later on appeal.

Practically, this underscores the importance of early, vigorous advocacy for developmentally appropriate services for minor parents—while acknowledging that the child’s urgent need for permanency is the overriding consideration.

D. Appellate Deference to Trial Findings

Consistent with longstanding Vermont practice, the Supreme Court reiterates that:

  • It will affirm the family court’s factual findings unless “clearly erroneous;”
  • It will uphold conclusions if supported by those findings.

Here, the Court did not reweigh evidence but asked only whether there was some credible evidence supporting the trial court’s view of stagnation, lack of constructive role, and best interests. This underscores that TPR appeals are uphill battles when the record contains detailed, adverse findings on parental progress and the child’s successful adjustment to foster care.

VI. Conclusion

In re N.S. reinforces and applies several core principles of Vermont CHINS and TPR law:

  • Parental stagnation remains the primary vehicle for establishing a change of circumstances necessary to modify a disposition order. It is measured against the action steps in the case plan and the passage of time.
  • Heavy cannabis use can support a stagnation finding where:
    • Substance use was part of the original CHINS concern;
    • The case plan targeted substance use; and
    • The parent fails to engage in treatment or appreciate the risks, especially when caring for a medically fragile child.
  • The constructive role analysis is broadened in the context of special-needs children to encompass consistent participation in complex medical care and adherence to safety regimens, not just positive behavior during limited visitation.
  • Youthful parenthood, while relevant to service design and support needs, does not alter the legal requirement that the child’s perspective on a reasonable time governs the best-interests analysis.
  • Issue preservation remains crucial: challenges to the suitability of case plans or services must be raised early and clearly in the trial court.

Although this entry order is not precedential, it provides a detailed illustration of how Vermont courts currently handle TPR cases involving young parents, substance use, and high-needs children. It underscores the judiciary’s focus on the child’s urgent need for stable, medically competent caregiving and the expectation that parents, regardless of age, must show meaningful, sustained progress within a timeframe the child can afford.

Case Details

Year: 2025
Court: Supreme Court of Vermont

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