Opioid use has surged during the COVID-19 pandemic. Data show the use of fentanyl and methamphetamine climbed steeply in 2020 and drug overdose deaths jumped by 18% last year.
The opioid epidemic has serious consequences for millions of Americans. Opioid misuse increases the risk of illness from COVID-19 and leads to long-term consequences for mental and physical health. People who misuse illegal substances are more likely to experience job loss, interpersonal violence, and become involved in criminal activity.
There is compelling evidence that children, especially, suffer serious consequences when opioid use rises. When pregnant women use opioids, their children may experience developmental and behavioral problems throughout their lives. Cases of neonatal abstinence syndrome—which affects unborn children—rose by more than 400% from 2004 to 2014.
Children whose parents misuse opioids are more likely to live in an unsafe environment, experience accidental poisoning, and struggle with substance misuse themselves.
A group of researchers at the Bronfenbrenner Center for Translational Research are working to quantify the impact of opioid use on children and develop solutions that support children and families. They conducted a scoping review this year and have also evaluated a program for parents with child welfare cases participating in family drug treatment court.
Their systematic review included 52 studies that looked at the consequences of opioid use for children. It found that young children are significantly more likely to be poisoned accidentally when a parent is misusing opioids. They also found children of opioid users were more likely to experience depression, anxiety, social withdrawal, aggression, impulsivity, and disruptive behaviors during early childhood.
Children of opioid users were more likely to be involved in child welfare systems; this was equally likely whether parents misused opioids, alcohol, or another drug such as cocaine.
In adolescence and beyond, children of opioid users were more likely to engage in risky sexual activity, drug use, and criminal activity. They were more likely to experience problems with their peers and more likely to attempt suicide. Kids’ risks increased even more if parents experienced depression, criminal involvement, or serious physical health problems.
Some data show that opioid use leads to decreased trust and warmth between parents and kids, harms communication, and erodes the parent-child relationship.
The data on the impact of parental opioid use is not bulletproof. Most of the studies didn’t use representative samples, making it difficult to know whether the results apply more broadly. We lack data on how family income, race, and ethnicity come into play. And there is opportunity to examine how parent opioid use affects other aspects of kids’ lives, such as academic achievement. Despite these limitations, the evidence is clear that the opioid epidemic is bad for kids.
“This review has shown that there is clearly a link between opioid misuse and adverse child outcomes,” Cornell researcher Laura Tach said. “But we still don’t know whether that association is causal, or what mechanisms are driving it.”
In addition to describing and quantifying the problems, the researchers sought to understand ways to support families coping with opioid abuse. They evaluated the Strengthening Families Program for parents involved in drug treatment court who also had an open case with the Department of Social Services for child maltreatment.
The program involves weekly group meetings where parents and children come together with the support of community parent educators. The goal is to help families recognize their strengths and develop skills to support one another.
A study of the program found that participants were more likely to complete drug treatment and more likely to be reunited with their children. Parents also reported improved communication, more warmth and affection with children, better family organization, and less conflict.
“Too often, our interventions focus just on the caregiver, or just the child,” Tach said. “What sets Strengthening Families apart is its focus on supporting two generations together. Parents and children get to spend time together, and both groups come away with concrete skills that benefit the whole family.”
The take-home message: The opioid epidemic disproportionately affects the health and well-being of children. Creating programs that support parents and children together is one step to helping alleviate the negative impact on kids.
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