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Revised assessments highlight the necessity for enhanced treatment

A significant portion of children in the United States is being raised in environments where at least one parent engages in problematic alcohol or drug use—heightening the likelihood that these children will follow suit, a recent study indicates.

Utilizing data from 2023 to provide the most up-to-date perspective available, researchers speculate that 19 million children—1 in 4 youth under 18 in America—live with a parent or another adult who fits the definition of substance use disorder.

Out of this group, around 6 million children reside with an adult who also suffers from a mental health issue alongside their substance abuse disorder.

The predominant substance of misuse among parents was alcohol, with survey findings estimating that 12 million parents qualify for some degree of alcohol use disorder. Over 6 million parents may qualify for cannabis use disorder. Approximately 3.4 million meet the criteria for disordered use of multiple substances.

The count of children living with a parent with any type of substance abuse disorder in 2023 surpasses the 17 million tallied in a study published only months ago that utilized data from 2020.

“The upturn and the reality that one in four children now resides with a parent struggling with substance use disorder accentuates the urgent need to connect these parents with effective treatments, broaden early intervention strategies for children, and mitigate the risk that these children will develop substance use problems themselves,” stated Sean Esteban McCabe, the lead author of the new study and the senior author of the recent one.

The latest results are documented in the journal JAMA Pediatrics by a team from the University of Michigan Center for the Study of Drugs, Alcohol, Smoking, and Health, which McCabe heads. He is a professor at the U-M School of Nursing and Institute for Social Research, as well as a member of the U-M Institute for Healthcare Policy and Innovation.

Both investigations utilized data from the National Survey on Drug Use and Health, a governmental initiative that has monitored drug and alcohol consumption in the U.S. since the 1970s, providing critical data for researchers and policymakers alike.

This survey’s future is clouded by potential staffing and budget reductions at the federal agency housing it, the Substance Abuse and Mental Health Services Administration (SAMHSA). The complete staff was given layoff notifications in April.

Aside from alcohol and cannabis, McCabe and his team estimate that a little more than 2 million children are living with a parent facing a substance use disorder related to prescription medications, and just over half a million share their homes with a parent whose illicit drug use—including cocaine, heroin, and methamphetamine—meets the standards for a substance use disorder.

The researchers comprise Vita McCabe, the director of University of Michigan Addiction Treatment Services in the Department of Psychiatry at Michigan Medicine, which is U-M’s academic medical institution.

“It is recognized that children raised in environments where adults are struggling with substance use are more prone to endure adverse childhood experiences, use alcohol and drugs at an earlier age and with greater frequency, and face their own mental health diagnoses,” expressed Vita McCabe, a board-certified specialist in addiction medicine and psychiatry. “This underscores the significance of informing parents about effective treatment options available, such as naltrexone and/or acamprosate for alcohol use disorder, cognitive behavioral therapy for cannabis use disorder, and buprenorphine or methadone for opioid use disorders inclusive of both prescribed and non-prescribed opioids.”

Both the recent study and the one released in March in the Journal of Addiction Medicine evaluated substance use disorders and significant mental health issues based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders 5, commonly referred to as DSM-5.

In the March study, the researchers indicated that revisions in the definition of substance use disorder in DSM-5, compared to its earlier version, resulted in a substantial increase in the estimated number of children living with a parent affected by substance abuse issues.

Ty Schepis, an addiction psychologist at Texas State University, served as the lead author of the prior study and is also the senior author of the current paper.

“Our new discoveries contribute to better understanding how many children are cohabitating with a parent afflicted with a severe and comorbid substance use disorder and other mental health challenges like major depression,” he remarked. “This is crucial as it poses extra risks for these children as they transition into adulthood.”

The research was supported by the National Institute on Drug Abuse, a component of the National Institutes of Health (R01DA031160, R01DA043691).

Story detailing previous paper using 2020 data: Millions of children reside with parents facing a substance use disorder

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