Millions of children live with parents who have a substance use disorder

Nearly 17 million children and adolescents in the United States are estimated to live with a parent who has a substance use disorder, according to a study led by Texas State University, University of Michigan and Wayne State University.

The study found that alcohol use disorder was the leading contributor, affecting 12.8 million children. Cannabis use disorder was the second most prevalent, affecting 5 million children, while prescription opioid use disorder affects more than 1 million children.

Of these categories, children may have parents who struggle with more than one substance use disorder. Parents with opioid use disorders also face higher risks of overdose, adding to the challenges these families face.

The research results are published in the Journal of Addiction Medicine.

“These findings remind children that they are not alone. The nearly 17 million children who are living with a parent with substance use disorder should convey a strong signal that it is time to focus more attention on children and families impacted by addiction,” said co-author Sean Esteban McCabe, Ph.D., U-M professor of nursing and director of the Center for the Study of Drugs, Alcohol, Smoking and Health.

“Our team is working on family-based programs to prevent the intergenerational transmission and vicious cycle of addiction.”

The updated number marks an 81% increase from earlier estimates, largely due to updated diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders. The transition from the fourth edition (DSM-IV) to the fifth edition (DSM-5) introduced revised definitions and criteria for certain conditions, leading to improved identification and more inclusive diagnostic guidelines.

For example, the DSM-5 criteria and new approach to diagnosis offers a way to diagnose substance use disorder among parents who were symptomatic but undiagnosed “orphans” based on the older approach in the DSM-IV.

“The increase in the number of children who live with a parent with a substance use disorder was a great surprise, and it highlights the massive scale of services that these parents and children will need to be successful,” said Ty Schepis, Ph.D., professor of psychology at Texas State and lead author of the study. “These children are at high risk for not just substance use issues of their own, but also mental health challenges and interactions with the legal and child welfare systems.”

McCabe says the findings from the study are being disseminated across a number of different audiences as a way to reach more children and reduce stigma for kids who live with a parent with substance use disorders. It also indicates that the needs of children impacted by this living environment have increased, reinforcing the importance of work by organizations in the space, such as the initiative by Sesame Workshop. Sesame Workshop is the global nonprofit behind Sesame Street, which focuses on supporting young children and their circle of care impacted by parental addiction.

Funded by the National Institute on Drug Abuse and conducted in collaboration with U-M, Texas State, Wayne State and Vital Strategies, the study offers insight into the significant number of children and adolescents potentially exposed to heavy substance use in the home. The findings emphasize the importance of reaching this population through targeted interventions to improve their health and well-being.

The study also received funding from the U-M Office of the Vice President for Research and will serve as a key preliminary study for future projects that will make a positive difference for children and their families, McCabe says.

Research reported in this news release was supported by NIDA of the National Institutes of Health under award numbers R01DA043691 and R01DA031160.

Study: US Youth Exposed to Parental Substance Use Disorder in the Home: A Comparison of DSM-IV and DSM-5 Criteria (DOI: 10.1097/ADM.0000000000001469)