Abstract: Opioids and Child Welfare

Across the country, placements in foster care are rising. In 2016, the U.S. Department of Health and Human Services reported that 273,539 children in the U.S. entered foster care. In 34 percent of those cases, parental drug abuse was one of the factors leading to the child’s removal from their family. Additionally, the U.S. Substance Abuse and Mental Health Services Administration estimates that 400,000 births nationally are affected by prenatal exposure to alcohol and illicit drugs, which represents 10 percent of all live births. As the opioid epidemic continues, increasing numbers of children are at high risk for developmental and behavioral disorders because of their prenatal substance and alcohol exposure. In addition, children who remain at home may endure the challenges and trauma resulting from impaired caregiving due to parental substance use disorders (SUDs). This article explores the intersection of the opioid epidemic and child welfare, examining current research and publicly available data to discuss policy opportunities for better serving families affected by parental SUDs, including: ensuring health and safety for infants prenatally exposed to substances; appropriate identification, diagnosis, and treatment of developmental and behavioral needs; ensuring parents have access to outpatient treatment and services that can allow families to stay together when safe and appropriate; and ensuring sufficient access to inpatient treatment options that can serve parents and children together.

Author Biography

Douglas Waite, MD is medical director of The Keith Haring Clinic at Children’s Village. He is Assistant Clinical Professor of Pediatrics at Mount Sinai Hospital, a member of the board of directors for the National Organization for Fetal Alcohol Syndrome, the Child Welfare League of America and the American Academy of Pediatrics (AAP), District 2. Dr. Waite has special interests in fetal alcohol spectrum disorders, post-traumatic stress disorder and the effects of child abuse and neglect upon child development and serves on two expert panels formed by the AAP, Center for Disease Control and US Administration for Children and Families to develop protocols for screening children in child welfare and the general pediatric population for fetal alcohol and drug exposure. Mary Greiner, MD, MS is a child abuse pediatrician and Associate Professor of Pediatrics at Cincinnati Children’s Hospital. She completed medical school at Virginia Commonwealth University’s Medical College of Virginia, pediatrics residency at Wake Forest University Baptist Medical Center, and child abuse fellowship at Cincinnati Children’s. She is the medical director of the Comprehensive Health Evaluations for Cincinnati’s Kids (CHECK) Foster Care Center at Cincinnati Children’s and is interested in research evaluating innovative approaches to delivering healthcare for children in or at risk of entering foster care. Zach Laris, MPH, has worked on staff at the American Academy of Pediatrics since 2012, and currently serves as Director, Federal Advocacy & Child Welfare Policy. Prior to joining AAP, Zach worked as a federal contractor, analyzing and writing about behavioral health care financing policy and the implementation of the Affordable Care Act. Zach received an MPH from The George Washington University, where he wrote a master’s thesis about federal policy options for improving access to evidence-based psychosocial interventions for children in foster care. Zach received a BA in Political Science and International Relations from The American University. He is originally from Syracuse, NY.