Substance Abuse and Child Welfare Resources

While parental substance abuse is not a new challenge for child welfare agencies, the current opioid epidemic is proving to have an immeasurable impact on foster care caseloads and child welfare budgets across the country.

A great deal of anecdotal information exists about the opioid epidemic and increasing foster care caseloads, but little or no data directly links the two. Here is what we do know:

• In FY2017, there were nearly 433,000 children in foster care in the U.S., the highest number since 2008. In the same year, nearly 270,000 children entered care, representing a slight decrease since 2016.
• The number of children under the age of 1 entering foster care is increasing and has become the highest percentage, by age group, of children entering foster care; from 39,697 in 2011 to 50,076 in 2017.
• The number of children experiencing neonatal abstinence syndrome (NAS) is on the rise; from 3.4 per 1000 hospital births in 2009 to 8.0 per 1000 hospital births in 2014.
• From 1999-2014, the incidence of parental alcohol or other drug use as a reason for removal more than doubled, from 15.8-31.8 percent.

 

Below are NCSL and national resources, examples of state initiatives, national organizations, and news stories that can provide more information about the current opioid crisis. Included are 50-state data and policy compilations, statewide initiatives and local programs, as well as national organizations that are working in this field.

Resources

• NEW! Preventing Opioid Misuse: Legislative Trends and Predictions Blog
• NCSL’s Rx for America’s Opioid Addiction Deep Dive, Prezi Presentation: the Prezi is an interactive presentation including videos from experts, PowerPoint presentations and an overview of the session from NCSL’s Legislative Summit in Chicago.
• NCSL’s Injury Prevention Legislation Database: includes legislation on pain clinics, pain management, rescue drugs and prescription drug monitoring programs.
• U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, 2017 Adoption and Foster Care Analysis and Reporting System (AFCARS) Report: for the first time provides data showing that 36 percent of children entering foster care in FY 2017 did so because of parental drug use. This is the first time data specific to parental drug use has been reported.
• Administration for Children and Families, Information Memorandum 16-05: Information about changes to the Child Abuse Prevention and Treatment Act (CAPTA) within the Comprehensive Addiction and Recovery Act of 2016 (CARA)
• A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders, 2016 report from the Substance Abuse and Mental Health Services Administration (SAMHSA):
  • Webinar 1
  • Webinar 2

• Child Welfare Information Gateway, Parental Substance Use and the Child Welfare System
• Child Welfare Information Gateway, Parental Drug Use as Child Abuse
• U.S. GAO, Parental Substance Abuse: Implications for Children, the Child Welfare System, and Foster Care Outcomes This is a 1997 report; while dated, many of the concepts related to parental substance abuse and the child welfare system remain relevant.

• 2005 Substance Abuse Child Welfare Waiver Demonstrations, Synthesis of Findings
• Center for Disease Control and Prevention, Incidence of Neonatal Abstinence Syndrome: 28 states; 2009-2013
• National Association of State Alcohol and Drug Abuse Directors (NASADAD), Summary of the 21st Century Cures Act

State Initiatives

• Connecticut Family Stability Pay for Success Project: in short, pay for success is a public-private partnership strategy that ties payment for social programs to the achievement of measurable results. The project will support new treatment teams delivering Family-Based Recovery to families struggling with substance use disorders.
• Indiana Governor's Task Force on Drug Enforcement, Treatment & Prevention Final Report
• NCSL YouTube Video on How Kentucky Tackled Heroin
• Maryland Senate Special Committee on Substance Abuse
• Maryland House Special Committee on Drug & Alcohol Abuse
• Massachusetts’s Opioid Addiction Working Group
  • Action Plan
  • Recommendations
• New York Office of Children and Family Services, Opiate Abuse Resources and Services
• New York Senate Task Force on Heroin
• Ohio 2014 Child Welfare Opiate Engagement Project
• Ohio, The Opiate MBR: Strengthening Ohio’s Fight Against Drug Abuse
• Rhode Island Overdose Prevention and Intervention Task Force
• Utah Naloxone: organization dedicated to increasing the awareness about, and access to, Naloxone, an overdose reversal drug, in Utah.
• Vermont’s Child and Recovering Mothers (CHARM) Collaborative: multidisciplinary group of agencies across Vermont serving women with opiate addiction and their infants. The Collaborative includes child welfare, medical, and addiction professionals in coordination of efforts and treatment.
• West Virginia, Lily’s Place
  • Lily’s Place Continuing to Care for Addicted Babies, March 3, 2016

National Organizations

• National Center on Substance Abuse and Child Welfare (NCSACW)
  • NCSACW, Presentations and Publications for Legislators

• Substance Abuse and Mental Health Services Administration (SAMHSA)
  • Preventing or Reducing Opioid Abuse and Overdose: Selected Resources, SAMHSA’s Center for the Application of Prevention Technologies
• National Governor’s Association
  • Prescription Drug Abuse Project
  • Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States
• National League of Cities (NLC) and National Association of Counties (NACo), National Citi-County Task Force on the Opioid Epidemic
  • A Prescription for Action: Local Leadership in Ending the Opioid Crisis, Joint Task Force Report
  • A Prescription for Action webpage

News

While much of the information is anecdotal, as the news articles below will show, states are increasingly making the link between the opioid epidemic and rising foster care caseloads.

• Reuters Investigates, Helpless and Hooked, December 2015
• Parents’ Drug Abuse Strains Child-Welfare Agencies, Jan. 12, 2016
• VT takes custody of unprecedented number of young children, Sept. 16, 2015
• Senate (NH) approves bill to define opioid abuse as child neglect, March 10, 2016
• Concern mounts on opioid crisis’ toll on children, Oct. 17, 2015
• Heroin, Opioid Abuse Put Extra Strain on U.S. Foster Care System, Oct. 27, 2015
• Children at Risk: Drug Epidemic Affecting Child Safety, March 10, 2016
• Children caught in the crosshairs of substance abuse, March 11, 2016
• Pa. seeing more heroin-addicted babies, abused children of addicted parents, April 8, 2016
• Parents’ heroin addictions put too many kids in foster care, Sept. 19, 2016
• Drug Epidemic Takes Toll on Foster Care System, Sept. 28, 2016
• 44 percent of NH’s DCYF cases involved substance abuse in 2015, Sept. 29, 2016
• Opioid Epidemic’s youngest victims are a growing group, new data show, Sept. 29, 2016
• Is U.S. Opioid Crisis Straining State Child Welfare Systems? Sept. 30, 2016
• Caring for the Opioid Epidemic’s Youngest Victims, Oct. 5, 2016
• Advocates seek immunity for youth victims of sex trafficking, Oct. 6, 2016
• Drug-Addiction Epidemic Creates Crisis in Foster Care, Oct. 7, 2016
• Substance abuse cited as No. 1 reason for DCF cases (MA), Oct. 11, 2016

About This NCSL Project

The Denver-based child welfare project staff focuses on state policy, tracking legislation and providing research and policy analysis, consultation, and technical assistance specifically geared to the legislative audience. Denver staff can be reached at (303) 364-7700 or childwelfare@ncsl.org.

NCSL staff in Washington, D.C. track and analyze federal legislation and policy and represent state legislatures on child welfare issues before Congress and the Administration. Staff in D.C. can be reached at (202) 624-5400 or cyf-info@ncsl.org.