Elizabeth’s baby was due in June, and that’s exactly when she came— on the very morning of her due date, a new little girl entered the world. Elizabeth was ecstatic to become a mother, sharing the special moment with her partner, but as the newborn was examined, doctors came back with bad news: the baby was unnaturally stiff and had difficulty breathing. Elizabeth’s heart sank as she heard the diagnosis: neonatal abstinence syndrome, or NAS. After years of opioid addiction, beginning with prescription painkillers like Percocet and culminating with heroin usage, her worst fears had come to fruition: Elizabeth’s baby girl had been born with an opioid addiction.
The shocking increase of children born with addictions—a nearly fivefold leap in the past decade—is only one of the ways widespread opioid abuse has fractured American families. Beginning in the late 1990s, opioid use in the United States has been skyrocketing, particularly among rural and economically disadvantaged communities. Rates of overdose deaths in rural areas have superseded rates of urban areas, in part a manifestation of increasing rural poverty. But the trend of opioid abuse is not contained to just one region of the United States—across the country, the CDC has opioid addiction statistics which estimate that 115 Americans per day die after overdosing on opiates.
Though the shocking uptick in opiate abuse began years ago, new and more powerful drugs have contributed to a recent rise in overdose deaths. The start of the opiate crisis saw most users abusing prescription opioid painkillers, like Percocet, Vicodin and OxyContin. Though these are legal drugs, they include opiates—a compound also found in heroin—that manages pain and supplies a rush of feel-good dopamine. Whether they gathered pills from their own prescriptions or from relatives and friends, some of those who abused painkillers began looking for a stronger, longer-lasting rush of dopamine: heroin. For those abusing painkillers, the odds of eventual heroin use are 3.5 times higher than those who don’t; in fact, in one survey of heroin users, nearly half began their addiction with painkillers.
With heroin and prescription pill abuse higher than ever, a new class of drug entered the opiate market: extremely potent opioids, often exponentially stronger and faster-acting than heroin. Fentanyl, one of these opioids, is fifty times stronger than heroin—those who abuse the substance are at a much greater risk of overdose death, as even small amounts of the substance can be fatal. In 2016, fentanyl was at the root of almost half of all opioid-related deaths—more than heroin and prescription painkillers.
But statistics can’t capture the effects of opioid abuse on the children of the crisis.
Take Lane and Reed, both toddlers when their mother died from overdose. After Lane, three years old, stumbled across his mother’s syringes and heroin, both children were taken from her custody—fortunately, they had grandparents willing to care for them. But many children like Lane and Reed do not.
About half of all opioid overdoses occur within the 25-44 age group, the time when many Americans first become parents. Because of this, the opioid abuse crisis led to a crisis of its own: an overflow of children and adolescents in the foster care system. Across the country, the number of youth entering foster care has spiked—largely due to parents or caretakers abusing opioids. In Georgia alone, there has been a 75% increase in foster intake between 2013 and 2016. In Texas, Florida and Oregon, children have been forced to sleep in state buildings when there aren’t enough foster homes available. And as demand spikes for foster care, funding is dwindling— federal funds for children’s services have decreased by 16% between 2004-2014 and is still on the decline, putting a greater burden on state and local governments to handle the influx of children.
An overflow in the foster system isn’t the only dangerous effect of opioid use. Like Elizabeth’s baby, an increasing number of newborns have opioid addictions. Then there are the children who accidentally ingest their parents’ drugs: the number of children admitted to hospitals for opioid overdose has doubled since 2004. As opioid abuse grows among adults, so does it among juveniles—many adolescents who misuse opioids are first given them by friends or relatives, and 122,000 teenagers across the United States currently have an addiction to prescription pain relievers. In 2016, a Harvard Medical School study demonstrated that children growing up in households where substances are abused are more likely to exhibit antisocial and behavioral problems, as well as abuse substances themselves. And no statistics can summate the effects of watching your parents seize during overdose, having to care for younger siblings when parents are no longer able, or being separated from your family by child services. Children who undergo these types of traumatic events are much more likely to suffer from mental and physical disease later in life.
But families caught in the middle of the opioid crisis are not without help. Multisystemic Therapy (MST) is a family- and community-oriented treatment; rather than focusing on removing youth from their homes, MST addresses the entire ecosystem of a young person’s life. That often means addressing the root causes of parental substance abuse: anxiety, trauma, depression or partner conflict. Traditional treatment through child protection services often involves multiple different providers seeing individuals rather than an entire family, resulting in an incongruent and complex set of experiences. Instead, MST treatment includes a strong focus on comprehensive family engagement, with sessions occurring in the home for the ease of families. Access to evidence-based substance abuse treatment for the whole family—including both parents and youth—has proven an effective system to address substance abuse.
MST’s family- and community-oriented approach is not only effective, but highly economic as well. According to a study from the National Council for Adoption, it costs taxpayers nearly $25,000 per youth in the foster system—with a family-focused approach and treatment sessions occurring with caregivers, MST seeks to avoid home removal and foster entrance by helping provide youth with a safer home. This type of intervention not only reduces future criminal activity and drug abuse among juveniles, but also saves thousands of dollars as youth are kept in-home. In fact, the Journal of Family Psychology estimates MST’s net benefit per youth to be up to $200,000.
With pragmatic, sensitive and evidence-based therapy, families struggling with opioid abuse can find hope. Though addiction is a difficult and trying disease, with the right resources, fractured families have the power to come together again.
To learn more about the scale and impact of the opioid epidemic, take a look at our infographic and visit our substance abuse resources page.