Impact of Parental Substance Use Disorder on Millions of U.S. Children

In the United States, nearly 19 million children—approximately one in four—live with at least one parent suffering from a substance use disorder (SUD). This includes misuse of alcohol, marijuana, prescription opioids, or illegal drugs. Recent research reveals that the number of affected children has increased significantly, with over 2 million more children affected since 2020 and a rise of 10 million compared to estimates based on data from 2009 to 2014. The study, published in JAMA Pediatrics, utilized data from the 2023 National Survey on Drug Use and Health, which surveyed nearly 57,000 individuals aged 12 and older.

The findings emphasize the severity of the issue, as children of parents with SUD are at heightened risk for developing mental health issues, behavioral problems, and early substance use. The disorder, characterized by heavy and frequent substance consumption and behaviors like driving under influence and conflicts over substance use, hampers parental caregiving abilities. Consequently, affected children are more likely to experience exposure to violence, early initiation into substance use, academic challenges, and involvement with child welfare systems. They are also more prone to mental health problems during childhood and adulthood and have a higher likelihood of developing their own substance use disorders later in life.

Among these children, about 3.5 million live with parents who have multiple substance use disorders, and over 6 million live with parents facing both SUD and significant mental health issues such as depression or anxiety. Alcohol remains the most common substance involved, impacting roughly 12.5 million children.

An important factor in the increased estimates is the broader diagnostic criteria for SUD introduced over recent years, which have led to an over 80% rise in the number of affected children. The data further indicates a continuous rise since 2014, underscoring the growing challenge faced by families and health systems.

Addressing this crisis requires better identification of at-risk parents and their children. Currently, pediatric screenings often overlook parental substance use, and advocacy efforts suggest integrating screening processes for both children and adults. The U.S. Preventive Services Task Force has yet to recommend routine screening for children, but doing so could facilitate early intervention.

Enhanced funding and policy initiatives from government levels are vital to provide necessary support and prevent long-term adverse outcomes. Investing in mental health and substance use treatments can reduce future societal costs and help break the cycle of addiction and its impacts on children.