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Beyond the substance abuse epidemic: the consequence ripple to children and youth

Millions of people are directly impacted by addiction and the crisis continues to forge a path of destruction with little signs of slowing.

Good people becoming shells of themselves that display and example of what we all would hate to become is heartrending. Young families with so much hope and potential to be the face of America that we all want to be proud of being shattered by the sledgehammer of consequences wielded by addiction is tragic. Neighborhoods and communities buckling under the weight of monetary and social costs of addiction reflected in unemployment, crime rates, incarceration and re-entry services and overall societal impairment is dismal.

Perhaps the greatest and most sickening tragedy is the elusive tradition of self-destruction through the unintentional grooming of the ones who bring the utmost hope. Are we setting our children up to carry the torch of substance enslavement?

There has been a rise in neonatal abstinence syndrome in newborn babies nationally to a rate of 1.19 per 1000 hospital births to 5.63 per 1000 hospital births, presenting a critical public health issue with substantial medical, economic and personal burden.[1] That burden persists in longer-term effects of prenatal exposure to illicit substances to include behavioral disorders and developmental delays that may emerge even if the child is raised with household exposure to parental substance use disorders. School aged children with a history of prenatal exposure to alcohol and other substances tend to have higher rates of neurocognitive, behavioral, mood, anxiety and conduct disorders.[2]

An estimated 1 in 8 in U.S. children age 17 years or younger live in households with at least one parent with a past year substance use disorder.[3] Parental substance use disorders can have a profound negative impact on the lives of children and youth including an increased risk for physical or emotional abuse and neglect, lower socioeconomic status and delays in all areas of development. These children are more likely to have difficulties in social and academic settings and are at greater risk for developing mental health as behavioral problems as well as substance use disorders.[4]

The substance abuse and addiction crisis is also contributing to a rise in foster care placements nationally. Maryland state, 27% of the estimated 4,000 children in foster care were removed from their families specifically due to parental substance abuse. Factors associated with parental substance use such as neglect, physical abuse and parental incarceration account for an additional 76% of Maryland children in foster care.[5] The prevalence of substance use disorders is markedly higher among youth in care.[6]

It seems that the children and youth of today may be destined for a substance use disorder at some point in life and prevention efforts must go beyond talking to them about substance abuse. With growing attention on mental health treatment, particularly child and adolescent mental health, I question whether some current trends in mental and behavioral health treatment practices may be subtly contributing to the problem. My next post will discuss some trends in child mental health care to consider as we all continue our efforts to end the addiction crisis.

[1] Sanlorenzo, L. A., Stark, A. R., & Patrick, S. W. (2018). Neonatal Abstinence Syndrome: An Update. Current Opinion in Pediatrics, 30(2), 182–186. http://doi.org/10.1097/MOP.0000000000000589.

[2] Sandtorv, L. B., Hysing, M., Rognlid, M., Nilsen, S. A., & Elgen, I. B. (2017). Mental Health in School-Aged Children Prenatally Exposed to Alcohol and Other Substances. Substance Abuse: Research and Treatment, 11, 1178221817718160. http://doi.org/10.1177/1178221817718160

[3] Lipari, R.N., Van Horn, S.L. (2017). Children living with parents who have a substance abuse disorder. Substance Abuse and Mental Health Services Administration: Rockville, MD.

[4] Smith, V.C., Wilson, C.R., COMMITTEE ON SUBSTANCE USE AND PREVENTION (2016). Families affected by parental substance use. Pediatrics, 138(2).

[5] Child Trends (2015). Maryland foster care: federal fiscal year 2015. Retrieved from https://www.childtrends.org/wp-content/uploads/2017/01/Maryland-Foster-Care-Factsheet_2015.pdf.

[6] Braciszewski, J. M., & Stout, R. L. (2012). Substance Use Among Current and Former Foster Youth: A Systematic Review. Children and Youth Services Review, 34(12), 2337–2344. http://doi.org/10.1016/j.childyouth.2012.08.011

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