Opioids, including prescription opioids, heroin, and fentanyl, killed more than 42,000 people in 2016, an average of 115 people per day.
Although the impact on adults is tragic, an increasing number of children are also suffering, especially as opioid addiction reaches crisis levels. From birth on, these children are living with the consequences of their parents’ addiction.
Babies of mothers who use opioids during pregnancy can be born with a drug withdrawal syndrome called neonatal abstinence syndrome (NAS). These babies can experience a number of symptoms including: continuous crying, tremors, seizures, feeding difficulties, sweating, fevers, and difficulty breathing. In 2012, a baby was born every 25 minutes with opioid withdrawal — an estimated 21,732 babies. This was five-times more than in 2000.
In addition to pain of these children, there are significantly higher costs to the public associated with children born with NAS. On average, a newborn with NAS will spend nearly 17 days in the hospital compared with two days for newborns without the syndrome. The longer stay and more intense medical treatment result in average costs of $66,700 for newborns with NAS compared to $3,500 for newborns without NAS. A 2015 study found that more than 80% of infants with NAS are in the Medicaid program.
Foster Care and Parental Substance Abuse
As recent federal study found that after more than a decade of declines in the national foster care caseload, the number of children entering foster care began to increase in 2012. Between 2012 and 2016, the number of children in foster care across the U.S. increased by 10%, from 397,600 to 437,500.
Overall, the percentage of children entering foster care where parental substance abuse was identified as a cause of the child’s removal from the home has increased steadily, although this may underreport the problem. In 2000, substance abuse was an identified cause in approximately 10% of removals to foster care. In 2016, it was the identified cause in more than 30% of removals. According to the U.S. Government Accountability Office (GAO), the number of children under the age of one entering foster care increased 15% from FY 2012 to FY 2015.
Impact on the States
Some states have been particularly hard hit. West Virginia has had a 42% increase of children in its foster care system since 2014. West Virginia also has the highest number of drug overdose deaths with 52 per 100,000 people in 2016. Ohio, which had the second highest rate of overdose deaths with 39.1 per 100,000, had a 28% increase in the number of children in state care since 2015. New Hampshire, with the third highest rate of overdose deaths, has seen a 30% increase since 2014.
Mitigating the Impact of Opioid Addiction
Efforts the mitigate the impact of opioid abuse and parental addiction on children are ongoing.
Under the Child Abuse Prevention and Treatment Act (CAPTA), governors are required to provide assurance that their states have laws or programs that include policies and procedures to address the needs of infants affected by prenatal substance exposure.
According to the GAO, 42 states require healthcare providers to notify child protective services (CPS) about infants affected by substance abuse, while eight states only encourage notification. One state requires healthcare providers to notify CPS if they determine the infant is at risk for abuse or neglect.
As part of its 2018 budget, Congress included the Family First Prevention Services Act, which earmarked $1.5 billion over 10 years to be used to prevent children — including those born dependent on opioids — from entering foster care.
These numbers show the vital importance of addressing the opioid addiction in the U.S. It is important not only for the adults who are addicted but also for their children who suffer the physical and social consequences of their parents’ addiction.