Multigenerational Effects of the Opioid Epidemic

Treatment for opioid addiction usually focuses on the individual. But children and family members of the addicted individual are also affected—and overlooked, say researchers Carol Levine and Suzanne Brundage from the United Hospital Fund (UHF), who maintain that an urgent response to the “ripple effect,” as it’s called, is needed to prevent the multigenerational trauma that affects children whose parents are addicted to opioids.

State and local agencies have many roles to play, but not everyone is on the same page. To help understand the issues and what can be done, the United Hospital Fund, with support from the Milbank Memorial Fund and the Alfred P. Sloan Foundation, hosted a multi-disciplinary meeting with the goal of producing a policy and programming agenda to address the crisis. The effect of the opioid crisis on children and families has been identified as an area of interest by the Reforming States Group.

Over 40 policymakers, providers, and stakeholders in children’s health, welfare, family caregiving, substance use disorder, behavioral health, and law enforcement gathered to discuss the effect of the opioid epidemic on women, children, and families. Policy and program models from New York, West Virginia, Massachusetts, Ohio, Wisconsin, and Vermont were presented.

According to the researchers, statistics barely begin to capture much of the effect on children and families throughout the lifespan:

• Women and prenatal health. Women are disproportionally affected by maternal opioid use and overdose deaths.
• Infants and developmental needs. The number of babies in the US affected by neonatal abstinence syndrome, conditions that occur when babies withdraw from drugs they have been exposed to, tripled between 2004 and 2013.
• Trauma-exposed families. Children living with household substance abuse are exposed to trauma.
• Youth caregivers. Caregivers (children as young as 5) are not recognized, counted, or supported.
• Kinship caregivers. The number of grandparents raising grandchildren has doubled since 1970.

“States are working hard to address the causes and consequences of the opioid epidemic,” says Michelle Alletto, program officer at the Fund. “We’re pleased to partner with UHF and experts in the field to try and bring best practices to states that not only help those suffering with substance use disorder, but also their children and families.”

The Fund will assist the UHF in the publication of a report that synthesizes the meeting’s findings and recommendations. A Fund-sponsored gathering of state health policymakers, who are looking for interagency strategies they can implement to stop the ripple effect, is planned for next spring.