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The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families: Recommendations for an Action Agenda Based on a Multidisciplinary Meeting

Brundage, Suzanne C.; Levine, Carol. – 2019

While opioid addiction is widely recognized as a national epidemic, one aspect of the crisis has received little attention: the short- and long-term effects on children and adolescents whose parents are addicted. An individual’s substance use disorder (SUD) sends ripples through families and communities and ignoring these ripples can cause long-lasting consequences. Children affected by familial SUD are at increased risk of similar problems themselves, and kinship caregivers who often step in to care for these children are also likely to have increased physical and mental health needs. The opioid epidemic affects families in many ways. To begin to illuminate the magnitude of the “ripple effect,” and the challenges facing family members, United Hospital Fund hosted a two-day meeting of multidisciplinary researchers, clinicians, and policymakers in October 2018. The agenda was focused on five main populations: women of childbearing age; young children and their mothers; children exposed to trauma; youth caregivers; and kinship caregivers. Though the multidisciplinary group did not attempt to reach consensus, participants generally agreed on these four broad areas for action: • Pervasive stigma, misunderstanding, and fear about SUD and treatment; • Failure to make the ripple effect a public and political priority, which exacerbates a shortage of family-centered treatment options and inadequate funding for programs that work; • Silos in government and service organizations that lead to lack of communication, coordination, and collaboration, particularly about risk assessment of children and reporting requirements; • Missed opportunities to identify children at risk and provide them and their families with essential support. The need to address these problems is urgent. Some evidence-based programs in place today are meeting the unique needs of these groups, and innovative approaches are emerging, but the response to date has been inadequate. We need to simultaneously generate more knowledge about what works for families, while implementing best practices. The good news is that existing capabilities in agencies and programs supporting children and families can be leveraged along with lessons from prior public health crises—the HIV/AIDS and crack cocaine epidemics, in particular—to formulate a response that helps children thrive and that preserves families.