Abstract
* Abbreviation: MAT — : medication-assisted treatment The United States is experiencing unprecedented rates of drug overdose deaths and drug-related problems. This epidemic is driven primarily by opioids. Although most responses to this opioid epidemic are focused on preventing harm to adults, there are at least 5 pathways by which opioid-related problems can spill over and affect child health and safety: 1. child or adolescent poisoning and overdose: this could happen because of intentional misuse or accidental ingestion of prescription drugs by young children; 2. opioid misuse in pregnancy: opioid misuse in pregnancy is associated with inadequate prenatal care, preterm birth, low birth weight, respiratory depression, and neonatal abstinence syndrome1; 3. impaired parenting and attachment: parents’ opioid misuse may impair their ability to adequately supervise, bond with, and care for their children; 4. material deprivation: money spent on drugs may come out of family finances needed to care for children; and 5. extended separation from parents: children may be separated from a parent with an opioid-related problem because of a parent’s incarceration, residential psychiatric or drug treatment, or death or because of a child’s placement in foster care. Indeed, quantitative and qualitative studies suggest that increases in parental opioid misuse and overdose death have resulted in concomitant increases in these adverse childhood experiences and that many children are ending up in … Address correspondence to Kenneth A. Feder, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Hampton House Room 782, 624 N. Broadway, Baltimore, MD 21205. E-mail: kfeder1{at}jhu.edu
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