Caught in the Crosshairs: Supporting Foster Youth Impacted by the Opioid Epidemic

There is no doubt that the current opioid crisis is plaguing the nation and leaving scores of victims in its wake. Over 90 people die a day from an opioid overdose, with a death toll of over half a million people between 2000 and 2015. While the media has focused primarily on the lives lost from opioid use, one population has been seemingly overlooked: children in foster care due to a parent's drug use. 

According to the U.S. Department of Health and Human Services' Administration on Children and Families, the number of children in foster care across the United States rose nearly 7% between 2013 and 2015 to approximately 429,000. Parental drug abuse accounted for approximately 32% of placements during that period.

The primary focus of the opioid crisis has been attempting to stop overdoses and deaths. It is, however, just as important to support the youngest victims of the crisis – the youth whose lives have been uprooted and permanently changed due to parental drug abuse.

What Type of Support is Needed?

Children experience the effects of the opioid crisis in different ways. First, many who are impacted experience significant levels of complex trauma, both from the grief over losing a parent to death or placement and from leaving the home and entering the foster care system. Children with parents with opioid and fentanyl addiction also have likely witnessed drug abuse, with some being the ones that found their parents unconscious or deceased. The child may also feel guilty that he or she was not able to get help in time to save the parent.

In addition to grief and trauma, many youth in foster care due to a parent's substance abuse have experienced neglect and abuse. They may not have been given the nutrition and medical care needed to thrive, resulting in the need for medical care. In addition, they may experience delays in social-emotional development and self-help skills due to neglect. In contrast, they may also act like a "little adult" due to having to take on adult responsibilities, such as caring for a parent or preparing meals, at a very young age in order to survive.

Trauma-informed counseling often helpful for individuals who have experienced the sudden death or illness of a loved one or those that witnessed scary and traumatic situations. Through counseling, children have the opportunity to process their experiences, work through their emotions, and develop healthy coping strategies, which are all things they might not have learned growing up with parents with substance abuse disorders.

Most youth with these experiences develop symptoms of post-traumatic stress disorder, similar to military members who experience trauma during war. Actively involving foster parents in the counseling process can help foster youth feel supported and can help create a safe and therapeutic environment in the home. It also helps the child develop the ability to trust the foster parents after a childhood where trust was likely broken.

Mental health counseling and allowing foster youth safe places for processing their emotions and traumatic experiences has been found to significantly reduce the likelihood of the child developing trauma-related mental health disorders. In addition, it also reduces the behavioral symptoms of stress and trauma because the youth learn healthy coping strategies and are given the language and tools needed to identify their emotions and work through their traumatic experiences.

Additionally, many youth with traumatic histories related to a parent's drug abuse need support in learning to play and be a child. Too often, these youth spend their childhood caring for their parents or having to be a "little adult" to cope with trauma. Supporting youth in exploring recreational activities and engaging in typical childhood activities can often go a long way in a child's healing.

Stopping the Drug Abuse Cycle

Recent studies suggest that children who live with parents that abuse drugs or alcohol are eight times more likely to develop a drug abuse disorder themselves. Some adolescents placed into foster care following a parental overdose are already using drugs or alcohol themselves. This suggests a cycle of drug abuse that moves from one generation to the next.

Therefore, it is important that foster youth with parents that have substance use disorders also receive support specifically related to preventing or treating substance abuse. This involves helping youth develop the skills necessary to make positive choices and develop healthy coping skills to deal with stress and anxiety.

One recent study from The Ohio State University found that involving children in their parents' substance abuse treatment was beneficial for both the parents and the children. In this study, mothers with substance abuse disorder participated in Ecology-based Family Therapy with their children. The results indicated that in families that participated together, the risk of future drug abuse was reduced in both the mothers and in the children.

For adolescents that are already using drugs, it is important to help the teens access appropriate trauma-informed substance abuse treatment and rehab designed to break the cycle of intergenerational substance abuse.

It is clear from recent statistics that there is a significant and increasing need for increasing support for foster youth placed because of parental substance abuse. Children coming into care following their parents' overdose often experience significant levels of abuse, neglect, and trauma that must be addressed to help the child process their emotions and overcome their experiences. However, with access to appropriate trauma-informed support that is also designed to stop the cycle of intergenerational substance abuse, children can begin to heal and thrive.