Background The US opioid crisis started in 1996. Assessing its effects on children of addicted or overdosing parents is the first step toward remediation.
Methods Using 1999–2019 mortality, opioid shipment, child maltreatment, criminal justice, and National Survey on Drug Use and Health data by state, we calculated how many children experienced Adverse Childhood Experiences (ACEs) attributable to the opioid crisis. We counted children with an ACE because a parent repeatedly misused prescription opioids prior to other drug abuse. We estimated additional ACE exposure of those children by counting parental overdose deaths and running panel regression or tabular analyses of attributable fractions of divorce, maltreatment, assault, and incarceration.
Results Around half of children with ACEs suffered at least one ACE because of the opioid crisis. Of Americans ages 0–34, 17% (25,000,000) had a parent who repeatedly misused opioids, with more than 80% of misuse non-recreational. Misuse resulted in children experiencing an estimated 10 million additional ACEs: 485,741 parental death, 1,158,000 parental divorce, 3,231,000 parental incarceration, and 5,434,000 child maltreatment.
Conclusion The ubiquity of ACEs resulting from the opioid crisis means abatement requires screening everyone under age 35 for ACEs/adverse effects of toxic shock. Case management of those affected probably requires adding school counseling/behavioral health staff. Desirable responses include group cognitive-behavioral therapy for affected children and Strengthening Families programming. Those exposed should be screened and monitored for depression, asthma, and substance use disorders.
Learning Outcomes Aware the opioid crisis doubled ACEs nationally
Better equipped to create/promote abatement plans for ACEs from opioids
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