Approximately 11% (8.3 million) children live with one or more parents who is dependent on alcohol or needs treatment for illicit drug abuse (USDHHS, 2009). Most families with parental substance use disorders do not come to the attention of child welfare, however for those families who do, addressing substance use disorders effectively and collaboratively is critical. Substance use disorders in the home are frequently reported in cases of child abuse and neglect – a recent summary of research shows great variation in estimates of substantiated child abuse and neglect cases involving substance use by a custodial parent or guardian, with some regional prevalence estimates being higher than national estimates (Seay, 2015). There is a growing knowledge of how to best serve families affected by substance use and who are involved in the child welfare system as well as how to provide evidence-based services that support both the parent and the child to promote family recovery.
The National Center on Substance Abuse and Child Welfare (NCSACW) has identified effective strategies and synthesized lessons learned from demonstration grants in numerous communities to improve outcomes for children and families affected by parental substance use disorders. This article highlights strategies and outcomes from the Substance-Exposed Infants In-Depth Technical Assistance Program and the Children Affected by Methamphetamine Grant Program and offers links to free training and resources for treatment professionals to enhance their knowledge and strategies to work with families in the child welfare system.
Serving Infants with Prenatal Substance Exposure and their Families
Substance use treatment, child welfare, and medical providers, have been making significant efforts at the state and local level to collaboratively address the needs of infants prenatally exposed to substances. NCSACW manages a Substance Exposed Infants In-Depth Technical Assistance Program (SEI IDTA) to strengthen the capacity of states and local jurisdictions to improve the safety, health, and well-being of these infants and the recovery of pregnant and parenting women and their families. of particular focus are women with opioid use disorders and their infants with Neonatal Abstinence Syndrome (NAS). This 18-month initiative, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), supports six States (one with a focus on Tribal communities) in efforts to strengthen collaboration and linkages across child welfare, addiction treatment, medical providers, and early child care and education systems. The States have identified a set of collaborative challenges that emerged in the first 18 months of the project, including:
Out of these challenges, the states have worked on implementing practice and policy changes, such as:
For more information about the SEI IDTA Program, visit our website or contact NCSACW at: [email protected]
Resources on Treatment for Opioid Use Disorders
NCSACW has developed a resource guide on best practices in the treatment of opioid use disorders and Neonatal Abstinence Syndrome (NAS). Please email us at [email protected] to request a copy of this resource guide and the practice and policy publications on opioid use disorders. NCSACW has also facilitated a series of webinars on the topic of treatment for opioid use disorders during pregnancy and Neonatal Abstinence Syndrome. Visit our website to learn more and access the webinar recordings.
SAMHSA will soon release A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare, Collaborating Medical, and Service Providers. This guidance publication is intended to support the efforts of states, tribes, and local communities in addressing the needs of pregnant women with opioid use disorders and their infants and families. It also provides background information on the treatment of pregnant women with opioid use disorders, summarizes key aspects of guidelines that have been adopted by professional organizations across many of the disciplines, presents a comprehensive framework to organize these efforts in communities, and provides a collaborative practice guide for community planning to improve outcomes for these families. A set of appendices provides details on implementing the recommendations in the guide as well as a summary of lessons from one community’s experience over the past decade. Stay tuned and visit our website for an update on the release of this valuable document!
Services for Children Affected by Parental Substance Use: The Children Affected by Methamphetamine (CAM) Program
CAM Program Strategies
Comprehensive screening and supportive services for children and parents
Developmental and behavioral interventions for children
Parent training and education
Trauma-focused child and parent interventions
Coordinated care
From 2010-2014, SAMHSA administered the Grants to Expand Services to Children Affected by Methamphetamine in Families Participating in Family Treatment Drug Court, whichsupported 12 Family Treatment Drug Courts. The goal of the program was to improve the well-being, permanency, recovery and safety outcomes of children and families who are in, or at-risk, out-of-home placement as a result of a parent’s or caregiver’s methamphetamine or other substance use disorder. The primary focus of the grant was to provide services directly to the children and to provide supportive services for parents, caregivers, and families involved in Family Treatment Drug Courts. NCSACW provided performance measurement and technical assistance to the grantees on a variety of topics including collaboration, program sustainability and substance use disorder treatment practices for parents and families.
Over the four-year grant period, several important implementation lessons emerged, including:
Visit our website for more information on the CAM program and read the CAM Brief for a summary of program strategies and outcomes.
Free Online Training for Treatment Professionals on Child Welfare
NCSACW recently launched an updated online tutorial for substance abuse treatment professionals. Through this course, students can learn more about the impact of child welfare and dependency court requirements on parents who are in substance use disorder treatment and who are involved with the child welfare system. The course is designed to highlight key considerations and effective strategies for working with these families to achieve reunification and recovery. This course is approved for 4.5 continuing Education Units (CEUs). Visit our website to take this free online training today.
The National Center on Substance Abuse and Child Welfare (NCSACW) is a national resource center that provides information, expert consultation, training and technical assistance to child welfare, dependency court and substance abuse treatment professionals to improve the safety, permanency, well-being and recovery outcomes for children, parents and families. NCSACW is funded through an intragency agreement between the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Administration for Children and Families (ACF).