In the past three decades, the United States has experienced at least three major shifts in substance use trends that have had dramatic effects on children and families. However, the increase of opioid misuse has been described by long-time child welfare professionals as having the worst effects on child welfare systems that they have seen. Studies indicate that there is substantial overlap between parents involved in the child welfare and substance use treatment systems. Identifying these families is difficult, as neither child welfare nor substance use treatment are required to capture the data elements necessary to identify families in both systems.
It is important for professionals in the child welfare, substance use disorder treatment, and court systems and their partners to understand how many children and families in their community are affected by parental alcohol and other drug (AOD) use and child maltreatment. Some key national datasets and individual research studies identify the prevalence of substance use among families involved with child welfare services. Staying abreast of these statistics can help professionals understand trends, determine community need, and better tailor services for families.
Prevalence of Parental Alcohol or Drug Abuse as an Identified Condition of Removal in the United States, 2019
These data indicate that the prevalence of parental alcohol or other drug (AOD) abuse as an identified condition of removal of children and placement in out-of-home care has increased from 2000 to 2019. Data from 2000 show a prevalence rate of 18.5%. This increased to 38.9% in 2019, an increase of 20.4%.
Parental Alcohol or Other Drug Abuse as an Identified Condition or Removal by State, 2019
When calculating the national average, 38.9% of children removed from their homes and placed in out-of-home care had parental alcohol or other drug (AOD) abuse as an identified condition for removal. The map presents state averages which range from 3.6% to 69.0%.
States often anecdotally report that the percentage of child welfare removals involving parental AOD abuse is much higher in their state than indicated in the data. Possible explanations for these discrepancies may include 1) lack of child welfare protocols for screening and assessment regarding identification of substance use disorders; 2) inconsistent protocols regarding data entry for child welfare; 3) discrepancies in how AOD abuse is captured in the state child welfare’s data systems; and 4) differences in the point at which the AOD abuse is identified and entered in the data system. Often, at the local level, multiple removal reasons are reported and sometimes only the primary reason for removal is reported by the federal system(s).
Percent of Children Removed with Parental Alcohol or Drug Abuse as an Identified Condition of Removal by Age, 2019
When looking at information regarding children removed from their homes and placed in out-of-home care who had parental alcohol or other drug (AOD) abuse as an identified condition for removal, there has been a particular interest in understanding how this is affecting families involved in child welfare with children under age 1. Half of the children under age 1 (50.7%) removed from their homes and placed in out-of-home care had parental AOD abuse as an identified condition of removal. The percentage for children age 1 and older (36.1%) was closer to the overall national average (38.9%).
Percent of Children Under Age 1 Who Entered Out-of-Home Care in the United States, 2019
From 2000-2018, the percentage of children under age 1 entering out-of-home care steadily increased. Data from Fiscal Year 2019 showed a slight decrease; a reduction of only 0.2%. Whereas children under 1 represented 13.4% of total removals in 2000, this has increased to close to a quarter (18.7%) of all removals in the most recent fiscal year.
Number of Children who Entered Out-of-Home Care, by Age at Removal in the United States, 2019
Data regarding age of removal was organized to create three age groups: children birth — age 5, children age 6 — 12, and children age 13 — 18+. When looking at these three groups, children birth – age 5 make up nearly half (48.6%, N=122,585) of the children removed from their homes and placed in out-of-home care during Fiscal Year 2019. Children age 6 — 12 make up 28.8% (N=72,781) and children age 13 — 18+ make up 22.6% (N=56,924) of the children removed from their homes and placed in out-of-home care during the same time period.
Number of Children who Entered Out-of-Home Care with Incidence of Parental Alcohol or Drug Abuse as an Identified Condition of Removal, by Age at Removal in the United States, 2019
Data regarding parental alcohol or other drug (AOD) abuse as an identified condition for removal is organized by three age groups (children birth — age 5, children age 6 — 12, and children age 13 — 18+). When looking at these three groups, 60.3% (N=57,250) of children birth - age 5 had parental AOD abuse as an identified condition for removal during Fiscal Year 2019. For children age 6 — 12, 29.0% (N=27,529) had parental AOD abuse as an identified condition for removal and for children age 13 — 18+, 10.7% (N=10,117) had parental AOD abuse as an identified condition for removal during the same time period.
Percent of Children Under Age 1 With Parental Alcohol or Drug Abuse as an Identified Condition of Removal in the United States, 2019
From 2000-2018, the percentage of children under age 1 who entered out-of-home care with parental alcohol or other drug (AOD) abuse as an identified condition of removal steadily increased. Data from Fiscal Year 2019 showed a slight decrease; a reduction of only 0.2%. in 2000, 27.8% of children under age 1 had parental AOD as an identified condition of removal. This increased to 50.9% of children under age 1 in 2019.
Substance Abuse Treatment Admissions by Substance Use Flag and Gender in the United States, 2018
The most recent Treatment Episode Data Set Admissions (TEDS-A) contains data from Fiscal Year 2018. The percentages represent the prevalence of the identified substance as a primary drug at the time of treatment episode entry. For both men and women, alcohol was the most frequently identified primary substance, identified in 44.6% of treatment admission for men and 35.0% of treatment admissions for women. Heroin (30.1% of treatment admissions for men and 30.9% of treatment admissions for women) and marijuana (31.3% of treatment admissions for men and 26.5% of treatment admissions for women) were the next most frequently identified substances. While this data summarizes the national trends for treatment admission, state specific patterns of use differ widely. Collaboratives and stakeholders are encouraged to look at their state specific data trends.
Treatment Admissions for Women of Childbearing Age (Ages 15–44) Who Were Pregnant at Treatment Admission in the United States, 2018
The most recent Treatment Episode Data Set Admissions (TEDS-A) contains data from Fiscal Year 2018. The percentages represent the percentage of substance use disorder treatment admissions for women ages 15 – 44 where the woman was identified as pregnant at the time of admission. Nationally, women were identified as pregnant at the time of admission for 4.3% (N=20,878) of treatment admissions. While this data summarizes the national trends for treatment admission, state specific patterns of use differ widely. Collaboratives and stakeholders are encouraged to look at their state specific data trends.
