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Child Welfare and Substance Use

After more than a decade of sustained declines in the national foster care caseload, beginning in 2012, the number of children entering foster care began to rise. Between 2012 and 2016, the number of children in foster care nationally rose by 10 percent, from 397,600 to 437,500. The experience of individual states varied, though more than two-thirds (36 states) experienced caseload increases. Hardest hit have been six states whose foster care populations rose by more than 50 percent over this four year period.

While many believe parental substance use – including prescription drugs, illicit drugs and alcohol, but especially opioids – has been the primary cause of the increase in foster care placements, thus far there has been little empirical evidence to support this assertion. To better understand how select indicators associated with substance use relate to the changing trend in child welfare caseloads, ASPE carried out a research study that included both quantitative analysis and qualitative data collection. The quantitative portion of the study examines the strength of the relationship between two substance use indicators – drug overdose death rates and drug-related hospitalization rates - and child welfare caseloads at the county level. The qualitative portion of the study documents the perspectives and experiences of child welfare administrators and practitioners, substance use treatment administrators and practitioners, judges and other legal professionals, law enforcement officials, and other service providers—the local experts—who on a day-to-day basis work with families struggling with substance use disorders. Combined, the quantitative and the qualitative results describe how the child welfare system interacts with community partners to serve an increasing population of parents whose substance use has impaired their ability to parent, placing their children at risk.

A series of research briefs will describe the study’s findings. Links to individual briefs appear below.  Additional briefs will be added as they become available throughout 2018.

  1. Substance use, the Opioid Epidemic and the Child Welfare System: Key Findings from a Mixed Methods Study (posted March 2018)
  2. The Relationship between Substance Use Prevalence and Child Welfare Caseloads (posted March 2018)
  3. Substance Use, the Opioid Epidemic and the Child Welfare Caseloads: Methodological Details from a Mixed Methods Study (posted June 2018)
  4. Medication-Assisted Treatment for Opioid Use Disorder in the Child Welfare Context: Challenges and Opportunities (posted November 2018)
  5. Challenges in Providing Substance Use Disorder Treatment to Child Welfare Clients in Rural Communities (posted January 2020)
  6. Availability of Treatment for Opioid Use Disorder in Areas of High Foster Care Increases (posted April 2020)
  7. Strategies Rural Communities Use to Address Substance Misuse among Families in the Child Welfare System (posted July 2020)
  8. Treatment for Opioid Use Disorder May Reduce Substantiated Cases of Child Abuse and Neglect (posted January 2021)