Blending Perspectives and Building Common Ground. Chapter 4. The Extent and Scope of the Problem


The language authorizing this Report to Congress specifically required that we describe the extent and scope of the problem of substance abuse among families involved with the child welfare system.  In this chapter we review data available from a variety of sources.  The data available represent different and often conflicting numbers and patterns.  These differences are largely the result of the differing methodologies by which they were obtained, differences in the populations studied, and differences in how the researchers defined both what represented a substance abuse "problem" and what threshold of conduct represented child maltreatment.  In addition, the figures presented below examine the problem from a variety of standpoints:  the prevalence of substance abuse among the child welfare population; the prevalence of child maltreatment and other parenting problems among substance abusing parents; and the prevalence of children residing in families with substance abuse problems, regardless of whether specific maltreatment issues have been identified.

Our basic conclusions are as follows:

  • While parents, especially mothers, abuse alcohol and other drugs at lower rates than do persons without children, there are a great many children, 8.3 million, living with substance abusing parents (Huang et al, 1998).  Few of these children come into contact with the child welfare system.
  • Most studies find that for between one third and two-thirds of children involved with the child welfare system, parental substance abuse is a contributing factor.  Lower figures tend to involve child abuse reports and higher findings most often refer to foster care. There are as many substance abusing fathers with children in their households as mothers (HHS/SAMHSA, 1997d), although mothers are far more likely to come to the attention of child protective services agencies.
  • Substance abusing African American women are more likely to come to the attention of Child Protective Services agencies than are white or Hispanic women with substance abuse problems.
  • Children prenatally exposed to drugs and alcohol represent only a small proportion of the children affected and potentially endangered by parental substance abuse.
  • Both the abuse of alcohol and the abuse of illicit drugs are linked to child maltreatment.  In many families, both alcohol and illicit drugs are abused simultaneously, making the two problems indistinguishable.  Numerically, however, the problem-level use of alcohol is far more prevalent than illicit drug use.  Binge drinkers (those who drink five or more drinks on the same occasion) outnumber cocaine users by 21 to 1 and outnumber heroin users 98 to 1 (HHS/SAMHSA, 1998c).
  • Many parents, especially mothers, who enter substance abuse treatment are motivated to do so by concerns regarding their parenting and how their substance abuse is affecting their children (HHS/SAMHSA 1996b).