Blending Perspectives and Building Common Ground. How many children live with substance abusing parents?

04/01/1999

The child welfare system serves children who come to its attention as the result of abuse and neglect reports.  These children, however, are a small fraction of those who live in households in which a parent has a serious alcohol or drug problem.  Data from the 1996 National Household Survey on Drug Abuse (NHSDA) reveal that an estimated 8.3 million children in the United States, 11 percent of all children in the U.S., live in households in which at least one parent is either alcoholic or in need of substance abuse treatment. 

Figure 4-1. Children Age 0-17 Living with One or More Substance Abusing Parents by Parent's Primary Problem, 1996

As shown in Figure 4-1, 2.1 million of these children live in families in which the predominant problem is illicit drugs; 3.8 million live in families in which the primary problem is alcohol, and 2.4 million of these children live with parents who abuse both alcohol and illicit drugs in combination.  The children living in substance abusing households are evenly spread across the age spectrum, from infants to teenagers, as shown in Figure 4-2.

Figure 4-2. Number of Children (in Millions) Living with One or More Parents Who are Alcoholic or in Need of Substance Abuse Treatment by Age of Child, 1996

The substance abuser is the mother in about half these families, and the father in the other half.  These figures include only those children residing with their parent(s) at the time of the survey and do not include children who had been removed to foster care (Huang et al, 1998).  Figure 4.3 and Table 4-A illustrate the number of children living in families with varying levels of substance abuse problems.

Figure 4-3. Number of Children (in Millions) Age 0-17 Living with One or More Substance Parents Using Different Definitions of Substance Abuse, 1996.

Definition of Substance Abuse Number of Children Less than or Equal to 17 Years Old Living With One or More Parents With This Level of Use

(in millions)
Percentage of Children Less than or Equal to 17 Years Old in the U.S. Population Living With One or More Parents With This Level of Use

(in percent)
TABLE 4-A.
Children1 Living With Parents Who Use Alcohol or Other Drugs, 1996
Parent is in need of treatment for illicit drug abuse 4.5 6.0
Parent is dependent on illicit drugs 2.8 3.8
Parent is dependent on alcohol 6.2 8.3
Parent is dependent on alcohol and/or illicit drugs 7.5 10.0
Parent is dependent on alcohol and/or in need of treatment for illicit drugs 8.3 11.1
Parent used an illicit drug in the past month 8.4 11.2
Parent used an illicit drug in the past year 10.6 14.3
1  Includes biological, step, adoptive or foster children.

2  For definitions of dependence and "in need of treatment" used in this analysis, see Huang et al, 1998.

Source:  Huang et al, 1998, based on the 1996 National Household Survey on Drug Abuse.

Additional data on the characteristics of alcohol and drug using parents from the 1994 and 1995 National Household Surveys on Drug Abuse reveal that there were an estimated 649,000 women and 645,000 men with problem levels of illicit drug use who were living with children younger than 18 years of age.  Problem drug users living with children represent 30 percent of all women with this level of drug problem and 18 percent of such men (SAMHSA, 1997d).  As shown in Table 4-B, parents with problem levels of drug use look remarkably like parents without such problems demographically, particularly with regard to race. 

  Parents with Problem Drug Use Parents without Problem Drug Use
  Men Women Men Women
TABLE 4-B.
Percentage Distribution of Demographic Characteristics Among Population
Aged 18 or Older Who Lived with Children Under Age 18
by Gender and Problem Drug Use1:  1994-1995
Age Group (Years)
  18 - 25 12.2* 18.7 5.5 11.8
  26 - 34 43.0 41.9 28.2 32.8
  35 and older 44.8* 39.9* 66.3 55.3
Total 100.0 100.0 100.0 100.0
Race/Ethnicity
  White 64.9 71.7 73.0 68.2
  Black 14.9* 20.0 9.9 14.4
  Hispanic 10.5* 7.4* 12.6 12.6
Total 90.3 99.1 95.5 95.22
Education
  Less than high school 33.0 28.3 17.0 17.1
  High school graduate 44.3 40.2 31.0 34.5
  Some college 12.9 21.3 21.3 25.1
  College graduate 9.7 10.1 30.6 23.2
Total 100.0 100.0 100.0 100.0
Current Employment Status
  Full-time 74.9 31.3 81.5 45.7
  Part-time 3.6 12.1 4.6 17.6
  Unemployed 14.9 12.9 4.2 5.0
  Other 6.5 43.6 9.6 31.7
Total 100.0 100.0 100.0 100.0
Marital Status
  Married 78.2 47.4 91.3 75.2
  Divorced or Separated 11.3 31.4 4.9 12.5
  Never married 10.1 21.1 3.0 9.7
Total 99.6 99.9 99.2 97.43
Family Member Participated in Welfare Programs
  Yes 19.8 40.9 5.9 12.3
  No 80.2 59.1 94.1 87.7
Total 100.0 100.0 100.0 100.0

Footnotes:

1 Problem drug users are defined as respondents who needed treatment for drug use in the past year.  This includes respondents who were dependent on any illicit drug using criteria similar to those of the DSM-IV; past-year injection drug users; past-year frequent drug users (marijuana use daily or almost daily, or weekly use of cocaine, hallucinogens, inhalants, analgesics, sedatives, tranquilizers, or stimulants); those who had used any heroin in the past year.

2 Total is not 100, because the category "other" for racial /ethnicity is not included.

3 Total is not 100, because the category "widow" for marital status is not included.

* Low precision for reported estimates.

Source:  U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies.  National Household Survey on Drug Abuse, 1994-B, 1995.  This table originally appeared in HHS/SAMHSA, 1997d, Substance Use Among Women in the United States.

Nearly three-quarters (72 percent) of problem drug using mothers and 65 percent of problem drug using fathers are white, 20 percent of these mothers and 15 percent of these fathers are black, and 10 percent of these fathers and 7.4 percent of these mothers are Hispanic.  Figure 4-4 shows the racial/ethnic distribution of mothers with problem levels of illicit drug use. 

Figure 4-4. Mothers with Problem Levels of Illicit Drug Use by Race, 1994-1995.

As a group, parents with substance abuse problems have somewhat less education, are somewhat less likely to be employed full time, and are much less likely to be married and much more likely to participate in welfare programs than are other parents.  Seventy-five percent of fathers with substance abuse problems are employed full time, as are nearly one-third of such mothers.

Prenatal drug abuse has been a particular focus of media, policy and research attention.  Some 221,000 infants (5.5 percent) are born each year prenatally exposed to illicit drugs.  Most of these have been exposed to marijuana (2.9 percent or 119,000 children), while 1.1 percent (45,000) are exposed to cocaine and 1.5 percent (61,000) pregnant women used prescription medications during pregnancy without physician direction (U.S. Department of Health and Human Services, National Institute on Drug Abuse [HHS/NIDA], 1994).  In addition, some 140,000 pregnant women (3.5 percent of all pregnant women) each year drink heavily, placing their children at risk for Fetal Alcohol Syndrome and Fetal Alcohol Effects (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention [HHS/CDC], 1997).  Figure 4-5 shows the number of women who use illicit drugs or drink heavily during pregnancy. 

Figure 4-5. Number of Women Using Illicit Drugs or Drinking Heavily During Pregnancy by Substance.

Table 4-C shows the numbers of women using illicit drugs by pregnancy and child rearing status.  Substance abuse rates are considerably lower among women who have children in the home than among women who are not raising minor children, and pregnant women report lower substance use rates than non-pregnant women.  Particularly notable, and encouraging, are the very low reported rate of binge drinking and of heavy drinking among pregnant women.

TABLE 4-C.
Past-Month Substance Use by Women Age 15-44, by Pregnancy and Child-rearing status, 1996-1997
INDEX WOMAN'S PREGNANCY AND CHILD-REARING STATUS

(NUMBER IN THOUSANDS)
Pregnant Raising Child(ren) <2 Years Old All Children Are 2+ Years Old No Children
N % N % N % N %
Population N

  (thousands)
2,400 100 7,500 100 25,000 100 26,000 100
Any illicit drug 59 2.5 385 5.5 981 4.1 2,579 10.4
    Any, excluding marijuana 28 1.2 147 2.1 417 1.7 1,150 4.6
    Cocaine 4 0.2 33 0.5 151 0.6 353 1.4
    Heroin 4 0.2 5 0.1 19 0.1 41 0.2
Binge drinking1 30 1.3 622 9.2 2,395 10.3 4,009 16.7
Heavy drinking2 6 0.3 133 2.0 532 2.3 1,100 4.6

Footnotes: 

1 5 or more drinks on the same occasion 1 or more days in the past 30 days.

2 5 or more drinks on the same occasion 5 or more days in the past 30 days.

Source:  Adapted from Preliminary Results from the 1997 National Household Survey on Drug Abuse (1998c), p. 94-95.  Annual averages based on 1996 and 1997 samples.

With respect to drug use by pregnant women and by parents, African American women have higher rates of illicit drug use and particularly cocaine use than do white women (HHS/SAMHSA, 1997d).  However, there are many more white women, including white pregnant women and white parents, who use illicit drugs than there are minority women in these categories who use illicit drugs (HHS/SAMHSA, 1998a).  The number of African American women who use cocaine during pregnancy, (30,000 in 1992) far exceeds the number of white and Hispanic women who used that drug prenatally (HHS/NIDA, 1994).  Studies have shown, however, that African American children prenatally exposed to illicit drugs are much more likely than white children to be both reported to child protective services (Chasnoff, 1989) and to be placed in foster care, even after taking into account factors such as the family's previous child welfare involvement, the physical health of the child, and other related factors (Neuspiel et al, 1993).

Rates of both alcohol and illicit drug abuse are even higher among Native Americans than among other ethnic groups in the U.S., although most national data on substance abuse have insufficient samples to separately analyze data for Native Americans (HHS/SAMHSA, 1998a).

Child welfare agencies tend to focus their attention on infants and very young children of substance abusers, particularly children who have been prenatally exposed to illicit drugs.  But as Figure 4-2 illustrated, children of all ages reside in substance abusing families, and prenatally exposed infants represent a very small proportion of children in such households.  These data also illustrate how closely intertwined and inseparable alcohol and illicit drug abuse are.