Implementing evidence-based practices to support families affected by opioid use disorders

An estimated 600,000 U.S children live with a parent who has an opioid use disorder (OUD)1,2; thus, they remain at risk of adverse consequences, including withdrawal symptoms if exposed during the prenatal period, out of home (OOH) placement due to child safety concerns, trauma (if parents experience an overdose), and a higher risk of developing their own SUD in adolescence.3 Responding to the opioid epidemic presents numerous challenges for the various systems that serve children, parents and their families.

Children and Family Futures (CFF) is at the forefront of supporting tribes, states, counties, courts, and community-based agencies to implement evidence-based practices to improve outcomes for children, parents and their families who are affected by the opioid epidemic. CFF, through the National Center on Substance Abuse and Child Welfare contract, provides in-depth technical assistance (IDTA) to tribes, states, and local jurisdictions. IDTA programs strengthen capacity to improve the safety, health, and well-being of pregnant and postpartum women with opioid use disorders and their infants with prenatal substance exposure, their extended family, and other caregivers by implementing Plans of Safe Care.

Effectively addressing the opioid epidemic requires a multi-systems collaborative approach by child welfare, law enforcement, court systems, substance use disorder treatment and mental health treatment, and healthcare providers. It’s essential that these professionals understand medication-assisted treatment (MAT) as a viable option for parents/caregivers that have substance use disorders, especially opioid use disorders.

CFF facilitates the implementation of multi-system collaborative approaches to improve early identification of opioid use disorders, engagement into substance use disorder treatment, and training on the use of medication-assisted treatment. CFF has developed resources to assist communities, organizations, and agencies to better understand and implement evidence-based approaches to support safety, well-being, and recovery of children and families.


CFF has disseminated nearly 18,500 materials related to opioid use disorders and medication-assisted treatment since 2016
CFF has responded to over 5,700 technical assistance requests about opioid use disorders and medication-assisted treatment since 2016


Over 70% of drug overdose deaths in 2019 involved an opioid4
From 2010 through 2017, there was a relative increase of 82% in the rate of infants born with a NAS diagnosis5
Adolescents of parents who misuse prescription opioids are at twice the risk of a suicide attempt, compared to adolescents of parents who do not misuse prescription opioids6
Adolescents who use prescription opioids are at an increased risk of suicide, with 33% of adolescents who report prescription opioid use attempting suicide, compared to 6% of adolescents who report no use of prescription opioids7


Through federally- and foundation-funded projects, Children and Family Futures and its small business subsidiary, Center for Children and Family Futures, produces publications, reports, Technical Assistance tools and web-based learning for the field. The following are featured resources from our work. For more resources or information related to a specific topic, please visit our resources page or click the “Request Assistance” button below or at the top of the page.


  1. Clemans-Cope, L., Lynch, V., Epstein, M., & Kenney, G. M. (2019). Opioid and substance use disorder and receipt of treatment among parents living with children in the United States, 2015-2017. Annals of Family Medicine, 17(3), 207-211.
  2. The Annie E. Casey Foundation. (2021). Child population in the United States. The Annie E. Casey Foundation, Kids Count Data Center. Retrieved October 28, 2021, from,1729,37,871,870,573,869,36,868,867/14,15,65/421,422
  3. Centers for Disease Control and Prevention. (2020). High-risk substance use among youth.
  4. Centers for Disease and Control. (2021). Understanding the epidemic.
  5. Hirai, A. H., Ko, J. Y., Owens, P. L., Stocks, C., & Patrick, S. W. (2021). Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010–2017. Journal of the American Medical Association, 325(2),146-155.
  6. Brent, D. A., Hur, K., & Gibbons, R. D. (2019). Association between parental medical claims for opioid prescriptions and risk of suicide attempt by their children. JAMA Psychiatry, 76(9), 941-947.
  7. Wilkins, N. J., Clayton, H., Jones, C. M., & Brown, M. (2020). Current prescription opioid misuse and suicide risk behaviors among high school students. Pediatrics, 147(3).