ANN ARBOR, Mich. — Roughly 19 million U.S. children, about one in four under the age of 18, live with a parent or other adult whose drinking or drug use meets the criteria for a substance use disorder, according to new University of Michigan research published in JAMA Pediatrics.
Using 2023 data from the National Survey on Drug Use and Health, the team found alcohol to be the most common problem, affecting an estimated 12 million parents. Cannabis use disorder was next at just over 6 million, while about 3.4 million parents showed disordered use of multiple substances. Nearly 6 million children live with adults who have both substance use and mental health disorders, a combination the authors say compounds the risks.
Lead author Sean Esteban McCabe said the rise from prior estimates “brings more urgency to the need to help connect parents to effective treatments [and] expand early intervention resources for children.”
For EMTs, paramedics and firefighters, the study’s findings highlight how public health issues translate directly into emergency calls. Children living in households with untreated addiction face higher risks of accidental fires, overdoses, medical neglect, abuse and trauma — situations that frequently require firefighters, EMTs and paramedics to intervene. Understanding these underlying factors can help first responders anticipate hazards on scene, tailor patient care and engage other community resources to protect vulnerable kids.
“We know that children raised in homes where adults have substance use issues are more likely to have adverse childhood experiences, to use alcohol and drugs earlier and more frequently, and to be diagnosed with mental health conditions of their own,” said Vita McCabe, co-author and director of University of Michigan Addiction Treatment Services.
The study’s authors urge expanded access to evidence-based treatments such as naltrexone for alcohol use disorder and buprenorphine for opioid addiction, along with cognitive behavioral therapy and family-focused interventions. They also warn that looming federal budget cuts could jeopardize the national survey that supplies much of the nation’s substance-use data.
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