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Substance Use, the Opioid Epidemic, and the Child Welfare System: Key Findings from a Mixed Methods Study

March 7, 2018
By Laura Radel, Melinda Baldwin, Ph.D., Gilbert Crouse, Ph.D., Robin Ghertner and Annette Waters, Ph.D.

After more than a decade of sustained declines in the national foster care caseload, the number of children entering foster care began to rise in 2012. Between 2012 and 2016, the number of children in foster care nationally rose by 10 percent, from 397,600 to 437,500. Although the experience of individual states varied, 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.

Many in the child welfare field think that 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 at the national level.

One study suggests that in 10 states there has been an exponential growth in the number of reports of maltreatment for infants with neonatal abstinence syndrome (Lynch et al., 2018). To better understand how substance use interacts with the child welfare system, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) carried out a research study that included both quantitative analysis and qualitative data collection. We were assisted by Mathematica Policy Research, which collected and summarized most of the qualitative interviews for the study.

The quantitative portion of the study examines the strength of the relationship between child welfare caseloads and two indicators of substance use 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 who work on a day-to-day basis with families struggling with substance use disorders. Combined, the quantitative and 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.

This research brief is the first of a series of reports that present the study’s findings. This brief identifies the key takeaway messages gleaned from the range of qualitative and quantitative data analyzed.

A full list of the available briefs can be found at https://aspe.hhs.gov/child-welfare-and-substance-use.


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