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Journal of Applied Research on Children


Disrupting pathways to negative outcomes in children and adolescents who have caregivers with Substance Use Disorder (SUD) is of the highest priority if we are to gain control over the opioid epidemic. This population is at very high risk for becoming the next generation of individuals with SUD, as well as other types of psychopathology and eventual juvenile/criminal justice involvement. In addition to experiencing severe/chronic adversities during their development, these youth are now further propelled toward these negative trajectories due to the COVID-19 crisis which substantially compounds the issues (e.g., estrangement from otherwise normalizing social influences, such as school, nondelinquent peers, extended families, health care, etc.) for both the young person and the parent with SUD. We review the literature establishing the linkages between adverse childhood experiences (ACEs) and pathways to SUD. Our focus is particularly on opportunities for intervention across development using family-based programs that directly address parenting skills and trauma. Invoking structural level change to merge SUD treatment and evidence-based family intervention infrastructures in communities promise to both reduce externalizing behaviors and internalizing symptoms in these youth, as well as reinforce recovery in the parents. Currently, these systems do not intersect, thus, children do not often receive programming and treatment of caregivers for SUD is less effective without engagement of the family unit.


  • Children of caregivers with Substance Use Disorder (SUD) are at high risk for developing SUD themselves
  • These children experience adversity and trauma, which is the link to negative developmental and behavioral outcomes
  • Evidence-based parenting and family interventions are available that have potential to disrupt pathways to SUD, preventing these children from developing SUD
  • Trauma-informed approaches are critical to improve outcomes
  • Providing both treatment for parents with SUD and family intervention is essential to improve child outcomes and reinforce recovery in the parent
  • Web-based interventions have potential to reach otherwise hard-to-reach populations
  • Education of professionals who work with these families is a critical component
  • National and local policies should be informed by this science


This published version is made available on Dickinson Scholar with the permission of the publisher. For more information on the published version, visit Journal of Applied Research on Children's Website.

© 2020. This publication is made available under the CC-BY-NC-ND 4.0 license:

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