Editorial: Parenting in the Context of Opioid Use: Mechanisms, Prevention Solutions, and Policy Implications

Abstract

The United States (U.S.) is experiencing an opioid epidemic of historic significance. In 2019, 10.1 million people misused prescription opioids in the past year (Substance Abuse Mental Health Services Administration, 2020) and more than 70,000 overdose deaths occurred (Hedegaard et al., 2020). The U.S. economic costs of this epidemic during 2017 alone were estimated at more than 1 billion USD (Florence et al., 2021). National-level epidemiological data from the U.S. indicate that the rates of opioid misuse, addiction, overdose, and fatalities are increasing at a particularly fast rate among women and individuals of childbearing and child-rearing age (Center for Disease Control Prevention, 2017;Hedegaard et al., 2020). Opioid-using behaviors among individuals who are parenting can have detrimental effects on their parenting and parent-child relationships, and can have downstream effects on child brain development, health, and subsequent risk for drug use (Wilens et al., 2002;Lander et al., 2013). Further, despite knowledge rooted in neuroscience that drug addiction is a disease, substance use in pregnancy is often perceived to be a choice, and women are frequently blamed for not having enough self-control to stop using substances (Schiff et al., 2021). Pregnant women who use opioids report having their pregnancy criminalized-experiencing harsh judgement by hospital staff (e.g., being called "drug addicts" or "dope fiends") and/or being rejected from OB/GYN clinics because they are on medication assisted treatment (Syvertsen et al., 2021). These experiences threaten the likelihood that women seek and have access to prenatal care, access treatment for opioid use disorder, and access early intervention services for their children (Peacock-Chambers et al., 2020).In 2017, the U.S. Department of Health and Human Services designated the opioid epidemic as a public health emergency and announced a 5-point strategy to combat this crisis, which included supporting cutting-edge research on addiction and improving access to prevention, treatment, and recovery support services (U.S. Department of Health Human Services, 2017). However, despite knowledge about the harmful associations between opioid use and parent and child development outcomes and national efforts to combat this crisis, significant gaps in the extant literature remain. Further, the COVID-19 pandemic has precipitated additional parenting challenges and stressors (Roos et al., 2021). Deaths related to opioid use are considered "deaths of despair" that have only magnified during this pandemic (Volkow, 2020). Given the well-established effects of substance use on parenting skills (Suchman et al., 2011(Suchman et al., , 2017Lander et al., 2013) and the known effects of parental opioid use on infant and child development (Kocherlakota, 2014), addressing these knowledge gaps could improve the health and well-being of millions of children and families worldwide.