Effects of Opioid Treatment Programs on Child Well-Being

Abstract

Children exposed to parental opioid use disorder are at an elevated risk of maltreatment. We study whether parents’ access to medication-assisted opioid treatment programs (OTPs) affects the well-being of their children. An administrative decision to lift a moratorium on access to these programs in Indiana created the opportunity for this study. We show that after a county opened an OTP, methadone dispensing increased and emergency department visits related to opioid overdose decreased there, offering evidence of the success of these programs. We also show that the opening of these OTPs did not have significant effects on reports of child maltreatment, but that out-of-home foster care placements were reduced by 22 percent. Our findings are consistent with past research showing that child welfare cases involving parental substance use tend to be complex and tend to have longer times to parent/child reunification than child welfare cases in which substance use is not present. We argue that expanding access to opioid treatment programs may help reduce foster care placements.

The Opioid Crisis and Child Maltreatment Across Counties and Time in the United States, 2007–2017

“…The findings presented in this study suggest that investing in counties suffering from the highest poverty rates, increasing residential mobility opportunities in communities facing median and lower opioid mortality, and advancing harm reduction efforts to decrease opioid mortality would decrease child maltreatment. Evidence from harm reduction interventions show evidence of decreasing foster care entry but not child maltreatment reporting (Bullinger, Wang, and Feder, this volume). Interventions to weaken the associations of this study rely on rebuilding community-level social controls and reinvestment in institutions that defend against consequences of opioid mortality.…”