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May 16, 2025 – A staggering one in four children in the United States-nearly 19 million in total-lived with at least one parent who met the criteria for a substance use disorder (SUD) in 2023, according to a new analysis of national survey data. The findings, published in JAMA Pediatrics and led by researchers at the University of Michigan, highlight a growing public health concern with far-reaching implications for children and families nationwide.
Key Findings
The study analyzed data from the 2023 National Survey on Drug Use and Health, which included responses from the civilian, noninstitutionalized US population aged 12 and older. Researchers found:
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18,968,894 children (about 25% of all US children) lived with at least one parent with a DSM-5-defined substance use disorder.
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Of these, 7.6 million children lived with a parent with moderate or severe SUD.
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3.4 million children had parents with multiple SUDs.
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6.1 million children lived with a parent who had both a substance use disorder and a mental illness, such as major depressive disorder or serious psychological distress.
Alcohol use disorder was the most common diagnosis among parents, followed by cannabis, prescription medication, and other noncannabis drug use disorders.
Risks for Children
Children exposed to parental SUD face significantly higher risks of developing adverse health outcomes compared to their peers, including:
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Early initiation of substance use
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Substance-related problems
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Mental health disorders
“These findings signal the need for more attention at the federal, state, and local levels on the children and families affected by addiction,” the study authors wrote. They emphasized that evidence-based, family-focused interventions can help prevent negative health consequences for these vulnerable children.
Study Methodology and Limitations
The analysis followed rigorous reporting standards and used deidentified data, exempting it from institutional review. Data was collected through interviews with one adult per household, who reported on the relationships and health status of household members, including children under 18.
However, the study’s authors noted several limitations, including potential sampling and self-report biases common to large-scale surveys. Additionally, the number of children in each household was capped at three or more, meaning the true number of affected children may be even higher.
Call to Action
The researchers urge policymakers and healthcare providers to prioritize support for families impacted by parental substance use disorders. Expanding access to family-based treatment programs and mental health services could mitigate the long-term effects on children and break the intergenerational cycle of addiction.
Disclaimer:
This article is based on findings from a study published in JAMA Pediatrics and reported by Medscape. The information provided is for general informational purposes only and should not be construed as medical advice. If you or someone you know is struggling with substance use or mental health issues, please seek help from a qualified healthcare professional.
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