Millions of U.S. kids live with parents with substance use disorders
June 3, 2025
Millions of U.S. kids live with parents with substance use disorders
At a Glance
- Almost 19 million U.S. children—1 in 4—lived with at least one parent or primary caregiver who had a substance use disorder in 2023.
- The findings highlight the need for treatment for parents and interventions for families affected by substance use disorders.
In 2023, more than 46 million adults in the U.S. had a substance use disorder (SUD) in the previous year. In addition to serious or even life-threatening health risks for the substance users, SUDs can also affect entire families. Children whose parents or other caregivers have substance use problems are more likely to have negative experiences early in life. They’re also more apt to start using drugs or alcohol at younger ages themselves. And they have greater incidence of SUDs and other mental health conditions.
A research team led by Drs. Sean Esteban McCabe, Ty Schepis, and Vita McCabe at the University of Michigan wanted to know how many U.S. children were exposed to substance use and addiction at home. The team used data from the 2023 National Survey on Drug Use and Health. This survey collects nationwide data on drug use, substance use disorders, and mental health issues each year. SUDs were defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which mental health professionals use to diagnose mental health conditions. Findings appeared in JAMA Pediatrics on May 12, 2025.
Based on the survey and population data, the researchers estimated that nearly 19 million children under age 18 lived with one or more parents with an SUD in 2023. That’s a quarter of all U.S. children. More than 7.5 million lived with a parent with a moderate to severe SUD. Nearly 3.5 million had a parent with multiple SUDs. And more than 6 million children had at least one parent with a co-existing SUD and mental illness (defined as major depressive disorder or serious psychological distress).
Alcohol use disorder was the most prevalent parental SUD among surveyed households, affecting more than 12 million children. More than 6 million kids had a parent with cannabis use disorder, while more than 2 million had a parent with a disorder related to prescription drugs. About 1 million had a parent with a substance use disorder related to illicit drugs other than cannabis.
“The fact that 1 in 4 children now live with parental substance use disorder brings more urgency to the need to help connect parents to effective treatments, expand early intervention resources for children, and reduce the risk that children will go on to develop substance use issues of their own,” says Sean Esteban McCabe.
The new findings show the importance of addressing substance use disorder in parents. Family-based interventions to address substance use disorders have the potential to improve the health of millions of U.S. children and their families.
—by Kendall K. Morgan, Ph.D.
Related Links
- Scientists Find Common Brain Network for Substance Use Disorders
- Lack of Buprenorphine Access for Adolescents in Residential Facilities
- Telehealth Improves Treatment for Opioid Use Disorder
- Treatment for Opioid Use Disorder in Jail Reduces Risk of Return
- Few are Prescribed Medications to Treat Alcohol Problems
- Understanding Drug Use and Addiction
- National Survey on Drug Use and Health (NSDUH)
References
US Children Living With a Parent With Substance Use Disorder. McCabe SE, McCabe VV, Schepis TS. JAMA Pediatr. 2025 May 12:e250828. doi: 10.1001/jamapediatrics.2025.0828. Epub ahead of print. PMID: 40354076.
Funding
NIH’s National Institute on Drug Abuse (NIDA).
