Last year, a national survey by The Associated Press-NORC Center for Public Affairs Research reported that two-thirds of respondents thought their communities were not doing enough to make treatment programs accessible and affordable to those who need them.
That perception is mirrored in what researchers report. As of 2017, there were more than a million people with substance use disorders who felt the need for treatment but did not get any at a hospital, a drug or alcohol rehabilitation facility, or a mental health center.
The situation is dire for people from all walks of life, including parents. Only 28 percent of parents with an opioid use disorder receive drug or alcohol treatment at a specialty facility or other doctor’s office, and parents with other types of substance use disorders are even less likely to be treated; just 6 percent reported being treated at a specialty facility or other doctor’s office.
These findings are part of a new study conducted by researchers at the Urban Institute, using data from the National Survey on Drug Use and Health to better understand the experience of families living with opioid use disorder and other substance use disorders. The authors find that 4.8 million U.S. parents have a substance use disorder, including 623,000 parents with opioid use disorder. The authors also find that almost two-thirds (62 percent) of the parents with opioid use disorder have a co-occurring mental illness, such as severe depression.
Barriers to treatment
Low rates of treatment for substance use disorder are caused by a confluence of structural factors, including shortages of medical providers who treat substance use disorder, challenges linking people who need treatment to available providers, geographic distance to providers, public transit accessibility, insurance coverage, and affordability. In many communities, people may not even be aware of available diagnostic, treatment, and recovery options.
In addition, despite new resources supporting family-centered treatment, many treatment services are not family friendly and do not offer convenient hours or child care. For a parent balancing multiple jobs or with limited options for affordable child care, this makes treatment a nearly impossible choice.
Finally, many providers do not have the tools to link people to supportive services—such as food, housing, or legal assistance—that could facilitate treatment initiation and recovery. And in many cases, supportive services are simply not available because of a lack of funding.
Can we forge a new path for treatment and recovery?
Untreated, opioid and other substance use disorders are devastating diseases for families. Children of parents with substance use disorder have more difficulties in academic, social, and family functioning; have higher rates of mental and behavioral disorders; and are more likely to develop substance use disorder themselves.
Our study found that one in five parents with opioid use disorder has had suicidal thoughts and behavior in the past 12 months. This should truly give us pause. Our country cannot afford to lose more lives to this crisis. And no child can afford to lose a parent to this disease.
But our study also found that 42 percent of parents with an opioid use disorder received treatment for mental health in the past 12 months. This should give us some hope. Mental health problems were once more hidden and not considered treatable illnesses but are now much more openly discussed and effectively managed with treatment. We know that substance use disorder treatment can also be life changing to people with substance use disorders. That’s why it’s so troubling to see such low rates of treatment among parents. It is critical that we expand the availability of treatment and the supportive services that can help parents recover and better support their children.
Medical providers need more training, technical assistance, staff support, and incentives to screen and diagnose substance use disorders, motivate behavior change, facilitate initiation of treatment, and manage the chronic relapsing nature of substance use disorder. Given that parental substance use disorder involves significant risks for both parents and children, more research on parental substance use disorder is called for. For example, it would be helpful to know which encounters between parents and the health system are most effective for screening and brief intervention for substance use disorder (e.g., birth hospitalization versus newborn well-visits) and if further refinements to standard techniques could better reach and motivate parents. In addition, it would be helpful to explore the feasibility of novel approaches like integrating parental screening for substance use disorder with pediatric care.
More information about this study and other research on the growing opioid crisis can be found here.