Article Figures & Data
Tables
- Table 1
Sociodemographic and Health Characteristics of Parents Living With Their Childrena by Past 12 Months OUD or Other SUD Status,b 2015-2017
OUD P Value for Differencec SUDs Except OUD [Ref] n % (95% CI) n % (95% CI) Age group, y ≤25 103 11.0 (7.8, 14.1) 0.59 652 10.0 (8.8, 11.2) 26-34 171 35.4 (28.6, 42.1) 0.31 1,001 31.5 (28.8, 34.1) ≥35 172 53.7 (46.3, 61.0) 0.20 1,302 58.5 (56.0, 61.0) Female sex 251 48.9 (42.8, 54.9) 0.04 1,408 42.6 (40.0, 45.3) Family income as a % of the federal poverty leveld <100 162 29.0 (23.2, 34.7) 0.00 719 19.4 (17.3, 21.4) 100-200 135 28.6 (22.4, 34.8) 0.11 752 22.9 (20.7, 25.1) >200 149 42.5 (34.3, 50.7) 0.00 1,484 57.7 (55.3, 60.2) Race or Hispanic origin Non-Hispanic white 307 73.6 (66.7, 80.6) 0.00 1,720 61.9 (59.7, 64.2) Other 139 26.4 (19.4, 33.3) 0.00 1,235 38.1 (35.8, 40.3) Insurance status, current Any private, including military 152 40.2 (32.4, 47.9) 0.00 1,654 63.5 (61.0, 65.9) Medicaid 191 35.3 (30.4, 40.2) 0.00 755 18.8 (16.9, 20.7) Other insurance 30 9.0 (4.9, 13.1) 0.05 152 4.6 (3.6, 5.7) No insurance 73 15.6 (10.7, 20.4) 0.30 394 13.1 (11.3, 15.0) Self-reported fair or poor health 119 29.7 (24.1, 35.4) 0.00 358 12.0 (10.2, 13.8) Mental health, past 12 moe Suicidal thoughts and behavior 90 20.1 (15.4, 24.8) 0.00 368 10.6 (9.2, 11.9) Major depressive episode 115 25.1 (19.7, 30.4) 0.00 528 16.4 (14.5, 18.4) Any mental illness 279 61.9 (55.9, 67.9) 0.00 1,279 40.3 (37.9, 42.6) Serious mental illness 106 23.5 (19.0, 28.0) 0.00 420 13.2 (11.6, 14.7) SUDs, past 12 mo OUD without another SUD 247 57.8 (51.2, 64.5) n.a. 0 n.a. Other SUDs 199 42.2 (35.5, 48.8) n.a. 2,955 100.0 Alcohol use disorder 107 22.4 (17.3, 27.6) 0.00 2,440 85.7 (83.9, 87.6) Marijuana 54 12.8 (8.4, 17.2) 0.82 472 13.3 (11.7, 15.0) Cocaine, including crack 32 6.0 (3.3, 8.7) 0.04 80 2.8 (1.9, 3.7) Methamphetamines 44 9.2 (5.4, 13.0) 0.00 126 3.4 (2.6, 4.2) Tranquilizers 50 9.8 (6.4, 13.1) 0.00 58 1.6 (1.0, 2.2) Otherf 44 7.7 (4.8, 10.7) 0.00 82 2.4 (1.7, 3.1) Sample size 446 2,955 Rate among parents living with their children 446 0.9 (0.8, 1.0) 0.00 2,955 5.9 (5.6, 6.1) NSDUH = National Survey of Drug Use and Health; OUD = opioid use disorder; Ref = reference; SUD = substance use disorder.
↵a Defined as any parent living with a child aged <18 years in the household; sample size 44,464 for 2015-2017.
↵b Estimates are derived from the pooled 2015-2017 NSDUH and adhere to NSDUH requirements for estimation and suppression.9
↵c Two-sided t test used to compare difference in means between parents with OUD living with their children and parents with another SUD but not OUD living with their children.
↵d NSDUH computes this measure by using each sample person’s age, family size, number of children in the household, and family income, including any imputed income. Because the income questions ask about total family income in $10,000 increments, the computation assumes the midpoint of the category.
↵e Mental illnesses are defined as a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder, assessed by the Mental Health Surveillance Study Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition—Research Version—Axis I Disorders, which is based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. These mental illness estimates are not direct measures of diagnostic status. Serious mental illness is defined as mental illness that results in serious functional impairment, which substantially interferes with or limits ≥1 major life activities. For details on the methods, see Section D of the 2016 NSDUH: Methodological Summary and Definitions.9
↵f Includes use disorders for sedatives, inhalants, prescription stimulants, and hallucinogens.
- Table 2
Mean Receiving Drug or Alcohol Use Treatment in a Specialty Facility or Private Doctor’s Officea in the Last 12 Months Among Parents Living With Their Childrenb by Past 12 Months OUD or Other SUD Status, 2015-2017c
OUD (n = 446) P Value for Differenced SUDs Except OUD (n = 2,955) [Ref] n % (95% CI) n % (95% CI) Treatment for illicit drug or alcohol use at a specialty facility or private doctor’s office 133 28.0 (21.6, 34.3) 0.00 184 5.6 (4.7, 6.5) Treatment for illicit drug use at a specialty facility or private doctor’s office 121 25.9 (19.7, 32.1) 0.00 98 2.9 (2.3, 3.6) Treatment for alcohol use at a specialty facility or private doctor’s office 35 5.9 (3.4, 8.5) 0.14 124 4.0 (3.1, 4.9) Any treatment for mental health 187 42.2 (34.9, 49.5) 0.00 753 26.0 (23.9, 28.2) NSDUH = National Survey of Drug Use and Health; OUD = opioid use disorder; Ref = reference; SUD = substance use disorder.
↵a Including hospital inpatient setting, rehabilitation inpatient setting, rehabilitation outpatient clinic, outpatient mental health center, or private doctor’s office.
↵b Defined as any parent living with a child aged <18 years in the household.
↵c Estimates are derived from the pooled 2015-2017 NSDUH and adhere to NSDUH requirements for estimation and suppression.9
↵d Two-sided t test used to compare difference in means between parents with OUD living with their children and parents with another SUD but not OUD living with their children.
Additional Files
The Article in Brief
Opioid and Substance Use Disorder and Receipt of Treatment Among Parents Living With Children in the United States, 2015-2017
Lisa Clemans-Cope , and colleagues
Background Previous research shows that about one in five people with opioid use disorder receive treatment, but little is known about the prevalence of the disorder or treatment for it among parents who live with children.
What This Study Found An estimated 623,000 parents with opioid use disorder in the United States are living with children under the age of 18, and fewer than one-third of the parents have received substance use treatment. An additional four million parents have other substance use disorders, with even lower treatment rates. Researchers from the Urban Institute analyzed data from the 2015 to 2017 National Survey of Drug Use and Health, a nationally representative cross-sectional survey. They found that the rate of opioid use disorder among parents living with a child under 18 years of age was 0.9%, or an estimated 623,000 parents. Of these, 42% had one or more other substance use disorders in addition to opioid use disorder. Among parents living in households with children, 6%, or an estimated 4.2 million parents, had substance use disorders that did not include opioids. More than one in five parents with opioid use disorder had suicidal thoughts and behavior and nearly 25% had serious mental illness, a higher rate of mental health problems than parents with other substance use disorders. Twenty-eight percent of parents with opioid use disorder received drug or alcohol treatment at a specialty facility or other doctor's office, compared to 6% of those with other substance use disorders.
Implications
- Primary care practices can play a critical role in addressing substance use disorder issues among parents, the authors state, including screening and diagnosing substance use disorders, motivating behavior change, and facilitating initiation of treatment.
