Title:The Opioid Crisis, Impact on Children, and Mitigation Strategies
Volume: 15
Issue: 1
Author(s): Edore Onigu-Otite*, Nancy Shenoi, Nidal Moukaddam and Asim Shah
Affiliation:
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine,
Houston, TX, USA
Keywords:
Opioid use disorder, child development, drug overdose, opioid epidemic, child maltreatment, emotional neglect, child neglect, screening, resilience, adverse childhood experiences.
Abstract: The opioid epidemic continues to make a significant impact on public
health across multiple domains. While patients with opioid use disorders (OUD)
remain in the face of this epidemic, the effect of the opioid epidemic, including on
children and families, remains unheard. The impact of the opioid crisis is felt the
most by individuals who do not use opioids themselves, with children being the
most vulnerable victims of the opioid epidemic, an aspect of this epidemic that
receives far less attention. The socio-ecological model approach is used to increase
awareness of the lived experiences of children growing up in households with OUD
and to promote the incorporation of treatment considerations based on available
research. A literature review was conducted using computer-based searches using
PubMed, PsycINFO, Medline, and Google Scholar databases. This entailed
searching according to the following keywords (or stems when possible): opioids,
opioid overdose, parental opioid use, child maltreatment, resilience, and adverse
childhood experiences. Keywords were combined by using the Boolean operators
"AND" and "OR". Additionally, the ancestry approach, where potential studies
were identified from the reference sections of existing reviews on the association
between opioids and children, was used. Given that prenatal opioid use is
extensively studied, and our focus was on lived experiences, studies focused solely
on the effects of prenatal opioid use were excluded. Selected studies were varied in
scope and methodologies. We reviewed the bibliographies of identified studies for
additional studies and used both forward and backward searching. The economic
cost of OUD and fatal opioid overdose is staggering and estimated to be about
$1.02 trillion. Exposure to parental opioid use in childhood can have a significant
impact on children's current and future lives. Conversely, for parents with OUD,
children often provide a strong motivation for treatment. Children of adults with
OUD are at higher risk of early exposure and initiation of opioid misuse. Opioid
exposure in childhood, in turn, is associated with adult opioid misuse and OUD.
Screening at healthcare visits is advocated to detect and mitigate the impact of
OUD on children. The odds of using school-based mental health services are
greater in boys compared to girls. Emerging evidence suggests that boys manifest
less resiliency in the face of parental opioid exposure. This indicates a more
nuanced understanding of the developmental outcomes of parental opioid exposure.