Parental Opioid Abuse: A Review of Child Outcomes, Parenting, and Parenting Interventions

Accelerating the Pace of Science: Improving Parenting Practices in Parents with Opioid Use Disorder

“…Regardless of the specific effects of parental opioid use on child outcomes, OUD does not occur in a vacuum (Dawe, Harnett, Staiger, & Dadds, 2000;Peisch et al, 2018). For example, children of heroin-dependent mothers do not show deficits in cognitive or behavioral functioning except that they have a higher risk for ADHD when compared to children of parents with low SES (Ornoy, Segal, Bar-Hamburger, & Greenbaum, 2001).…”

“…Additionally, parental provision of autonomy and limit setting are better explained by contextual factors (e.g., single status, family size) for parents with OUD rather than OUD alone . Moreover, much like other mental health disorders, including other substance use disorders, OUD often co-occurs with a variety of other disorders and stressful life circumstances (Austin & Shanahan, 2017;McCabe et al, 2008;Peisch et al, 2018). The compounding effects of these stressors may make regulated parenting nearly impossible from a cumulative risk orientation (Atzaba-Poria, Pike, & Deater-Deckard, 2004).…”

“…There is still more to understand about the specific contexts and challenges for parents with OUD, but evidence-based interventions exist that target factors related to OUD and parenting, including prenatal and child health promotion, child maltreatment prevention, and enhancement of the general quality of family relationships (Black et al, 1994;Greenberg & Lippold, 2013;Ingoldsby, 2010;Sandler, Schoenfelder, Wolchik, & MacKinnon, 2011). Previous reviews on OUD and parenting have called for an increase in basic research to improve our understanding of parenting with OUD and develop additional interventions (Peisch et al, 2018); we propose that simultaneous to those efforts, steps be taken to accelerate the pace of science by utilizing the NIH stage model. Approaches to using the stage model to accelerate the pace of science include: (1) adapting parenting interventions that have been found to be at least efficacious in stage 1 research, (2) oversampling parents with OUD in research already in stages 2-4 research to compare parenting outcomes for those with and without OUD, (3) testing interventions that have been specifically developed for parents with OUD in the community in stage 4 research, and (4) utilizing effectiveness-implementation hybrid trials (Curran, Bauer, Mittman, Pyne, & Stetler, 2012) to simultaneously evaluate effectiveness and implementation outcomes.…”

“…Several reviews related to OUD and parenting have been previously conducted; one relied primarily on qualitative data (Mirick & Steenrod, 2016), and others focused on issues specifically related to medication-assisted treatment and NAS/NOWS, rather than issues affecting parenting (Klaman et al, 2017), or focused on child outcomes related to parental substance use (Morton & Wells, 2017). In the only publication to our knowledge that has systematically reviewed the literature on opioid use and parenting, Peisch et al (2018) provided an in-depth overview of the sparse literature on parenting with OUD and presented a framework for advancing research starting with basic research and ending with the creation of a research-supported intervention. Peisch and colleagues found few rigorously conducted studies examining parenting and child outcomes for parents with OUD and few research-evaluated interventions for parents with OUD, and they called for an increase in the generation of basic science and intervention development related to parenting with OUD.…”

Opioid and Substance Use Disorder and Receipt of Treatment Among Parents Living With Children in the United States, 2015-2017

“…1 Children whose parents have OUD are at higher risk of experiencing health and emotional problems, cognitive deficits, and family instability. [2][3][4][5][6] Research shows about 1 in 5 people with OUD receive treatment, 7 but little is known about the prevalence of OUD among parents who are living with children and their receipt of treatment, which could reduce the harmful effects of OUD on families. A previous report using data from 2009 to 2014 studied characteristics of children living in a household with a parent who had a substance use disorder (SUD) 8 ; that study is dated, however, and did not examine parental OUD or treatment.…”