Parental opioid use disorder: Examining their children's experiences, needs, and road to resilience

Abstract

Problem Over 8 million children in the United States live with a parent with substance use disorder (SUD), inclusive of opioid use disorder (OUD). This is an adverse childhood experience (ACE), that often leads to poor outcomes such as developing SUD or mental illness. Interventions and research have focused more on the parent and not their children. Without emphasis on child's experiences, their needs, and building interventions toward developing resilience, the intergenerational cycle of SUD/OUD will persist. Methods Nine children (ages 12–17) in custody of Social Services, who experienced a parent with OUD, participated in this pilot study. The intervention was SAMHSA's Children's Program Kit: Supportive Education for Children of Addicted Parents. Thematic analysis of verbal responses/behaviors, observations, field notes, and any retained materials (i.e., handouts) was conducted over eight sessions. Findings Findings included three themes regarding participant's experiences: Meaning of a Parent; Others Involved; and Witnessing the Cycle. Two sub‐themes also emerged: Ways to Cope and Support from Various Sources. Conclusions Results support mental health nurses as forerunners in building, implementing, and evaluating child‐focused interventions for children of parents with OUD. Interventions should focus on the needs of the children and use a strength‐based approach to promote their resilience.

Resilience in children of parents with mental illness, alcohol or substance misuse—An integrative review

“…This impact was described in interviews (Collishaw et al, 2016;Kahl & Jungbauer, 2014) and synonymous with lower self-reported symptom load (Collishaw et al, 2016;Watson et al, 2014). This was corroborated by the findings of Palumbo et al (2022) where adolescents described a desire to remain in the homes of their biological parents despite adversity. Many also felt betrayed by social workers or their relatives for relocating them to foster homes.…”

“…The adolescents in the study by Palumbo et al (2022) had varying experiences of their substance-using parent, but most described their parent as someone who managed to take care of their basic needs despite active drug misuse. 2016) also declared the importance of the ill or diagnosed parent's ability to express emotions as associated with good mental health in the children growing up with parental mental illness.…”

Fostering better outcomes for youth of parents with opioid use disorder

“…These children likely witness their parents in active use, in withdrawal, seeking the drugs, and perhaps in periods of recovery. The environment can be unstable, chaotic, and caregiving for siblings, as well as parentification tends to occur (Palumbo et al, 2021). Given the chronicity of OUD, multiple separations often ensue while that parent is actively using or is in an inpatient drug treatment (Feder et al, 2019).…”

“…Still, not all families in which a parent has OUD have the same level of dysfunction and some may be able to remain intact with added resources and support (Matjasko et al, 2022). Children often desire to remain with their parents (Palumbo et al, 2021) and some evidence supports that retaining custody facilitates parent's recovery (Hall et al, 2016). The intent of the Family First Prevention Services Act passed in 2018 was to provide families with necessary SUD and behavioral health treatment and to avoid the removal of children (Children's Defense Fund, 2020).…”

“…Of course, despite experiencing multiple ACEs, some youth exhibit resilience (Mechling et al, 2021). Evidence shows that one of the greatest facilitators of resilience in this population is social support (Matjasko et al, 2022; Palumbo et al, 2021).…”