November 14, 2022

Although it has been a concern in past generations, today’s opioid crisis is causing an even more severe impact on child welfare and family reunification than the substance epidemics of the past. With a sharp increase in multigenerational drug use over the last ten years, as well as a national average of 38.9% of child removal judgments being due to substance use and abuse, judges are encountering more and more cases dealing with the effects of drug addiction on families. And the sentencing process for these cases requires a different approach than either of these two issues requires separately.

The effects of drug addiction on families are numerous and complex. For court rulings and sentencing procedures, these effects play a crucial role in determining treatment plans, punitive sentences, and recovery processes. Every aspect of a drug-related child welfare case must be considered carefully in order to provide the most effective treatment and recovery options for parents with substance use disorders.

What Are the Effects of Drug Addiction on Families?

Since drug addiction typically starts with other environmental, emotional, and social stressors, they frequently demonstrate multigenerational patterns. In fact, children with at least one parent with a drug addiction or substance use disorder are far more likely to struggle with emotional, behavioral, and substance use problems in the future. Much of this stems from the decreased ability of parents to respond appropriately to attachment needs during childhood development (food, housing, financial support, emotional availability, etc.). The most significant effects of drug addiction on families include:

  • Emotional and relational effects, leading to child development concerns and relational stress and alienation
  • Economic effects that include food insecurity, housing concerns, and basic needs being adequately addressed
  • Instability in family structure, as well as social and community support due to harmful habits connected to substance use

Additionally, an estimated 33% to 66% of child maltreatment cases are believed to include a parent with a substance use disorder. An estimated 8.3 million children likely live with a parent with a SUD or drug addiction, or about 1 in 10 children in the U.S. As such, the impact of drug addiction on families adds significant stress to the child welfare system.

Challenges to Recovery and Family Reunification

Parents who have substance use disorders or drug addictions see more significant difficulties in reunification with their children if they are removed from the home and placed in the foster care system. The reasons behind this difficulty include many aspects of emotional, behavioral, and relational challenges related to drug addiction.

Co-Occurring Disorders

In many cases, the effects of drug addiction on families start with the prominence of co-occurring disorders with substance use and abuse. Emotional and behavioral issues, especially mental health disorders, play a significant part in drug use and addiction. And in many of these cases, the children of parents with co-occurring disorders find themselves in positions of role reversal, financial insecurity, and emotional distress.

Co-occurring disorders also create additional challenges for recovery since depression and anxiety, among others, often both precede and stem from habitual substance use. In these cases, substance recovery alone may not be enough to provide a stable environment to meet reunification timelines and requirements.

A Need for Coordinated Treatment Services

Even when co-occurring disorders are not present, recovery and treatment plans often neglect to include a holistic approach for maintaining long-term sobriety. Brain function is drastically altered through substance use, creating both temporary and permanent effects on habits, routines, pleasure-seeking, and decision-making. Relationships are frequently disrupted, and social and familial structures are manipulated to facilitate extended drug use.

To see successful results to counteract the effects of drug addiction on families, several different institutions and support systems must be able to coordinate efforts efficiently. Child welfare workers, courts, SUD treatment providers, and community partners must all work together to provide a comprehensive treatment plan that leads to family reunification.

A Limited Timeline for Reunification

But with this substantial coordination to provide effective treatment, the required Adoption and Safe Families Act (ASFA) timeline becomes limited. The law stipulates a reunification hearing after twelve months of a parent starting recovery treatment. This timeline becomes difficult to achieve if resources, treatment programs, and therapeutic support systems are not agile and well coordinated.

Potential Impact on Juveniles

Research has shown a connection between parental drug addiction and substance abuse and an increased risk of children in these homes developing struggles with substances as well. The impact of drug addiction on families, then, is a multigenerational threat. Many sentencing choices reflect this danger, as substance use disorders may result in children being placed in temporary and even permanent foster care. Treatment plans, then, need to be as successful as possible in order to minimize the potential damage to the next generation. Reunification depends on a safe and secure home environment, and only properly designed and executed treatment and recovery strategies will provide such an environment.

Considerations for Improving the Chances of Reunification

As with any child welfare case, the end goal is reunification first. This is why treatment plans and compulsory counseling and therapy are key components of an appropriate sentence. These treatment plans need to keep in mind the needs of a parent working toward reunification:

  • Ability to maintain a stable income
  • Housing, food, and clothing needs for the individual and their families
  • Dependable transportation
  • An achievable set of requirements to prove continued sobriety

If an individual is unable to keep appointments because of additional childcare needs or difficulty in scheduling appointments around work requirements, there is a lower probability of maintaining these requirements. And if they cannot maintain all aspects of their sentence terms, they are likely to lose the opportunity for reconciliation.

In these cases, judges must weigh the pros and cons of repeated appointments for counseling and therapy, drug testing, and court appearances that may interfere with employment requirements. When court-mandated recovery plans exceed an individual’s abilities to maintain work schedules and attain appropriate childcare, the sentencing defeats the purpose of the treatment.

Effective Drug Addiction Treatment Plans

Addiction can be treated, but there is usually no cure. It is a chronic condition with longstanding effects on psychological, physical, emotional, and social health and well-being. However, these effects can be managed. In fact, sufficient treatment plans can even help counteract drug addiction’s disruptive effects. Individuals suffering from drug addiction can regain the self-control necessary, both physiologically and psychologically, with adequate recovery support. But this recovery requires a well-crafted treatment and therapy plan.


Parents with SUDs and drug addictions should start recovery programs and counseling as soon as possible. While there are programs designed to achieve this goal consistently, not all judges are aware of such programs, nor do their sentencing policies take into consideration the immediate need for recovery for parents. Again, the short timeline required by ASFA makes this a necessity.


Treatment plans should include support for physical, behavioral, psychological, social, and familial aspects of recovery. In many cases, the physical treatment of addiction, namely in the form of treating withdrawal, is the only facet addressed. But increasingly, judges are making rulings that include all aspects of recovery, offering a holistic approach that accounts for habitual triggers, emotional and psychological difficulties, reconciliation of relationships, and connection to others who are working through addiction issues. In these cases, there is a higher likelihood of continued recovery, increasing the likelihood of reunification for families.

Consistent and Accountable

Consistency in therapies and treatments is key to parents in early recovery. When sentencing includes plans that intentionally counteract the effects of drug addiction on families through monitoring, screening, adjustments to plans, and positive reinforcement techniques, families have a higher chance of staying together.

Utilizing Drug Use Screening to Prevent the Continued Impact of Drug Addiction on Families

The key components of any recovery plan should include treating withdrawal symptoms, assistance in maintaining treatment, and therapies to address potential stress cues and exposure to triggers that could result in relapse. Within these components, many different behavioral therapies have been shown to be effective in treating addiction. Cognitive-behavioral therapies, contingency management, motivational enhancement therapies, family therapy, and twelve-step facilitation all offer benefits for maintaining recovery from drug addiction.

For two specific behavioral therapies, drug testing can play a crucial role in building the road to recovery. In both of these treatment options, consistent substance testing can be used for positive reinforcement.

Contingency Management and the Sweat Patch

Through rewards and encouragement, contingency management builds habits and patterns of behavior that aid in maintaining treatment plans. When incorporated with cognitive-behavioral therapy, contingency management helps reinforce the work of identifying cues and stressors that could lead to relapse.

The PharmChek® Sweat Patch, in this behavioral therapy, acts as a data point for identifying these cues by coordinating with counseling supports like self-reporting. But beyond its use as a detection tool, the Sweat Patch can also be used as a marker for maintaining sobriety and learning new patterns to remain abstinent.

Motivational Enhancement Therapy and the Sweat Patch

As an individual enters into a treatment plan, their own enthusiasm and personal desire to remain sober should be fostered. Motivational enhancement therapy is designed specifically for this purpose, building confidence when an individual is most ready to make significant changes to their patterns.

Drug testing can be a positive motivational tool when used properly and in conjunction with therapies such as this. PharmChek® Sweat Patches are ideal for this purpose, especially when compared to less hygienic and consistent methods of drug use detection. By monitoring for extended periods of time, these patches create a more accurate picture of a parent’s efforts to remain in recovery.

Relapse and Continued Treatment

The conventional view of recovery is that it should be without relapse. However, research shows that between 40 and 60 percent of individuals who enter recovery programs encounter relapses at some point during their treatment plans. The court system tends to use these relapses as data points for re-incarceration or custody revocation.

But this punitive approach to addressing relapse in drug addiction and sentencing often leads to even further damage in the process of recovery. Instead of further punitive consequences, the legal system needs to embrace a more journey-centered approach and methodology to continued treatment. Relapse should not be seen as a failure of the treatment plan. Each weak point in the journey should be used as an opportunity to rebuild the individual’s confidence and encourage them to step back into the program with renewed hope for completion and full recovery.

In terms of sentencing, shortfalls of the plan should be addressed by doubling down on the recovery plan with support from the caseworkers, judicial system, and communities surrounding individuals in recovery. Drug addiction can only be treated fully if the support system around addicts is strong enough to lift them back up when they meet temporary failure.