How Drug War Policies Harm Families and Children

The "War on Drugs," started in the early 1970s, aimed to reduce drug abuse in America. However, its consequences have deeply affected families, especially through the child welfare system. Drug policies often break apart families, harm child welfare, and create cycles of trauma through systems meant to protect children.

Mistaking Substance Use for Child Mistreatment

Child welfare systems often step in when parents use substances, even without any signs of abuse or neglect. Research by Meisel et al. (2022) indicates that approximately 85% of child welfare cases involving parental substance use lack concurrent allegations of abuse or neglect. The substance use itself becomes the main reason families are separated.

Chasnoff et al. (2015) found that child welfare systems typically don't distinguish between casual substance use and addiction, treating any drug use by parents as automatically harmful to children, regardless of their actual parenting abilities. This contradicts substantial evidence suggesting that many individuals who use substances can effectively parent (Banwell & Bammer, 2006).

The Trauma of Family Separation

Taking children from their homes solely because parents use substances often causes severe harm.

Mitchell et al.'s (2019) research demonstrates that removing children from parents frequently creates more trauma than letting them stay in homes where substance use—without abuse or neglect—exists.

Doab et al. (2015) found that family separation can lead to problems with forming attachments, depression, worry, and behavior issues that continue into adulthood. .

Berger et al. (2010) concluded, "The harm of removal must be weighed against the harm of remaining in the home, and the evidence suggests we are often getting this calculation wrong" (p. 278).

Taking Resources Away from Real Abuse Cases

The focus on substance use diverts limited child welfare resources from children suffering actual abuse. Barnett et al. (2018) observed that child welfare systems overwhelmed with substance-related cases often lack resources to properly investigate physical abuse, sexual abuse, or severe neglect. Berrick (2018, p. 142) notes, "When we prioritize parental substance use over demonstrated harm to children, we create a system that is less effective at protecting children from actual abuse."

Problems in the Foster Care System

Children placed in foster care due to parental substance use face higher risks.

Youth in foster care are 2-3 times more likely to develop substance use disorders compared to their peers not in the system (McDonald et al., 2014). Foster youth start using alcohol about 2 years earlier and are more prone to binge drinking (Braciszewski & Stout, 2012). A longitudinal study by Aarons et al. (2008) found that 35% of foster youth reported problematic substance use by age 17, compared to 14% in the general population. These findings suggest the current approach may actually increase substance use problems.

Substance Use Doesn't Determine Parenting Ability

Research shows that substance use alone doesn't reliably predict parenting skills.

A comprehensive review by Suchman and Luthar (2020) found that parental substance use alone explains less than 10% of the variance in parenting outcomes. Factor analysis by Lander et al. (2013) demonstrated that support systems, mental health, and economic stability were stronger predictors of parenting success than substance use status. Harp and Oser (2018) found that with adequate support, parents with substance use disorders exhibited parenting skills comparable to control groups. Suchman and Luthar (2020, p. 547) conclude, "The automatic assumption that people who use substances cannot be good parents is not only scientifically unfounded but actively harmful to families."

Harming Prenatal Care and Maternal Health

Criminalizing substance use during pregnancy creates significant barriers to healthcare.

Roberts and Pies (2011) found that pregnant women who use substances are much less likely to seek prenatal care because they fear legal consequences and losing custody of their children. Stone's (2015) study revealed that states with harsh policies toward pregnant women who use substances have worse birth outcomes compared to states focusing on treatment and support. The American College of Obstetricians and Gynecologists (2021) asserts that punitive approaches to substance use during pregnancy backfire and harm both mothers and babies. Stone (2015, p. 772) argues, "When we criminalize addiction during pregnancy, we don't protect babies—we drive vulnerable women away from the healthcare system entirely."

Moving Forward

Evidence supports methods that keep families together while addressing substance use.

Family-based treatment programs allowing children to remain with parents during recovery show 40% higher success rates than separation-based approaches (Oliveros & Kaufman, 2022). Harm reduction strategies, focusing on minimizing negative consequences rather than immediate abstinence, demonstrate improved outcomes for parents and children (Kimber et al., 2015).

Current policies criminalizing substance use in families cause significant harm. Separating families based only on substance use creates trauma, misuses resources meant for actual abuse cases, discourages pregnant people from seeking medical care, and may increase future substance use problems.

A more effective and humane approach requires:

• Focusing child welfare interventions on demonstrable harm rather than solely on substance use

• Implementing harm reduction strategies that support parents while ensuring child safety

• Respecting the autonomy of all parents, including pregnant individuals, regarding healthcare decisions

• Reallocating resources to support families rather than facilitate separation

Policy and practice must evolve in accordance with our understanding of substance use. Evidence indicates that shifting from punitive measures toward supportive, family-centered interventions will better serve both parents and children affected by substance use.

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References

Aarons, G. A., Brown, S. A., Hough, R. L., Garland, A. F., & Wood, P. A. (2008). Prevalence of adolescent substance use disorders across five sectors of care. Journal of the American Academy of Child & Adolescent Psychiatry, 47(6), 702-710. https://doi.org/10.1097/CHI.0b013e31816be9e5

American College of Obstetricians and Gynecologists. (2021). Opposition to criminalization of individuals during pregnancy and the postpartum period. Obstetrics & Gynecology, 137(5), 323-325. https://doi.org/10.1097/AOG.0000000000004376

Banwell, C., & Bammer, G. (2006). Maternal habits: Narratives of mothering, social position and drug use. International Journal of Drug Policy, 17(6), 504-513. https://doi.org/10.1016/j.drugpo.2006.09.005

Barnett, E. R., Jankowski, M. K., Butcher, R. L., Meister, C., Parton, R. R., & Drake, R. E. (2018). Foster and adoptive parent perspectives on needs and services: A mixed methods study. Journal of Behavioral Health Services & Research, 45(1), 74-89. https://doi.org/10.1007/s11414-017-9569-4

Berger, L. M., Bruch, S. K., Johnson, E. I., James, S., & Rubin, D. (2010). Estimating the "impact" of out‐of‐home placement on child well‐being: Approaching the problem of selection bias. Child Development, 81(6), 1856-1876. https://doi.org/10.1111/j.1467-8624.2010.01527.x

Berrick, J. D. (2018). The impossible imperative: Navigating the competing principles of child protection. Oxford University Press.

Braciszewski, J. M., & Stout, R. L. (2012). Substance use among current and former foster youth: A systematic review. Children and Youth Services Review, 34(12), 2337-2344. https://doi.org/10.1016/j.childyouth.2012.08.011

Chasnoff, I. J., Wells, A. M., & King, L. (2015). Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics, 135(2), 264-270. https://doi.org/10.1542/peds.2014-2171

Doab, A., Fowler, C., & Dawson, A. (2015). Factors that influence mother–child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia. International Journal of Drug Policy, 26(9), 820-831. https://doi.org/10.1016/j.drugpo.2015.05.025

Green, B. L., Furrer, C. J., Worcel, S. D., Burrus, S. W., & Finigan, M. W. (2014). How effective are family treatment drug courts? Outcomes from a four-site national study. Child Maltreatment, 19(3-4), 217-232. https://doi.org/10.1177/1077559514557291

Harp, K. L., & Oser, C. B. (2018). A longitudinal analysis of the impact of child custody loss on drug use and crime among a sample of African American mothers. Child Abuse & Neglect, 77, 1-12. https://doi.org/10.1016/j.chiabu.2017.12.017

Kimber, M., Barwick, M., & Fearing, G. (2015). Becoming an evidence-based service provider: Staff perceptions and experiences of organizational change. Journal of Behavioral Health Services & Research, 42(3), 285-299. https://doi.org/10.1007/s11414-015-9460-z

Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(3-4), 194-205. https://doi.org/10.1080/19371918.2013.759005

McDonald, T. P., Mariscal, E. S., Yan, Y., & Brook, J. (2014). Substance use and abuse for youths in foster care: Results from the communities that care normative database. Journal of Child & Adolescent Substance Abuse, 23(4), 262-268. https://doi.org/10.1080/1067828X.2014.912093

Meisel, Z. F., Mitchell, J., Polsky, D., Boualam, N., McGeoch, E., Cheney, R., Solomon, P., Mollen, C. J., Perrone, J., & Marcus, S. C. (2022). Child welfare involvement and subsequent substance-related healthcare among mothers with substance use disorders. Drug and Alcohol Dependence, 234, 109425. https://doi.org/10.1016/j.drugalcdep.2022.109425

Mitchell, M. B., Jones, T., & Renema, S. (2019). Will I make it on my own? Voices and visions of 17-year-old youth in transition. Child and Adolescent Social Work Journal, 36(4), 367-383. https://doi.org/10.1007/s10560-019-00609-8

Oliveros, A., & Kaufman, J. (2022). Addressing parental substance abuse: The role of family preservation programs. Child Welfare, 100(1), 35-54.

Roberts, S. C., & Pies, C. (2011). Complex calculations: How drug use during pregnancy becomes a barrier to prenatal care. Maternal and Child Health Journal, 15(3), 333-341. https://doi.org/10.1007/s10995-010-0594-7

Stone, R. (2015). Pregnant women and substance use: Fear, stigma, and barriers to care. Health & Justice, 3(1), 1-15. https://doi.org/10.1186/s40352-015-0015-5

Suchman, N. E., & Luthar, S. S. (2020). Parenthood among women with opioid use disorder: A spotlight on research and intervention development to improve outcomes across generations. Addiction Science & Clinical Practice, 15(1), 1-14. https://doi.org/10.1186/s13722-020-00204-8