Disrupting negative developmental trajectories using evidence-based preventive interventions for children with a substance dependent caregiver

Abstract

Disrupting pathways to negative outcomes in children and adolescents who have caregivers with substance use disorder (SUD) is of the highest priority if we are to gain control over the opioid epidemic. This population is at very high risk for becoming the next generation of individuals with SUD, as well as other types of psychopathology and eventual juvenile/criminal justice involvement. In addition to experiencing severe/chronic adversities during their development, these youth are now further propelled toward these negative trajectories due to the COVID-19 crisis, which substantially compounds the issues (e.g., estrangement from otherwise normalizing social influences, such as school, nondelinquent peers, extended families, health care, etc.) for both the young person and the parent with SUD. We review the literature establishing the linkages between adverse childhood experiences and pathways to SUD. Our focus is particularly on opportunities for intervention across development using family-based programs that directly address parenting skills and trauma. Invoking structural level change to merge SUD treatment and evidence-based family intervention infrastructures in communities promises to both reduce externalizing behaviors and internalizing symptoms in these youth, as well as reinforce recovery in the parents. Currently, these systems do not intersect; thus, children do not often receive programming and treatment of caregivers for SUD is less effective without engagement of the family unit.