Bulletin for 

professionals

U.S. Department of Health and Human Services

Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

Child Welfare Information Gateway

Children’s Bureau/ACYF

1250 Maryland Avenue, SW

Eighth Floor

Washington, DC 20024

703.385.7565 or 800.394.3366

Email: info@childwelfare.gov

www.childwelfare.gov

Substance Abuse 

and Child 

Maltreatment

What’s Inside:

Impact of parental substance abuse 

on children

Service delivery issues

Practice implications

Implications

Resources for further information

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• Substance abuse has a major impact on the 

child welfare system. It is estimated that 9 

percent of children in this country (6 million) 

live with at least one parent who abuses 

alcohol or other drugs (Office of Applied 

Studies, 2003). Research has demonstrated 

that children of substance abusing parents 

are more likely to experience abuse—physical, sexual, or emotional—or neglect than 

children in non-substance abusing households 

(DeBellis, Broussard, Herring, Wexler, Moritz, 

& Benitez, 2001; Dube, Anda, Felitti, Croft, 

Edwards, & Giles, 2001; Chaffin, Kelleher, 

& Hollenberg, 1996; Kelleher, Chaffin, 

Hollenberg, & Fischer, 1994). 

December 2003
Substance Abuse and Child Maltreatment www.childwelfare.gov

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

Parents who abuse substances are less likely 

to be able to function effectively in a parental 

role. This can be due to:

Impairments (both physical and mental) that 

occur while under the influence of alcohol 

or other drugs.

Expenditure of often limited household resources on purchasing alcohol or 

other drugs.

Time spent seeking out drugs.

Time spent using alcohol or other drugs. 

The basic needs of children, including nutrition, supervision, and nurturing, often go 

unmet due to parental substance abuse, 

resulting in neglect. Additionally, families in 

which one or both parents abuse substances, 

and particularly families with an addicted 

parent, often experience a number of other 

problems including mental illness, unemployment, high levels of stress, and impaired family 

functioning, all of which can put children at 

risk for abuse.

The statistics vary, but studies have shown that 

between one-third and two-thirds of child maltreatment cases involve substance abuse (U.S. 

Department of Health and Human Services, 

1999). In a recent survey by the National 

Center on Child Abuse Prevention Research, 

85 percent of States reported substance abuse 

was one of the two major problems exhibited by families in which maltreatment was 

suspected (National Center on Child Abuse 

Prevention Research, 2001).

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 Impact of Parental 

Substance Abuse on 

Children

Maltreated children of substance abusing 

parents are more likely to have poorer physical, intellectual, social, and emotional outcomes and are at greater risk of developing 

substance abuse problems themselves (U.S. 

Department of Health and Human Services, 

1999). Data indicate that abused or neglected 

children from substance abusing families are 

more likely to be placed in foster care and are 

more likely to remain there longer than maltreated children from non-substance abusing 

families (U.S. Department of Health and 

Human Services, 1999).

Because of the severity of problems experienced by maltreated children of substance 

abusing parents, and the fact that they are 

often in the foster care system longer than 

maltreated children from non-substance 

abusing families, expenditures related to 

substance abuse among families in the child 

welfare system are significant. One study estimates that of the more than $24 billion States 

spend to address different aspects of substance abuse, $5.3 billion (slightly more than 

20 percent) goes to child welfare costs related 

to substance abuse (National Center on 

Addiction and Substance Abuse at Columbia 

University, 2001).
Substance Abuse and Child Maltreatment www.childwelfare.gov

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Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

Service Delivery Issues

Along with the high cost of serving these 

families, child welfare agencies often face a 

number of service barriers, such as:

Inadequate treatment resources to meet 

existing needs.

Lack of training for child welfare workers on 

substance abuse issues.

Conflicts in the time required for sufficient 

progress in substance abuse recovery to 

develop adequate parenting potential, 

legislative requirements regarding child 

permanency, and the developmental needs 

of children (Young & Gardner, 2003).

Agencies are faced with strict timeframes 

imposed by the Adoption and Safe Families Act 

of 1997 (ASFA) that do not necessarily coincide 

with the realities of substance abuse treatment. 

For example, despite a Federal mandate that 

pregnant and parenting women receive priority 

for accessing substance abuse treatment services, 

States report it is often difficult for these parents 

to access an open treatment slot quickly (GAO, 

2003). Once a slot is available, treatment itself 

may take many months (some residential treatment programs can be as long as 12 months). 

Also, if the parent has custody of the child(ren) 

and requires residential treatment, there may be 

an additional barrier since many of these programs do not allow children to live in the facility. 

Although ASFA requires that parental rights be 

terminated if a child has been in foster care for 

15 of the past 22 months, many States cannot 

adhere to this timeframe due to problems accessing substance abuse services in a timely manner, 

resulting in delayed permanency decisions for 

children in the foster care system (GAO, 2003). 

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Practice Implications

Because so many maltreatment cases involve 

substance abuse, agencies are developing 

strategies to address the issue more effectively. All of these strategies require collaboration among the various systems within which 

affected families are involved (e.g., child 

welfare, substance abuse, public assistance, 

and dependency court). Examples of innovative approaches include: 

Stationing addiction counselors in child 

welfare offices. 

Giving mothers involved in the child welfare 

system priority access to substance abuse 

treatment slots. 

Developing or modifying dependency 

drug courts to ensure treatment access and 

therapeutic monitoring of compliance with 

court orders.

Developing cross-system partnerships to 

ensure coordinated services (e.g., formal 

linkages between child welfare and other 

community agencies to address each 

family’s needs).

Conducting cross-system training.

Developing creative approaches to fund 

these efforts (e.g., using State or local 

funds to maximize child welfare funding for 

substance abuse-related services or using 

Temporary Assistance to Needy Families 

[TANF] funds to purchase substance abuse 

treatment) (Young and Gardner, 2002).

Not all of the above approaches are appropriate 

in all instances. Agencies should focus on the 

specific needs of the families they serve when 

selecting among these (and other) approaches.

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Substance Abuse and Child Maltreatment www.childwelfare.gov

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

Implications

Parental substance abuse continues to be 

a serious issue in the child welfare system. 

Maltreated children of substance abusing 

parents often remain in the child welfare 

system longer and experience poorer outcomes. Additionally, since the passage of 

ASFA, these children may be less likely to 

reunify with parents and are subject to alternative permanency decisions in greater numbers 

than children from non-substance abusing 

families. Moreover, scarce resources and 

lack of coordination among various service 

systems often make it difficult to address the 

multiple needs of these children and families. The inability of residential programs to 

accommodate children can result in an additional barrier. Some agencies have developed 

innovative approaches for addressing child 

maltreatment and substance abuse, but many 

have not. Given the prevalence of substance 

use disorders among the child welfare population, several approaches have been initiated 

to address this issue:

Focus on early identification of at-risk 

families in substance abuse programs. 

Such preventive efforts can reduce the 

number of maltreated children and 

help families obtain needed services 

(U.S. Department of Health and Human 

Services, 1999). 

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Improve communication between the 

child welfare system and the substance 

abuse treatment system. Communication, 

understanding, and active collaboration between service systems are vital 

to ensuring that child welfare-involved 

parents in need of substance abuse treatment are accurately identified and receive 

appropriate treatment in a timely manner 

(Child Welfare League of America, 2001; 

U.S. Department of Health and Human 

Services, 1999).

Close the gap between treatment need 

and available treatment slots. Even with 

strong working relationships among systems, 

more treatment slots, particularly in the more 

intensive levels of care and providing genderspecific comprehensive services, need to be 

developed to meet the need for all parents. 

Creative financing and resource development 

need to be priorities for administrators and 

policymakers (U.S. Department of Health and 

Human Services, 1999).

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Substance Abuse and Child Maltreatment www.childwelfare.gov

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

References

Chaffin, M., Kelleher, K., & Hollenberg, J. (1996). Onset of physical abuse and neglect: Psychiatric, 

substance abuse, and social risk factors from prospective community data. Child Abuse & 

Neglect, 20(3), 191-203.

Child Welfare League of America. (2001). Alcohol, other drugs, & child welfare. Washington, D.C.: 

Author. (www.cwla.org/programs/bhd/aodbrochure.pdf)

DeBellis, M.D., Broussard, E.R., Herring, D.J., Wexler, S., Moritz, G., & Benitez, J.G. (2001). 

Psychiatric co-morbidity in caregivers and children involved in maltreatment: A pilot research 

study with policy implications. Child Abuse & Neglect, 25, 923-944.

Dube, S.R., Anda, R.F., Felitti, V.J., Croft, J.B., Edwards, V.J., & Giles, W.H. (2001). Growing up with 

parental alcohol abuse: Exposure to childhood abuse, neglect, and household dysfunction. 

Child Abuse & Neglect, 25, 1627-1640.

General Accounting Office. (2003). Foster care: States focusing on finding permanent homes for 

children, but long-standing barriers remain (GAO-03-626T). Washington, D.C.: Author.

Kelleher, K., Chaffin, M., Hollenberg, J., & Fischer, E. (1994). Alcohol and drug disorders among 

physically abusive and neglectful parents in a community-based sample. American Journal of 

Public Health, 84(10), 1586-1590.

National Center on Child Abuse Prevention Research. (2001). Current trends in child abuse 

prevention, reporting, and fatalities: The 1999 fifty State survey. Chicago: Prevent Child Abuse 

America. (www.preventchildabuse.org/learn_more/research_docs/1999_50_survey.pdf) 

National Center on Addiction and Substance Abuse at Columbia University. (2001). Shoveling up: 

The impact of substance abuse on State budgets. New York: Author. (www.casacolumbia.org/

absolutenm/templates/articles.asp?articleid=239&zoneid=31).

Office of Applied Studies. (2003). Children living with substance-abusing or substance-dependent 

parents. Rockville, MD: Substance Abuse and Mental Health Services Administration. 

(www.drugabusestatistics.samhsa.gov).

U.S. Department of Health and Human Services. (1999). Blending perspectives and building 

common ground: A report to Congress on substance abuse and child protection. Washington, 

DC: U.S. Government Printing Office.
Substance Abuse and Child Maltreatment www.childwelfare.gov

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

Young, N., & Gardner, S. (2002). Navigating the pathways: Lessons and promising practices in 

linking alcohol and drug services with child welfare. Technical Assistance Publication (TAP) 

27. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for 

Substance Abuse Treatment.

Young, N., & Gardner, S. (2003). A preliminary review of alcohol and other drug issues in the States’ 

children and family service reviews and program improvement plans. Retrieved April 14, 2003 

from www.ncsacw.samhsa.gov/files/SummaryofCFSRs.pdf.

Resources for Further Information

Websites

Child Welfare League of America

(www.cwla.org/programs/bhd/aod.htm) 

The Child Welfare League of America (CWLA) is the Nation’s oldest and largest membership-based 

child welfare organization. CWLA addresses all aspect of child welfare, one component of which is 

the relationship between child welfare and substance abuse.

Child Welfare Workforce and Training Resources 

(www.childwelfare.gov/systemwide/workforce)

The Network is designed to enable State trainers, practitioners, social work educators, and other 

stakeholders to locate the most current training information and materials for the child welfare 

workforce. Information on training related to substance abuse issues is available.

National Center on Substance Abuse and Child Welfare 

(www.ncsacw.samhsa.gov)

NCSACW was formed to improve systems and practice for families with substance use disorders 

who are involved in the child welfare and family judicial systems by assisting local, State, and Tribal 

agencies.

National Institute on Drug Abuse, Child and Adolescent Workgroup 

(www.drugabuse.gov/about/organization/ICAW/ICAWInterest.html) 

One component of NIDA’s Child and Adolescent Workgroup is Prenatal Drug Exposure and DrugAbusing Environments. This group examines the impact of prenatal drug exposure on physical and 

developmental outcomes, as well as interventions to address adverse consequences of prenatal 

drug exposure.

National Organization on Fetal Alcohol Syndrome 

(www.nofas.org) 

NOFAS works to raise public awareness of Fetal Alcohol Syndrome (FAS) and to develop and 

implement innovative ideas in prevention, intervention, education, and advocacy in communities 

throughout the nation.
Substance Abuse and Child Maltreatment www.childwelfare.gov

 This material may be freely reproduced and distributed. However, when doing so, please credit Child Welfare 

Information Gateway. Available online at www.childwelfare.gov/pubs/factsheets/subabuse_childmal.cfm.

Substance Abuse and Mental Health Services Administration 

(www.samhsa.gov)

SAMHSA is the Federal agency charged with improving the quality and availability of prevention, 

treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society 

resulting from substance abuse and mental illnesses.

Additional Publications

Administration for Children and Families. (1994). Protecting children in substance-abusing families. 

Washington, D.C.: U.S. Dept. of Health and Human Services. (www.childwelfare.gov/pubs/

usermanuals/subabuse/index.cfm) 

Center for Substance Abuse Treatment. (2003). The child welfare-substance abuse connection: A 

compendium of training curricula and resources. Rockville, MD: Substance Abuse and Mental 

Health Services Administration, U.S. Department of Health and Human Services.

National Center on Addiction and Substance Abuse at Columbia University. (1999). No 

safe haven: Children of substance-abusing parents. New York: The National Center 

on Addiction and Substance Abuse at Columbia University. (www.casacolumbia.

org/pdshopprov/files/No_Safe_Haven_1_11_99.pdf)

Young, N.K., Gardner, S.L., & Dennis, K. (1998). Responding to alcohol and other drug problems in 

child welfare: Weaving together practice and policy. Washington, D.C.: CWLA Press.