{"id":32090,"date":"2024-03-20T17:04:13","date_gmt":"2024-03-20T17:04:13","guid":{"rendered":"https:\/\/caseyfamilyv2.wpengine.com\/substance-use-disorders-keep-families-together-2\/"},"modified":"2026-08-07T16:09:17","modified_gmt":"2026-08-07T16:09:17","slug":"los-trastornos-por-consumo-de-sustancias-mantienen-unidas-a-las-familias","status":"publish","type":"post","link":"https:\/\/www.casey.org\/es\/substance-use-disorders-keep-families-together\/","title":{"rendered":"\u00bfC\u00f3mo pueden las familias afectadas por el trastorno por consumo de sustancias permanecer juntas de manera segura?"},"content":{"rendered":"
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This brief was developed in partnership with Children and Family Futures<\/a>.<\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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Estimates on the prevalence of substance use disorder among families involved with the child welfare system vary widely, ranging from 5% to 90%.1<\/sup><\/a>,<\/sup>2<\/sup><\/a> The wide variation is attributed to a variety of factors, including the population studied (for example, families receiving in-home versus out-of-home child welfare services) and differences in state child protection protocols and data systems in collecting information about when substance use is a factor in cases. According to data collected and reported by all states, parental substance use is cited as a factor in about one-quarter (26%) of substantiated cases of child maltreatment and in over one-third (36%) of cases in which a child is removed from home.3<\/sup><\/a>,<\/sup>4<\/sup><\/a>\u00a0Families affected by parental substance use disorder have a lower likelihood of successful reunification with their children, and their children tend to stay in foster care longer than children of parents without substance use disorder.5<\/sup><\/a>,<\/sup>6<\/sup><\/a>,<\/sup>7<\/sup><\/a>,<\/sup>8<\/sup><\/a>,<\/sup>9<\/sup><\/a><\/p>\n

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Substance use disorder is a disease of the brain that can be effectively treated and managed<\/a> and accurate and equitable screening and assessment is critical in identifying if families need support and what types of support they need. A\u00a0prevention-based approach in which families affected by parental substance use are engaged in assessment and treatment services (when clinically necessary) as\u00a0early<\/em>\u00a0as possible can reduce reactive, crisis-based responses, including child protection investigation and family separation.<\/p>\n

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Fortunately, investing in healing interventions for these families can prevent family separation and result in successful recovery for parents, and in cases where separation has occurred, these strategies can lead to timely reunification. Child welfare leaders should rely on evidence about what works<\/em> to meet the complex needs of families affected by substance use disorder and keep families together, including complying with reunification timelines when separation has occurred. This brief offers strategies for minimizing the time children are separated from parents as a result of substance use disorder.<\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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Addressing stigma<\/h2>\n \n \n \n

Substance use disorders \u2014 and child abuse and neglect \u2014 are some of the most highly stigmatized conditions, much in the same way of mental health disorders.10<\/sup><\/a>\u00a0Stigma exists at various levels (structural, public, self-inflicted) and creates various challenges for parents with substance use disorder compared to families where substance use disorder is not a factor, including the challenge to access services. It also may influence whether parents feel comfortable reaching out for support, making it an important consideration for child welfare leaders and those working in substance use treatment services when determining how to make support available to families that may need it.<\/p>\n

Structural stigma<\/strong> refers to laws, policies, or regulations that intentionally and unintentionally result in discrimination.<\/p>\n

Public stigma<\/strong> stems from beliefs and behaviors of individuals and groups \u2014 based on stereotypes \u2014 that result in discrimination, such as the belief that individuals choose <\/em>to overuse drugs and alcohol rather than the belief that individuals are affected<\/em> by a substance use disorder which affects the person\u2019s brain chemistry. Self-stigma<\/strong> is often the result of internalized stereotypes and negative beliefs and is often a barrier to individuals accessing treatment for substance use disorder and other services.<\/p>\n

Parents with substance use disorder face many challenges associated with stigma and often must work through self-stigma to engage in treatment. This path involves understanding that their substance use may be affecting their children, and acknowledging that they need help. A family-centered approach is critical to eradicating stigma and ensuring the best outcomes for families affected by substance use disorder.<\/p>\n

For more information, see: Disrupting Stigma: How Understanding, Empathy, and Connection Can Improve Outcomes for Families Affected by Substance Use and Mental Disorders. <\/a><\/em><\/p>\n<\/div>\n \n \n \n <\/div>\n<\/div>\n\n\n

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Keeping families together<\/h2>\n \n \n \n

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Family separation is a traumatic event for everyone involved, and has both short-term effects on children, such as developmental regression and difficulty sleeping, and long-term effects, including heart disease, hypertension, permanent neurological changes, mental health concerns, and substance use.11<\/sup><\/a>,<\/sup>12<\/sup><\/a> Keeping families together, whenever safe to do so, is critical to child and family well-being. The federal Family First Prevention Services Act provides two opportunities to prevent separation of families affected by substance use disorder.<\/p>\n

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Support to children placed with parents in residential treatment<\/h3>\n

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States may claim Title IV-E foster care maintenance payments for a child in foster care who is placed with a parent in a licensed family-based residential treatment facility<\/a>.13<\/sup><\/a>\u00a0This component of the Family First Act allows funds that otherwise would pay for the placement of a child in out-of-home care to cover the room and board costs of the child residing with a parent in a residential family-based substance use treatment program. States vary in their implementation approaches.<\/p>\n

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In California<\/strong>, a voluntary placement agreement is implemented for the placement of children with their parents in a licensed residential family-based treatment facility. Detailed guidance<\/a> was released in 2021 that covered licensure and other requirements for these types of placements. Minnesota<\/strong> implemented state statutes<\/a> governing licensure requirements for residential family-based treatment programs. Utah <\/strong>has put in place various strategies, such as child and family team case reviews and trial home placements, to overcome implementation challenges. The case reviews are held with the family, service providers, family allies, and others. The team meets regularly to discuss key decision points on a case, such as reunification. A court may authorize a trial home placement when a parent is ready to discharge from treatment and a decision has been made that the family is not yet ready for reunification. When a child already has been living with a parent in a residential family-based facility, the trial home placement period is used as a time for the family to transition living on its own and ensure there is enough support to minimize risk of relapse.<\/p>\n

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For more information, see: Implementing the Substance Use Disorder Provisions of the Family First Prevention Services Act<\/a>.<\/em><\/p>\n

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Funding for additional supports<\/h3>\n

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A new funding stream, Title IV-E prevention services, supports substance use disorder treatment, mental health services, and in-home parenting skill-based programs that are reviewed and rated by the Title IV-E Prevention Services Clearinghouse<\/a>. As of November 2023, 16 substance use disorder interventions have been rated and approved, including Motivational Interviewing<\/a>, Screening, Brief Intervention, and Referral to Treatment<\/a>, and Sobriety Treatment and Recovery Teams (START)<\/a>.<\/p>\n

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For more information, see:<\/p>\n