{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T11:25:28Z","timestamp":1794482728636,"version":"4.9.1"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"Importance<\/jats:title>Parents\u2019 overdose death can have a profound short- and long-term impact on their children, yet little is known about the number of children who have lost a parent to drug overdose in the US.<\/jats:p><\/jats:sec>Objective<\/jats:title>To estimate the number and rate of children who have lost a parent to drug overdose from 2011 to 2021 overall and by parental age, sex, and race and ethnicity.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This was a cross-sectional study of US community-dwelling persons using data from the National Survey on Drug Use and Health (2010-2014 and 2015-2019) and the National Vital Statistics System (2011-2021). Data were analyzed from January to June 2023.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Parental drug overdose death, stratified by age group, sex, and race and ethnicity.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Numbers, rates, and average annual percentage change (AAPC) in rates of children losing a parent aged 18 to 64 years to drug overdose, overall and by age, sex, and race and ethnicity.<\/jats:p><\/jats:sec>Results<\/jats:title>From 2011 to 2021, 649 599 adults aged 18 to 64 years died from a drug overdose (mean [SD] age, 41.7 [12.0] years; 430\u202f050 [66.2%] male and 219\u202f549 [33.8%] female; 62\u202f606 [9.6%] Hispanic, 6899 [1.1%] non-Hispanic American Indian or Alaska Native, 6133 [0.9%] non-Hispanic Asian or Pacific Islander, 82\u202f313 [12.7%] non-Hispanic Black, 485\u202f623 [74.8%] non-Hispanic White, and 6025 [0.9%] non-Hispanic with more than 1 race). Among these decedents, from 2011 to 2021, an estimated 321\u202f566 (95% CI, 276\u202f592-366\u202f662) community-dwelling children lost a parent aged 18 to 64 years to drug overdose. The rate of community-dwelling children who lost a parent to drug overdose per 100\u202f000 children increased from 27.0 per 100\u202f000 in 2011 to 63.1 per 100\u202f000 in 2021. The highest rates were found among children of non-Hispanic American Indian or Alaska Native individuals, who had a rate of 187.1 per 100\u202f000 in 2021, more than double the rate among children of non-Hispanic White individuals (76.5 per 100\u202f000) and non-Hispanic Black individuals (73.2 per 100\u202f000). While rates increased consistently each year for all parental age, sex, and race and ethnicity groups, non-Hispanic Black parents aged 18 to 25 years had the largest AAPC (23.8%; 95% CI, 16.5-31.6). Rates increased for both fathers and mothers; however, more children overall lost fathers (estimated 192\u202f459; 95% CI, 164\u202f081-220\u202f838) than mothers (estimated 129\u202f107; 95% CI, 112\u202f510-145\u202f824).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>An estimated 321\u202f566 children lost a parent to drug overdose in the US from 2011 to 2021, with significant disparities evident across racial and ethnic groups. Given the potential short- and long-term negative impact of parental loss, program and policy planning should ensure that responses to the overdose crisis account for the full burden of drug overdose on families and children, including addressing the economic, social, educational, and health care needs of children who have lost parents to overdose.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.0810","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T15:01:14Z","timestamp":1715180474000},"page":"789","source":"Crossref","is-referenced-by-count":36,"title":["Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021"],"prefix":"10.1001","volume":"81","author":[{"given":"Christopher M.","family":"Jones","sequence":"first","affiliation":[{"name":"Substance Abuse and Mental Health Services Administration, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Han","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gery P.","family":"Guy","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Losby","sequence":"additional","affiliation":[{"name":"National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily B.","family":"Einstein","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Delphin-Rittmon","sequence":"additional","affiliation":[{"name":"Substance Abuse and Mental Health Services Administration, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora D.","family":"Volkow","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson M.","family":"Compton","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"11","key":"yoi240018r2","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1377\/hlthaff.2021.00460","article-title":"Neonatal opioid withdrawal syndrome is associated with infant foster care entry at the county level.","volume":"40","author":"Loch","year":"2021","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"yoi240018r3","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1001\/jama.2020.24991","article-title":"Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010-2017.","volume":"325","author":"Hirai","year":"2021","journal-title":"JAMA"},{"issue":"11","key":"yoi240018r5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.16015","article-title":"Associations of parental marijuana use with offspring marijuana, tobacco, and alcohol use and opioid misuse.","volume":"2","author":"Madras","year":"2019","journal-title":"JAMA Netw Open"},{"key":"yoi240018r6","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.768802","article-title":"\u201cI grew up amidst alcohol and drugs:\u201d a qualitative study on the lived experiences of parental substance use among adults who developed substance use disorders themselves.","volume":"13","author":"Meulewaeter","year":"2022","journal-title":"Front Psychiatry"},{"issue":"1","key":"yoi240018r7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.jadohealth.2004.06.004","article-title":"Pathways to adolescent alcohol use: family environment, peer influence, and parental expectations.","volume":"37","author":"Nash","year":"2005","journal-title":"J Adolesc Health"},{"issue":"12","key":"yoi240018r8","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1046\/j.1360-0443.2002.00238.x","article-title":"Parental substance use as a modifier of adolescent substance use risk.","volume":"97","author":"Li","year":"2002","journal-title":"Addiction"},{"issue":"2","key":"yoi240018r9","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1111\/camh.v27.2","article-title":"Parental death by external causes during childhood and risk of psychiatric disorders in bereaved offspring.","volume":"27","author":"Burrell","year":"2022","journal-title":"Child Adolesc Ment Health"},{"key":"yoi240018r11","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1035564","article-title":"The association between grandparents as caregivers and overdose mortality in Appalachia and non-Appalachia counties.","volume":"11","author":"Beatty","year":"2023","journal-title":"Front Public Health"},{"issue":"1","key":"yoi240018r12","doi-asserted-by":"publisher","DOI":"10.1177\/00027162221142648","article-title":"The opioid epidemic and children\u2019s living arrangements in the United States, 2000-2018.","volume":"703","author":"Caudillo","year":"2023","journal-title":"Ann Am Acad Pol Soc Sci"},{"issue":"8","key":"yoi240018r13","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00175-X","article-title":"A last taboo in public health.","volume":"7","author":"Lancet Public Health","year":"2022","journal-title":"Lancet Public Health"},{"issue":"8","key":"yoi240018r14","doi-asserted-by":"publisher","first-page":"e683","DOI":"10.1016\/S2468-2667(22)00158-X","article-title":"Substance use disorder and suicide-related behaviour around dates of parental death and its anniversaries: a register-based cohort study.","volume":"7","author":"Hiyoshi","year":"2022","journal-title":"Lancet Public Health"},{"key":"yoi240018r15","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1080\/09540121.2016.1176683","article-title":"Social support as a protective factor for children impacted by HIV\/AIDS across varying living environments in southern Africa.","volume":"28","author":"Barenbaum","year":"2016","journal-title":"AIDS Care"},{"issue":"7","key":"yoi240018r16","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1017\/S0033291719001193","article-title":"Self-harm and violent criminality linked with parental death during childhood.","volume":"50","author":"Carr","year":"2020","journal-title":"Psychol Med"},{"issue":"1","key":"yoi240018r17","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12904-017-0223-y","article-title":"When a parent dies\u2014a systematic review of the effects of support programs for parentally bereaved children and their caregivers.","volume":"16","author":"Bergman","year":"2017","journal-title":"BMC Palliat Care"},{"issue":"5","key":"yoi240018r18","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1001\/jamapediatrics.2020.0613","article-title":"Potential emerging risks among children following parental opioid-related overdose death.","volume":"174","author":"Hulsey","year":"2020","journal-title":"JAMA Pediatr"},{"issue":"3","key":"yoi240018r19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1111\/spco.2012.6.issue-3","article-title":"Pathways to lifespan health following childhood parental death.","volume":"6","author":"Luecken","year":"2012","journal-title":"Soc Personal Psychol Compass"},{"issue":"5","key":"yoi240018r20","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1080\/074811801750257527","article-title":"Childhood family disruptions and adult well-being: the differential effects of divorce and parental death.","volume":"25","author":"Mack","year":"2001","journal-title":"Death Stud"},{"issue":"9","key":"yoi240018r26","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/S2215-0366(23)00119-0","article-title":"Increasing overdose deaths among Black Americans: a review of the literature.","volume":"10","author":"Gibbons","year":"2023","journal-title":"Lancet Psychiatry"},{"issue":"29","key":"yoi240018r27","doi-asserted-by":"publisher","first-page":"940","DOI":"10.15585\/mmwr.mm7129e2","article-title":"Vital signs: drug overdose deaths, by selected sociodemographic and social determinants of health characteristics - 25 states and the District of Columbia, 2019-2020.","volume":"71","author":"Kariisa","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"yoi240018r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.110940","article-title":"Racial inequities and addiction research.","volume":"251","author":"Compton","year":"2023","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"yoi240018r29","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1111\/milq.v98.3","article-title":"Situating the continuum of overdose risk in the social determinants of health: a new conceptual framework.","volume":"98","author":"Park","year":"2020","journal-title":"Milbank Q"},{"issue":"4","key":"yoi240018r30","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1002\/cpp.v24.4","article-title":"Cultural competence in the treatment of addictions: theory, practice and evidence.","volume":"24","author":"Gainsbury","year":"2017","journal-title":"Clin Psychol Psychother"},{"issue":"10324","key":"yoi240018r34","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/S0140-6736(21)02252-2","article-title":"Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission.","volume":"399","author":"Humphreys","year":"2022","journal-title":"Lancet"},{"issue":"3","key":"yoi240018r35","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1080\/10522158.2017.1300113","article-title":"Substance abuse treatment engagement among mothers: perceptions of the parenting role and agency-related motivators and inhibitors.","volume":"20","author":"Seay","year":"2017","journal-title":"J Fam Soc Work"},{"key":"yoi240018r36","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.copsyc.2017.02.014","article-title":"Parenting and addiction: neurobiological insights.","volume":"15","author":"Rutherford","year":"2017","journal-title":"Curr Opin Psychol"},{"key":"yoi240018r37","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jsat.2018.03.005","article-title":"Parenting outcomes of parenting interventions in integrated substance-use treatment programs: a systematic review.","volume":"89","author":"Moreland","year":"2018","journal-title":"J Subst Abuse Treat"},{"issue":"1","key":"yoi240018r38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/ADM.0b013e318270f7b0","article-title":"Integration of parenting skills education and interventions in addiction treatment.","volume":"7","author":"Arria","year":"2013","journal-title":"J Addict Med"},{"key":"yoi240018r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2023.100492","article-title":"Sex-related differences in the prevalence of substance use disorders, treatment, and overdose among parents with young children.","volume":"17","author":"Gao","year":"2023","journal-title":"Addict Behav Rep"},{"key":"yoi240018r40","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100054","article-title":"Parenting and childcare responsibilities, harm reduction service engagement, and opioid overdose among women and men who use illicit opioids in New York City.","volume":"3","author":"Scheidell","year":"2022","journal-title":"Drug Alcohol Depend Rep"},{"key":"yoi240018r41","doi-asserted-by":"publisher","first-page":"105","DOI":"10.2147\/SAR.S319180","article-title":"Substance use in pregnancy: identifying stigma and improving care.","volume":"12","author":"Weber","year":"2021","journal-title":"Subst Abuse Rehabil"},{"issue":"3","key":"yoi240018r43","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1001\/jamapsychiatry.2023.4523","article-title":"Pregnancy and postpartum drug overdose deaths in the US before and during the COVID-19 pandemic.","volume":"81","author":"Han","year":"2024","journal-title":"JAMA Psychiatry"},{"key":"yoi240018r44","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.childyouth.2019.03.040","article-title":"Innovations in child welfare interventions for caregivers with substance use disorders and their children.","volume":"101","author":"Bosk","year":"2019","journal-title":"Child Youth Serv Rev"},{"issue":"9","key":"yoi240018r45","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1016\/j.clinthera.2019.06.003","article-title":"The impact of the opioid epidemic on children and adolescents.","volume":"41","author":"Winstanley","year":"2019","journal-title":"Clin Ther"},{"issue":"26","key":"yoi240018r46","doi-asserted-by":"publisher","first-page":"707","DOI":"10.15585\/mmwr.mm7226a2","article-title":"Prevalence of adverse childhood experiences among US adults\u2014Behavioral Risk Factor Surveillance System, 2011-2020.","volume":"72","author":"Swedo","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"8","key":"yoi240018r47","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/jama.1997.03550080047038","article-title":"Long-term effects of home visitation on maternal life course and child abuse and neglect. fifteen-year follow-up of a randomized trial.","volume":"278","author":"Olds","year":"1997","journal-title":"JAMA"},{"issue":"14","key":"yoi240018r48","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1001\/jama.280.14.1238","article-title":"Long-term effects of nurse home visitation on children\u2019s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial.","volume":"280","author":"Olds","year":"1998","journal-title":"JAMA"},{"key":"yoi240018r1","unstructured":"US Centers for Disease Control and Prevention\u2019s National Center for Health Statistics. Provisional mortality dashboard. Accessed September 20, 2023. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"key":"yoi240018r4","unstructured":"Ghertner? R, Baldwin? M, Crouse? G, Radel? L, Waters? A. The relationship between substance use indicators and child welfare caseloads. 2018. Accessed September 18, 2023. https:\/\/aspe.hhs.gov\/sites\/default\/files\/migrated_legacy_files\/179971\/SubstanceUseCWCaseloads.pdf"},{"key":"yoi240018r10","unstructured":"US Centers for Disease Control and Prevention\u2019s National Center for Health Statistics. Wide-ranging online data for epidemiologic research (WONDER). 2023. Accessed August 23, 2023. https:\/\/wonder.cdc.gov"},{"key":"yoi240018r21","unstructured":"US Centers for Disease Control and Prevention. Adverse childhood experiences prevention: resource for action. 2019. Accessed September 18, 2023. https:\/\/www.cdc.gov\/violenceprevention\/pdf\/preventingACES.pdf"},{"key":"yoi240018r22","unstructured":"Substance Abuse and Mental Health Services Administration. National survey on drug use and health (NSDUH). Accessed August 20, 2023. https:\/\/www.samhsa.gov\/data\/data-we-collect\/nsduh-national-survey-drug-use-and-health"},{"key":"yoi240018r23","unstructured":"Han? B. Key substance use and mental health indicators in the United States: results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. 2020). Accessed May 1, 2023. https:\/\/www.cdc.gov\/nchs\/hus\/sources-definitions\/nsduh.htm"},{"key":"yoi240018r24","unstructured":"Centers for Disease Control and Prevention\u2019s National Center for Health Statistics. Vital Statistics Data Files \u2013 Detailed Mortality, 2011-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program."},{"key":"yoi240018r25","unstructured":"US Centers for Disease Control and Prevention. SUDORS dashboard: fatal overdose data. 2023. Accessed October 23, 2023. https:\/\/www.cdc.gov\/drugoverdose\/fatal\/dashboard\/index.html"},{"key":"yoi240018r31","unstructured":"US Department of Health and Human Services. HHS overdose prevention strategy. 2021. Accessed September 20, 2023. https:\/\/www.hhs.gov\/overdose-prevention\/"},{"key":"yoi240018r32","unstructured":"National Academies of Science, Engineering, and Medicine. Medications for opioid use disorder saves lives. 2019. Accessed September 14, 2023. https:\/\/nap.nationalacademies.org\/catalog\/25310\/medications-for-opioid-use-disorder-save-lives"},{"key":"yoi240018r33","unstructured":"The White House. The president\u2019s commission on combating drug addiction and the opioid crisis. Accessed July 23, 2023. https:\/\/trumpwhitehouse.archives.gov\/sites\/whitehouse.gov\/files\/images\/Final_Report_Draft_11-15-2017.pdf"},{"key":"yoi240018r42","unstructured":"Guttmacher Institute. Substance abuse during pregnancy. Accessed January 25, 2024. https:\/\/www.guttmacher.org\/state-policy\/explore\/substance-use-during-pregnancy"},{"key":"yoi240018r49","unstructured":"US Census Bureau. Table FM-3. Average number of own children under 18 per family, by type of family: 1955 to present. Accessed on October 16, 2023. https:\/\/www2.census.gov\/programs-surveys\/demo\/tables\/families\/time-series\/families\/fm3.xls"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2818228\/jamapsychiatry_jones_2024_oi_240018_1721838756.473.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T15:07:37Z","timestamp":1723043257000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2818228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":49,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2024.0810","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2024,8,1]]}}}