More than 320,000 children in the United States lost a parent to a drug overdose from 2011 to 2021, a study by the National Institute on Drug Abuse found. 

No national study had previously looked at the amount of children affected by the overdose crisis, according to a news release announcing the findings. Study co-author Dr. Emily Einstein, the chief of NIDA’s Science Policy Branch, said the study was inspired by similar research during the COVID-19 pandemic. 

During the decade studied, 649,599 people aged 18 to 64 died of a drug overdose. Children were more likely to lose their fathers than their mothers, the study found. 

“Something that’s very important about this particular dataset is that it paints the picture of people who use drugs as people who have full lives,” said Einstein. “I think very often we think of people with addiction or who use drugs as that being their defining characteristic, especially when someone dies of an overdose … Nearly half of these people who die have a child who lives in their household. I think that gives us concrete data so we can start to understand the full picture of someone’s whole life and how we need to address all the factors in their life, both for their own addiction and then to mitigate the trauma experienced by children left behind.” 

While the “highest number of affected children were those with non-Hispanic White parents,” the study found that children in “communities of color and tribal communities were disproportionately affected,” according to the news release. Children with non-Hispanic American Indian or Alaska Native parents consistently experienced the loss of a parent to overdose, with 187 per 100,000 children in this group affected. That’s more than double the rate among White and Black children, who were affected at a rate of 76.5 per 100,000 children and 73 per 100,000 children, respectively, the study found.

The rate of children whose parents died by drug overdose “more than doubled” during the 10-year period studied, according to the news release. The increase was seen across all racial and ethnic populations, the study found, but children with young, non-Hispanic Black parents saw the highest increase in rate of loss each year, with about a 24% increase in overdose deaths annually. 

Einstein said the increasing numbers showed the overdose crisis is an “emergency of the highest order.”

“It’s important to keep in mind that children who are in households where their parents use drugs are very likely to have environmental risk factors and probably biological risk factors that may raise their own likelihood of using drugs,” Einstein said. “And then if you layer in this traumatic event of losing a parent to an overdose, that means that these children are just extraordinarily vulnerable.” 

Susan Ousterman, a Pennsylvania woman who runs support groups for parents who have lost children to overdoses, said she often sees grandparents raising their grandchildren as their parents struggle with substance use or die of an overdose. Ousterman said she hopes the study will emphasize the need to talk to children about substance use and addiction without stigmatizing people who use drugs. 

“There’s just not enough support out there for kids,” she said. 

The study called for more focus on whole-person healthcare that treats substance use disorder and prevention resources that can be used to support families. Einstein said that children who lose parents to overdoses need be able to access “the support and psychiatric care that they need as they grow up.” 

“It’s important for us to realize that substance use and addiction impacts whole family units,” Einstein said, noting that parents who use drugs may feel more ashamed of disclosing their substance use or seeking treatment. “As we think about better ways to improve people’s receipt of care, we need to think about the whole family unit and everyone it’s impacting.”