Although opioid misuse/abuse is considered an epidemic, few randomized control trial (RCT) interventions focus on parental opioid use to improve parenting behaviors and child outcomes. The table below presents a review of parenting interventions among opioid addicted parents. Click on the chart to expand it.

Overall, very few studies (5 total) examine child and parenting outcomes when parents abuse opioids. So far, there are no consistent findings on which parenting practices are associated with improved child outcomes with most studies reporting no significant differences in outcomes. Future studies should focus on including fathers, investigating how parenting programs may reduce opioid use, and distinguish between parental prenatal vs postnatal opioid use.

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In 2016, Rhode Island was one of the top states for illicit drug use had the tenth highest accidental fatal overdose rates in the United States. In response to this, state leaders created a multi-component strategic plan with the goal of reducing fatal overdoses. The use of peer recovery supporters in targeted environments and the distribution of naloxone kits were part of this strategic plan.

AnchorED was a pilot study designed to send peer recovery mentors to emergency rooms with high rates of accidental opioid overdose. When a patient is treated for an accidental opioid overdose in an emergency department, the hospital staff called a peer recovery mentor to provide consultation before the patient is discharged. The consultation typically takes around 30 minutes and patients received kits containing information on 1) overdose prevention, 2) how to administer naloxone along with naloxone. The program also provided mentors to those who agreed to services after leaving the emergency room. The program also provided individuals with transportation to treatment centers along with linkages to long-term peer mentors.

AnchorMORE, a second pilot study, expanded outreach to include areas of high overdose rates, such as local shelters or needle exchange programs. During regular visits (3-4 times a week), peer recovery specialist teams provided naloxone education, distributed naloxone kits, and offered referrals for addiction treatment services. The specialists also met with local businesses, including bars and restaurants, to train staff on how to respond to an overdose.

Overall, AnchorED peer mentors contacted 1392 individuals through ER visits. Of those, 89% received naloxone training, 87% agreed to engagement with a peer mentor after the ER, and 51% agreed to service referrals. AnchorMORE peer recovery specialists had 8,614 street-based interactions and distributed a total of 854 naloxone kits The most common interaction was for referrals for basic needs such as access to food pantries or transportation assistance. The second most common interaction was for outpatient substance abuse treatment services, while the least common was referrals for inpatient substance abuse treatment services. Fatal overdoses, after connection to a peer specialist and naloxone kit, were not measured. These two pilot studies show the importance of peer recovery specialists for overdose prevention and education, outreach, and resource referral in a variety of settings.

Waye, K. M., Goyer, J., Dettor, D., Mahoney, L., Samuels, E., Yedinak, J. L., & Marshall, B. D. L. (n.d.). Implementing peer recovery services for overdose prevention in Rhode Island: An examination of two outreach-based approaches. Addictive Behaviors, 89, 85–91. https://doi.org/10.1016/j.addbeh.2018.09.027

The Early Intervention Family Drug Court (EIFDC) was started in 2010 in Sacramento, CA to protect the welfare of children while giving parents the opportunity and resources to access substance abuse treatment services. EIFDC is different from family court in that it is a voluntary pre-plea or administrative court. Participating parents and caregivers receive intensive case management, parenting classes intensive outpatient substance abuse treatment and cognitive behavioral strategies, mental health counseling for adults and children as well as screening and assessment for both substance use disorders and child welfare issues. Initially, EIFDC targeted mothers who had used substances during pregnancy or who had a newborn test positive for substances at the time of delivery. The program has now expanded to include fathers of infants who have been exposed to substances.

Specific to substance abuse treatment services, 86.8% entered treatment after enrollment in EIFDC, 2.1% began treatment the day they started EIFDC, and 9.5% entered treatment before beginning the program. Although the EIFDC parents were not more likely to complete treatment than the comparison parents, they stayed in treatment longer than comparison parents (131.6 vs 102.7 days). Compared to families receiving services and usual,  more EIFDC children remained at home after cases closed (92.1% vs. 69.5%). Overall, the program has led to a decrease in child welfare caseloads, a decrease in traumatic experiences for children and an overall decrease in Child Welfare costs.  For more information on EIFDC, please visit this website.

SAMHSA. (n.d.). Early Intervention Family Drug Court (EIFDC). Retrieved from https://ncsacw.samhsa.gov/technical/rpg-i.aspx?id=80