ANN ARBOR, Mich. — Roughly 19 million U.S. children, about one in four under the age of 18, live with a parent or other adult whose drinking or drug use meets the criteria for a substance use disorder, according to new University of Michigan research published in JAMA Pediatrics.
Using 2023 data from the National Survey on Drug Use and Health, the team found alcohol to be the most common problem, affecting an estimated 12 million parents. Cannabis use disorder was next at just over 6 million, while about 3.4 million parents showed disordered use of multiple substances. Nearly 6 million children live with adults who have both substance use and mental health disorders, a combination the authors say compounds the risks.
Lead author Sean Esteban McCabe said the rise from prior estimates “brings more urgency to the need to help connect parents to effective treatments [and] expand early intervention resources for children.”
For law enforcement, the findings underscore the intersection of public health and public safety. Children in homes with untreated addiction face higher rates of adverse childhood experiences — factors linked to juvenile offending, domestic disturbances and substance-related calls that officers routinely handle.
“We know that children raised in homes where adults have substance use issues are more likely to have adverse childhood experiences, to use alcohol and drugs earlier and more frequently, and to be diagnosed with mental health conditions of their own,” said Vita McCabe, co-author and director of University of Michigan Addiction Treatment Services.
The study’s authors urge expanded access to evidence-based treatments such as naltrexone for alcohol use disorder and buprenorphine for opioid addiction, along with cognitive behavioral therapy and family-focused interventions. They also warn that looming federal budget cuts could jeopardize the national survey that supplies much of the nation’s substance-use data.
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