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Parenting and the Opioid Epidemic: A Systematic Scoping Review

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Abstract

As concern about opioid misuse grows, harm reduction has emphasized individualized care (e.g., treatment access) and systemic solutions (e.g., public policy). A gap in the literature exists surrounding opioid impacts that exist between the individual and societal levels of analysis. This literature review examines opioid impact at the family level, specifically as the parent-child dyad, to identify knowledge gaps and explore implications for treatment and policy. A scoping search of the literature in English was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and PsychINFO. We followed an iterative search approach and tailored terms to refine search results, narrowed to two domains: (1) opioid-related substance use, and (2) family or parent/child dyad. Three rounds of review resulted in 63 articles, analyzed for descriptive content and characteristics, combined with qualitative thematic analysis. Findings include articles disproportionately focused on mothering versus fathering, yet also evidence that opioid-dependent fathers (vs. other substance use) show more impairments in parenting. Other thematic findings discuss how substance use contributes to maladaptive parental behaviors. There is a need for greater emphasis on the impact of opioid use disorder (OUD) on families and children.

Highlights

  • Though our search was highly targeted toward family addiction studies, only 74.6% of articles specified family and children in the inclusion criteria and just nine studies engaged family/parenting-specific interventions.

  • Our review generally suggests that dual diagnosis is more likely to be considered in large studies with sample size over 500 (17.4 vs 6.4%), but trauma is more likely to be addressed as a factor in studies with smaller sample sizes (12.8 vs 1.6%).

  • Generally, about half of the articles focused on issues surrounding parenting, with half of those focused on mothering (14, 22.2%) and just four (6.4%) focused on fathering.

  • Family relationships were a central theme in 24 (38%) of the articles and family dissolution was specifically addressed in six (10%) articles.

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The list of articles reviewed is available in an appendix accessible in online supplemental materials and no other data files exist for this manuscript.

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Acknowledgements

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $2,295,760 through grant T26HP39463 with 10% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

Funding

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $2,295,760 through grant T26HP39463 with 10% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov. Financial and non-financial interests: The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Extension, Utah State University, 2001 State Street Suite S1-300, Salt Lake City, UT, USA

    Maren Wright Voss, Amy J. Campbell & Amelia Van Komen

  2. Utah State University, 9900 Old Main Hill, Logan, UT, USA

    Tyson S. Barrett

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  1. Maren Wright Voss
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Correspondence to Maren Wright Voss.

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Appendix: List of Articles Reviewed

Appendix: List of Articles Reviewed

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    Ahmadi, J., Arabi, H., & Mansouri, Y. (2003). Prevalence of substance use among offspring of opioid addicts. Addictive Behaviors, 28(3), 591–595. https://doi.org/10.1016/S0306-4603(01)00260-X

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    Ashrafioun, L., Dambra, C. M., & Blondell, R. D. (2011). Parental prescription opioid abuse and the impact on children. The American Journal of Drug and Alcohol Abuse, 37(6), 532–536. https://doi.org/10.3109/00952990.2011.600387

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    Austin, A. E., & Shanahan, M. E. (2017). Prescription opioid use among young parents in the United States: Results from the National Longitudinal Study of Adolescent to Adult Health. Pain Medicine, 18(12), 2361–2368. https://doi.org/10.1093/pm/pnw343

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Voss, M.W., Barrett, T.S., Campbell, A.J. et al. Parenting and the Opioid Epidemic: A Systematic Scoping Review. J Child Fam Stud 32, 1280–1293 (2023). https://doi.org/10.1007/s10826-023-02576-2

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