October 12, 2017

TO: President’s Commission on Combating Drug Addiction and the

Opioid Crisis

Dear Commission Members,

Thank you for your excellent preliminary report designed to address the terrible consequences of substance use disorders in America. Your insights and wisdom about this debilitating disease clearly show through in the many thoughtful recommendations set forth to date. The toll on the health and wealth of the nation, as well as on the individuals involved, is monumental, and we sincerely hope that your recommendations are adopted and implemented.

As you prepare your final report, I hope you will take into consideration the consequences of substance use disorders on America’s children. All-too-often forgotten is the tragic impact on the children whose lives are forever changed due to their parents’ or other relatives’ involvement in substances that disrupt the family. Such Adverse Childhood Experiences lead to a host of problems from abuse and neglect, stress and trauma, academic and social failure, to a lifetime of physical and mental health problems. While treatment for adults with a substance use disorder can lead over time to better outcomes for the entire family, the sad truth is that only 10 percent of these adults get treatment, and sometimes it is not successful with the first try, thus leaving other family members, including children, vulnerable to the ravages of this disorder.

Recent reports have highlighted this problem, including

· SAMHSA’s recently-released CBHSQ Report on Children Living with Parents Who have a Substance Use Disorder reveals that about 1 in 8 children lived in households with at least one parent who had a substance use disorder (excluding prescription drug-related disorder) in the past year, and observing that their estimates of the number of these children “…are needed for adult prevention efforts and programs that support and protect affected children.”

· The September issue of JAMA Psychiatry reports that “substantial increases in alcohol use, high-risk driving, and DSM-IV alcohol use disorder constitute a public health crisis” which as of 2010 cost the nation $250 billion per year. Distinguished researcher Dr. Marc Schuckit in an accompanying Editorial observed that America is “…facing a crisis with alcohol use, one that is currently costly and about to get worse.” And we know from decades of research that children in families disrupted by alcohol problems suffer significantly both near-term and often for a lifetime.

· The September-October issue of Academic Pediatrics includes an entire supplement devoted to “Child Well-Being and Adverse Childhood Experiences in the US” features 30 articles from researchers and practitioners calling attention to the toxic social and environmental factors that reduce the chances that children will survive, thrive, and contribute to their family’s well-being, as well as that of their neighborhood and the nation. Drug and alcohol issues contribute substantially to these Adverse Childhood Experiences that hold back America’s youth.

Recent media attention has begun to put a compelling face on these statistics. The problems this attention addresses begin in utero, in some cases, and can cause a lifetime of loss and suffering for the impacted children. Not only are the foster care systems across the country reeling under this epidemic, there are countless grandparents who are ill equipped, emotionally or financially, to raise children again and are being asked to step up to overwhelming responsibilities for the rest of their lives, with no support.

[ https://www.nbcnews.com/storyline/americas-heroin-epidemic/generation-risk-children-center-america-s-opioid-crisis-n806456 ]

We wrote about the challenge of including a focus on these children at risk in our response to the Surgeon General’s Report on Alcohol, Drugs, and Health, noting that while the report was a major achievement and a major contribution to our understanding of this critical issue, children were, regrettably, omitted from the report. We have attached this article.

The view of our organization is that addressing the crisis of drug problems in the US requires more than just providing prevention, intervention, treatment and recovery support services for adults. While in the long run reduced levels of substance use disorders may eventually reduce the number of children impacted, the trends are not encouraging. Therefore policies and program supportive of these affected children are of ever-great importance. Further, there are programs proven to have a positive impact on these children, but regrettably these are neither prevalent nor well-funded.

We hope you will include recommendations to support treatment for young mothers and their impacted babies; to support evidence-based whole family recovery programs; to support educational support groups for school age-children with parents who are currently suffering from substance use disorders and those whose parents are struggling to recover. Jessica Hulsey Nickel gave powerful testimony to the need for student assistance programs in her testimony at the Commission’s first public meeting. Such programs have a long history of not only helping children to manage and to heal from the chronic trauma they face daily in their homes, they also improve academic achievement, decrease classroom disruptions and absence, thus furthering the school’s educational goals.

It is also vital to encourage public attention to the drug and alcohol issue through a national media campaign to enlist their support for the essential prevention, treatment and recovery to bring down this problem. Using mass and social media to address the challenge can be effective in mobilizing individuals and communities to take action. In particular we as a nation must protect children of parents with substance use disorders as they are the most vulnerable and all too often suffer a lifetime of health, social, and economic problems if early exposure to family disruption and discord are not addressed. We have effective approaches but the public must know there is hope and how they can help.

This is a matter of social and economic justice, an humanitarian approach, of investment in our Nation’s future.

Please contact us should you have any questions about this message, or if we can be of assistance in any way in the preparation of or support for your final report. You have our best wishes for success.

Yours truly,

National Association for Children of Addiction

Gary M. Weiss, MD

Board Chair

Sis Wenger

Board Chair President and CEO

cc: Richard Baum

Acting Director, ONDCP

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