Foster Care and Health in Medicaid-Enrolled Children Experiencing Parental Opioid Use Disorder

Children exposed to parental opioid use disorder (POUD), whether in utero or during childhood, are an especially vulnerable population. Between 2000 and 2017, foster care entries involving parental drug use increased nationwide - a trend partly attributed to the ongoing opioid crisis. While the impact of the opioid crisis on adults and newborns is widely studied, there is limited research evaluating the outcome of the crisis on children. 

In a study in JAMA Network Open, Dr. Angélica Meinhofer, assistant professor of population health sciences, and colleagues examine the health and health care outcomes of children experiencing POUD, with and without foster care involvement. 

Researchers utilized nationwide Medicaid claims data to determine the physical and mental health conditions, developmental disorders, substance use, and health care utilization among children aged 4 to 18 experiencing POUD. Researchers evaluated data for 1,985,180 Medicaid-enrolled children. 

Findings indicate that foster care involvement increased by 213 percent for Medicaid-enrolled children experiencing parental opioid use-related disorder between 2014 and 2020. Foster children had higher rates of adverse health outcomes, including mental health, developmental, and substance use diagnoses relative to those not involved in foster care. Foster children also had higher rates of health care utilization across a wide array of preventive services, including well-child visits and immunizations. Health care utilization increased sharply in the first year entering foster care but decreased as children exited care. 

Given their results, researchers suggest that children experiencing POUD must be met with early identification, prevention, and treatment. They emphasize the critical role of systems, policies, and clinical care designed to support these children and their families.  


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