12-05-2025
Nearly 19 Million U.S. Children Live With a Parent With Substance Use Disorder
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A staggering 19 million U.S. children were estimated to be living in a household with at least one parent battling a substance use disorder (SUD) in 2023, according to a new study based on data from the National Survey on Drug Use and Health.
This figure accounts for nearly one-quarter of all children in the United States, highlighting the prevalence of parental substance abuse among young individuals.
The findings also revealed that more than 6.1 million children lived with a parent facing both SUD and a mental illness, such as major depressive disorder or serious psychological distress.
The study, published in the journal JAMA Pediatrics, analyzed data from over 62 million parents—and defined SUD according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
These criteria include disorders related to alcohol, cannabis, cocaine, prescription drugs and other substances.
Mother alcoholic drinks alcohol from a bottle with child is foreground covering ears.
Mother alcoholic drinks alcohol from a bottle with child is foreground covering ears.
Alexander_Safonov
Researchers highlighted the serious risks faced by children exposed to parental SUD.
Compared to their peers, these children are more likely to develop a range of adverse outcomes, including early substance use initiation, substance-related problems and mental health disorders.
The study provided a detailed breakdown, revealing that 7.6 million children lived with a parent experiencing moderate or severe SUD, while 3.4 million lived with a parent struggling with multiple SUDs.
Among parental substance use disorders, alcohol was the most common, followed by cannabis, prescription-related issues and other non-cannabis drug use disorders.
Experts emphasized that these findings are a call to action for federal, state and local governments to invest in family-centered interventions.
These children are particularly vulnerable to adverse childhood experience, the researchers noted—and without support, they may continue the cycle of substance use and mental health struggles.
The study also acknowledged its limitations, including the reliance on self-reported data, suggesting that the actual number of children affected may be even higher.
"Additionally, the number of offspring in the household was truncated at three, suggesting that estimates represented the lower bound of youths exposed to parental SUD," the researchers noted.
"Direct comparison of the impact of DSM-IV-defined vs DSM-5-defined parental SUD severity is an important step for future research," they wrote.
With nearly one in four American children impacted by a parent's substance use disorder, the study's authors are urging greater awareness and support for these families.
Evidence-based treatments for both SUD and mental illness, particularly those that include family support, could help mitigate the long-term consequences for these vulnerable children.
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Reference
McCabe, S. E., McCabe, V. V., & Schepis, T. S. (2025). US children living with a parent with substance use disorder. JAMA Pediatrics.
