The Overdose Crisis: How Many Children Lost a Parent to Overdose?

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Summary: Over a million people have died of drug overdose since the overdose crisis began in 1999, but little is known about how many children have lost a parent to overdose over the past twenty-six years.

Key Points:

Between 1999 and 2023, overdose deaths in the U.S. increased by over 500%
The first significant reduction in overdose fatalities since the crisis began occurred in 2024
Recent initiatives, such as harm reduction, played a role in this decrease
Long-term consequences of the crisis persist for individuals, families, and communities around the country
A recent study examined data to report how many children lost a parent to overdose during the ten-year period from 2011-2021

The Overdose Crisis: Promising Recent News, But Serious Long-Term Effects Persist

In all the media stories we’ve read and reported on during the overdose crisis, the warnings from officials, the overdose awareness days, the drug treatment awareness days, we rarely see discussion about one outcome of the crisis that’s heartbreaking: the children who’ve lost parents to overdose.

Every life lost to overdose is a tragedy.

And when children feel the impact, it makes the tragedy even worse – if that’s possible.

Children, Parents, and Overdose: The Impact of Adverse Childhood Experiences (ACEs)

It’s part of the crisis we almost never talk about.

Why?

According to Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), it’s because our attention is focused elsewhere:

“The numbers and mortality are so high that it attracts all of the attention and urgency to address it, to protect people from dying. But at the same time, we’ve basically neglected to realize that when someone dies, there is a family that’s left behind. And if the family has young children, that makes them very, very vulnerable.”

Tragedies like the death of a parent are considered adverse childhood experiences (ACEs), which can increase risk of long-term physical, psychological, and emotional consequences. Children who lose a parent to overdose live through at least two ACEs, because child development experts indicate having a parent with a substance use disorder (SUD) and the death of a parent are both ACEs – and the more ACEs a child lives through, the higher the risk of negative consequences later in life.

ACEs include:

Emotional, physical, or sexual abuse
Emotional or physical neglect
Domestic violence or violence in the community
Living with a parent/caregiver with a mental health disorder
Living with an individual who has an alcohol or substance use disorder (AUD/SUD)
Having an incarcerated family member, or a family member sentenced to incarceration

Research shows individuals with four or more ACEs have increased risk of:

Developmental problems that affect both body and brain
Impaired function in key life domains: cognitive, social, emotional
Impaired impulse control
Increased rates of disease-related disability

In a report published in 2019, researchers at the Centers for Disease Control (CDC) showed that ACEs are associated with several of the leading causes of premature mortality in the U.S.:

Suicide
Alcohol/drug overdose
Cancer
Coronary disease
Diabetes

ACEs are real and can have a lasting negative impact: the research shows that unequivocally. In fact, the discovery of the impact of ACEs on long-term health led to what we now call trauma-informed care.

But our focus here is on the kids: let’s look at the numbers.

Children, Parents, and Overdose: Facts and Figures

The study “Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021,” published in May 2024, sheds light on this aspect of the overdose crisis. The research team examined records on overdose deaths between 2011 and 2021 to determine how many children lost a parent to overdose during the height of the crisis.

Here’s what they found:

The rate of children who lost a parent to overdose per 100,000 increased:
- 2011: 27 per 100,000
- 2021: 63.1 per 100,000
Children who experienced the highest rate of loss, by demographic group:
- Non-Hispanic American Indian or Alaska Native (NHAI/AN): 187.1 per 100,000
NHAI/AN children compared to other demographic groups:
- Non-Hispanic White: 76.5 per 100,000
- Non-Hispanic Black: 73.2 per 100,000
The largest annual average percentage change (AAPC):
- Non-Hispanic Black parents age 18-25: 23.8% AAPC
By parent role:
- Fathers: 192,459 children lost their father
- Mothers: 129,107 children lost their mother

Total: 321,566 children lost a parent to overdose between 2011 and 2021

When we write about the overdose crisis, we often say it impacts individuals, families, and communities. This is what we mean. When a person dies of overdose, the ripples expand. While we often discuss the impact on spouses and friends, we often overlook the impact on children – perhaps because it’s so painful and distressing to think about. However, if we want to move forward and heal as a nation, we need to face the facts.

Help for Children, Help for Parents

The loss of a parent is one of the most significant emotional and psychological events that occurs during our lives. Few things reach the same level of import. And when the loss occurs during childhood, the impact can be devastating.

We’ll share additional commentary from NIDA Director Dr. Nora Volkow:

“These findings emphasize the need to better support parents in accessing prevention, treatment, and recovery services. In addition, any child who loses a parent to overdose must receive the care and support they need to navigate this painful and traumatic experience.”

The impact on children highlights the need to reduce stigma, increase awareness, and eliminate barriers to care. Every overdose death is preventable, and we’re committed to working every day to ensure that parents with opioid use disorder (OUD) know they can achieve sustainable, long-term recovery – not only for themselves, but also for the benefit of their children.

Finding Help: Resources

If you or someone you know needs professional treatment and support for a co-occurring opioid use disorder (OUD), a.k.a. opioid addiction, and mental health disorder, please contact us here at Crownview Co-Occurring Institute: we can help. In addition, you can find support through the following online resources: