This report was initially prepared by CSR, Incorporated under Contract No. 271-89-8325 with NIDA. CSR staff responsible for developing the report were James Colliver, Fe Caces, and Elizabeth Quinn. The report subsequently was modified by James Colliver and Arthur Hughes of NIDA to incorporate statistical testing of differences in prevalence estimates.
July 1994
ACKNOWLEDGEMENTS
This publication was developed under the joint sponsorship of the National Institute on Drug Abuse (NIDA) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE). Andrea Kopstein served as the NIDA Project Officer, and Sharman Stephens and Laura Feig served as ASPE Liaison Representatives.
Joseph Gfroerer of the Office of Applied Studies of the Substance Abuse and Mental Health Services Administration reviewed the manuscript at each stage, provided statistical consultation, and, together with Joan Epstein, conducted the preliminary analysis reported in Appendix 2.
This report provides data on substance abuse by women of childbearing age and by parents and examines the number of children potentially at risk because of parental drug abuse. The study is based primarily on data from the 1991 National Household Survey on Drug Abuse (NHSDA) but also includes 1991 data from the Drug Abuse Warning Network (DAWN). This study reflects the first attempt to address this topic using data from some of these sources, notably the NHSDA. The study was sponsored jointly by the Office of the Assistant Secretary for Planning and Evaluation and the National Institute on Drug Abuse, with technical assistance from the Substance Abuse and Mental Health Services Administration. Estimates from the NHSDA should be regarded as conservative because of potential underreporting of drug use.
The basic findings of this study are:
(1) Parents with children in the household use illicit drugs less often than do men and women ages 15-44 without children. Past-month illicit drug use is reported by 5.7 percent of women ages 15 - 44 with children in the home compared to 11.2 percent of women ages 15 - 44 without children. Rates for men show similar patterns.
(2) Based on this analysis, it is estimated that there are approximately 6 million children under 18 years of age (9 percent of all such children) whose parent(s) have used illicit drugs in the past month. Marijuana is the illicit drug used most often by parents.
(3) Contrary to expectations, there is little difference in rates of illicit drug use among parents in large metropolitan areas, small metropolitan areas, and nonmetropolitan areas.
(4) The prevalence of illicit drug use among parents has similar demographic patterns as does drug use in the general population. Use rates differ according to income/poverty status, employment, education, age, race/ethnicity, and marital status.
(5) In addition to illicit drug use, the study examined the prevalence of binge alcohol consumption among parents. Consumption of five or more drinks at one time on at least three occasions in the past 30 days is reported by 5.2 million parents (4 percent of mothers and 13 percent of fathers).
Nationwide, an estimated 12.8 million children under 18 years of age live with a parent who reportedly has used illicit drugs in the past year. This figure, which is derived from the 1991 NHSDA, represents approximately 18 percent of all children in this age group. Of the 12.8 million children, approximately 6 million -- 9 percent of children under 18 years old -- have parents who report having used illicit drugs in the past month. Illicit drug use includes any use of illegal drugs such as cocaine, marijuana, heroin, or hallucinogens and nonmedical use of prescription psychotherapeutic drugs such as tranquilizers, stimulants, sedatives, and analgesics. Marijuana is the illicit drug used most often by parents.
Children under 18 years old who live with at least one parent who uses drugs tend to be younger than children overall. For example, 20 percent of children of both past-year and past-month drug users are under 3 years old, whereas 17 percent of all children are in this age group. This is consistent with the findings, discussed below, that drug use is more prevalent among younger parents than among older parents.
Overall, 4.6 million self-reported past-month drug users have biologically-related minor children, and 63 percent of these parents, including 78 percent of mothers and 49 percent of fathers, have at least one of their children living with them. With the addition of stepchildren and adopted children, an estimated 3.4 million past-month drug users are parents and have their minor children living with them. Among all parents in this category, the prevalence rate of past-month drug use is 5.3 percent.
Analyses of data on parents' use of specific drugs show the following:
As noted above, drug use patterns differ by age, race/ethnicity, marital status, education, employment status, and family income. These patterns are similar to what previous research has shown occurs in the general population. Some important patterns are:
Parents with children in the home use illicit drugs less frequently than do men and women (ages 15 - 44) without children. Still, this analysis found that an estimated 12.8 million children live with parent(s) who report illicit drug use in the past year, and 6.2 million live with parents(s) who report past month illicit drug use. Where substance abuse is serious enough to affect parental functioning, some of these children may suffer deleterious social and emotional effects. In addition, some of the children in substance-abusing families will have been exposed to alcohol and other drugs prenatally. The data presented in this report show that drug use among parents, as among the general household population, appears to be closely related to age, income/poverty status, and a host of other factors which are themselves interrelated.
The fact that many families and children are directly affected by alcohol and drug abuse strongly suggests that mainstream service providers working with families in health, social services, and education systems need to be aware of the potential for abuse of alcohol and drugs among their clients, and should play an active role in identifying and intervening with families, including referral for appropriate treatment. Drug treatment programs must recognize that a portion of individuals seeking their services are likely to be families with young children, and that services appropriate to families are needed. Moreover, the effectiveness of services for children and families at risk would be enhanced through better coordination among providers.