New England's opioid use epidemic: Policy implications for families involved with the child welfare system

Cities and towns across New England are battling an unprecedented opioid use epidemic. One population uniquely affected by the epidemic is pregnant and postpartum women. As they navigate the challenges and complexities of treatment and recovery, their involvement with the child welfare system is one of both crisis and opportunity. Though these families often encounter the child welfare system during times of crisis, there is potential for multifaceted secondary prevention as families with complex needs could be connected to valuable resources. 

Based in a safety net hospital, one example of a secondary prevention intervention is Project RESPECT-Plus, a research study involving postpartum women in treatment for opioid use disorder that aims to improve child and family wellbeing. Baseline data indicates that 65.2% of participants no longer have custody of at least one child, 44.3% were homeless in the past year, 54.2% report food insecurity, 80% have been diagnosed with a mental health disorder, and 27.1% have a history of domestic violence victimization. These data suggest that interventions targeting these families must incorporate a holistic approach to family wellbeing. With states such as Massachusetts declaring the epidemic a public health emergency, the time is now to advocate for policies that address the intersecting needs of these families, such as 1) increased multidisciplinary collaboration to address social determinants of health such as homelessness, mental health, and domestic violence; and 2) increased care coordination between the child welfare system and substance abuse treatment programs.