LATE BREAKING ABSTRACT I: THE CHANGING INTERFACE OF THE CHILD WELFARE AND SUBSTANCE ABUSE TREATMENT SYSTEMS IN THE CONTEXT OF THE OPIOID EPIDEMIC

As the opioid epidemic escalates, children are under-recognized victims. Child welfare caseloads are rising after years of decline. Despite much speculation, limited empirical evidence documents the connections among opioid misuse, drug overdose deaths, and increasing rates of foster care placement. Two recent Federal events have the potential to broaden the conversation about this important interface. First, ASPE/HHS released briefs from their landmark mixed-method study examining the role of parental substance use (including opioids) and child welfare placements, focusing on county level nation-wide data and in-depth interviews with 180+ multi-sector professionals. Second, attempts to support families hit by the opioid epidemic led to adding the Family First Prevention Services Act (P.L. 115-123) to the budget. This offers unprecedented opportunities for states to provide prevention, treatment and early intervention services for families at risk of foster care placement, with the potential to substantially increase the percentage of federal child welfare dollars on prevention services (beyond foster care).

These federal initiatives underscore the need to sustain partnerships among researchers, practitioners, and policymakers so implementation can capitalize on evidence based interventions for substance abusing parents and their children in the CWS. This roundtable includes perspectives from Federal staff involved in conducting relevant studies and in overseeing programs that support partnerships among child welfare, family court, and substance abuse treatment services. Included are two NIDA funded researchers (along with their project officer) providing perspectives on intervention and implementation research with relevant examples of the challenges and opportunities in this complex research. One project is an RCT examining contingency management for substance abuse and the Pathways Triple P parenting program (both evidence based practices) for parents with an active CPS case who enroll in treatment for substance use disorder. The other is an intervention efficacy trial conducted in a Medicaid-only billable environment with rural, isolated or homeless populations. The project uses a range of evidence based practices to support families with substance abuse problems and CWS involvement and links to housing, employment/education and social services. Discussion foci: (a) how to ensure opportunities are increasingly available to support families and communities devastated by parental substance abuse and CWS involvement; (b) research-practice-policy partnerships are supported to facilitate the delivery, adoption, and implementation of evidence based programs/practices; and (c) identification of gaps in research, implementation and translation.