# Caregiver substance use among families in the U.S. child welfare system: national prevalence estimates

**Authors:** Susan Yoon, Charis Stanek, Juan Lorenzo Benavides, Taylor Napier, Yujeong Chang, Choong Rai Nho

PMC · DOI: 10.3389/fpsyt.2025.1620676 · Frontiers in Psychiatry · 2025-07-21

## TL;DR

This study estimates how common substance use is among caregivers in U.S. child welfare cases and finds higher rates among certain groups.

## Contribution

The study provides new national prevalence estimates of alcohol and drug dependence among caregivers in the U.S. child welfare system.

## Key findings

- About 8% of caregivers met criteria for alcohol dependence and 3% for drug dependence.
- Higher rates of substance dependence were found among White, male caregivers and those with domestic violence or depression.
- Alcohol and drug dependence showed distinct patterns based on income, education, and child placement history.

## Abstract

Understanding the prevalence of caregiver substance use among families affected by the child welfare system can inform prevention and intervention efforts to reduce co-occurring caregiver substance use and child maltreatment. This study examined the national prevalence estimates of alcohol and drug dependence among caregivers affected by the U.S. child welfare system and explored variations based on child and caregiver characteristics.

A secondary data analysis was conducted using the most recent data from the National Survey of Child and Adolescent Well-being (NSCAW-III).

Results indicated that approximately 8% of caregivers met criteria for alcohol dependence and 3% for drug dependence, with about 11% reporting either alcohol or drug dependence. For both alcohol dependence and drug dependence, higher prevalence rates were observed among White caregivers, male caregivers, caregivers of male children, and caregivers who were experiencing domestic violence and/or depression. Distinct patterns emerged in the prevalence rates of alcohol versus drug dependence across caregiver income, education, employment status, and the number of children’s out-of-home placements.

Our findings highlight nuanced differences between alcohol and drug dependence and point to the need for targeted and contextually responsive programs that address the complex intersection of caregiver substance use and child maltreatment.

## Full-text entities

- **Diseases:** -III (MESH:C537189), neglect (MESH:D058069), COVID-19 (MESH:D000086382), aggression (MESH:D010554), trauma (MESH:D014947), drug misuse (MESH:D009293), Abuse (MESH:D019966), major depression (MESH:D003865), depression (MESH:D003866), pain (MESH:D010146), Alcohol Use Disorders (MESH:D000437), mental health (OMIM:603663), child maltreatment (MESH:C562515), child abuse and neglect (MESH:C535569), physical abuse (MESH:D059445)
- **Chemicals:** heroin (MESH:D003932), Alcohol (MESH:D000438), substance (MESH:C012600)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

49 references — full list in the complete paper: https://tomesphere.com/paper/PMC12320045/full.md

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Source: https://tomesphere.com/paper/PMC12320045