Drug overdose deaths are taking a growing toll on U.S. children

In 2019, 2% of children nationwide had lost a family member to a drug overdose, according to a study by researchers at the USC Dornsife College of Letters, Arts and Sciences and Pennsylvania State University. The results, published in the American Journal of Public Healthshed light on the often-overlooked emotional toll of overdose deaths on the youngest and most vulnerable members of society and provide the first concrete data to quantify their impact.

Since 2006, opioid-related deaths have increased faster than those caused by other substances. In 2019, opioid overdose deaths were 2.4 times more common than non-opioid-related deaths. By 2022, they were three times more common.

The study uncovered a troubling trend: About 2% of children born in 2009 lost a family member to an overdose by age 10, compared to just over 1% of children born in 2001.

“We expect this percentage to continue to rise, potentially reaching 5%, by the time children born in 2009 turn 18,” said Emily Smith-Greenaway, dean of sociology and professor of spatial studies at USC Dornsife. “It’s alarming how much younger children lose loved ones.”

Ashton Verdery, co-author and professor of sociology and social data analysis at Penn State, underscored the concern. “We found that 5-year-olds are experiencing losses now at the same rate as 10-year-olds were 15 years ago,” he said.

Meanwhile, researchers found that the rate of deaths in the family from other causes has remained stable.

Fraying of family systems

The death of a family member, regardless of the cause, can destabilize a child's life, often leading to long-term mental health problems, academic challenges and even substance abuse later in life, research on childhood bereavement shows. A study found that adolescent boys, particularly those who have lost a parent, are vulnerable to alcohol and drug abuse.

When the loss is due to a drug overdose, the trauma is often more intense because of the suddenness of the loss and the stigma associated with it, the researchers explained.

“Not only do children lose the support they need at critical developmental times, but these losses often occur in traumatic and painful circumstances – the toll can last a lifetime,” Smith-Greenaway said.

While it was not surprising to the research team that children are two to two and a half times more likely to lose a male relative than a female relative to an overdose, the recent increase in overdose deaths among women is particularly concerning. Overdose deaths among women ages 35 to 44, particularly pregnant or postpartum women, more than tripled between 2018 and 2021, according to the National Institutes of Health. Smith-Greenaway noted that this trend could place further strain on already fragile family systems.

To estimate the number of children affected by familial overdose deaths, researchers combined CDC data on drug- and fertility-related causes of death with census data from 2000 to 2019 – a period not affected by the COVID-19 pandemic was.

While the study focused on immediate family members, Smith-Greenaway and Verdery suspect that the number of children affected would likely be higher if the deaths of friends, neighbors or stepparents had been included. Additionally, the sharp increase in overdose deaths between 2020 and 2023, which the study does not take into account, suggests that their estimates may underestimate the full extent of the crisis.