What’s New in Psychology
One in Four American Children at Risk for ACEs
Jim Windell
There are various reasons why children may experience an ACE – an adverse childhood experience.
Reasons for children to experience an ACE, which are potentially traumatic events that take place during childhood, can include violence, abuse and growing up in a family with mental health or substance abuse problems.
A new study suggests that perhaps one in every four American children may experience an ACE because of the substance abuse of a parent.
The new findings were published in the journal JAMA Pediatrics by a team from the University of Michigan Center for the Study of Drugs, Alcohol, Smoking, and Health, and is directed by Sean Esteban McCabe, Ph.D. The findings are based on data from the National Survey on Drug Use and Health, a federal program that has tracked U.S. drug and alcohol use since the 1970s, yielding data that researchers and policymakers have used.
McCabe, a professor in the U-M School of Nursing and Institute for Social Research, and a member of the U-M Institute for Healthcare Policy and Innovation, and his team used data from 2023 to give as current a view as possible. The researchers estimate that 19 million young people under age 18 live with a parent or other adult who meets the definition for a substance use disorder. Of them, an estimated 6 million live with an adult who has a mental illness in addition to their substance use disorder.
The most common substance that parents showed disordered use of was alcohol, with survey data leading to estimates that 12 million parents meet criteria for some level of alcohol use disorder. Just over 6 million parents may meet criteria for cannabis use disorder. About 3.4 million meet criteria for disordered use of multiple substances.
“The increase and fact that one in four children now live with parental substance use disorder brings more urgency to the need to help connect parents to effective treatments, expand early intervention resources for children, and reduce the risk that children will go on to develop substance use issues of their own,” said Sean Esteban McCabe, Ph.D., lead author of the new study.
In addition to alcohol and cannabis, McCabe and his colleagues estimate that just over 2 million children live with a parent who has a substance use disorder related to prescription drugs, and just over half a million live with a parent whose use of illicit drugs such as cocaine, heroin and methamphetamine meets criteria for a substance use disorder.
The researchers include Vita McCabe, M.D., MHSA, the director of the University of Michigan Addiction Treatment Services in the Department of Psychiatry at Michigan Medicine, U-M’s academic medical center.
“We know that children raised in homes where adults have substance use issues are more likely to have adverse childhood experiences, to use alcohol and drugs earlier and more frequently, and to be diagnosed with mental health conditions of their own,” said Vita McCabe, who is board-certified in addiction medicine and psychiatry. “That’s why it’s so important for parents to know that there is effective treatment available, including the medications naltrexone and/or acamprosate for alcohol use disorder, cognitive behavioral therapy for cannabis use disorder, and buprenorphine or methadone for opioid use disorder including both prescription and non-prescription opioids.”
Ty Schepis, Ph.D., an addiction psychologist at Texas State University and senior author of the article, added: “Our new findings add to the understanding of how many children are living with a parent who have severe and comorbid substance use disorder and other mental illness such as major depression. This is important to note because of the additional risk that this creates for children as they grow into adults.”
To read the original article, find it with this reference:
McCabe, S.E., McCabe, V.V., & Schepis, T.S. (2025). U.S. Children Living with a Parent with Substance Use Disorder. JAMA Pediatrics. doi:10.1001/jamapediatrics.2025.0828
