What Early Childhood Program Staff Should Know
It is important that staff working in Head Start and child care settings know about substance misuse.
Substance misuse is more common than you may think. It refers to the inappropriate use of any type of drug, both legal and illegal. This includes medications prescribed by a doctor. Substance misuse affects every income and racial group. Even adults who spend their days caring for young children can struggle with substance misuse.
In fact, it is estimated that one in eight children lived with a parent who misused substances in the past year. (SAMHSA, 2017) When parents or caregivers misuse substances, children are impacted. They may be born dependent on drugs, have developmental delays, or show more challenging behaviors. Children who grow up with a parent who misuses substances are three times more likely to be abused, and four times more likely to experience neglect than their peers. (Smith & Wilson, 2016)
Substance misuse can occur for many reasons and is even linked to mental health problems. For example, feelings of depression and physical pain can go hand-in-hand. Many opioids that are prescribed as pain relievers have an addictive quality, and can temporarily help with feelings of depression, making individuals who use them at high risk for misuse.
Alcohol, tobacco, and marijuana are commonly thought of when discussing problems with substance use and misuse. A more recent major public health problem [PDF, 370KB] is the misuse of opioids, which can be legally prescribed or bought as street drugs. Every day, 91 Americans die from an overdose, and more than 1,000 people are treated in emergency departments for misuse of prescription opioids.
How Head Start and Child Care Programs Can Help
Head Start, home visitors, and child care staff often have a window into the real-life circumstances and needs of families. You may be the front-line in identifying issues that signal substance misuse. It can be hard to navigate these complex situations, but you have unique opportunities to engage families and even prevent harm to children.
Your program can be a valuable resource to families by helping them to know what services are available in the community. Your Health Services Advisory Committee (HSAC) can develop policies, guidelines, and community partnerships. Know the eligibility requirements of programs that serve families impacted by opioid misuse. This information is necessary when discussing service and treatment options with families.
Opioid and Substance Misuse Basics
What Are Opioids?
Opioids are a powerful class of potentially addictive drugs that may be prescribed legally for pain relief, or they can be bought illegally. Prescription opioids include oxycodone, hydrocodone, codeine, morphine, and fentanyl; street drugs such as heroin are also opioids.
- Prescription Opioids: What You Need to Know [PDF, 1.2MB]
General Questions about Substance Misuse
Not everyone who uses opioids or other substances is addicted. This short handout [PDF, 617KB] from the National Institute on Drug Abuse addresses the following topics:
- What Is Addiction?
- Do You or a Loved One Have a Drug Use Problem?
- Signs of Drug Use and Addiction
- How Does Drug Use Become Addiction?
- Addiction Risk Factors
- Does Addiction Run in Families?
- Why Is It So Hard to Quit Drugs?
- "Why Are Drugs So Hard to Quit" and other videos
- Opioid Overdose Prevention Toolkit: Facts for Community Members [PDF, 370KB]
- State-level data and other reports on opioid deaths are available from the CDC (reports)
How Does Substance Misuse Affect Children and Families?
Just like with alcohol, if a pregnant women misuses opioids, her infant may be born physically dependent to the drug or have other affects, such as developmental delays. Foster care systems throughout the country have seen dramatic increases in children entering the foster care system as a direct result of opioid misuse.
- 5 Things to Know About the Opioid Epidemic and Its Effect on Children
- Drug Use and Families: Online Module
Addressing Substance Misuse During Pregnancy
- Substance Misuse During Pregnancy
- Pregnancy and Opioid Pain Medications [PDF, 1MB]
- Five Action Steps to Address Maternal Depression in Head Start Programs: Training Modules
- Assessment and Intervention in the Home: Women and Infants Affected by Opioids [PDF, 1.3MB]
Caring for Children Exposed to Substances
- Understanding the Impact of Prenatal Substance Exposure: Implications for Early Childhood Programs
- Challenges of Foster Parents Who Care for Infants with Neonatal Abstinence Syndrome (NAS) [PDF, 1.4MB] – Includes guidance for soothing infants with NAS
- Drug-Exposed Children: What Caregivers Should Know [PDF, 307KB]
- Teacher Toolbox – Find strategies and resources for working with children with substance exposure in the classroom
- Intervention Ideas for Infants, Toddlers, Children, and Youth Impacted by Opioids [PDF, 332KB]
- Healthy Alternatives for Little Ones (HALO) – An overview of a 12-unit holistic health and substance abuse prevention curriculum for children ages 3–6 in child care settings
Preparing for Sensitive Conversations
Sensitive topics often emerge in early childhood programs. Young children may share a story from home that concerns staff or act out difficult situations during playtime. Beginning these conversations with children and families is not an easy task. These resources can help:
- Training Topic: Strategies for Talking with Children about Difficult Issues
- Better Parent Communication: What Do I Say When a Parent Tells Me Something Difficult?
- Finding a Mental Health Provider for Children and Families in Your Early Head Start/Head Start Program
- Fostering Resilience in Families Coping with Depression: Practical Ways Head Start Staff Can Help Families Build on Their Power to Cope
- Family Connections: A Preventive and System-Wide Training Guide and Mental Health Consultation Model to Support Early Childhood Professionals in Engaging Children and Families
Trauma-informed Family Support and Curricula
- Trauma-Informed Care for Families Affected by Substance Use Disorders
- Trauma-Informed Approaches Need to be Part of a Comprehensive Strategy for Addressing the Opioid Epidemic
Resource Type: Article
National Centers: Early Childhood Health and Wellness
Last Updated: April 4, 2019