Mental Health

Substance Misuse

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.

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?

Related Resources:

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.

Addressing Substance Misuse During Pregnancy

Caring for Children Exposed to Substances


Young Children

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:

Trauma-informed Family Support and Curricula