Opinion: The Foster Care System Feeds the Opioid Crisis

Elizabeth Long, Dec 25, 2021

The United States is failing one of its most vulnerable populations—orphans. Thousands of children enter the U. S. Foster Care System in hopes of a better future and receive little more than trauma. Kids shuffle from house to house, never experiencing a consistent home or long-term reliable parental care. Much less, love. Children enter the foster care system for a variety of reasons—from parental abuse and neglect, to incarceration or death of their parents. Over the past five years, the number of children in foster care increased [1]. Alongside the increase of foster care entries, our country has faced a drastic increase in opioid overdose deaths. Thousands of people die of drug overdose each year, and the United State’s foster care system contributes to this tragic epidemic. Children enter foster care, perhaps due to parental substance abuse, and often end up following in their parents’ footsteps, an outcome attributable to the harmful foster care system that offers minimal guidance and support. Children within the system are also likely to experience abuse. The foster care system fails to offer children sufficient parental support and simultaneously increases their risk of  experiencing traumatic events, therefore facilitating a generational cycle of opioid abuse and/or homelessness. This cycle ultimately furthers our nation's devastating opioid epidemic.


Many children enter foster care with a history of trauma. Yet, within the system, they are likely to experience even more; a setback that statistically increases their likelihood of substance abuse [2]. According to the 2011-2012 National Survey of Children's Health, children living in foster care are “thirty times as likely as children living with two biological parents to have had four or more Adverse [Childhood] Experiences” (ACEs) [3]. ACEs include traumatic events such as experiencing or witnessing abuse, parental neglect, substance use, divorce, mental illness, or familial violence [4]. While a unique child may experience a majority of their ACEs before foster care, frequently moving homes and growing up without unconditional parental love—two things essentially guaranteed in life within the system—are traumatic experiences on their own. That said, many children also live through countless traumas during their time in foster care. Abuse within the system is overwhelmingly common. According to a study done in Oregon and Washington State, one-third of children reported abuse from their foster parent or another adult living in their foster home [5]. These data are devastating. The United States offers abandoned youth no other option than a life where they are not only unprotected but likely to be harmed. Furthermore, in 2010, the National Center for Biotechnology Information found that “exposure to traumatic experiences, especially those occurring in childhood, has been linked to substance use disorders (SUDs), including abuse and dependence” [6]. The tragic experiences these children endure at a young age form a foundation for a substance abuse disorder later in their life.


At 18 years old, children age out of foster care and receive virtually no support. Almost immediately, they lose access to any financial, educational, or social support services previously offered to them. After a childhood filled with trauma, and often without a solid foundation, 18-year-olds face the terrifying adult world. Many of these emerging adults never received financial guidance and lack any savings or knowledge about budgeting, taxes, or even how to pay rent. In addition, many of these children never received a solid education. Children in foster care are twice as likely to be absent from school [7]. Consequently, many children in foster care also miss out on the guidance and extracurricular benefits that schools might offer. They exit the foster care system and enter the world without support, education, or financial backing. Without a strong foundation, many of these emerging adults may turn to drugs. Within the first four years after leaving foster care, twenty percent of these young adults experience homelessness [8]. 


For some youth, life on the streets may be an improvement from their previous home. But, homelessness bears its own challenges. Aside from surviving, the newly homeless teens must consider a temptation easily accessible on the streets that offers an escape from their traumatic life—opiates (commonly, heroin). Children in foster care are already at higher risk of substance abuse and other health problems due to their likelihood of ACEs. CDC studies linked higher ACE scores—assessed by assigning one point for each adverse experience—to an increased risk of heart disease, chronic illnesses, mental illness, suicide, health risk behaviors, and substance abuse [9], all ailments that could facilitate opiate addiction as a form of self-medication. Furthermore, many children initially entered the foster care system due to parental drug abuse. Therefore, they are genetically more susceptible to substance abuse, as “genetic factors account for 40 to 60 percent of a person's vulnerability to addiction” [10]. As a result of their traumatic childhood and immense lack of support, newly “aged out” teens may enter a situation where this genetic vulnerability to addiction plays a significant role. They may quickly fall prey to a deadly opioid addiction.


The United States faces an opioid crisis. In 2017, the United States Department of Health and Human Services declared this opioid epidemic a public health emergency. Since then, the issue has only worsened. Opioids sweep through the nation, killing thousands and preying on innocent children within the Foster Care System. In a study of 406 17-year old foster care children, researchers found that “forty-five percent of foster care youth reported using alcohol or illicit drugs within the last six months; 49% had tried drugs sometime during their lifetime and 35% met criteria for a substance use disorder” [11]. Clearly, children who experience foster care are highly vulnerable to drug use and substance abuse—both during their time in the system and after. This increased risk of substance abuse due to our country’s defective foster care system ultimately furthers a potentially generational cycle of substance abuse and/or homelessness. 


If our country hopes to win the battle against the opioid epidemic—a ruthless beast—we must begin by uprooting and reforming its feeder: the destructive foster care system. From childhood, these children are set up to feed the opiate crisis. Childhood trauma and lack of parental and societal support increase a child’s risk of substance abuse and homelessness (which, in itself, increases a person’s risk of drug use). To halt the cycle, we must cut off the pipeline of traumatizing foster care that feeds homelessness and opiate addiction. Through reforming the United State’s Foster Care system, we will be able to improve the opioid crisis and many more national tragedies. Time is of the essence. It is our duty to save these precious lives.


1. Centers for Disease Control and Prevention. (2019, November 7). Vital signs: Estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention - 25 states, 2015–2017. Centers for Disease Control and Prevention. Retrieved November 4, 2021, from https://www.cdc.gov/mmwr/volumes/68/wr/mm6844e1.htm
2. DiLorenzo, P. S., reports, T. I. staff, Senderling-McDonald, C., Tiano, S., & Sankaran, V. (2020, July 30). When trauma slips into addiction. The Imprint. Retrieved November 11, 2021, from https://imprintnews.org/child-trauma-2/when-trauma-slips-into-addiction/32462#:~:text=Correlation%20Between%20Addiction%20and%20Trauma&text=Trauma%20increases%20the%20risk%20of,to%20cope%20with%20traumatic%20events
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4. Kylie Rymanowicz, M. S. U. E. (2021, May 25). Adverse childhood experiences (aces): What are they and how can they be prevented? Early Childhood Development. Retrieved November 4, 2021, from https://www.canr.msu.edu/news/adverse-childhood-experiences
5. Nan Edge February 21st, Kennedy March 16th, Jamie May 9th, Trevor June 20th, Leslie November 17th, Steven Pfeiffer March 7th, grace garcia June 15th, Jamie Marie Parsons June 28th, Connie Ford Johnson January 15th, Stefanie Alvarez January 24th, Honest July 1st, GREG SMITH July 2nd, Delia September 14th, Carolina O Martinez October 6th, Mariana November 10th, nekoda campbell January 6th, Jim O Hallquist February 14th, Lone Warrior Girl March 17th, Ann June 2nd, … *, N. (2020, December 10). Sex abuse and the foster care system. Focus for Health. Retrieved November 4, 2021, from https://www.focusforhealth.org/sex-abuse-and-the-foster-care-system/
6. Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751
7. Fostering success in Education. (n.d.). Retrieved November 4, 2021, from https://fosteringchamps.org/wp-content/uploads/2018/04/NationalEducationDatasheet2018-2.pdf
8. 35 Foster Youth Homelessness Statistics You should know. Alternative Family Services. (2021, May 25). Retrieved November 4, 2021, from https://www.afs4kids.org/blog/35-oster-youth-homelessness-statistics-you-should-know/
9. Kylie Rymanowicz, M. S. U. E. (2021, May 25). Adverse childhood experiences (aces): What are they and how can they be prevented? Early Childhood Development. Retrieved November 4, 2021, from https://www.canr.msu.edu/news/adverse-childhood-experiences
10. The role of genes in drug addiction. Scholastic. (n.d.). Retrieved November 4, 2021, from http://headsup.scholastic.com/students/the-role-of-genes-in-drug-addiction
11. Vaughn, M. G., Ollie, M. T., McMillen, J. C., Scott, L., & Munson, M. (2007, September). Substance use and abuse among older youth in Foster Care. Addictive behaviors. Retrieved November 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633867/