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

In 2019, an estimated 1.4 million U.S. children — 2% of all 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 Penn 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.

Drug overdoses and the opioid crisis shape childhood

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’s professor of sociology and professor of sociology and spatial studies at USC Dornsife . “It’s alarming how much younger children lose loved ones.”

Co-author Ashton Verdery of Penn State underscored the concern. “We found that 5-year-olds today are just as likely to suffer losses as 10-year-olds were 15 years ago,” he said.

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

Drug overdose deaths disrupt 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, especially 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 stages, but these losses often occur in traumatic and painful circumstances – the toll can last a lifetime,” Smith-Greenaway said.

While it wasn't 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.

Expanding research on drug overdose deaths

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

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.

About the study

In addition to Smith-Greenaway and Verdery, the research team also included Cayley Ryan-Claytor and Nilakshi Sarkar from Penn State University and former USC Dornsife doctoral student Michelle Livings, now at Princeton University.

The study was supported by National Institute on Aging grant 1R01AG060949 and the Pennsylvania State University Population Research Institute, which is supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development infrastructure grant P2C-HD041025.