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Rate at Which Children Orphaned From Drug Overdose Doubles in 10 Years

A multi-agency group has just released a study analyzing the National Survey on Drug Use and Health from the decade of 2001 to 2021 to see just how many children are orphaned or lose a parent due to drug overdose. The trend is not good. The rate at which children experience the death of a parent from a drug overdose has more than doubled in 10 years, from 27 to 63 per 100,000 children.

The groups participating in the study include the Centers for Disease Control (CDC), the National Institute on Drug Abuse (NIDA), and the Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health. Nora Volkow, National Director of NIDA, is quoted in the news release saying that “any child who loses a parent to overdose must receive the care and support they need to navigate this painful and traumatic experience.”

The total number of children who lost a parent due to drug overdose in this 10-year period is a shocking 321,566 children. Half of those who die from drug overdose are parents. Table 1 from the CDC indicates that deaths from drug overdose hit hardest from ages 35 to 44 which are prime parenting years. 

Figure 1: The rate of drug overdose deaths, by age groups 15 and over: United States, 2020 (blue) and 2021 (green). Image source by CDC is public domain.

A SAMHSA report from 2015 estimated that one child out of eight lived with a parent suffering from substance use disorder (SUD). The authors say that:

Children with a parent who has an SUD are more likely than children who do not have a parent with an SUD to have lower socioeconomic status and increased difficulties in academic and social settings and family functioning.

According to a study in Ireland of surviving family members of a drug overdose victim, 

The children of those left behind are a particularly vulnerable group who require specialised community based bereavement support by organisations who understand the impact of substance misuse within the family.

A more microscopic look into the impacts of the death of a parent from drug overdose comes from Allegheny County, Pennsylvania, where a study was conducted based on 664 individuals who had died of drug overdose and were also listed as a parent on a birth certificate. The results were summarized as follows:

Within 3 months following the parent’s death, more than 1 in 10 of the Medicaid-enrolled children had used mental health services (11.1%). Within 5 years, this had increased to nearly 1 in 4 children (24.8%).

In many cases, increased access to mental health services should be seen as a positive sign. Over that same five-year period, 8.5% of the children had experienced an “out-of-home placement,” as the report calls it. There is no comparison in the report to an average rate for the use of mental health services or the need for a placement outside the home among the general population. The study noted there was no increase in the rate of court-involved delinquency involvement with children who had lost parents from overdose.

An intriguing report from the Eastern Economic Journal found that there was no measurable impact on the lifetime earnings of a child who experienced the death of an opposite-sex parent, and a small lifetime differential for the loss of a same-sex parent (2%-4%). This was smaller than the lifetime earnings impact of parental separation or divorce (3% to 12%). These numbers have been used to calculate damages in wrongful death court cases.

Another study from Denmark found a decisive earnings differential. Sons who lose fathers during the first 1,000 days of life (birth to three years of age) had a 13.4% reduction in annual earnings in 2013 compared to the average. The study found the same effect whether it was sons or daughters, mothers or fathers. However, the impact on earnings diminishes with the age of the child at the time of the parent’s death. For children aged 21 and older, the impact on income from the death of a parent is “insignificant.”

Written by Steve O’Keefe. First published May 13, 2024.


“More than 321,000 U.S. children lost a parent to drug overdose from 2011 to 2021,” National Institutes of Health News Release, Wednesday, May 8, 2024.

“Drug Overdose Deaths in the United States, 2001-2021,” National Center for Health Statistics, December 2022.

“Children Living With Parents Who Have a Substance Use Disorder,” Substance Abuse and Mental Health Services Administration, August 2017.

“The impact of drug and related deaths on families,” Cork Open Research Archive, February 2019.

“Potential Emerging Risks Among Children Following Parental Opioid-Related Overdose Death,” Journal of the American Medical Association (JAMA), April 13, 2020.

“The Effect of the Loss of a Parent on the Future Earnings of a Minor Child,” Eastern Economic Journal, June 2010.

“The Long Goodbye: The Economic Effects of a Parent’s Death,” Copenhagen Business School, retrieved May 10, 2024.

Image Copyright: meepoohyaphoto.


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