The opioid epidemic is well recognized as a national crisis, but the impact on children and adolescents whose parents or close family members are addicted has received little sustained attention. A new United Hospital Fund project is examining the impact of parental opioid use disorder on the mental health, development, and family responsibilities of children and adolescents in those families—and making recommendations for change.

An early project activity was convening a two-day meeting in the fall of 2018 that brought together some 40 national and local experts in child development, family policy, addiction treatment, and child welfare, as well as state and local government officials. With information from that meeting, coupled with extensive research and interviews, UHF has produced a report that offers the first comprehensive look at the successive waves of loss and trauma experienced by newborns, young children, adolescents, and their families. The Ripple Effect: The Impact on the Opioid Epidemic on Children and Families draws on lessons learned from the HIV/AIDS and crack/cocaine epidemics—which, like the opioid crisis, were characterized by stigma; failure to provided needed services to children and families; and increased numbers of children entering foster care or kinship care, caring for younger siblings, and experiencing behavioral and physical health issues.

The report lays out a blueprint for action aimed at public and private agencies and professionals in four broad areas:

1) Reduce stigma and misunderstandings of opioid use and treatment
2) Make investing in a response to the ripple effect a priority
3) Ensure that government and private agencies work as a team
4) Identify children at risk as early as possible

Funders: This project is generously supported by the Alfred P. Sloan Foundation and in collaboration with the Milbank Memorial Fund.

The Children's Health Initiative Team
Suzanne C. Brundage

Suzanne Brundage is director of the Children’s Health Initiative at United Hospital Fund, an independent nonprofit focused on improving health care for New Yorkers. The Children’s Health Initiative focuses on informing public policy and advancing new delivery system models that strengthen pediatric primary care, including how health care partners with other sectors to improve child health and well-being. She was named the first Patricia S. Levinson Fellow in 2017 and 2018 at UHF for her work to improve health care for vulnerable populations.  

Prior to working at United Hospital Fund, Suzanne was the assistant director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS) in Washington, DC. She has also worked with Catholic AIDS Action in Namibia, Nationwide Children’s Hospital, and Boston Medical Center. Suzanne is a member of the Bennington College Board of Trustees and the national Children’s Health Leadership Network. In 2018 she was named to City & State New York's "40 Under 40" list and Crain's New York's list of 100 notable women in health care. 

She holds a BA from Bennington College and an MS degree from the Harvard T.H. Chan School of Public Health.

Carol Levine directs the United Hospital Fund's Families and Health Care Project, which focuses on developing partnerships between health care professionals and family caregivers, especially during transitions in health care settings (  Before joining the Fund in 1996, she directed the Citizens Commission on AIDS in New York City from 1987 to 1991, and The Orphan Project, which she founded, from1991 to 1996.  As a senior staff associate of The Hastings Center, she edited the Hastings Center Report.

Ms. Levine is the editor of Always on Call: When Illness Turns Families into Caregivers (2nd ed., Vanderbilt University Press, 2004); co-editor,  with Thomas H. Murray, of The Cultures of Caregiving: Conflict and Common Ground Among Families, Health Professionals and Policy Makers (Johns Hopkins University Press, 2004); and editor of Living in the Land of Limbo: Fiction and Poetry about Family Caregiving (Vanderbilt University Press, 2014).

In 1993, Ms. Levine was awarded a MacArthur Foundation Fellowship for her work in AIDS policy and ethics.  She was named a WebMD Health Hero in 2007.

In 2009, Ms.Levine was named a Purpose Prize fellow, an honor for social entrepreneurs over 60 who are using their experience and passion to take on society’s biggest challenges.

In 2016, Ms. Levine was named one of the Top 50 "2016 Influencers in Aging" by Next Avenue, a digital publication dedicated to covering issues for people 50 and older.

Kristina Ramos-Callan
Kristina Ramos-Callan