State-by-State Impact of Opioid Epidemic on Children Detailed

An estimated 2.2 million children nationwide were affected by the opioid crisis as of 2017; West Virginia had highest rate of children affected; California had the highest number of children 

NEW YORK, NY—November 13, 2019— The opioid epidemic that is ravaging communities throughout the United States placed an estimated 2.2 million children and adolescents in crisis as of 2017—28 out of every 1,000. These children had a parent with opioid use disorder—which can have a devastating, lifelong impact—or had the disorder themselves, according to an analysis produced by United Hospital Fund (UHF) and Boston Consulting Group and released today. 

The analysis, The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemic’s Impact on Children, maps out the impact on children in each state in 2017, revealing a wide variation. West Virginia had the highest rate, with 54 out of every 1,000 children affected. Although California had the lowest rate, it had the highest number of children affected—196,000, or 20 out of every 1,000. 

If current trends continue, the number of children affected nationwide by opioid use will rise to an estimated 4.3 million by 2030, and the cumulative lifetime cost will reach $400 billion in additional spending on health care, special education, child welfare, and criminal justice. That figure does not consider productivity losses or missed opportunities.

“This report shines a light on a population affected by opioids that is often hidden from view,” said study co-author Suzanne Brundage, director of UHF’s Children’s Health Initiative. “But these estimates should not cause despair. Instead, they highlight the urgent need to take action now to help these children and their families.”

Although the opioid crisis is the deadliest drug epidemic in U.S. history, its long-lasting impact on children has received little attention. In March 2019 UHF examined this critical issue in a groundbreaking report, The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families, which discussed the successive waves of loss and trauma experienced by newborns, young children, and adolescents affected by opioid use disorder—from neonatal withdrawal, to entering foster care, to developing an opioid addiction themselves. For this new report, UHF partnered with Boston Consulting Group to determine just how many children face such consequences as well as the cost to society. 

“Fortunately, there are programs and interventions that can go a long way toward helping the vulnerable children and families caught up in the opioid crisis,” said UHF president Anthony Shih, MD. “This data, though grim, can be used by policy officials in multiple sectors.”

The report lists 10 priority strategies that can help children affected by opioids, including investing in evidence-based programs for youth development; increasing the availability of family-based mental health services; expanding treatment and recovery programs for adolescents; and supporting foster and kinship caregivers.

The new report and charts were produced by United Hospital Fund and Boston Consulting Group through a pro-bono engagement. It can be downloaded from UHF’s website here.
About United Hospital Fund
United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at and follow us on Twitter


Nov. 13, 2019
Children's Health Initiative