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. The initiative has released two groundbreaking reports on this critical issue (see links below). 

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 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 provide 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

UHF partnered with the Boston Consulting Group to produce its second Ripple Effect report, which—for the first time ever—provided a state-by-state analysis of both the number of children affected by opioids as well as the economic impact. The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemic’s Impact on Children estimated that the nation's opioid epidemic placed 2.2 million children and adolescents in crisis as of 2017—28 out of every 1,000. If current trends continue, according to the report, the number of children affected nationwide 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. 

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

Families and Opioids Team
Suzanne C. Brundage

Suzanne C. Brundage is a public health and health care strategist committed to creating the conditions in which children and families thrive. She is the director of UHF’s Children’s Health Initiative, which was established to strengthen health care’s focus on health disparities rooted in childhood. 

Through a dual focus on service delivery and policy, Suzanne has worked on a range of issues including social determinants of health and education; primary care; Medicaid; and substance use disorders. She is a trusted collaborator, thought partner, and consensus builder for many organizations and individuals nationwide focused on strengthening systems for families. She was named the first Patricia S. Levinson Fellow at UHF for her work to improve health care for vulnerable populations. 

Before working at UHF, Suzanne was the assistant director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, D.C. She has worked with a wide range of health nonprofits and safety net institutions, including Healing Through Remembering in Northern Ireland, Catholic AIDS Action in Namibia, Nationwide Children’s Hospital in Ohio, 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 in conflict resolution and international affairs and an MS in health policy and management from the Harvard T.H. Chan School of Public Health.

Kristina Ramos-Callan
Kristina Ramos-Callan