UHF’s Suzanne Brundage Testifies About Impact of Opioid Epidemic on Children before NYS Senate Task Force

The number of children in New York State affected by the opioid epidemic is staggering: 125,000. Only California, Texas, and Florida have higher totals.

With the opioid epidemic posing a major threat to the health and well-being of New Yorkers across the state, the Joint Senate Task Force on Opioids, Addiction and Overdose Prevention held a hearing in Albany on November 15, 2019 to assess strategies for addressing the epidemic. Suzanne Brundage, director of UHF’s Children’s Health Initiative, was invited to testify and discussed a report released by UHF earlier in the week that details the impact of the epidemic on children, The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemic’s Impact on Children

A transcript of her testimony follows:

The United Hospital Fund (UHF) is an independent nonprofit organization dedicated to building a more effective health care system for every New Yorker. Since 1879 UHF has helped solve vexing problems in the health care system and collaborated on addressing critical health issues facing New Yorkers. We analyze public policy, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. 
We thank the Joint Senate Task Force for the opportunity to testify on the impact of the opioid epidemic on children. We appreciate the Senate’s support for programs such as the CHARM project aimed at coordinating care for expectant mothers with opioid use disorder. 

Childhood Adversity Due to The Opioid Epidemic 

While the opioid epidemic is a major threat to the health and well-being of New Yorkers, we are particularly concerned by the long-lasting and profound impact the epidemic has on children of parents suffering from opioid use disorder. Growing up in a household with substance use exposure is classified by experts as an Adverse Childhood Experience (ACE) and can make children vulnerable to additional ACEs, such as loss or separation from a parent. As the Centers for Disease Control and Prevention reaffirmed last week, ACEs have been strongly linked to poor school performance, chronic illness, and premature death. These potential outcomes can threaten the health, vitality, and productivity of the next generation. Countering that threat requires a comprehensive public strategy focused on supporting families with substance use disorders and investing in the healthy development of their children.

National and New York Estimates of the Opioid Epidemic’s Impact on Children 

To aid policymakers in developing these strategies, UHF partnered with Boston Consulting Group to estimate, by state, the number of children affected by the opioid epidemic and to project the additional societal cost. UHF published this analysis, The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemic’s Impact on Children, on Wednesday, November 13, 2019. A copy of the report is attached to our written testimony for your reference. This analysis builds upon a March 2019 report, The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families, which outlines mitigation strategies that emerged from a two-day convening of numerous New York State Commissioners and experts.  

We estimate that, in 2017, 2.2 million children nationwide had a parent with opioid use disorder or had OUD themselves. That is 28 out of every 1,000 children. Most were under the age of 12. 

While New York State’s rate of affected children is on par with the national rate, the number of children is staggering: 125,000. Only California, Texas, and Florida have higher totals. The breakdown of the NY estimate is:
•    90,000 children were residing in a household with a parent with OUD
•    13,500 lost a parent due to an opioid-related death or incarceration

•    10,500 were removed from home for kinship or foster care 
•    11,000 children had OUD themselves or had accidentally ingested opioids 
These are nonduplicative estimates. 

Despite promising signs that the opioid epidemic has hit an inflection point, the number of children affected will continue to grow. If current trends continue, the number of children affected by opioid use will rise to a projected 4.3 million by 2030. That will cost the nation $400 billion in additional spending on health care, special education, and other expenses over the lifetimes of these children. We estimate the cost to New York State will reach $22.5 billion by 2030, not counting lost productivity or missed opportunities. 

State Strategy

We urge the Senate to pursue a comprehensive strategy to mitigate the effects of the opioid epidemic on parents and children. There are already a range of tested interventions, including funding youth development programs, increasing the availability of family-based mental health services, and expanding supports for foster and kinship caregivers. Federal supports, including the CDC’s Preventing Adverse Childhood Experiences guide and new funding through the Family First Prevention Services Act, can help the state.

The report outlines 10 priority strategies the Senate should consider as it continues its policy making to address the opioid crisis:
•    Reduce stigma and misunderstanding of opioid use and treatment, particularly among people interacting with pregnant women and parents
•    Coordinate the response across health care, law enforcement, child welfare agencies, and schools, so families struggling with substance use disorder receive a “no-wrong-door” approach to evidence-based services
•    Create protocols for emergency responders to connect children on the scene of potentially traumatic events to appropriate recovery services
•    Provide kinship caregivers and foster parents with tools for responding to trauma in children
•    Encourage schools to practice trauma-informed care
•    Research the needs of youth caregivers and develop programs to support them
•    Increase the availability of family-based mental health services 
•    Invest in evidence-based programs for youth development 
•    Encourage integrated health and social services that simultaneously meet the needs of parents and children 
•    Reduce geographic and racial/ethnic disparities in access to services 

We have the tools—we just need to put them in place.   

For a video of an abridged version of this testimony, go here

Nov. 20, 2019
Focus Area
Coverage and AccessClinical-Community Partnerships
Children's Health Initiative