The Impact of the COVID-19 Pandemic on Substance Misuse Among Child Welfare-Involved Families

Background and Purpose: The onset of the COVID-19 pandemic represents one of the most stressful life events in recent times. Disruptions in typical parenting activities and school closures meant parents found themselves juggling parenting and work responsibilities. Due in part to heightened stress or distress during the pandemic, emerging research in the general population shows increased prevalence in substance use and shifting patterns in specific substances used. These trends have important implications for child welfare-involved families because parental substance misuse is often present in child abuse and neglect cases. Children from substance-affected families are exposed to higher rates of trauma, less likely to reunify with their biological parents, and for those who reunify more likely to re-enter child welfare. To identify and provide appropriate treatment services, child welfare agencies must first clearly understand substance use patterns, including how substance use behaviors are shaped by major life events over time. The present study aimed to investigate patterns in 1) the proportion of child welfare cases involving substance use and 2) specific substances used. We further examined how the early phases of the pandemic may have impacted the mean percentage of cases involving substance use.

Methods: We used administrative data from Ohio Statewide Automated Child Welfare Information System (SACWIS). SACWIS data are routinely collected as part of the investigative and intervention process following referrals for child abuse and neglect. Cases opened between January 2019 to June 2022 were included. We examined if the primary female parent had a substance misuse problem according to the comprehensive family assessment at the time of entry. We investigated longitudinal patterns of the percentage of cases involving any substance use and the specific categories of substances used. Single changepoint analyses were used to test for significant differences in mean percentage of cases involving substance misuse during selected weeks of each year.

Results: Unlike the other years studied, the percentage of substance-involved cases increased drastically from the start of 2020 and peaked in the second quarter. Interestingly, when polysubstance users are excluded, the observed increases were diminished for all categories except for cannabis. The changepoint analyses validated the observed changes. In all years except for 2020, the number of new cases significantly increased in the first two months of the year. However, in early 2020, we found a statistically significant decrease in the number of new cases, but an increase in the percentage of cases involving any substance use, polysubstance use, and cannabis use, which corresponds to the declaration of national emergency concerning the COVID-19 pandemic.

Conclusions and Implications: Our finding that the proportion of substance-involved cases increased in the early phases of the pandemic corroborates nationwide studies. That cannabis use was a main driver of the observed increase suggests parents may have been using substances to cope during that time. The high prevalence of polysubstance use is particularly concerning given the negative impact it can have on treatment outcomes. Our findings support the need for targeted treatment programs specific to parental substance use behaviors.