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The Opioid Crisis: Foster Care, School Support, and the Importance of Taking Action

Updated: May 26, 2021

By Arnav Durani and Michelle Hull, CEI interns

Although the opioid epidemic is often understood through the eyes of those battling opioid use disorder, families cannot be forgotten when considering the devastating impact of drug misuse. Children growing up in homes affected by opioid misuse shoulder profound and heartbreaking burdens, which can include legal, social, economic, and emotional traumas.

COVID-19 has only intensified this crisis. When asked about the impact of the pandemic, Megan Moncur, the Associate Director for Opioid Policy at the FDA, shared that deaths due to opioid misuse are on the rise, with more than 30 states reporting an increase in opioid-related deaths since the start of the pandemic (U.S. Food and Drug Administration, 2020). Experts point to the anxiety, grief, and isolation that has accompanied the coronavirus as critical factors in this shift. Given the growing number of people battling opioid use disorder, more children are being put in the custody of other caregivers, such as grandparents or relatives, or are entering the foster care system (2020).

Whether or not children’s primary caregivers are changing, the emotional impact of living with family members struggling with opioid use disorder cannot be underestimated. There are numerous points to consider when reflecting on how to best support children living in the wake of this crisis. Schools have a significant role to play in providing children with the socio-emotional support needed to navigate the complexities of the COVID-19 era for children impacted by the opioid crisis.

The Opioid Crisis and the Foster Care System

Outside of school, children growing up in homes impacted by opioid use disorder may experience a multitude of emotional stressors, including a change in their primary caretakers.  In 2017, over 2 million children were in foster care as a direct result of the opioid crisis (Collins, 2018). That number is only projected to rise in time, with an estimate of 4.1. million children affected by opioid use disorder in the foster care system by 2030 (Brundage et al., 2019).

While foster care provides a sometimes necessary landing spot for children living in the wake of opioid misuse, social services staff are struggling to adequately support the influx of children in the system. Caring for children who have suffered the emotional, behavioral, and physical consequences of being raised by someone struggling with substance misuse requires a significant amount of time and energy, which are scarce resources in the foster care system. Moreover, an increase in the number of children in the foster care system means more adoptive homes are needed, and there are not enough families willing to adopt for every child to find a new home. As a result, more children are entering foster care than leaving, further straining the system’s limited resources (Fryar et al., 2017).

Although the number of children entering the foster care system is staggering, the above statistics don’t account for all of the children impacted by the opioid crisis. Throughout the COVID-19 pandemic, reports of parental abuse, neglect, and substance use have plummeted (Milton, 2020). However, many worry that these behaviors have become more prevalent without being appropriately documented. Because children have been at home, teachers have not been able to closely monitor their students’ well-being. To bridge this gap, schools must take responsibility for their role in ensuring that all children are receiving the care and support needed to thrive, both within and outside of school.

Combatting the Opioid Crisis in Schools

While COVID-19 has posed new challenges in supporting students, schools are critical intervention points in buffering against the harmful effects of the opioid crisis. In the absence of familial stability, school serves as a critical anchor for students living in turbulent homes. However, the trauma experienced at home creates additional challenges in the classroom. Teachers routinely witness behavioral issues from affected students such as difficulty regulating emotions and focusing, physical aggression, and a lack of empathy towards peers. This poses two primary challenges: stalled social and cognitive development and a chaotic classroom environment for other students. With COVID-19 and remote learning causing increased stress, these behaviors have increased in their frequency and intensity. Although remote learning has forced educators to be more creative in caring for their students, the effects of growing up in the wake of opioid misuse can be managed by intentional teacher intervention—even from a distance (Klein, 2018).

The Teaching Tolerance Toolkit for “The Opioid Crisis” provides strategies for teachers struggling to manage “disruptive” behavior (Collins, 2018). Teaching Tolerance invites educators to view challenging behavior through a trauma lens and provides strategies to create a trauma-sensitive classroom. The U.S. Department of Education suggests numerous strategies and resource guides to assist schools in better caring for affected students, including a database of classroom lesson plans, activities, and a teachers’ guide to fostering connectedness (U.S. Department of Education, n.d.; Office of National Drug Control Policy, 2019).

The Importance of Taking Action Now

As the opioid crisis rages on, schools can provide a stabilizing environment for children who are otherwise living in chaos and fear. The toolkits above highlight the critical work of community organizations and their dedication to supporting schools—in person and online—in addressing the opioid crisis’ effect on children. Although the opioid epidemic is only growing more serious with time, school systems have the opportunity to manage the devastating effects of substance misuse and addiction, beginning with building a trauma-skilled classroom today.


Brundage, S.C., Fifield, A., & Partridge, L. (2019). The ripple effect: National and state estimates of the U.S. opioid epidemic’s impact on children. United Hospital Fund.

Collins, C. (2018). Toolkit for “the opioid crisis.” Teaching Tolerance.

Fryar, G., Jordan E., & DeVooght, K. (2017, November 29). Supporting young people transitioning from foster care: Findings from a national survey. Child Trends.

Klein, R. (2018, November 3). Teachers are the first responders to the opioid crisisThe Hechinger Report.

Levin, D. (2019, June 12). Inside the elementary schools where drug addiction sets the curriculumThe New York Times.

Mullane, S. (2019, April 9). The work of Dr. Bruce Perry: Breaking the intergenerational cycle of trauma. Center for Educational Improvement.

Office of National Drug Control Policy (2019). Substance use prevention: A resource guide for school staff. 

U.S. Department of Education. (n.d.). Combating the opioid crisis: Schools, students, families

U.S. Food and Drug Administration. (2020, September 1).FDA insight: The opioid epidemic and COVID-19 pandemic.

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