By: Evelyn Frankford, Principal of Frankford Consulting, Senior Associate at the Center for Health and Health Care in Schools

Children with family members who struggle with opioid addiction are as much victims of the epidemic as the adults themselves, not only as neonates but over a longer period, as they proceed through childhood and school, according to researchers at Education Development Center (EDC).[1] Over the long term, familial opioid addiction and overdoses place these children at increased risk of social and cognitive impairments and their own substance misuse, and they have a higher incidence of disease.[2] In the short term, they struggle with emotional, social, and behavioral challenges; may develop mental health conditions such as anxiety; and often demonstrate difficult behaviors at school.[3]

Many schools are aware of trauma-informed practices that mitigate the unpredictability and stress that children of parents abusing opioids can experience. A continuum of trauma-informed supports, from calming, supportive environments to small group interventions to individualized clinical services, not only can help the children but provides teachers with tools to manage young people’s stress in ways that work for them too.

And because schools are not islands separate from the communities in which they operate, partnerships with community organizations are essential for building a comprehensive approach to deploying supports to children and their families, both those who experience opioid abuse and those who don’t.   Such partnerships can expand the trauma-informed lens and improve coordination in responding to the needs of children, families, and the community by enhancing communication across sectors, improving training for all personnel in school and community, and ensuring access to services for those who need them.

Taking on the task of creating such trauma-informed environments is hard work, requiring systems change rather than simply adding a program here or a school counselor there. Clinical staff alone do not guarantee a trauma-informed approach. Rather, the task that schools and their community partners face is examining and aligning programs, practices, and policies to create health-promoting environments, guided by principles of prevention science and public health. Such a focus is different from beginning by adding more mental health services for those with serious emotional problems, though adding such services may also be necessary.

Alignment means looking at both school and community programs that promote youth development – for example, at a local Y or community center or via sports for all – to map their strengths and opportunities for coordination with one another to reach as many children as possible. Building relationships across schools and community enables shared training activities. It may mean building relationships with agencies that serve senior citizens as growing numbers of grandparents care for young children when parents are unable to.

The Center for Health and Health Care in Schools has created an Action Guide, Partner Build Grow to help school-community partnerships address complex issues affecting student health and achievement, including the opioid crisis experienced by some students’ parents. The Action Guide applies a collective action approach to prevention as a strategy – working with the whole school and the whole community – to alter the environment and align programs and activities to address trauma. Most important, the Guide provides guidance to the multiple stakeholders in carrying out the activities that such partnerships will have to undertake, helping them do the work of organizational change to create trauma-informed environments for students – and the adults around them – who are facing great challenges.


[1] Education Development Center. (2019, March 4). 3 ways schools can support children affected by the opioid crisis [Blog post]. Retrieved from https://www.edc.org/3-ways-schools-can-support-children-affected-opioid-crisis

[2] Smith, V. C., & Wilson, C. R. (2016). Families affected by parental substance use. Pediatrics, 138(2), e20161575.

[3] Fuxman, S., Kar, H., Lucinski, L. S., & Rots, G. (2019, April). Caring for the hidden victims: Strategies to support children and youth exposed to opioids. Presentation to be delivered at the Rx Drug Abuse & Heroin Summit, Atlanta, GA.

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