By Dr. Rachel Docekal, MBA, Ed.D. – CEO, Hanley Foundation
This week, JAMA Pediatrics released a study that should stop every one of us in our tracks: nearly 19 million children in the United States—about one in four—are growing up with at least one parent who has a substance use disorder.
Let that sink in—one in four.
As someone who has dedicated her life to advancing prevention, treatment, and recovery services, I was deeply moved, but not surprised, by these findings. At Hanley Foundation, we see the impact of substance use disorder (SUD) on families every day. However, the sheer scale highlighted in this study is staggering. It also reinforces something we already know to be true: addiction is not just an individual disease—it is a family disease. And children are often the silent sufferers.
A Crisis Hidden in Plain Sight
The study reveals that 7.6 million children live with a parent whose addiction is considered moderate or severe, and 3.4 million live with a parent with multiple substance use disorders. Perhaps even more sobering, over 6 million children live with a parent who has both a substance use disorder and a co-occurring mental health condition.
Children in these households face unique and often traumatic challenges. They may witness overdoses, experience inconsistent caregiving, live in fear of the unknown, and carry shame for something they don’t understand and didn’t cause. Without support, these children are also at greater risk for anxiety, depression, ADHD, and substance use later in life.
As the CEO of Hanley Foundation—and as a mother—these numbers are more than statistics. They represent real lives, real stories, and real urgency.
What We’re Doing—and What We Must Do
At Hanley Foundation, we believe every child deserves the chance to feel safe, heard, and understood, especially when addiction disrupts their world. That’s why we created our Child-Centered Family Program, a free, three-day intensive designed specifically for children ages 7–12 who have been impacted by a parent or caregiver’s substance use.
This program offers a safe, supportive space for children to process their experiences, learn about addiction in age-appropriate ways, and—most importantly—know they are not alone and not to blame. Through group discussions, therapeutic play, and structured activities, children build tools for resilience and healing that can last a lifetime.
I encourage families, schools, pediatricians, and community leaders to help us reach the children who need it most. The program is entirely free of charge and open to the community.
Practical Ways to Support Families
This new research also underscores how important it is for parents, caregivers, and professionals to be proactive. Whether you’re a pediatrician, teacher, relative, or family friend, here are steps you can take:
- Create open conversations: Let children know it’s okay to talk about addiction. Reassure them it’s not their fault.
- Safely store medications and substances: Lock up all prescriptions and ensure harmful substances are out of reach.
- Know the signs: Withdrawal, anxiety, fearfulness, or regression may be signs a child is struggling.
- Offer support, not shame: Addiction is a disease. Parents with SUD love their children, and many avoid treatment due to stigma and lack of access. Offer compassion and resources.
- Refer to programs like ours: When we support children, we break the generational cycle of addiction.
A Call to Action
It is time we stop whispering about the impact of addiction on families and start shouting from the rooftops that children deserve support, stability, and love, even in the face of addiction.
To every policymaker, educator, healthcare provider, and parent reading this: the time to act is now.
At Hanley Foundation, we are committed to leading this effort with empathy, science, and unwavering hope. Let’s ensure that every child affected by addiction knows this truth: they are not invisible. They are not forgotten. And they are not alone.
Learn more about our Child-Centered Family Program or to register for an upcoming session.
Because one in four is not just a number. It’s a call to care.
Hanley Foundation is devoted to reshaping the narrative of addiction through prevention, advocacy, treatment, and recovery support. Our comprehensive prevention education programs have positively impacted Florida’s communities, making us the largest prevention services provider. For over four decades, our treatment facility, Hanley Center, has offered private, confidential, and personalized addiction and mental health care, surrounded by a tranquil tropical setting that promotes healing and recovery.
