Illuminating the impacts on children of caregiver substance use

While the number of new child welfare cases in Colorado has declined over the last several years, the number of cases involving substance use by a caregiver has increased. 

Caregiver substance use, both legal and illegal, can have consequences for children. For many caregivers, substance use remains within socially acceptable levels, and does not affect the health, safety, or well-being of their children. However, experts recently examined the impact of substance use by a caregiver on a child and made several key recommendations specific to Colorado.

Among the key data findings in the report recently released by Illuminate Colorado

  • The majority of child welfare referrals related to substance abuse issues involved an infant less than 1 month old (2012-2016).
  • More than 10% of the individuals whose action or inaction directly caused or contributed to a child maltreatment death were impaired by alcohol at the time of the incident, and just over 12% were impaired by drugs (2011-2015).
  • 48% of families involved in a fatal incident of child maltreatment reviewed by the Child Fatality Review Team had a history of identified substance abuse. 
  • 30% of adults that reported an adverse childhood experience came from households with substance abuse. 

"Nationally, the opioid epidemic has been declared a public health emergency and communities and families across Colorado are feeling the effects of this crisis, as well as the effects of other substances being used and misused across our state" said Jade Woodard, executive director of Illuminate.   

In the fall of 2017, the ZOMA Foundation provided funding to Illuminate Colorado to lead the development of statewide recommendations and strategies to prevent child maltreatment and improve outcomes for children affected by caregiver substance use. The recommendations are intended to serve as a research-based framework for substantial, actionable change to better meet the needs of children impacted by caregiver substance use. They provide a starting point for multi-sector partners as they develop goals, objectives, and activities to prevent harm and improve outcomes for children.

"We recognized that there are many efforts currently being implemented to address substance use disorders in Colorado and engaged statewide leaders with subject matter expertise to guide this work," said Woodard. "The next steps are to share the findings​,​ secur​e​ additional endorsement of the​ recommendations, and map implementation plans."   

The Substance Abuse Trend and Response Task Force, the Colorado Department of Human Services Prevention Steering Committee, and the Colorado Children’s Trust Fund Board have all already vetted the following recommendations.

Spanning prevention, intervention, treatment, and recovery, recommendations address impacts on children birth through adolescence, related to caregiver substance use, substance misuse, and substance use disorders to prevent child maltreatment and improve outcomes for families.


  1. Revise the child abuse definitions in the Colorado Children’s Code to de-emphasize the focus on positive drug tests for controlled substances at time of birth.
  2. Evaluate the options for increasing accessibility and availability of Part C Early Intervention Services for children that were prenatally exposed to substances.
  3. Increase availability and accessibility of substance use treatment and recovery support services for parents / caregivers, specifically pregnant & postpartum women.
  4. Increase Early Childhood Mental Health Services to adequately address issues of trauma in children in early childhood settings and support similar networks for school settings.
  5. Expand the resources and influence of the Colorado Children’s Trust Fund to coordinate and support state and local efforts to prevent child maltreatment by preventing substance exposure in newborns.
  6. Support the work of the Opioid and Other Substance Use Disorders Interim Study Committee to identify and advocate for increasing access to treatment for parents/caregivers and their children.


  1. Embed a professional, such as a family navigator, case manager, or social worker, in law enforcement teams interfacing with families, specifically drug task forces, to provide training to officers, support services to families, and access to outside resources.
  2. Promote community-based approaches to expanding child care options for parents accessing substance use disorder treatment and recovery services.
  3. Endorse the Child Maltreatment Prevention Framework for Action & encourage inclusion of considerations related to the impact on children of caregiver substance use in child maltreatment prevention community planning efforts.
  4. Support existing efforts to scale a continuum of home visiting programs across the state.
  5. Disseminate tools that build skills among professionals interfacing with families to have educational conversations with caregivers about substance use, safe storage, and child safety.
  6. Support the dissemination of a toolkit to improve social connections in communities to reduce parental stress and increase support systems to promote resilience and buffer potential impacts on children of caregiver substance use.
  7. Conduct a review of the educational and awareness needs, review best practices, and develop a plan to address these needs related to the impact on children of caregiver substance use.
  8. Partner with existing organizations and coalitions addressing policy approaches to building safe, stable, nurturing relationships and environments and bring the lens of the impact on children of caregiver substance use.
  9. Promote community-based strategies to implement plans of safe care for substance exposed newborns and their caregivers as required by the federal Child Abuse Prevention and Treatment Act (CAPTA).
  10. Increase consistency in implementation of best practice approaches in the identification of and response to newborns prenatally exposed to substances and their caregivers at the time of birth across Colorado.
  11. Support existing practice improvement efforts to increase accessibility and availability of substance use disorder treatment and recovery support services that meet the needs of parents / caregivers, including pregnant and postpartum women.
  12. Expand the use of the Dependency and Neglect System Reform approach in child welfare cases with substance use or co-occurring mental health disorders throughout the state.
  13. Increase support services to the whole family to support caregiver's recovery and children's needs and to prevent generational cycles of substance use.
  14. Advocate for improved data collection, interoperability of data collection systems, and data sharing to inform decision making and improve practice related to addressing the impact on children of caregiver substance use.

Learn more and download the complete report Impacts on Children of Caregiver Substance Use: Recommendations for Policy & Practice Report authored by Illuminate Colorado and supported by the Zoma Foundation at 

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