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Prevalence of Parental Alcohol or Drug Abuse as a Condition Associated with Removal

In the United States, 2000 to 2021

Source: AFCARS Data, 2000-2021, as of 3/21/23

The percentage of children in out-of-home care with parental alcohol or other drug (AOD) abuse as a condition associated with removal has steadily increased from 18.5% in 2000 to 39.1% in 2021.

Note: Estimates based on all children in out of home care at some point during the Fiscal Year

View Source Data (PDF 95KB)

Section: Policy and Practice Resources

By State, 2021

Source: AFCARS Data, 2021, as of 3/21/23

National Average 39.1%

N=603,823

Percentage12345670-10%11-20%21-30%31-40%41-50%51-60%60%+

Nationally, 39.1% of children placed in out-of-home care had parental alcohol or other drug (AOD) abuse as a condition associated with removal in 2021. The map provides the percent by state.

States often anecdotally report that the percentage of child welfare removals involving parental AOD abuse is much higher in their state than indicated in the data. Possible explanations for these discrepancies may include 1) lack of child welfare protocols for screening and assessment regarding identification of substance use disorders; 2) inconsistent protocols regarding data entry for child welfare; 3) discrepancies in how AOD abuse is captured in the state child welfare’s data systems; and 4) differences in the point at which the AOD abuse is identified and entered in the data system. Often, at the local level, multiple removal reasons are reported and sometimes only the primary reason for removal is reported by the federal system(s).

Note: Estimates based on all children in out of home care at some point during the Fiscal Year

View Source Data (PDF 104KB)

Section: Policy and Practice Resources

Find Help with a Personal Situation

Substance Use and Mental Health Treatment Locator

To find treatment facilities confidentially, 24/7, please call 1-800-662-4357 (HELP).

To locate general treatment services, visit the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Treatment Locator online or call 1-800-662-4357 (HELP). This service provides referrals to local treatment facilities, support groups, and community-based organizations. It is a free, confidential, 24-hour-a-day, 365-day-a year information service, in English and Spanish, for individuals and family members needing treatment for a mental and/or substance use disorder.

National Child Abuse Hotline

If you suspect a child has been harmed by abuse or neglect, please call 1-800-422-4453.

If you suspect that a child has been harmed or is at risk of being harmed by abuse or neglect, call the National Child Abuse Hotline at Call the National Child Abuse Hotline at 1-800-422-4453. Serving the United States and Canada, the hotline is staffed 24 hours a day, 7 days a week with professional crisis counselors who—through interpreters—provide assistance in over 170 languages. All calls, texts, and chats are confidential. If you believe a child is in immediate danger of harm, call 911 first.

National Suicide Prevention Line

For free and confidential support for people in distress, 24/7, please call or text 988, chat 988Lifeline.org, or call 1-800-273-8255.

If you or someone you know is having thoughts of suicide or experiencing a mental health or substance use crisis, help is available and there are options to receive compassionate care. You can call or text 988 or chat 988Lifeline.org. You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Both are confidential and available 24/7 to everyone in the United States and will connect you to a trained counselor at a suicide crisis center nearest you.

Contact Us

The National Center on Substance Abuse and Child Welfare offers free technical assistance to a variety of systems on making policy and practice changes to improve outcomes for families affected by substance use disorders and involvement with child welfare services. To learn more about technical assistance services or if you have a question please email NCSACW at ncsacw@cffutures.org or call toll-free at 1–866–493–2758.

National Center on Substance Abuse and Child Welfare