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Modern Family: The U.S. opioid crisis has shifted family dynamics

Paul Bertke didn’t expect to be raising young children well into his 50s.

But a barrage of prescription opioids, heroin and fentanyl has inundated Dayton, Ohio, and his stepdaughter got hooked. So six years ago, Bertke and his wife, Angela, who live in the Dayton suburb of Kettering, stepped in to care for her kids.

“When we got married, she became my child, too,” says Bertke, 52. “You just want what is best for them, and it just breaks your heart to see them going down this path that you know is very deadly.”

The Bertkes are far from the only relatives pushed into a parental role for children whose actual parents are in the throes of addiction. The opioid epidemic has devastated families across the U.S., and the ripple effects – including strained household budgets and public resources – are especially visible in beleaguered communities like Dayton, the hub of an area that’s been called the nation’s “overdose capital.”

Montgomery County, which surrounds Dayton, saw a five-year rate of 50 opioid overdose deaths per 100,000 people from 2013 to 2017, compared with the state’s death rate of 26.1. The county has sharply cut its high number of unintentional overdose deaths since the middle of 2017, but a lower death toll doesn’t necessarily mean fewer people suffer from addiction, and measuring deaths alone can mask the full context of a community’s drug problem.

Link to original article here, originally posted on:


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Grandparents Raising Grandchildren

Grandfamilies, or kinship families, are those in which children live with and are being raised by grandparents, relatives or other adult extended family members. Grandparents play an important role in providing safe and stable homes to children who cannot remain in the care of their parents. Due to a parent’s substance use disorder, death, disability or military deployment, grandparents can provide a continuum of care ranging from childcare to taking full responsibility for raising their grandchild.

The Numbers and Characteristics of Grandfamilies in the U.S.

According to the U.S. Census, in 2016, 2.5 million grandparents were responsible for the basic needs of one or more grandchildren under the age of 18 living with them. There were nearly 6 million children under the age of 18 living in a household maintained by a grandparent in 2016. Of those 6 million children, nearly 2.6 million were under age six.

While there is great diversity within these family groups, some grandparents are more likely to be raising their grandchildren than others. Grandparents who live with their grandchildren tend to be:

  • Younger
  • Less educated
  • More likely to be divorced or widowed
  • More likely to be in poverty
  • More likely to be unable to work due to illness or disability.

In addition, grandparents raising grandchildren are represented at higher rates among Black, American Indian and Alaskan Native racial and ethnic minority groups, though rates have been increasing among White, non-Hispanic grandparents.

Happy Grandpa And Child

Why Are Grandparents Raising Grandchildren?

Grandparents take over responsibility for the care of their grandchildren due to a variety of parental difficulties and stigmatizing family events including abuse and neglect, incarceration, physical and mental illness, death, military deployment, deportation, adolescent pregnancy, divorce and abandonment. Economic instability has also been associated with growth in multigenerational households. Parental substance abuse, whether as a result of the crack cocaine epidemic of the 1980s and 1990s, or today’s opioid epidemic, has long been cited as one of the most common reasons that grandparents raise their grandchildren.

Challenges and Stressors

Researchers have found that grandparents face numerous challenges that contribute to adverse physical and mental health outcomes. Commonly reported stressors include poverty or economic distress, the lack of a legal relationship to the grandchild, inadequate housing and social isolation. Strained family relationships may be another source of stress, and include marital distress and conflict with the grandchildren’s biological parents over the nature and extent of their involvement with the grandchildren.

There is consistent and substantial research evidence that grandparents raising grandchildren experience significant levels of depression. These rates of depression have been shown to be higher than those of single parents and those of the general population.

Impact of Grandparent Caregiving on Child Well-being

Despite many challenges, children fare well in the care of their grandparents. Compared to children not cared for by relatives, they have more stability, are less likely to run away and are more likely to report feeling loved. When children cannot remain with their parents, placing children with grandparents or other relatives reinforces safety, stability and well-being; reduces trauma; reinforces a child’s sense of identity; helps keep brothers and sisters together; honors family and cultural ties; and increases the likelihood of having a permanent home.

Grandparents and Grandchild

Importance of Supportive Services for Grandfamily Success

When caregivers in grandfamilies are offered supportive services, the social and mental health outcomes for the children involved improve substantially.

Examples of key support services include:

  1. Information and referral assistance such as kinship navigator programs,  that provide a single point of entry for learning about housing, household resources, physical and mental health care, and financial and legal assistance.
  2. Physical and mental health care for older caregivers and children including programs covered by Medicaid and Medicare. Quality counseling and trauma-informed mental health services have been shown to improve outcomes for both caregivers and children.
  3. Affordable legal services so that grandfamilies, whether they are inside or outside the foster care system, can access a continuum of legal relationship options and understand both the legal and practical differences of adoption, guardianship and legal custody.
  4. Lifespan respite programs that provide coordinated, community-based respite care services for family caregivers who provide care for children and adults with special needs.
  5. Financial support services, including access to Temporary Assistance for Needy Families (TANF); Social Security retirement, disability, and survivor benefits for both the caregivers and for the children; and Supplemental Security Income for low-income caregivers and children who are disabled.


Grandparents raising grandchildren are important resources to their families and communities. Finding ways to assist and help grandparents raising grandchildren is critical to supporting some of the most vulnerable families.

Link to original article, including references can be found here, originally posted on

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Butler Center for Research | July 2018

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