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The Relationship Between Foster Care Entries and High-Dose Opioid Prescribing in California

NCJ Number
Addictive Behaviors Volume: 93 Dated: June 2019 Pages: 52-58
Troy. Quast; Melissa A. Bright; Chris Deicher
Date Published
June 2019
7 pages
Since an important effect of the current opioid epidemic is on children whose parents are unable to provide appropriate care, this study used quarterly, county-level data for California for 2009-2016 to study the relationship between foster care entries and opioid misuse by their parents.
The linear regression analysis included both county and time fixed effects and controls related to child removal risk. The study improved on the limited existing research in the area by analyzing higher frequency data, examining a proximal measure of opioid abuse, and allowing for differential associations by urbanicity. The study found a positive association between the rate of child removals and the rate of residents who were cumulatively prescribed a high dose of opioids (>90 morphine milligram equivalents (MMEs) per day) during the quarter. A one standard deviation in this rate was associated with about a 9-percent increase in the overall removal rate. The study also found that the association between removals and high MMEs was especially pronounced in rural areas, and minimal in urban areas. These results provide a more precise estimate of the relationship between the potential for opioid misuse and child welfare. (publisher abstract modified)