Predicting Risk and Resilience in Children of Opiate-Dependent Parents

Children of drug abusers are at high risk for a wide-range of negative outcomes, including developmental and cognitive disabilities and substance abuse disorders.

A recent NIDA-funded clinical trial described the adversities experienced by children of opiate-dependent individuals in methadone treatment and the ability of some of these children to overcome these adversities (i.e., functional resilience), in an effort to predict the factors which contribute to resiliency.

Between 1993 and 1994, 130 families participated in the Focus on Families (FOF) project (a family-focused intervention); in 2005 and 2006, researchers re-interviewed the children in adulthood and found that 70% of them had experienced two or more childhood adversities (e.g., physical or sexual abuse, family substance abuse, mental illness or incarceration, etc), while 20% experienced four or more. Of the now young-adult sample, only 24% (whether enrolled in the intervention or not) met all established criteria for functional resilience, which included being actively employed or enrolled in school, having no history of substance abuse or dependence, and having no adult criminal charges in the prior 5 years.

Researchers attempted to uncover which factors might predict functional resilience and found that females were almost four times more likely to exhibit functional resilience in young adulthood than males, and individuals who demonstrated behaviors associated with internalizing problems (e.g., anxiety or depression) and externalizing problems (e.g., bullying, lying, having temper tantrums) were less likely to demonstrate functional resilience. Contrary to evidence in other samples, race/ethnicity and the number of adverse experiences in childhood were not reliable predictors of resilience in this study.

Authors conclude that while participation in the FOF program didn’t have a significant effect on resiliency in this sample, early intervention to prevent and reduce childhood internalizing and externalizing problems holds the most promise of supporting functional resilience later in life.


Skinner, ML, Haggerty, KP, Fleming, CB, Catalano, RF. Predicting Functional Resilience Among Young-Adult Children of Opiate-Dependent Parents. J Adolesc Health. 2009 Mar;44(3):283-90.