Children of drug users are at high risk for developing substance use disorders themselves later in life. From 1991 to 1993, researchers funded by NIDA recruited families, with a parent in methadone treatment for heroin addiction and at least one young child, into a randomized trial of the Focus on Families (FOF) intervention, which includes relapse prevention services and parent training skills. Results from the original analysis of the trial showed that FOF both reduced parents’ drug use and improved children’s delinquent behavior compared with participants in the control group, who only received standard services provided by methadone clinics. To assess whether FOF continued to have an effect on children as they grew up, the researchers performed a 12-year followup study—85 percent of the children originally enrolled in the trial participated. Of those, 59 percent had met the criteria for a substance use disorder at some point in their life. Overall, the rates of substance use and dependence were similar between childhood participants in the FOF and control groups. However, when the results are broken down by gender, males who received the FOF intervention had a significantly lower risk of developing a substance use disorder—specifically, alcohol and marijuana disorders—than those in the control group. This may be because the FOF intervention focuses on teaching parents to handle externalizing problem behaviors (such as getting into fights), which are more common in boys than girls, explain the authors. Of concern was the fact that at the time of the followup study, 32 percent of the parents in the FOF group had died, compared to 13 percent of parents in the control group. High mortality is typical in long-term studies of patients on methadone, though the researchers could not find evidence that higher exposure to the FOF intervention was related to mortality in this study. In fact, the highest mortality rate was found among families who were assigned to FOF but never participated in the skills training or case management. FOF participants who attended 75 percent or more of the assigned sessions had about the same mortality rate as participants in the control group.
Source: Haggerty KP,et al. Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction. 2008 Oct 8