ImportanceParents’ overdose death can have a profound short- and long-term impact on their children, yet little is known about the number of children who have lost a parent to drug overdose in the US.ObjectiveTo estimate the number and rate of children who have lost a parent to drug overdose from 2011 to 2021 overall and by parental age, sex, and race and ethnicity.Design, Setting, and ParticipantsThis was a cross-sectional study of US community-dwelling persons using data from the National Survey on Drug Use and Health (2010-2014 and 2015-2019) and the National Vital Statistics System (2011-2021). Data were analyzed from January to June 2023.ExposureParental drug overdose death, stratified by age group, sex, and race and ethnicity.Main Outcomes and MeasuresNumbers, rates, and average annual percentage change (AAPC) in rates of children losing a parent aged 18 to 64 years to drug overdose, overall and by age, sex, and race and ethnicity.ResultsFrom 2011 to 2021, 649 599 adults aged 18 to 64 years died from a drug overdose (mean [SD] age, 41.7 [12.0] years; 430 050 [66.2%] male and 219 549 [33.8%] female; 62 606 [9.6%] Hispanic, 6899 [1.1%] non-Hispanic American Indian or Alaska Native, 6133 [0.9%] non-Hispanic Asian or Pacific Islander, 82 313 [12.7%] non-Hispanic Black, 485 623 [74.8%] non-Hispanic White, and 6025 [0.9%] non-Hispanic with more than 1 race). Among these decedents, from 2011 to 2021, an estimated 321 566 (95% CI, 276 592-366 662) community-dwelling children lost a parent aged 18 to 64 years to drug overdose. The rate of community-dwelling children who lost a parent to drug overdose per 100 000 children increased from 27.0 per 100 000 in 2011 to 63.1 per 100 000 in 2021. The highest rates were found among children of non-Hispanic American Indian or Alaska Native individuals, who had a rate of 187.1 per 100 000 in 2021, more than double the rate among children of non-Hispanic White individuals (76.5 per 100 000) and non-Hispanic Black individuals (73.2 per 100 000). While rates increased consistently each year for all parental age, sex, and race and ethnicity groups, non-Hispanic Black parents aged 18 to 25 years had the largest AAPC (23.8%; 95% CI, 16.5-31.6). Rates increased for both fathers and mothers; however, more children overall lost fathers (estimated 192 459; 95% CI, 164 081-220 838) than mothers (estimated 129 107; 95% CI, 112 510-145 824).Conclusions and RelevanceAn estimated 321 566 children lost a parent to drug overdose in the US from 2011 to 2021, with significant disparities evident across racial and ethnic groups. Given the potential short- and long-term negative impact of parental loss, program and policy planning should ensure that responses to the overdose crisis account for the full burden of drug overdose on families and children, including addressing the economic, social, educational, and health care needs of children who have lost parents to overdose.

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2011 年至 2021 年美国因吸毒过量而失去父母的儿童估计数量

重要性父母吸毒过量死亡可能对其子女产生深远的短期和长期影响，但我们对美国因吸毒过量失去父母的儿童人数知之甚少。目的估计因吸毒过量而失去父母的儿童人数和比例从 2011 年到 2021 年，总体上以及按父母年龄、性别、种族和民族划分，失去了一位父母。设计、背景和参与者这是一项针对美国社区居民的横断面研究，使用了全国药物使用调查的数据和健康（2010-2014 年和 2015-2019 年）和国家生命统计系统（2011-2021 年）。数据分析时间为 2023 年 1 月至 6 月。暴露父母药物过量死亡，按年龄组、性别、种族和民族分层。主要结果和措施 18 岁失去父母的儿童比率的数量、比率和平均年度百分比变化 (AAPC)到 64 岁的药物过量，总体以及按年龄、性别、种族和民族划分。结果从 2011 年到 2021 年，649 599 名 18 岁到 64 岁的成年人死于药物过量（平均 [SD] 年龄，41.7 [12.0] 岁； 430 050 [66.2%] 男性和 219 549 [33.8%] 女性；62 606 [9.6%] 西班牙裔，6899 [1.1%] 非西班牙裔美洲印第安人或阿拉斯加原住民，6133 [0.9%] 非西班牙裔亚裔或太平洋岛民，82 313 [12.7%] 非西班牙裔黑人，485 623 [74.8%] 非西班牙裔白人，以及 6025 [0.9%] 拥有 1 个以上种族的非西班牙裔）。在这些死者中，从 2011 年到 2021 年，估计有 321 566 名（95% CI，276 592-366 662）社区居住儿童因吸毒过量而失去了 18 岁至 64 岁的父母。每 10 万名儿童因吸毒过量而失去父母的社区儿童比例从 2011 年的每 10 万名儿童 27.0 人增加到 2021 年的每 10 万人 63.1 人。非西班牙裔美洲印第安人或阿拉斯加原住民的儿童中这一比例最高2021 年，这一比例为每 10 万人中 187.1 人，是非西班牙裔白人（每 10 万人中 76.5 人）和非西班牙裔黑人（每 10 万人中 73.2 人）的两倍多。虽然所有父母年龄、性别、种族和民族群体的比率每年都在持续上升，但 18 至 25 岁的非西班牙裔黑人父母的 AAPC 最大（23.8%；95% CI，16.5-31.6）。父亲和母亲的比率都有所增加；然而，失去父亲的儿童总体数量（估计为 192 459；95% CI，164 081-220 838）多于失去母亲的儿童（估计为 129 107；95% CI，112 510-145 824）。 结论和相关性估计有 321 566 名儿童失去父母2011 年至 2021 年美国药物过量情况，不同种族和族裔群体之间存在明显差异。鉴于失去父母可能带来的短期和长期负面影响，方案和政策规划应确保对药物过量危机的应对措施考虑到药物过量对家庭和儿童造成的全部负担，包括解决经济、社会、教育和因吸毒过量而失去父母的儿童的医疗保健需求。