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Children whose parents or caregivers use drugs or alcohol are at increased risk of short- and long-term sequelae ranging from medical problems to psychosocial and behavioral challenges.

In the course of providing health care services to children, pediatricians are likely to encounter families affected by parental substance use and are in a unique position to intervene.

Children who were exposed to crystal methamphetamine prenatally may have developmental delays in communication, personal and social skills, fine and gross motor skills, and problem-solving skills as well as aggressive or withdrawn behaviors.

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In addition, medical professionals are mandatory reporters of suspected child maltreatment and may be the only professionals who have the opportunity to recognize that a child, especially one of preschool age, has been abused or neglected.

Effects of fetal cocaine and opioid exposure may appear during the newborn period as any of the following symptoms of withdrawal: irritability, poor and irregular feeding patterns, frequent crying, tremulousness, increased respiratory and heart rates, hypertonia, an exaggerated startle response, vomiting, frantic sucking, and difficulty being consoled.

Children with prenatal drug exposure are more likely to develop disruptive behavioral disorders such as oppositional defiant disorder; impaired intellectual and academic achievement; and cognitive problems, such as delayed language development, poor memory, and the inability to learn from mistakes.

This estimate includes costs related to alcohol and drug treatment and prevention services; substance use–related medical condition management and sequelae; lost earnings attributable to premature death, substance use–related illness, and loss of employment; goods and services associated with substance use–related crime, criminal justice, motor vehicle crashes, property damage, and fires; and police, fire department, adjudication, and sanctioning expenses.

of a nationally representative sample of infants demonstrated that in 2012, approximately 22 000 infants were diagnosed with neonatal abstinence syndrome.

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