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2 TFAH • WBT • PaininTheNation.org Despair Deaths and Substance Misuse Among Children Deaths from suicide among 0 to 17-year- olds grew 84 percent in the last decade (2007-2016) and are having devastating consequences for their families and communities. 4 Suicide is the third leading cause of death among children aged 10-14 and the second leading cause of death among those aged 15-24. 5 In just one year (from 2015 to 2016), the suicide rate grew by 10 percent among children under the age of 18. Suicide rates among girls aged 10-14 increased 231 percent in the last decade and rose 8 percent in 2016. 6 The number of high school students who reported seriously contemplating suicide also increased significantly from 13.8 percent in 2009 to 17.7 percent in 2015. 7 As of 2016, more than 1 million adolescents aged 12 to 17 (4.3 percent) had a substance use disorder (including either alcohol or drugs) and around one in five 12 to 20-year-olds reported consuming alcohol in the past month. Another survey found that more than half of high schooler's alcohol consumption was binge drinking and two in five reported consuming eight or more drinks in a single occasion. An estimated 90 percent of adolescent drinking is via binge drinking. 8 In addition to an increased risk of overdose, substance misuse can have long-term adverse effects on physical and mental health, academic and career attainment, relationships with family and friends and establishing and being a connected part of a community. The underlying root causes of misuse have also been shown to contribute to increased likelihood of poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that can emerge during teenage years. 9 Ongoing substance misuse has a high correlation with school dropout rates, chronic absenteeism, classroom behavior issues, and impaired cognitive development. 10 Indirect and Multigenerational Effects on Children The alcohol, drug and suicide epidemics have claimed more than one million U.S. lives in the past decade. For every one of these deaths, many additional Americans, including children, are affected, directly or indirectly. For example, despair deaths are straining our country's child welfare system as more and more children are forced into foster care because of parental death or substance misuse. In 2016, the number of children in foster care increased for the fourth consecutive year, with parental drug misuse cited as the reason for removal in more than one-third of cases. This trend has resulted in overloaded social workers and an insufficient number of foster parents. 11 Young people exposed to Adverse Childhood Experiences (ACEs)— stressful, traumatic events—are more likely to develop substance use disorders as adults. 12 Children whose parents misuse drugs or alcohol are also at increased risk of experiencing other ACEs, including emotional abuse and neglect. 13 ACEs often lead to an earlier age of initiation of alcohol use, 14 a greater likelihood of serious problems with drugs 15 and increased odds of attempting suicide. 16 ACEs are also linked to social, emotional and cognitive impairment, lower academic achievement and lower educational attainment. 17 In addition to trauma, children may be harmed physically when their mothers misuse substances during pregnancy, increasing the risk of a host of adverse birth outcomes, including low birth weight and infant death. Neonatal Abstinence Syndrome (NAS), which occurs when a baby exhibits drug withdrawal symptoms after birth, is associated with feeding difficulties, seizures and respiratory distress. A 2016 review of state trends found a 383 percent increase in the number of infants born with NAS from 2000 to 2012. Alcohol use during pregnancy can cause Fetal Alcohol Spectrum Disorders, conditions that can include physical problems, such as facial deformities and stunted growth, and behavioral and learning problems. In addition to these direct consequences of substance use during pregnancy, research has found that children who were exposed to substances in utero have a higher risk of subsequent abuse by their parents. Percent of high school students who seriously contemplated suicide 13.8% in 2009 17.7% in 2015 Increase in suicide rates among girls aged 10-14 231% over 10 years 8% in 2016

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