Association for Public Policy Analysis & Management

As opioid dependence has risen dramatically across the United States, the rate of children placed into custodial care has simultaneously increased. Popular media suggests that many of these children are taken into the homes of their grandparents. However, research has not yet established a relationship between the opioid epidemic and rates of grandparent caregiving. This link can be difficult to ascertain since child custody records do not consistently report opioid-related out-of-home placements. Further, many (and perhaps most) grandparent caregiving relationships are informal and will not appear in administrative state or county records of custody transfer. This paper links high rates of opioid use to increased custodial care by grandparents. While grandparent caregiving has been studied from the perspective of the child, rates of grandparent caregiving are also important to understand because welfare implications exist for aging caregivers who experience a unique set of health and resource constraints. Impacts of surrogate caregiving on the caregiver can range from physical health deterioration to psychosocial stressors or financial implications related to the hastening or delaying of retirement. These challenges may be compounded by the scarcity of resources in a fixed income household, by fragile caregiver health or by existing spousal caregiving responsibilities. This study links a decade of data from the American Community Survey at the Public Use Microdata Area (PUMA) level to PUMA-level opioid use prevalence statistics as compiled by the Center for Disease Control. Differential impact by age and minority group membership is also examined. Findings demonstrate a significant relationship between county opioid use rate and an increase in grandparent caregiving. A range of state and local social safety net programs are recommended to target the unique experiences of grandparent caregivers in communities that have been heavily impacted by opioid dependence.