Identifying Drug Endangered Children

The Challenge

The National Alliance for Drug Endangered Children defines drug endangered children as children who are at risk of suffering physical, mental or emotional harm as a result of parent or caregiver legal or illegal substance misuse. They may also be children whose caretaker’s legal or illegal substance use interferes with the caretaker’s ability to parent and provide a safe and nurturing environment. shares that nearly 9 million children live with at least one parent who has an SUD (substance use disorder), which is more than 12 percent of all children in the United States. Children living in environments where legal or illegal substance misuse is present are often subject to adverse childhood events such as physical, emotional, and psychological trauma (Barnard & McKeganey, 2004), putting them at risk for negative long-term challenges. They may be affected by prenatal drug exposure which, depending on the substance used, frequency, quantity and duration may lead to poor prenatal care, poor nutrition, prematurity or other developmental challenges. Children may also be affected by postnatal, adverse childhood experiences that could have long term consequences. It can be assumed that ALL drug endangered children are at risk, but at how much risk and risk for what varies (Drug Endangered Children: Risk Factors & Neuropsychological and Psychosocial Development, Dr. Kiti Freier-Randall).

The DEC challenge is identifying children affected by substance misuse environments as early as possible, intervening appropriately and providing services to the children and their family members. Children are often the first affected but can be the last recognized as being affected by substance misuse. National DEC teaches, trains and provides technical assistance support regarding the best practices for coordinating the various systems and professional disciplines able to intervene and provide services to these children and families in order to break the generational cycle of substance misuse.

Our Solution…

To address the DEC challenges and give children’s needs priority, National DEC has developed The DEC Approach: “a multidisciplinary strategy to change the trajectory of a drug endangered child’s life through recognition of a common vision, ongoing collaboration between disciplines, and ongoing change in practices and policies, all of which increases the likelihood of better outcomes for drug endangered children.” This approach trains practitioners to form community-based partnerships across multiple disciplines and effectively share their expertise and mutual interests, resources and responsibilities, help children and families in their communities. By working together these multidisciplinary state, local, tribal and regional DEC alliances provide help, hope and support to children and families to seek help in order to break the cycle of substance misuse. Our goal is healthy children, families and communities.

To contact staff with National DEC: 

Learn more about how to partner with National DEC or get involved in a DEC alliance in your community.

Learn more about Madison County’s CARES Team at or email 


Care givers who use, sell or produce drugs place children in danger. In these households, children can be imprisoned by fear, are at-risk of physical, sexual, emotional abuse and/or neglect and have a higher risk of injury and premature death. These dangers can take many forms.


These children are often neglected or abandoned by their caregivers. They may:

  • Appear extremely hungry or horde food
  • Appear dirty or smell unclean
  • Dress inappropriately for the season
  • Lack needed medical or dental care, immunizations, or glasses
  • Be chronically truant
  • Have parents that are disconnected to the school
  • Have inadequate supervision
  • Take on the adult role in the family for the younger siblings

Physical Abuse

Because drug use can lead to violence, children in homes with drugs may be abused by their caregivers or other adults in the home. Children who are being physically abused may:

  • Have unexplained injuries, broken bones, bruises, burns, open wounds, lacerations, welts, black eyes, or bite marks
  • Have grip marks on their arms
  • Have unexplained fear
  • Have physical signs of being tied up or otherwise restrained
  • Deny there is a problem when other warning signs are present
  • Have injuries in the shape of an object - belt, cord, iron, etc.
  • Have injuries that do not fit the story
  • Be frightened of parent, caretaker or other adults
  • Exhibit anti-social behavior

Sexual Abuse

Drug endangered children may be sexually abused by people using drugs or their caregivers may not have full protective capacity due to their own struggles. Children who are being sexually abused may:

  • Have unexplained bleeding, wounds, bruising or pain in genital area
  • Have unexplained sexually transmitted diseases
  • Be in pain when going to the bathroom
  • Have difficulty walking or sitting
  • Touch others in inappropriate sexual ways
  • Be afraid of being touched
  • Show self-destructive behaviors like cutting themselves or pulling out their hair
  • Exhibit regressive behavior
  • Have (or show) inappropriate interest in or knowledge of sex acts

Mental/Emotional Damage

People using substances may become very verbally abusive and manipulative to those around them. Children who are being mentally and emotionally abused may:

  • Be constantly afraid
  • Withdraw from situations they used to enjoy
  • Have low self-esteem
  • Have inadequate nurturing or affection
  • Exhibit behavioral, emotional and academic problems in school
  • Be extremely timid or passive or pushy and hostile
  • Be unusually upset or anxious
  • Be apathetic
  • Wet or soil self
  • Have difficulty making friends

Exposure and Accidental Poisoning

Children who live in substance exposed households can be exposed to the toxic chemicals used to "cook" meth or to the drugs themselves. Physical signs of exposure include:

  • Burning and watery eyes
  • Blurred vision
  • Skin irritation and redness
  • Burns on the skin
  • Sneezing and coughing
  • Difficult breathing, shortness of breath
  • Chest pain
  • Nausea and vomiting
  • Stomach pain
  • Diarrhea
  • Headaches
  • Fever
  • Hallucinations
  • Extreme irritability

How to Identify 'Drug Houses' There are many signs that people are using, selling or making dangerous drugs. You may have drug related activity in your neighborhood if:

  • There are houses or buildings with windows blackened or curtains always drawn
  • There are frequent visitors to a home, building or area at all times of the day and night or at odd hours
  • Occupants of a home appear unemployed/underemployed yet have plenty of money or pay bills with cash
  • There are chemical odors coming from a house, the garbage, or a detached building
  • The garbage contains numerous bottles, containers, stained bed sheets or coffee filters
  • You find inhaling or injecting paraphernalia, such as razor blades, straws, heated spoons, or syringe