Counties meet on substance use disorder services

Danielle’s daughter passed away, leaving her as the primary caregiver of her one-year-old granddaughter. Marcos cycled in and out of jail for years before getting sober, then relapsed after his wife was murdered. Jessica has sustained multiple years of sobriety, though it has not been without its challenges. Last year, she experienced a domestic violence situation and she is undergoing chemotherapy for a cancer diagnosis.

All of them received help from Prevention Links, a nonprofit that has partnered with Union County, N.J. to provide prevention education, parenting programs and peer support for those struggling with substance use. And in Jessica’s case, gives them a chance to give back as peer specialists.

Nearly 50 county leaders visited Union County in September for the Supporting Families Impacted by Substance Use Peer Exchange to discuss how counties can promote the wellbeing of children, youth and families affected by substance use disorder.

Prevention Links offered not just services, but a community that understands exactly what they are going through. However, recovery does not happen through one program alone — families need a network of treatment, peer support and other services. These stories underscored a central theme of the peer exchange: substance use disorder (SUD) rarely affects just one person, but often the entire family unit.

Debbie-Ann Anderson, director of Union County’s Department of Human Services, saw changes recently in her county. 

“There’s been a huge shift, and especially during the COVID era, when we had a lot of opioids on the streets disproportionately across the county and communities, that really, there were no real substance use disorders on record until COVID,” she said. “We took a larger look at how we really look at prevention, education, and intervention as we moved forward.”

Substance use touches nearly every aspect of family life, from parent-child relationships to maternal and infant health and kinship caregiving arrangements. A 2025 analysis estimated that nearly 19 million U.S. children live with a parent or caregiver who meets the criteria for a SUD, and children exposed to parental substance use face higher risks of early substance use and mental health challenges. This reinforces the importance of intervening at the family level, rather than treating substance use as solely an individual concern. Counties are often at the front lines of this issue, which gives them an important role in building coordinated systems of support for the whole family, not just the person directly impacted.

While community-based partnerships are critical to establishing effective local support infrastructure, counties can further strengthen these efforts by leveraging state and federal resources. The peer exchange explored how to draw on state and federal resources to expand and sustain support for families affected by substance use. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Administration for Children and Families (ACF) presented their funding opportunities to attendees.

SAMHSA funds work across the prevention-to-recovery continuum, including its Services Program for Residential Treatment for Pregnant and Postpartum Women, a companion State Pilot Program for Treatment for Pregnant and Postpartum Women and a range of youth-centered program supporting young people with SUDs and their families. 

ACF offers regional partnership grants that connect child welfare systems, SUD treatment providers and CBOs, along with technical assistance through its National Center on Substance Abuse and Child Welfare. Together, these programs reinforce a broader lesson from the peer exchange: counties don’t have to build this infrastructure alone.

Several takeaways emerged from the two days of discussion:

• The value of listening to people with lived experience and the critical role they can play supporting others through recovery
• The need to treat substance use as a family issue that considers the needs of both children and caregivers
• The fact that trusted CBOs like Prevention Links often already have the expertise and infrastructure counties need to reach impacted residents 
• The availability of state and federal partners ready to help sustain this work over the long-term

As counties consider how to apply these lessons at home, the next step is to discover where the gaps are and identify the opportunities to strengthen support for families impacted by substance use.

Behind national statistics are real people, like those county leaders heard from at Prevention Links. With one in four U.S. children living with a parent or caregiver who has a SUD, this is an issue nearly every county will encounter, regardless of size or geographic location. Counties should take inventory of the supports they already offer, identify where gaps exist and lean on state and federal partners to help fill them. Recovery is rarely a solitary journey – it is a family and even community process, and counties are well positioned to bring these systems of care together.