The Upward Intergenerational Effect of Opioid Epidemic on Children’s Support and Caregiving for Older Parents

The United States has endured a drug crisis for over three decades, with approximately 92,000 drug-related deaths in 2020 alone. Between 1999 and 2020, over 932,000 lives were lost to drug poisonings—nearly as many as U.S. military casualties from the Civil War to the present. While research has examined opioid use's effects on employment, crime, and family dynamics, little is known about the intergenerational impact of the opioid epidemic, particularly on caregiving responsibilities. This study investigates how opioid exposure affects adult children’s capacity to support and care for their older parents.

Using nationally representative data from the Health and Retirement Study (HRS) and zip-code-level prescription opioid data from the Drug Enforcement Agency (DEA), this study tracks child-parent pairs over 24 years. The analysis focuses on financial support, living arrangements, and informal caregiving (activities of daily living, instrumental activities of daily living, and financial management) for older adults, with an individual fixed effects model estimating the effects of opioid exposure.

The findings reveal a robust negative impact of opioid epidemic exposure on adult children’s ability to provide caregiving. Children are less likely to live near their parents, offer financial support, or assist with personal care and financial management. Additionally, the effects are more pronounced among racial and ethnic minorities, exacerbating existing inequalities.

This study is the first to explore the upward intergenerational effects of the opioid crisis on caregiving, highlighting the diminished ability of those affected by the epidemic to support their aging parents. These findings provide critical insights into the broader social implications of the opioid epidemic and emphasize the need for targeted interventions to mitigate its intergenerational and societal repercussions, particularly for disadvantaged populations.