Diverse problems in the family increase risk of drug-induced deaths among young people – placement in out-of-home care may protect some young people
Young people’s drug-related deaths and overdoses (non-fatal poisonings) are significantly more common among young people who have experienced diverse problems, such as a parent’s substance use or mental disorders or long-term financial difficulties in their childhood home. For some young people, placement in out-of-home care may reduce these risks, even though the overall risk for young people in out-of-home care is higher than for the rest of the population.
This information is revealed by a recent study carried out in the Out of Despair project. In the study, register data was used to monitor all children born in Finland in 1991 and 1997 and their biological parents until the end of 2019. A total of over 124,000 children were included in the study.
Placement in out-of-home care increased the risk, but may also protect some young people
According to the results, the probability of drug-induced death or an overdose leading to hospitalisation was clearly higher among children or young people who had been placed in out-of-home care at some point before the age of majority than in the rest of the population.
However, the link between the family's diverse problems and drug-induced deaths was particularly visible among young people who had never been placed in out-of-home care. For example, a parent’s substance use problem increased the likelihood of drug-induced death or overdose only among those who lived their entire childhood at home, whereas among young people in out-of-home care, a parent’s substance-use problem did not increase the likelihood of drug-related death or overdose compared to other young people in out-of-home care. This suggests that moving away from a harmful growth environment protects the young person.
In addition to out-of-home placement, long-term financial difficulties in the family were independently linked to drug-induced deaths or overdoses among young people.
“The result may indicate an accumulation of problems: mental health or substance use problems may affect the parents’ work ability and that way cause financial difficulties for the family and, at worst, lead to long-term poverty,” says Senior Researcher Karoliina Karjalainen from THL.
Prevention of drug-induced deaths requires help at an early stage
The study emphasises the importance of early support and multidisciplinary services, in particular. Close cooperation between substance use, mental health and social services as well as sufficient resources are important in order to support families in time. Access to substance use treatment should be improved for young people, for example, by offering opioid substitution treatment to minors, if necessary.
“The family’s diverse problems, other adverse childhood experiences and substance use may form a complex and intertwined bundle of problems in the lives of young people, and ultimately lead to serious consequences,” Karjalainen says.
“This is why prevention and early intervention are of primary importance, and sufficient timely and appropriate help should be available to families with children.”
The study has been published in the journal Drug and Alcohol Review.
Enquiries
Karoliina Karjalainen
Senior Researcher, THL
[email protected]
tel. +358 29 524 7933
Karjalainen, K., Raitasalo, K. & Rönkä, S. (2025). Drug-induced deaths and non-fatal poisonings in youth – Associations with household adversities and out-of-home care. Drug and Alcohol Review, 45: e70083.DOI: 10.1111/dar.70083
