More Than 1.4 Million US Children Have Lost a Family Member to Drug Overdose

<b>Objectives.</b> To estimate children's exposure to family overdose in the United States. <b>Methods.</b> We used recent demographic kinship modeling advances and the Centers for Disease Control and Prevention's most recent underlying cause of death estimates to model how many children aged younger than 18 years in 2019 had lost 1 or more parents, siblings, grandparents, aunts or uncles, or cousins to overdose mortality since birth. We calculated the number and proportion of children with such exposures and considered age, cohort, and gender patterning. <b>Results.</b> More than 1.4 million children in the United States, mostly adolescents, experienced a family overdose death, often losing central figures like parents or grandparents. Cohort analyses suggest dramatic increases in these exposures, portending mounting prevalence. <b>Conclusions.</b> Attention to the large population with lives disrupted by overdose deaths should include affected children. The long-arm consequences of the overdose crisis will continue to define the public health landscape for decades. (<i>Am J Public Health</i>. 2024;114(12):1394-1397. https://doi.org/10.2105/AJPH.2024.307847).