Substance misuse by parents, including opioid use disorder (OUD), is a risk factor for child neglect and downstream psychological and cognitive problems, with children sometimes placed in foster care. In the wake of increasing incidence of parental OUD in Fairfield and Pickaway counties, the Ohio State University College of Social Work, in collaboration with Job and Family Services, initiated the Enhancing Permanency in Children and Families (EPIC) program. EPIC uses a three-pronged approach to establish a coordinated system of care across multiple agencies and disciplines, including the Ohio Family Treatment Drug Court, peer recovery services, and parenting support based on the Nurturing Parent Program. The treatment court facilitates communication between substance abuse treatment providers and child welfare caseworkers, who, together with peer recovery coaches, make weekly visits to participating families. In addition, workers trained on the Nurturing Parent Program provide home-based support to caregivers for children placed with relatives, helping to establish healthy, non-punitive adult-child relationships. Parents with OUD are incentivized to work with the treatment court and start a course of medication for opioid use disorder (MOUD), while recovery coaches help to maintain retention in treatment and provide case management to connect participants with appropriate services.

The three key elements of EPIC - treatment court, peer recovery support, and guidance in parenting - have been shown increase the probability of parent-child reunification, helping to reduce caseloads in the child welfare system. A detailed description of the EPIC program rationale, implementation, and forthcoming evaluation is available here.