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 Invest in Early Childhood Education, Family Resource Centers, and Home Visiting

  • Recognize that investments in early childhood are critical to preventing substance misuse and substance use disorders.
  • Strengthen childhood interventions that target individual, family, school, and community precursors to drug use, misuse, and addiction.
  • Support evidence informed prevention strategies such as quality childcare programs, home visiting, and family resource centers of quality.


Overwhelming research shows that adverse early childhood experience can set the stage for future substance misuse and addiction[1].  This is because a child’s brain is built from the bottom up.  Early experiences, starting even at the prenatal period, affect the developing brain architecture, which serves as the foundation for all future learning, behavior, and health.   Adverse childhood experiences (ACEs) can impair this architecture and result in negative effects lasting into adulthood[2].

While learning how to deal with stress is an important factor of life, toxic stress is created when a child experiences continual stress from adverse circumstances within the child’s environment[3].  Adverse stress factors in a child’s life can include abuse, neglect, parental substance use, conflict within the home, incarceration of a parent, and poverty. Researchers found that individuals who experience multiple adverse situations in early life were at a substantially greater risk for physical and mental health issues such a substance misuse.  For example, a male child with 6 ACEs has a 4,600% increase in the likelihood of later becoming an IV drug user[4]


Research has demonstrated that investment and intervention in early childhood can dramatically alter a child’s life trajectory in a positive way[6].  Positive effects of these interventions include delayed initiation and decreased use of drugs when the child reaches adolescence[7].  Prevention interventions focused not only on the child but on those who care for the child as well.


Interventions studied and found successful include quality childcare programs, home visiting and family centered education and supports such as those found at family resource centers of quality[8].   For example:

  • Enrollment in quality early education has substantial positive impacts on children and their families including the increased health and quality of life, reduced drug use later in life, enhanced future incomes of participants, reduced crime rates, increased education, and increased incomes of mothers of participants[9].   The study indicated that for every dollar spent on high quality, birth-to-five programs for disadvantaged children resulted in a 13% per annum return on investment[10].
  • Participation in home visitation programs  not only improved maternal, infant and child health, reduce injuries, and neglect and maltreatment but also reduced rates of substance misuse among children later in life than those not enrolled in a program [11].
  • Family Resource Centers of Quality connect parents and caregivers with information, resources, programs and classes that help to build the nurturing environment essential to a child’s healthy development.


As a result of the current opioid crisis there are increasing numbers of children suffering toxic stress.  Currently, New Hampshire does not fund any comprehensive early intervention programs to address this issue or to help these children in crisis.  Funding for the childcare scholarship program for low income families and some home visiting programs exists but it is limited and does not reach all New Hampshire families in need.  Investments in early childhood interventions are a critical and cost-effective way to prevent a new generation of individuals from substance misuse. The need for collaboration between the early education and substance misuse fields has been recognized by stakeholders. The Governor's Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery Prevention Task Force has been asked to adopt children as a targeted population to encourage early childhood initiatives to be included in the 2017-2020 state plan.

Type of Policy Change:

  • Budget Policy – Support funding for evidence informed early childhood preventions such as childcare scholarship, home visiting, and family resource centers of quality
  • Legislative Policy – Support reducing barriers and increases access to early childhood preventions for all New Hampshire Families.


In order to ensure a healthy and productive future generation, New Hampshire must adopt priorities and support programs such as high quality early learning and child care programs, home visiting programs and family resource centers. 

[1] Principals of Substance Abuse Prevention for Early Childhood, NIDA, March 2016

[2] Brain Architecture, Key Concepts, Center on the Developing Child at Harvard University, 2016.

[3] Dong M, Giles WH, Felitti VJ, Dube, SR, Williams JE, Chapman DP, Anda RF. The Origins of Addiction:Evidence from the Adverse Childhood Experiences Study. Circulation 2004;110:1761–1766;

[4] Giles, at page 7.


[6] NIDA, at 11-19; 33-41

[7] NIDA at 33

[8] Id.

[9] The Life-cycle benefits of an Influential Early Childhood Program, Garcia, Jorge Luis, James J. Heckman, Duncan Ermini Leaf, and Maria Jose Prados.  2016.

[10] Id.

[11] NIDA, at 51.