While the health and substance abuse treatment community generally views substance abuse and addiction as a chronic, progressive disease, much of the rest of society, often including child welfare agencies, views substance abuse as an irresponsible choice that should be punished. This division lays the groundwork for a lack of understanding and cooperation between the two professional fields and others that produces ineffective interventions, unreasonable expectations and poor outcomes. The chapter discusses substance abuse among parents, illustrates the different perspectives of child welfare and substance abuse agencies, examines in more detail the legislative and policy context in which potential collaborations are being developed or abandoned, and suggests several directions both fields might consider in seeking to better address, together, the needs of these families. Tables, references