The damaging effects of parental and family substance abuse contribute to a host of child welfare problems including child abuse and neglect, juvenile delinquency, runaways, youth homelessness, and substance use among youth themselves. Focusing primarily on child welfare and substance abuse within the family context, the chapter discusses: (1) the effects of parental substance abuse on children; (2) challenges to social service providers; (3) promising approaches that address substance abuse from a child welfare perspective; (4) substance abuse programs that have an impact on child welfare; and (5) implications for program development and improvement. Comprehensive, family-focused approaches representing a continuum of care, including home-based services and family support and preservation programs as well as appropriate and accessible residential substance abuse treatment and aftercare, are needed in the effort to deal successfully with substance abuse and to provide effective child welfare services. These approaches, however, require greater coordination and integration of substance abuse prevention efforts and child and family welfare programs at Federal, State, and local levels. References