The authors acknowledge that the sparse literature on the impact of parental drug use is not sufficiently large to merit a systematic review. In this review, "problem drug use" is characterized by cycles of relapse and recovery. Parental problem drug use, alongside parental misuse of alcohol, has been shown in the literature to be one of the most likely reasons for children to be received into the care system. A study that reviewed child protective services' decisions to refer cases to the courts found that the likelihood of this occurring increased when parental drug problems were confirmed. A number of studies have shown that a parent's preoccupation with drugs can compromise a parent's ability to be consistent, warm, and emotionally responsive with his/her children, thus increasing children's risk of separation from the parent. Studies have also shown that children of drug-dependent parents have an elevated risk of problematic patterns of behavior. Studies have also shown, however, that factors such as strong family support, controlled and routinized drug dosage, and the maintenance of family routines are important mediating influences on the potential for negative outcomes for children. Regarding interventions for families with problem drug-using parents, the research literature indicates a recent proliferation of interventions aimed at improving parenting capacity; however, few of these interventions have been subjected to rigorous and independent evaluations. This paper focuses on four independently evaluated interventions, three of which met the criteria for experimental design. A Seattle-based project was a year-long experimental intervention intended to reduce parental drug misuse, enhance family-related protective factors, and decrease children's antisocial behavior. Although the intervention apparently contributed to some reduction in drug use among parents and the institution of more family rules, there was no change in the problem behaviors of the children or in their associations with peer networks. Another intervention involved residential drug treatment for parents, which provided an extended opportunity to target parenting behaviors. Parents showed significant improvements in moving from potentially serious parenting deficits in empathic responses to increased scores on average levels of empathy. A home visit intervention program targeted 60 women with drug problems, with an emphasis on good parenting and child development. Under this program, children were marginally more likely to have an improved home environment. Overall, there is no secure evidence base for developing effective interventions with drug-using parents, and even effective intervention programs have a limited capacity to reach more than a fraction of parents and children affected by problem drug use. 76 references