KARA follows investigative reporting on child death and near death by caregivers while the children are known to CPS (Child Protective Services). Please send us links to the reports in your state and we will make them available to a larger audience.
Pennsylvania’s TribLive investigative report on 845 reports of child death and “near death” from 2018–2022 found that at least 70 deaths and 170 “near deaths” (240 children—almost 30%) were tied directly to a parent’s drug use. Experts quoted in the story point out that these numbers are almost certainly low because of gaps and flaws in how and when statistics are recorded. Drug‑related child deaths in this sample outnumbered child gun deaths by two to one, and Child Welfare had been alerted in more than half of these cases.
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A recent national analysis estimated that in 2020 nearly 1 in 12 U.S. newborns—about 300,000 infants—were exposed in utero to alcohol, opioids, marijuana, or cocaine.newhampshirebulletin
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In one state‑level example, Maine reported that 4.5% of babies born in 2024 were “substance‑exposed/affected,” based on reports from healthcare providers—hundreds of babies in a single small state.datacenter.aecf
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In West Virginia, surveillance data showed prenatal substance exposure in 124 per 1,000 births (about 1 in 8 infants), with particularly high rates of opioid and stimulant exposure.
Drug overdoses now kill an estimated 100,000 people a year in the U.S., according to the CDC. But the Babies, toddlers, and young children poisoned or left neglected to death while adults use have largely been invisible in public discussions. Day in and day out, Dr. Rachel Berger, a research pediatrician and clinician at UPMC Children’s, sees more children, some only days old, arriving in the ER with illegal drugs in their systems. In the first 100 days of one recent year, UPMC Children’s treated 57 overdose victims under age 12. It has become so common that emergency‑room staff at Children’s and other local hospitals routinely give Narcan to any child who arrives in an altered state.
“No one has documented in any real way that this is not just a toddler here or a toddler there. There is a dramatic impact that has been so far off the radar in this commonwealth,” said Cathleen Palm, founder of the Center for Children’s Justice, a nonprofit focused on children’s welfare in Pennsylvania. When pressed about the TribLive findings, child‑welfare officials cited chronic staffing shortages, a dramatic increase in parental drug abuse, and fallout from mandatory reporting laws enacted after the Jerry Sandusky scandal as reasons they are struggling to keep up with reports.
This is not just a Pennsylvania tragedy. In Minnesota, Safe Passage for Children’s report on Minnesota Child Fatalities from Maltreatment 2014–2022 found that an average of two children a month were killed by caregivers, and that many of those deaths involved substance abuse and were preventable, often in families already known to child protection.kstp+1
In Allegheny County, Pennsylvania, an official Child Fatality/Near Fatality Ingestion Analysis reported that drug ingestions—mostly opioids—have become the leading cause of child fatalities and near‑fatalities there, with 40% of critical incidents in 2022 and nearly half in 2023 due to unintentional ingestion, almost all involving opioids and mostly in children under age three.cbsnews+1
Advocacy groups and analysts are also raising alarms in other states. Minnesota’s follow‑up reports on child fatalities from maltreatment in 2022–2023 and 2023–2024 continue to show substance abuse as a major factor in child deaths, and child‑welfare observers in other states have begun calling for similar, detailed reviews of drug‑related fatalities in children who were already on CPS radar. Even where no single investigative series has tied together all the cases, local and state data increasingly show child drug exposures, overdose deaths, and “near‑fatal” poisonings rising alongside the adult opioid epidemic.safepassageforchildren+1
This is a crisis in Pennsylvania only because one newsroom had the resources and courage to document it carefully. It is almost certainly a crisis in every state, but we will never know the true scale because of how poorly—by accident or by design—CPS and related systems keep and share records. There are almost no meaningful, public‑facing metrics about how many children in their care are exposed to drugs, nearly die, or are killed outright.
Read the children’s stories below:
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A stamp bag of fentanyl was found in the throat of 7‑month‑old Zhuri Bogle, pronounced dead in her Penn Hills home in January. Police charged the child’s grandmother and her boyfriend, who were babysitting that night; they are awaiting trial.
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Two‑year‑old Robert Craft was found unresponsive in a Munhall apartment littered with thousands of bags of heroin, needles, and other drug paraphernalia. He died hours later at Children’s Hospital. Two other children in the home, ages 4 and 7, were tested; the 4‑year‑old, who became “lethargic and incoherent,” tested positive for fentanyl but survived. The parents were charged in the 2022 case and are awaiting trial.
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Four‑month‑old Naoki Hines died after his mother found him unresponsive in their Carrick home. Fentanyl was found in his system; investigators later discovered a stamp bag of fentanyl in the house. His mother, Katie Grimes, has been charged in connection with his death and is awaiting trial.
TribLive’s investigation also found children who did not directly ingest drugs, but were killed because of what parents did—or failed to do—while under the influence.
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On October 4, a 32‑year‑old Lancaster County woman was found unconscious in her bedroom after injecting methamphetamine, leaving her 3‑month‑old daughter locked in a hot car outside the home. The baby died; the mother, who had already lost custody of two older children, was charged with third‑degree murder, involuntary manslaughter, and endangering the welfare of children.
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In another case, a Franklin County woman was charged with involuntary manslaughter after police said she took drugs and then fell asleep on top of her 6‑day‑old son, suffocating him. She told police she had used “scramble,” a mixture of heroin and fentanyl, before feeding the baby his bottle and then fell forward onto him while holding the bottle in his mouth.
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Still other children have died in the midst of drug operations: a 5‑year‑old girl died of fentanyl exposure in a Johnstown drug house in October 2022, and a Philadelphia toddler was shot and later died after his father used him as a human shield during a drug deal gone bad.
One of the biggest hurdles to addressing this crisis is a child‑welfare system that was designed primarily to respond to abuse but is poorly equipped to confront an epidemic of addiction. “Federal law and state law are very clear that a baby being born exposed to drugs is not child abuse,” Palm said. “The challenge we have as a society is not the concept of recognizing that families are under stress, particularly if you have an active substance abuse and infant in your home. That is a real stress. The problem is we as a society have created an infrastructure that is only to deal with child abuse.”
KSTP has reported on similar failures in Minnesota’s system, highlighting Safe Passage’s analysis of maltreatment deaths and how children have been killed by parents while known to CPS. KARA’s own investigation into 200 Minnesota child deaths in CPS and follow‑up work on why those deaths were not properly recorded in child‑welfare systems point to deep, national problems of data, transparency, and accountability.kstp+2
ALL ADULTS ARE THE PROTECTORS OF ALL CHILDREN
KARA Signature Video (4 minutes)
This is a crisis in Pennsylvania only because one media outlet had the will and capacity to expose it. It is almost certainly a crisis in every state, but we will never fully understand it until CPS, courts, and child‑fatality review systems are required to track and share the truth about drug‑related child deaths and near‑deaths—especially for children already on their radar.
As a society, we have built a child‑welfare system that was designed almost entirely to react after “classic” child abuse is identified, instead of proactively addressing the tangled mix of addiction, mental illness, poverty, and domestic violence that endangers children long before a hotline call is made. As a society, we are asking this narrow, overloaded infrastructure to manage problems it was never built for parents in the grip of powerful drugs, caregivers cycling in and out of treatment, and families collapsing under stress.
Without giving frontline workers the data, the tools, nor the time they need to respond in a humane and effective way child will continue to suffer and die.
Lawmakers and the public are struggling to keep up with how quickly these crises have evolved. Voters hear about overdose statistics and mental‑health emergencies, but they rarely see the hidden toll on infants and toddlers until a particularly shocking case briefly makes the news, and then the outrage fades without structural change. Elected officials are pulled in competing directions: pressured to preserve families and reduce system involvement, while also being blamed whenever a child dies after earlier reports were “screened out” or closed too quickly.
Under this pressure, policies often emerge as short‑term fixes, tightening or loosening reporting rules, adding a requirement here, a task force there. Not much will change without giving agencies sustained funding for addiction treatment, in‑home supports, or trauma‑informed services that might actually make homes safer. Workers on the ground juggle impossible caseloads, trying to distinguish between parents who can recover with help and situations where children are in immediate danger, all inside systems that measure paperwork completion better than children’s long‑term safety and healing.
So we end up with a framework that checks boxes on whether abuse has been legally proven, instead of a responsive network that sees the full continuum of risk: prenatal drug exposure, chronic neglect tied to addiction, repeated overdoses in the home, and the slow erosion of a child’s safety and hope. Until we acknowledge these complexities and reshape policy around the real lives of families—rather than the narrow categories in our laws—we will keep bouncing between outrage and denial, and far too many children will remain in homes where everyone is technically “on the radar,” but no one is truly safe.
We did not stumble into this crisis by accident. We built systems that wait for “clear abuse” while babies are born drug‑exposed, toddlers wander through homes littered with fentanyl, and overwhelmed caregivers are left to parent in the middle of an untreated addiction. We tell ourselves that someone, somewhere, must be watching. In every state, case after case shows children dying in families already “known to the system,” with almost no public record of how many, why, or what could have been done differently.
If you are reading this, you are already part of the small circle of adults willing to face these realities. Now we need you to step outside that circle.
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Ask for the numbers. Call and email your state legislators FIND THEM HERE, county commissioners, and child‑welfare leaders. Ask how many children in your state have died or nearly died in drug‑related incidents while known to CPS in the past five years—and demand that this information be collected and made public.
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Share this story. Send this article to at least three people—your faith community, coworkers, school board members, local journalists—and ask them what they think your town is doing to protect children in homes ravaged by addiction.
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Support those on the front lines. Speak up for better pay, training, and caseload limits for child‑protection workers, treatment for addicted parents, and trauma‑informed services for children who survive.
Every overdose death, every “near‑fatality,” every baby suffocated or poisoned in a drug‑soaked home is a decision point for us as a society. We can keep pretending this is rare and unavoidable, or we can insist on seeing, counting, and stopping it.
All adults are the protectors of all children. Please do one concrete thing today. make a call, send an email, share this report—so that the next child born into a home controlled by drugs has more than luck standing between them and a preventable death.
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