In this analysis, we sought to begin to identify how the opioid crisis is affecting children in families touched by problem drug use; how parents or caregivers could be better supported; and how service providers and systems—and the policies underpinning them—could better support families affected by the crisis. To do so, we consulted with national experts in the field and conducted site visits to two Appalachian communities significantly affected by the epidemic. However, the two communities we visited do not represent the wide range of communities and local contexts relevant to this ongoing nationwide epidemic.