This brief from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) uses results from a mixed methods study to determine how the current opioid epidemic, particularly parental opioid misuse, affects child welfare systems across the country. The study found four main challenges with the use of medication-assisted treatment (MAT) for parents involved with the child welfare system: 1) limited availability of appropriate treatment, 2) misunderstanding of MAT, 3) limited interactions between child welfare agencies and MAT providers, and 4) need for alignment between systems and stakeholders. The brief presents recommendations from ASPE on how to address and overcome these challenges.