Parental substance use disorders negatively impact a child's development both prenatally and postnatally. Caregivers struggling with substance use disorders, and Opioid Use Disorder in particular, often have difficulty accessing appropriate holistic clinical interventions and are at high risk of losing custody of their children due to abuse and neglect issues. Treatment interventions that attend to the caregivers' substance use disorders, mental health symptoms, and parenting needs are essential. Moreover, system collaboration among medical, mental health, substance use, corrections, and child protection providers is required to optimally address the parenting needs of caregivers with substance use issues to maximize treatment outcomes and enhance their children's overall development.