America’s response to the opioid epidemic over the past three decades has been fragmented and focused primarily on adults in isolation of their families. Little attention has been paid to the risks that children face from opioids, which has resulted in thousands of preventable pediatric fatal and nonfatal poisonings. Drawing on research showing that over 60% of pediatric opioid deaths occur outside medical settings—with nearly 40% in the home—this chapter highlights critical policy failures that have put children at risk. These include the Food and Drug Administration (FDA)’s inadequate regulatory response to the dangers opioids pose to children, problematic changes to methadone take-home policies during COVID, and the absence of emergency response training for families. The United States’ fragmented healthcare system treats addiction as an individual disease rather than a family issue, creating dangerous blind spots in our national response.