Nada Hassanein | Stateline.org (TNS) Every day, 8-year-old Emma sits in a small garden outside her grandmother’s home in Salem, Ohio, writing letters to her mom and sometimes singing songs her mother used to sing to her. Emma’s mom, Danielle Stanley, died of an overdose last year.

She was 34, and had struggled with addiction since she was a teenager, said Brenda “Nina” Hamilton, Danielle’s mother and Emma’s grandmother. “We built a memorial for Emma so that she could visit her mom, and she’ll go out and talk to her, tell her about her day,” Hamilton said. Lush with hibiscus and sunflowers, lavender and a plum tree, the space is a small oasis where she also can “cry and be angry,” Emma told Stateline.

Hundreds of thousands of other kids are in a similar situation: More than 321,000 children in the U.S. lost a parent to a drug overdose in the decade between 2011 and 2021, according to a study by federal health researchers that was published in JAMA Psychiatry in May.

In recent years, opioid manufacturers, distributors and retailers have paid states billions of dollars to settle lawsuits accusing them of contributing to the overdose epidemic. Some experts and advocates want states to use some of that money to help these children cope with the loss of their parents. Others want more support for caregivers, and special mental health programs to help the kids work through their long-term trauma — and to break a pattern of addiction that often cycles through .