There are 5.7 million children in the U.S. under 11 living with a parent with a substance abuse problem in the US.
Now one of the world's best-known shows, Sesame Street, is tackling the subject of the opioid addiction crisis.
The programme will explore the backstory of the puppet character Karli, whose mother is battling addiction. Karli, a bright green, yellow-haired friend of Elmo's, was introduced earlier this year as a character who was living in foster care.
"There's nothing else out there that addresses substance abuse for young, young kids from their perspective," said Kama Einhorn, a senior content manager with Sesame Workshop. The storyline is also intended to provide adults with substance abuse problems with a way to talk to their children about what they are going through.
The initiative is part of the Sesame Street in Communities resources available online. In one segment, Karli, voiced and manipulated by puppeteer Haley Jenkins, is joined by 10-year-old Salia Woodbury, whose parents are both in recovery from addiction.
"Hi, it's me, Karli. I'm here with my friend Salia. Both of our parents have had the same problem – addiction," Karli tells the audience. "My mum and dad told me that addiction is a sickness," Salia adds.
"Yeah, a sickness that makes people feel like they have to take drugs or drink alcohol to feel OK. My mom was having a hard time with addiction and I felt like my family was the only one going through it. But now I've met so many other kids like us. It makes me feel like we're not alone," the puppet continues.
Karli and Salia hold up hand-drawn pictures of flowers, with petals representing "big feelings", including anger, sadness and happiness. They discuss ways to feel better, including art and breathing exercises.
There are also scenes that feature Elmo's dad, Louie, explaining to him that addiction is a sickness, and Karli telling Elmo and Chris about her mum's special adult meetings. Viewers are referred to free online resources in both English and Spanish that include videos, storybooks, digital interactives and games.
Click play above to watch a clip from the programme
Children's therapist Jerry Moe, the national director of the Hazelden Betty Ford Children's Program, helped craft the segments and resources, says there has been a paucity of resources for the pre-school age-group.
"These boys and girls are the first to get hurt and, unfortunately, the last to get help," he said. "For them to see Karli and learn that it's not their fault and this stuff is hard to talk about and it's OK to have these feelings, that's important. And that there's hope."
Sesame Street, which has been on screens since 1969, has a long history of tackling topical issues in a way that makes them easier to understand and deal with for children. The programme has featured puppets with HIV, jailed parents and autism, and has explored homelessness and women's rights.
Salia's parents, Sam and Jaana Woodbury, said they welcomed the show's attention on opioid and alcohol addiction. They have been in recovery for eight years.
"When I was going through addiction, I felt extremely alone and isolated. I didn't have any connection to the outside world," said Jaana Woodbury. "I think it's amazing that Sesame Street is using their platform to share resources to help other women and fathers."