Substance use disorders among pregnant women and new mothers play a significant role in the health and well-being of the mother and her child. Tragically, overdose is the most common cause of maternal death in Texas. Substance use is also the primary reason Child Protective Services (CPS) interacts with families in Texas. As policymakers consider ways to prevent and address substance use disorders, addiction, and tragic overdoses in Texas, this brief shows the connection between parental substance use and the short- and long-term consequences for maternal health and child well-being, particularly for families with children under age three. Effective substance use prevention, treatment, and recovery supports would not only help curb maternal mortality, but also improve parent and child well-being, keep more families together in safe homes, and reduce stress on Texas’ foster care system. The end of this brief outlines the issues that policymakers should work on to address these issues.