The Adoption and Safe Families Act (ASFA) may have an impact on parents struggling with alcohol or other drug (AOD) problems, who are appealing the termination of their parental rights. We conducted a mixed-methods content analysis of court cases from Virginia, Florida, Louisiana, and Georgia involving parental appeals of the termination of their parental rights pre- and post-ASFA. Decisions to uphold termination of parental rights for parents with AOD issues were statistically more frequent post-ASFA. Qualitative differences emerged between pre- and post-ASFA cases with regard to reasons for appeals, substance use factors considered in the appeals, and rationale for final decisions.