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It is estimated that as many as one in eight children live in a household with at least one parent with a substance use disorder (SUD).[1] Many adults therefore come from homes that have been affected by addiction. The impacts of addiction can affect children both in their youth and into their adulthood.
A parent’s addiction can have a deep and devastating impact on a child. Some of the issues are transient, while others can be long lasting.
Parents with SUD are often unable to care for children properly. Sometimes, concerned neighbors or teachers speak out, and when they do, authorities can investigate and remove children from their homes. About 40% of cases involving children removed from homes are a result of parental substance misuse.[2]
Children who are neglected may perform poorly in school compared to their classmates.[3] They may have an increased risk of anxiety, depression, or other behavioral or conduct disorders [3]. In severe cases they may suffer developmental delays, be behind in school, or even be malnourished.
Researchers call growing up in a home with substance misuse an adverse childhood experience (ACE). Children in homes like this often have issues as adults, including:[4]
Addictions often involve a genetic component. Up to 53% of children with parental substance misuse will likewise themselves have a SUD in adulthood [3]
Codependency is when a child actually takes on the “adult” or parenting role for a parent with substance use disorder because they themselves are unable to parent. Examples of this include: [5]
Some children become their parent’s caregivers, rather than receiving care themselves. [6] Children may start to do this even at a young age, and may continue to “parent” their own parents into adulthood. Breaking codependency patterns isn’t easy, but it’s a critical step that can lead to the whole family’s healing process.
It’s never easy to live in a household touched by substance use disorder, but it’s helpful to remember that you’re not alone. Many other children live in similar circumstances, and plenty of adults are available to help.
Some kids benefit from remembering what experts call the Seven Cs:[8]
I didn’t cause it.
I can’t control it.
I can’t cure it.
But I can take care of myself by communicating my feelings, making healthy choices, and celebrating me.
Remember: you can’t take care of your parent if you aren’t taking care of yourself. Many resources exist to help you take care of your own mental health. Personal therapy can be helpful. There are also a lot of support groups for children of parents with SUDs.
If you’re ever in a situation in which you don’t feel safe, contact the National Domestic Violence Hotline. Don’t put your health and future at risk. Reach out for help when you need it.
Every family is different and there is no process that is going to work for every family. However, here are some general pieces of advice for how to begin a conversation with a parent about treatment for a SUD:
Don’t discuss substance misuse when you’re angry or your parent is intoxicated. Find a time that’s safe and neutral. Planning a time ahead might be helpful so that you can prepare what you are going to say and how you wish to say it.
Direct your parent to resources for addiction treatment programs. You can even help them by doing some research ahead of time about treatment specialists in your area and insurance coverage.
Children of patients with SUD are themselves at risk for mental health or substance use disorders. Make sure you have systems in place to take care of yourself – strong social relationships, professional therapy, etc. Make sure you are aware of your own genetic predisposition for a substance use disorder, and if you have any concerns about your own substance use, reach out to professionals for help.
Recovery can be a slow process, and relapse is common. It’s not unusual for parents to relapse to substance use once or even multiple times.
You may know kids in your neighborhood, church, or school living with addicted parents. You can provide a lifeline to them. All adults carry a responsibility to look out for children who might be the victims of neglect or abuse as a result of a parent with SUD.
If you notice signs of neglect or abuse in a child you know, report them. Even if you are wrong, you can’t be faulted for voicing your concerns to school authorities or law enforcement.
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.
