Parental substance misuse

Impact of parental substance misuse

Abuse and neglect

Living in a household where a parent or carer misuses substances doesn’t mean a child will experience abuse, but it does make it more difficult for parents to provide safe and loving care and this can lead to abuse or neglect.

Neglect

Parents who misuse substances may have difficulty:

• staying organised and giving their children effective and consistent support
• keeping their home and family clean
• recognising and responding appropriately to their own and their children’s physical needs
• paying for food, clothing and essential bills (for example if their income is being spent on drugs and alcohol)
• keeping harmful substances and equipment such as needles and syringes safely away from their children.

Some parents who use drugs or drink excessively may lose consciousness, leaving no other responsible adult present to care for their child and ensure their safety (Cleaver, Unell and Aldgate, 2011).

Emotional abuse

Parents who drink excessively or misuse drugs can become emotionally unavailable to their children (Cleaver, Unell and Aldgate, 2011). Mothers with drug problems can be:

• less responsive to their babies
• less willing to engage in meaningful play
• less able to respond in ways which encourage further interaction (Kroll and Taylor, 2003).

Parents who misuse substances can behave in a way that’s irrational, unpredictable or withdrawn, which may frighten their children (Cleaver, Unell and Aldgate, 2011).

Physical abuse

Parents who misuse substances may have difficulty controlling their own emotions. Harmful and excessive drinking can contribute to child physical abuse (Cleaver, Unell and Aldgate, 2011; Velleman, 2001).

Impact on brain development

Abuse and neglect are types of adverse childhood experiences (ACEs), which can affect the healthy development of children’s brains. The impacts of abuse and neglect on children’s brains can stretch beyond childhood and into adulthood.

Possible impacts include:

• impaired cognitive development, for example reduced impulse control
• inhibited executive function skills, such as problems with learning and memory
• weakened immune system

(Shonkoff et al, 2011; Shonkoff et al, 2014).

> Find out more about the effect of abuse and neglect on child brain development

Criminal activity

Parents and carers who misuse drugs or alcohol may turn to crime to fund their dependency. This may mean exposing their children to unsafe adults or involving them in criminal activity (Brophy, 2006).

One girl told Childline:

"My dad has a drug and alcohol problem. He makes me sleep with other men so he can get drugs. He’s also raped me before by putting drugs in my drink."

Girl, 15 (NSPCC, 2018)

Other effects

The impact of parental substance abuse varies according to each child’s health, stage of development, personality and relationship with their family.

Children whose parents misuse drugs or alcohol may be separated from their parents and/or family for short- or long periods of time due to:

• intervention from children’s services (being taken into care)
• parents being put in prison
• parents being hospitalised.

They may have to take on the role of carer for their family. This could include doing the housework, preparing food and looking after younger siblings (NSPCC, 2018).

Psychological effects

Many young people talk to Childline about the psychological effects of parental substance misuse. One girl said:

"My mum is up and down – sometimes she’s fine and sober – but it can quickly change and she becomes worse again…[she] gets abusive when she’s drunk and gets angry at me and my sisters. I don’t like being at home."

Girl, 15 (NSPCC, 2018)

Other psychological effects include:

• preoccupation with their parents’ substance misuse
• blaming themselves for their parents’ behaviour
• not being able to attend school regularly and/or having poor educational attainment
• difficulty establishing and maintaining healthy relationships
• developing behavioural, emotional or cognitive problems (Altobelli and Payne, 2014; Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013; Home Office, 2003; Templeton, 2014).

Risk and vulnerability factors

All families experience challenges from time to time. This doesn’t necessarily mean children are at greater risk of abuse. But when problems mount up, it can be more difficult for parents to cope – particularly if they are isolated or lack support.

Children who live in families experiencing multiple adversities can be more vulnerable. These include children whose parents:

• are involved in domestic abuse
• misuse substances
• have mental health problems
• have learning difficulties.

Responding

Reporting

If you think a child is in immediate danger, contact the police on 999. If you have concerns that a child may not be receiving the care they need, but they are not in immediate danger, you should share your concerns.

• Follow your organisational child protection procedures. Organisations that work with children and families must have safeguarding policies and procedures in place.
• Contact the NSPCC Helpline on 0808 800 5000 or by emailing help@nspcc.org.uk. Our trained professionals will talk through your concerns with you and give you expert advice. 
• Contact your local child protection services. Their contact details can be found on the website for the local authority the child lives in. 
• Contact the police.

Services will risk assess the situation and take action to protect the child as appropriate either through statutory involvement or other support. This may include making a referral to the local authority.

> See our information about recognising and responding to abuse

Assessment

Practitioners must work with children and families to identify and assess concerns and intervene appropriately so that the impact of parental substance misuse is minimised.

This involves carrying out a holistic assessment of the child’s development, the parents’ ability to meet the child’s needs and the impact of broader family and environmental factors.

Practitioners need to identify each family’s strengths. It’s important to distinguish between immediate concerns for the child’s safety and risks which can be mitigated with appropriate support (Bogg, 2013; Cleaver, Unell and Aldgate, 2011).

Effective assessments should:

• focus on the child and their needs
• give children the opportunity to discuss their experiences
• listen to and record the child’s views on the situation
• identify any children who are acting as carers for their parents and siblings
• treat children, parents and carers as individuals
• make sure parents know they are being listened to
• ask questions about the parent’s drug or alcohol use
• consider the wider environment such as support networks, housing and family finances
• talk to any extended family members or friends who offer support to the family
• collaborate with and seek the views of colleagues from other agencies who are involved with the family, such as health professionals, teachers, substance misuse services and criminal justice agencies (Bogg, 2013; Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013; Home Office, 2003).

Protective factors

Factors which help reduce the impact of parental substance misuse on children are:

• the child being able to ask for help
• parents being willing to acknowledge their difficulties and seek help and support
• the parent and child having a positive relationship
• social support being available to the family (for example relatives or friends who can provide the children with care and stability, offer financial support and make sure the home is clean and safe)
• the parent and child having good general physical and mental health
• having one parent who does not misuse substances
• being able to maintain daily routines (Bogg, 2013; Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013).

Giving children a voice

It’s vital to build safe and trusting relationships with children so they can speak out about any problems they are experiencing. This involves teaching children what neglect is and how they can get help.

Our Speak out Stay safe service for schools helps children understand abuse in all its forms and know how to protect themselves.

Supporting children and families

Intervention

Successful interventions to support families affected by parental substance misuse should use a holistic approach to look at and improve a family’s:

• day-to-day functioning
• psychological functioning
• parent-child relationships
• social factors (such as the family’s network, housing and financial situation) (Altobelli and Payne, 2014; Bogg, 2013; Cleaver, Unell and Aldgate, 2011).

The child’s perspective should always be prioritised.

It takes time for parents to change their behaviour so time-frames for interventions need to be flexible. There should be a balance between long-term support and more focused time-limited services (Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013).

Short-term support

Immediate support for families where there is parental substance misuse should involve setting pragmatic, realistic and timely goals which focus on solutions rather than problems.

For example, practitioners need to make sure:

• younger children are taken to nursery/school
• older children are not missing school
• all children receive the appropriate support with their school work
• children are taken to all necessary medical appointments/check-ups (including dental appointments).

Practical support for parents might include helping with:

• housing problems
• access to benefits
• financial support.

In the short-term practitioners should focus on building a good working relationship with parents rather than putting them under pressure to change entrenched, problematic behaviours immediately. However, it’s important to make sure that parents are addressing their substance misuse and are engaged with a drug or alcohol service (Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013; Home Office, 2003).

Medium- to long-term support

In the medium-to-long-term the family may need intensive support and therapy focussing on recognising and changing unhelpful, repetitive patterns of behaviour.

Children should be given opportunities to express their ideas and feelings. They also need help to understand more about their parent’s substance misuse. They need to know that it’s not their fault and that they can’t control or cure their parent’s addiction.

It’s important for practitioners working with the family to receive reflective and challenging supervision so they can maintain an unbiased viewpoint throughout their journey with the family. It’s also essential to work with colleagues in other agencies to gain different perspectives on the situation (Altobelli and Payne, 2014).

A reduction in parents’ use of substances doesn’t always automatically result in improved parenting (Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013). Parents may need support to learn:

• parenting skills
• how to cope with other challenges the family is facing.

Friend and family support

The family may suffer setbacks along the way, so it’s important for members of their support network to be able to step in and help where possible.

Educating extended family members, friends and communities on the impact of substance misuse on children and families can enable them to provide more effective support (Cleaver, Unell and Aldgate, 2011; Cornwallis, 2013).

Monitoring progress

Practitioners must maintain a focus on the wellbeing of the child. They should monitor and review children’s progress throughout the period of intervention and respond appropriately.

Services to support families affected by parental substance misuse

Parents Under Pressure™ is a service to support families where parents have drug and alcohol problems. It teaches parenting skills and helps parents improve their relationship with their children. Our evaluation of Parents Under Pressure suggested that the programme helped parents make positive changes.

> Find out more about Parents Under Pressure

Strategy and guidance

Statutory guidance across the UK highlights the responsibility of those in the education, community and care sectors to promote children’s welfare. This includes providing support to children and families experiencing substance misuse.

• Child protection in England
• Child protection in Northern Ireland
• Child protection in Scotland
• Child protection in Wales
• Key guidance for schools in the UK

In each nation of the UK the government has also set out how agencies should work together to tackle substance misuse.

In England, the 2017 drug strategy highlights the impact of parental drug misuse on children as well as the key role that families can play in supporting recovery (HM Government, 2017).

Public Health England has produced guidance for local authorities on Safeguarding and promoting the welfare of children affected by parental alcohol and drug use (Public Health England, 2018).

In Northern Ireland, the strategic direction for alcohol and drugs includes provision for family support services (Department of Health, 2018). 

Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths has a section on getting it right for children, young people and families (Scottish Government, 2018).

The Scottish Government has also produced good practice guidance for agencies and practitioners working with children, young people and families affected by problematic alcohol and/or drug use (Scottish Government, 2013).

In Wales, the Substance misuse delivery plan: 2019 to 2022 sets out the Welsh Government’s actions to reduce the harm caused by substance misuse (Welsh Government, 2019).

References and resources 

Altobelli, C. and Payne, C. (2014) Noticing the hidden harm. BACP children and young people, March: 4-8.

Bogg, D. (2013) Parental substance use: the challenge for social work. Families upfront, 9: 18-19.

Brophy, J. (2006) Research review: child care proceedings under the Children Act 1989 (PDF). London: Department for Constitutional Affairs.

Cleaver, H., Unell, I. and Aldgate, J. (2011) Children's needs: parenting capacity: child abuse: parental mental illness, learning disability, substance misuse, and domestic violence (PDF). London: The Stationery Office (TSO).

Cornwallis, T. (2013) A practical approach to tackling parental alcohol abuse. Community practitioner, 86 (2): 34-35.

Department of Health (2018) New strategic direction for alcohol and drugs. [Belfast]: Department of Health.

Home Office (2003) Hidden harm: responding to the needs of children of problem drug users: the report of an Inquiry by the Advisory Council on the Misuse of Drugs (PDF). London: Home Office.

HM Government (2017) 2017 drug strategy (PDF). London: HM Government.

Kroll, B. and Taylor, A. (2003) Parental substance misuse and child welfare. London: Jessica Kingsley.

National Institute for Health and Care Excellence (NICE) (2011) Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. London: NICE.

National Institute for Health and Care Excellence (NICE) (2012) Drug use disorders in adults. London: NICE.

NSPCC (2018) Children living in families facing adversity: NSPCC helplines report. London: NSPCC.

Public Health England (2018) Safeguarding and promoting the welfare of children affected by parental alcohol and drug use: a guide for local authorities. [Accessed 04/02/2019].

Shonkoff, J.P. et al (2011) Building the Brain’s “Air Traffic Control” System: How Early Experiences Shape the Development of Executive Function Working Paper 11. Cambridge: Center on the Developing Child, Harvard University. 

Shonkoff, J.P. et al (2014), Excessive Stress Disrupts the Architecture of the Developing Brain Working Paper 3. Cambridge: Center on the Developing Child, Harvard University.

Scottish Government (2013) Getting our priorities right: good practice guidance for agencies and practitioners working with children, young people and families affected by problematic alcohol and/or drug use. [Accessed 04/02/19].

Scottish Government (2018) Rights, respect and recovery: strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths (PDF). Edinburgh: Scottish Government.

Templeton, L. (2014) Supporting families living with parental substance misuse: the M-PACT Moving Parents and Children Together programme. Child and family social work, 19 (1): 76-88.

Velleman, R. (2001) Working with substance misusing parents as part of court proceedings. Representing Children 14: 36–48.

Welsh Government (2019) Substance misuse delivery plan: 2019 to 2022. Cardiff: Welsh Government.

Childline

If a child or young person needs confidential help and advice direct them to Childline. Calls to 0800 1111 are free and children can also contact Childline online or read advice on parents and alcohol and drugs on the Childline website. You can also download or order Childline posters and wallet cards.

Related NSPCC resources 

> See our research and resources on substance misuse

Further reading

For further reading about parental substance misuse, search the NSPCC Library using the keywords “substance misuse”; “addicted parents”; “alcoholic parents”; “children of addicted parents”; “drug and alcohol services”.

If you need more specific information, please contact our Information Service.