Children who grow up in a family with one or more parents who have a substance use disorder (SUD) are more likely to develop life-long psychological and behavioral problems than those who do not. Substance use disorder is characterized by persistent use of alcohol and/or other drugs that result in significant impairment (1).
Parental addiction to alcohol and other substances influences a child’s development and too often establishes patterns that follow them into adulthood. An average of 7.5 million (10.5%) American children under the age of 18 lived with a parent who had an alcohol use disorder in the last year. One in 8 children under the age of 18 live in a household with at least one parent struggling with a substance use disorder (1).
Children who grow up in an environment of substance use often experience some form of neglect or abuse and many experience trauma. The family system of inconsistency, unpredictability and chaos deprives children of the nurturing they need for healthy development. Because SUD parents are so consumed with their behavior, children often find themselves taking care of themselves. The rollercoaster of emotions leaves children exhausted, frustrated, confused, angry and hurt.
Denial is an important component of the SUD family system. No one is supposed to, or allowed to know what is really going on. Denial has a debilitating effect on child development. The stress of keeping the family secret forces children to internalize their feelings and emotions and fosters a sense of helplessness. In a recent publication, the American Academy of Child and Adolescent Psychiatry (2) described some of the emotional had behavioral patterns that are frequently observed in children who have been raised by a parent or caregiver who suffers from abuse of alcohol and other substances:
Guilt: Children often feel responsible for the alcohol/drug use. They rationalize that if they were better, or did everything just right, maybe the parent would not drink or use so much. They overestimate their control over the situation and feel like they are a failure.
Anxiety: Children constantly worry about the home situation; they fear that the addicted family member will become sick, or taken away. They are frighten by family violence, easily intimidated, overly sensitive, and avoid conflict at all cost. They guard their behavior and panic at the thought that someone might find out that they made a mistake.
Embarrassment: Families suffering with SUD are typically cloaked in secrecy. Children learn the message that in their house, there is a terrible secret and not to talk about it. They remain quiet about the addiction, and their feelings about it. Their silence often extends to the sharing of anything, even the most trivial, with their parents.
Inability to have close relationships: Children who experience unsettling emotions and strive to hide dysfunctional family situations, have difficulty trusting others. This isolates them and further diminishes self-esteem. Because children are ashamed, they avoid bringing friends to their home, limiting their opportunity for building relationships.
Confusion: Children of SUD parents are often frightened and vulnerable to their parent’s behavior and struggle to make sense of it. They often feel ignored and invalidated. The lack of attention and praise by the parent is often equated by the child as displeasure.
Anger: Children feel anger at the addicted parent and anger at the non-addicted parent for lack of support or protection. They often overreact to things they cannot control and feel constantly on guard.
Depression: Children often feel lonely and helpless to change the situation. They are passively taught to bury their feelings to spare themselves from the fury of an impaired parent. Such an environment crushes the ability to express themselves and develop their own personalities and characteristics.
Children of SUD parents are forced to adapt to their environments at great personal cost. At times, they can be fairly resilient and proficient at managing their situation. They learn what to avoid, when to avoid it, and how to modulate their anxiety to protect themselves. With encouragement, and the influence of others outside of their family, children can become healthier and overcome the effects of living in a dysfunctional family.
The National Association for Children of Alcoholics (NACoA) developed a tool call the “Seven Cs” to help young people understand that they are not responsible for their parents’ problems (3). This tool can help children learn to accept that it is not their fault when their parents drink too much or abuse drugs, and understand that they cannot control their parents’ behavior.
The Seven Cs
- I didn’t CAUSE it
- I can’t CURE it
- I can’t CONTROL it
- I can help take CARE of myself by:
- COMMUNICATING my feelings
- Making healthy CHOICES
- CELEBRATING me
For many, the effects of growing up with an addicted caregiver continues to have an impact well into adulthood. The long-term effect from this type of childhood often leads to emotional and mental health challenges that can include depression, mood and in some cases, substance use disorders. Adult children of substance use disordered parents can greatly from working with a therapist to help acknowledge and accept the past, recognize its impact on the present, and to learn new skills for coping. Support groups such as Al-Anon or ACA (Adult Children of Alcoholics) (4) are an excellent resource and provide an opportunity to talk openly about alcoholism and how it has affected your life. Being able to challenge your subconscious beliefs, about both the past and the present, helps to build resiliency which in turn empowers you to move forward into the future.
Donna Fogle is a licensed clinical social worker providing substance use therapy in the InSTEP (Integrated Substance Use Disorders) program at Brook Lane’s North Village outpatient office. She has over 35 years of experience in working with individuals affected by substance use disorders.
- Substance Abuse and Mental Health Services Administration (SAMHSA): https://www.samhsa.gov/newsroom/press-announcements/201708241000
- American Academy of Child and Adolescent Psychiatry. Alcohol Use in Families. No. 17; Updated May 2019
- National Association for Children of Alcoholics (NACoA). Teaching the Seven Cs. http://www.nacoa.net/pdfs/EDkit_web_06.pdf
- Resources: Al-Anon: https://al-anon.org/; ACA: https://adultchildren.org/