Alcoholics can destroy their own lives and traumatise the lives of their loved ones – particularly children.
Such trauma can leave children overwhelmed and unable to cope with their circumstances and this childhood trauma can reach well into adulthood, reverberating throughout their lives. To raise awareness of the plight of children living with alcoholics, the National Association of Children of Alcoholics (Nacoa) ran its second Children of Alcoholics Week in February. According to Nacoa, more than a million children are living with chronic alcoholic parents or guardians, although the number is probably significantly higher. Since the start of this century there have been countless reports highlighting the effects of alcohol misuse on the individual, teenagers, parenting and the impact on children.
As a society our relationship with alcohol is the subject of a great deal of comment and soul searching. Yet much of this debate centres on the impact alcohol has on our streets and communities – as a result of booze-fuelled disorder on Friday and Saturday nights. Yet research shows that as a society we should be equally concerned about the impact alcohol has in our homes and in our families. Substance misuse causes considerable harm. It is a wide-ranging problem, damaging individuals, families and entire communities – and it’s on the increase. Meanwhile, the number of children involved in the vicious circle of drug taking and problem drinking by their parents is also increasing. Although governments, policy makers and practitioners recognise the problem and are taking steps towards tackling the effects of substance abuse within families, the issue in general seems far from being solved.
It is difficult to estimate how many children are ultimately affected by parental substance misuse. There is much variation on the effects of substances on individual users and their families. Also, many children are hiding parental substance use as well as hiding from it (Bancroft et al 2004), and the fear of what will happen to them and to their parents prevents many from sharing their experiences. Parental substance misuse can cause considerable long-term harm to young people. Children are more likely to develop emotional, behavioural and social problems, use substances themselves and become educationally and socially excluded.
Alcohol is legally available and easily accessible throughout England. It is positively associated with socialising, relaxing and celebrating. Although problems linked to excessive alcohol consumption are widespread and well established, it seems that alcohol misuse is somehow more socially accepted and does not have the same stigma as using drugs.
Consequently, the issue of alcohol abuse, especially in families with children, often remains undiscovered, and the negative impact and effects of the excessive drinking behaviour of parents on children remain under-recognised and neglected. Home Office Hidden Harm report (2011) shows that parental substance misuse is a significant issue and states that two million parents drink every day and 6% of children live with a dependent drinker (around 700,000 children), while between 250,000 and 350,000 live with a problem drug user in the UK. Anecdotal evidence from professionals suggests that parental drug and alcohol use is a growing problem and is often interconnected to other issues (domestic violence, health problems, child welfare and poverty).
At the start of 2011, Public Health England reported that almost a quarter of the adult population of England were hazardous drinkers, while 6% of adults were dependent on alcohol. Some three-quarters of incidents of domestic violence were linked to alcohol misuse as well as half of assault cases and 63% of woundings. Substance use refers to using drugs, including alcohol. Substance misuse refers to use that is harmful. This can have serious negative consequences of a physical, psychological, social and interpersonal, financial or legal nature for users and those around them. Parental substance use does not necessarily lead to problems in childcare or the neglect or abuse of children. There are some parents who are in treatment and stable in their substance use, have good supportive networks and are able to look after their children without the need for additional services. Many parents are aware of the effect their substance use has on their children.
Harm reduction and engaging with specialist help, advice and treatment must be actively promoted with all parents. Risk assessments will help to determine the most appropriate course of action for professionals, including whether cases reach a child protection threshold or not.
Identifying need, harm and risk
Professionals should identify ways of reducing need, harm and risk by:
- Recognising that parental substance use impacts on children in different ways at all stages of development, from before birth to early adulthood. Those working with children who disclose their parents are using substances should reassure them that they are not responsible for their parent’s substance use or to blame for their parent’s problems, and that by talking things through they are not betraying anyone (Adfam 2006).
- A common framework for assessing parental substance misuse should be used and its impact on children, so that professionals can engage, assess and intervene as early as possible and in a consistent way.
- Promoting effective and accurate information sharing across all agencies so that the needs of the family can be met. Sharing information will help to ensure that children, young people and their families receive the services they need when they need them, and help achieve the desired outcomes. Sharing information will also help to prevent significant harm arising to children, young people and adults. Finally, it ensures that practitioners are working together and are effective and efficient in their work.
- Professionals should respond in a way they would ordinarily to a disclosure of other family problems, and not necessarily assume that a child protection referral must be made. Where confidentiality must be breached, professionals must be clear with the child that sharing information with other relevant professionals is done to ensure they are safe and so the family can receive appropriate help.
- Assessment should be child-centred and actively involve the child and family throughout.
It is important the professionals recognise that adults who use substances often experience other difficulties including mental health, domestic violence, homelessness, financial problems, poor physical health, minimal social support and criminality. Assessment and intervention should explore the impact of such factors, and acknowledge that even if the substance use is stable, reduced or no longer present, that other such identified factors may continue to impact on parenting and the child’s needs.
The welfare of the child is always paramount, and they must be protected from actual or likely risk of harm. Children of substance using parents are at increased risk of harm. All workers, including those working with adults, have a responsibility to promote a child’s wellbeing and identify those who may be at risk. If there are clear child protection concerns there must be no delay in following agency procedures.