Children of Addicted Parents Guide: The Impact of Substance Use on Families and Children

Parental drug and alcohol addiction can have a detrimental impact on families and children. Unfortunately, so many parents who need help don’t get it. Why? Although addiction is recognized as a chronic disease of the brain, many who use substances, who desperately need help, are still judged or condemned. Parents, in particular, are vulnerable to judgment, criticism, and legal repercussions because of the effects their substance misuse can have on their children. But treatment can help, and parents and children can recover from the effects of parental addiction.

Understanding Alcohol and Substance Use Disorder

Alcohol or substance use disorder is a chronic medical condition characterized by an impaired ability to stop the use of alcohol or drugs despite the adverse consequences use has on a person’s mental and physical health, relationships, and more.¹

Colloquially referred to as addiction, alcohol and substance use disorders can range in severity—from mild to severe. The good news is that even severe addictions can be treated, and individuals can and do recover from addiction.¹

Impact of Parental Addiction on Children

The effects that parental substance misuse and addiction can have on children can be lifelong.  And studies indicate a direct relationship between a parent’s alcohol or drug use and a child’s well-being. More specifically, a parent’s substance use can impact a child’s physical, psychological, cognitive, social, and economic well-being. Over time, continued parental substance use can have long-term detrimental effects on a child.²

These children, who have a parent who misuses substances, are at a higher risk for several adverse consequences. Some of those may include:³

• • Lifelong negative mental and physical health problems.
  • Physical, emotional, or sexual abuse.
  • Emotional or physical neglect.
  • An inability to regulate their emotions.
  • Experiencing anxiety, depression, or anger.
  • Dropping out of school or having unexcused absences.
  • Being involved in the juvenile justice system.
  • Developing an alcohol or substance use disorder themselves.

Unfortunately, approximately 1 in 8 children live with a parent or caregiver suffering from an alcohol or substance use disorder.³

Additionally, the repercussions of growing up with addicted parents or caregivers do not end with adulthood. In a study, known as Adverse Childhood Experiences (ACE), researchers looked at the long-term effects of childhood neglect and found that children who grew up in abusive home environments had a higher risk of developing chronic health problems as adults. These medical and psychiatric conditions included:⁴

• Alcohol misuse and addiction.
• Chronic obstructive pulmonary disease (COPD).
• Heart disease.
• Liver disease.
• Depression.
• Sexually transmitted diseases.

Signs Your Parent May Be Struggling with a Drug or Alcohol Addiction

In a healthy parent-child relationship, the parent takes on the role of the caregiver, providing physical shelter, emotional support, and financial security for a young person who is still developing. In parent-child relationships that involve substance misuse or addiction, however, these roles are often reversed, and the child assumes the role of the caregiver.

While only a healthcare professional can diagnose your parent or caregiver with a substance use or alcohol use disorder, it can be helpful to know the criteria. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), signs of problematic drug or alcohol use include:⁵

• Consuming alcohol or drugs in larger amounts or for longer than intended.
• Wanting to stop or cut down use of drugs or alcohol but being unable to do so.
• Spending a lot of time getting, using, and recovering from drug or alcohol use.
• Experiencing cravings and urges to drink alcohol or use drugs.
• Neglecting responsibilities at work or home because of drug or alcohol use.
• Continuing to use drugs or alcohol despite ongoing relationship problems that are caused or worsened it.
• Abandoning social or recreational activities or hobbies in order to use alcohol or drugs.
• Taking risks while using drugs or alcohol, such as driving a car.
• Continuing to use the drugs or alcohol despite the physical problems (e.g. blackouts or injuries) or psychological problems (e.g. depression or anxiety) it has caused or worsened.
• Experiencing tolerance, or needing to take more of the substance to get the desired effect.
• Developing withdrawal symptoms (e.g. nausea or insomnia) if the substance is abruptly stopped or the dosage is cut drastically back.

Talking to Your Parent About Their Addiction

As previously mentioned, addiction is a chronic and often progressive disease, and understanding that your parent is experiencing a serious medical condition rather than choosing to continue using alcohol or drugs can be helpful for both of you. While it is easy to get frustrated and become resentful of their behavior, it is also important to understand that addiction can change the way the brain works, making it difficult for your parent to stop using drugs or alcohol.⁶

Talking with your parent may feel intimidating, especially if you are unsure of how to share your concerns and encourage treatment in a way that removes shame and blame. Here are some tips to help you have a productive conversation with your parent about their substance use:⁷

• Get help from an expert. You can reach out to a trusted adult like a doctor, school counselor, or teacher, who can help guide you to an addiction care specialist and can help you navigate the conversation and get you help.
• Ask other trusted relatives and adults—aunts, uncles, grandparents, friends, or neighbors—to help. Addiction impacts the entire family unit.
• Share your concerns openly and honestly. It can be helpful to write down your feelings first. Before you approach your parent or caregiver about their substance use, it’s best to understand how to articulate your own feelings, and sometimes, writing those down is the best way to express them. You can also draw a picture to express your feelings.
• Have the conversation when they are not actively using drugs or alcohol or recovering from the effects of them.
• Stay calm when you talk to your parent or caregiver. It’s hard not to get emotional when you talk about the damage that they’re doing to themselves and your family, but if you’re able to stay calm and avoid blaming or shaming your parent, you may be able to get through to them better.
• Manage your own expectations. While your end goal might be that you parent seeks treatment—and they very well may promise that—know that it may take more conversations than this one. Addiction is a powerful disease, and it can cause people to fall back into their old habits. Stay persistent and try again.

Help for Adult Children of Addicted Parents

As previously mentioned, parental addiction can impact more than your childhood. It can have lasting effects into adulthood. And research shows that children, whose parents have alcohol or substance use disorder, are at a higher risk of developing an alcohol or drug addiction themselves. But these patterns do not need to be repeated. There are a number of resources for the adults, who grew up with parents who struggle with alcohol or substance misuse or addition. Some of these include:

• Monthly education and discussion sessions hosted by the National Association for Children of Addiction (NACoA). These free sessions for adult children who have been impacted by addiction in their families are intended to help them better understand the impact that addiction had on them growing up and help them heal as adults. Register online.
• Mutual-help groups like Al-Anon or Adult Children of Alcoholics—both 12-Step programs with in-person and virtual meetings worldwide—bring together people who are worried about a loved one who struggles with problematic alcohol use.
• Seeking counseling from a therapist, psychologist, or psychiatrist.
• Seeking family therapy, which takes the needs of the entire family into account.

Revisiting the past can be painful, and it can be extremely uncomfortable to confront aging family members about past behaviors. With the support and guidance of a therapist, 12-Step fellowship, or spiritual leader, reviewing the past can be much more productive and rewarding.

How to Get Your Parent into Drug and Alcohol Rehab

Though there are some tips to try to encourage your parent to seek treatment, it is not your job, as a child, to get your parent into substance use treatment. And, though it may be possible, it isn’t usually effective to force them to get help. They need to seek treatment when they are ready.

However, this is when getting a trusted adult to help can be beneficial. Together, you can reach out to a few nearby rehab facilities so you can compare programs and costs. This way, when your parent or caregiver is ready, you have a few options you can share with them.

Treatment for your parent or caregiver will be individualized to meet their specific needs but may include a combination of interventions and various levels of care.

Types of Rehab Treatment for Parents

• Detox. Medically managed detoxification is often the first step in a more comprehensive treatment program. Drug detox allows the body to rid itself of the substance and other toxins while under the supervision of a medical professional. During medically managed detoxification, your parent or caregiver progresses through withdrawal as safely and as comfortably as possible.
• Inpatient or residential rehab. For some, an inpatient treatment or residential rehab may follow detox. Inpatient care may take place in a hospital, specialized inpatient unit, or a dedicated recovery facility. During this time, your parent stays at the facility 24/7 for the duration of treatment, which typically involves individual therapy sessions, group counseling, family therapy, mutual-help groups, and other activities to help them learn how to avoid relapse in the future.
• Outpatient rehab. Outpatient care, which varies in levels of intensity, may be a step-down form of care after inpatient or residential treatment or it may serve as a point of entry in the continuum of care. Outpatient rehab involves attending classes and therapy sessions in a treatment facility or clinic outside the home but sleeping at home or in a sober living facility at the end of each day.
• Aftercare services. After a formal rehab program ends, many facilities provide aftercare, or ongoing support services. These services may include therapy sessions at the facility, access to mutual-help groups, membership in recovering alumni groups, family activities, workshops, volunteer activities, recreational events, and more.
• Sober living homes. While attending an outpatient program or after completing an inpatient program, your parent or caregiver may reside in a sober living house, which provides a substance-free place to live in the community with others in recovery. It allows them to practice the coping skills they learned in a safe environment.

Paying for Addiction Treatment

Health insurance plans will cover treatment for addiction and mental health disorders. With the passage of the Affordable Care Act, more Americans now have access to these forms of treatment. Plans can vary in terms of what type of coverage they provide or how long they will cover treatment, so it’s best to check with your provider or the rehab program you’re interested in attending.

If you don’t have insurance, there are other ways to pay for treatment, including payment plans and sliding fee scales. There are several centers that provide free or minimal-cost rehab for those who cannot pay.

What Happens After Rehab?

Parents who have been through a rehab program can experience a wide range of emotions, from gratitude and joy to depression and anxiety. These emotional responses are natural, and that’s why the aftercare plan, which likely includes therapy and mutual-help groups, is so important.

You’re not responsible for the outcome of rehab or for your parent’s continued sobriety. That’s worth repeating. You’re not responsible for the outcome of rehab or for your parent’s continued sobriety.

In the months following rehab, it’s important for you to have your own support system—including therapists, friends, and sober family members—to help you understand the nature of addiction and recovery, and to know what to expect from your parent or caregiver after rehab.

You may encounter any of the following behaviors from your parent or caregiver:

• They may exchange one addiction for another. People in recovery may switch from one addictive substance to another. For instance, someone in recovery from alcohol addiction may start drinking a lot of coffee, using tobacco products, or exercising daily. This behavior is not necessarily harmful; it may just be a transitional phase that will eventually resolve as the individual becomes more comfortable and confident with abstinence.
• They may experience strong emotions and mood swings. In sobriety, people have to confront the emotions that they suppressed when they were drinking or using drugs. These emotions may include resentment, anger, fear, anxiety, or guilt. It’s not uncommon for recovering individuals to struggle with emotional outbursts or to switch from one emotional state to another in a fairly short period of time. Individual and group therapy can help them manage these responses. Extreme mood swings or frequent outbursts, however, could point to an untreated mental health disorder that requires additional mental health treatment.
• They may expect to have a close relationship before you’re ready. You will likely have your own emotions to deal with after your parent or caregiver completes rehab. Your memories of abuse and neglect will not fade quickly or easily, and you may find that you don’t immediately trust your parent. Family therapy is crucial to help you and your parent or caregiver repair broken bonds and restore trust.
• They may relapse. Relapse is one of the most difficult outcomes for kids to accept. After investing so much hope in rehab, it can be devastating to see your parent fall back into their old habits of drinking or using drugs. Unfortunately, relapse isn’t uncommon, but it does not mean that rehab failed or that your parent won’t ever get sober. Relapse signals that more intensive support may be necessary to help them get back on track with their goals.

Recovery for Kids and Adult Children

According to family systems theory, addiction is a disease that arises from dysfunction in a family unit, not just from one individual’s behavior. By the same token, recovery from addiction must encompass the whole family, not simply the person who drinks too much or misuses drugs. For the children of addicted parents, no matter what their age, recovery often begins with regaining self-confidence and learning how to build trusting relationships with family and peers. The checklist below can help you find a recovery program that will address these needs as well as others.

The elements of a recovery program for children of addicted parents may include:

• Peer support groups, where members can share their experiences with addiction in a supportive, safe environment.
• Confidential access to a team of therapists, counselors, and social workers who specialize in helping family members affected by addiction.
• Individual therapy.
• Family therapy programs that engage parents, their children, and other family members in the work of recovering from addiction.
• Assessment and treatment for mental health disorders, such as depression, anxiety disorders, or post-traumatic stress disorder (PTSD).
• Grief and trauma therapies for children, teens, or adults who have been victims of abuse.
• Activities that support the emotional and spiritual side of recovery, such as experiential therapy, art therapy, meditation, and journaling.
• Activities that support physical health, such as nutritional counseling and exercise programs.
• Opportunities to learn about 12-Step recovery principles and attend meetings of fellowships like Al-Anon or Alateen.

Finding a supportive program can be the first step in a lifelong journey of recovery. You can start by researching programs in your community and by talking with people who have experience in substance use treatment.

Finding the Right Addiction Treatment Program for Your Family

Addiction treatment can help, and recovery is possible. If your parent or caregiver is ready to get help, American Addiction Centers (AAC) can help them begin their path to recovery. With treatment centers nationwide, AAC provides evidence-based therapies and family therapy to help heal strained family relationships and teach you and your parent how to better communicate and interact.

Call to speak to a knowledgeable and compassionate admissions navigator, who will listen to your story, answer your questions, explain your options, verify your insurance, and help your parent or caregiver begin the process of recovery.