RESEARCH STARTER

Parenting and alcohol use disorder

Parenting and alcoholism is a complex issue that significantly impacts family dynamics and child development. An estimated 7.5 million children in the U.S. live in households with an alcoholic parent, where the effects can be debilitating, leading to higher instances of domestic violence, child neglect, and mental health challenges such as anxiety and depression. Research indicates that children of alcoholics often face behavioral problems but can also develop resilience and coping strategies, particularly when they have access to supportive environments. The family system tends to revolve around the alcoholic's behavior, which complicates the ability to address other parenting challenges and may perpetuate cycles of substance abuse. Effective treatment for families affected by alcoholism often extends beyond the individual struggling with addiction to include family therapy approaches, emphasizing the need for positive communication and structure within the home. Interventions like Multidimensional Family Therapy (MDFT) and motivational interviewing (MI) have proven effective in helping both parents and children address alcohol-related issues. Ultimately, understanding and addressing the family context is crucial for fostering recovery and resilience in children impacted by parental alcoholism.

Full Article

DEFINITION: The connection between parenting and alsohol use disorder is two-pronged. One facet is the effect upon the family system when one or both parents abuse alcohol. A specific category, identified as the children of individuals with alcohol use disorder, incorporates both young children in the home and adults who grew up with parents who also abused alcohol. The second facet represents parents who have one or more children who abuse alcohol. The largest group of children in the home who abuse alcohol is teenagers, although college-age and young adult children, for whom parents feel partially responsible, also make up a large percentage.

Alcoholism and the Parental Role

Every person with alcohol use disorder (AUD) has a direct effect on several people, including spouses, children, and parents. This condition must be understood in context. As such, the most immediate and basic context is that of the family.

According to the Substance Abuse and Mental Health Services Administration's 2023 National Survey on Drug Use and Health, an estimated 12 million children under age seventeen were living in households with a parent or parents with alcohol use disorder. This condition is often destructive, evidenced by higher rates of domestic violence, child neglect, health problems, and alcohol-related death. Families with a parent who has a substance use disorder are more likely to experience conflict and to face financial challenges.

Many people, however, have coped effectively with the trauma of growing up with a parent with alcohol use disorder and have become competent adults. Longitudinal studies have noted that such persons relied on significantly more sources of support in their childhood and youth than was true of children who demonstrated coping problems. These notes highlight the importance of environmental and individual resilience factors that can assist in both prevention and adaptation.

Generally, substance use therapists and organizations assert that a biological vulnerability exists for AUD. Others disagree with the importance given to the genetic influence and prefer to focus on individual behaviors and environmental influences. Research has illustrated the importance of the home atmosphere; for example, families who ate dinner together (even families with one parent with AUD) were less likely to pass the disorder from parent to child. The sense of structure and of being cared for was assumed to be a contributing factor. In another longitudinal study, mothers who were warm and supportive were less likely to have children who grew up to develop AUD.

Parents Who Abuse Alcohol

Over time, parental patterns of behavior and communication are affected as a result of alcohol abuse, and these patterns often keep families from dealing with general parental and child problems because alcohol becomes the primary focus. In the recovery process, a parent becoming sober is a necessary but insufficient goal. Also needing to be addressed are the distorted behavioral and communication patterns that have developed in the family. Treatment is essential if the abstinence is to be maintained.

Research shows a link between substance abuse and child maltreatment. In effect, children of individuals with AUD are more likely to have behavioral problems and conduct disorders, and to report higher levels of depression, anxiety, and stress.

Studies have shown that children who grew up with at least one parent with AUD are more likely to experience adverse childhood experiences (ACEs). Research indicated that children of at least one parent with AUD reported, on average, 2.1 ACEs. Experiencing adverse childhood events increases several health risks, including smoking, obesity, depression, and development of a substance use disorder.

Alcohol use disorder in the family is not just about one person affecting others. All family members and persons in close relationships with the individual are affected. Possibly the ones most vulnerable are younger children, because of their small physical size and their dependent status. How effectively a family will function depends on the degree to which that family provides for the physical, social, emotional, and psychological well-being of family members.

When a parent has AUD, the family system becomes organized around the alcohol abuse. Therefore, an effective recovery process requires a change in the system itself, referred to as second-order change in family therapy, so that the family can develop patterns based on strengths, resiliency, and coping mechanisms.

Intervention

Fifteen years after Bill Wilson founded Alcoholics Anonymous, his wife, Lois Wilson, founded Al-Anon to help family and friends recover from the effects of someone else’s drinking. The preamble for Al-Anon Family Groups, as the organization is officially known, states that alcoholism is a family illness and that recovery is assisted by changed attitudes. Other organizations and approaches may state their purpose somewhat differently, but they all generally agree that the entire family benefits from inclusion in the recovery process.

The focus on adult children of parents with AUD started as a grassroots movement, initiated primarily by those who had experienced living with one or more family members who abused alcohol. Their desire to receive assistance for themselves was often overlooked by helping professionals who concentrated on the individual with AUD.

Family therapy, as a form of treatment and related intervention programs, has shown effectiveness in the treatment of families affected by alcohol abuse. One approach in particular, multidimensional family therapy (MDFT), has combined resources to treat issues related both to substance abuse and to conduct disorders. Other models include brief strategic family therapy (BSFT), functional family therapy (FFT), and community reinforcement and family training (CRAFT). The effectiveness of this therapeutic model lies in its careful design, which considers the chemical-dependent issue as being both family-based and multisystemic.

Parenting Children Who Abuse Alcohol

Viewed from the parental role, concern over a child’s alcohol abuse usually begins with adolescence and includes early adult years, especially the time when children are in college. In most family settings, the parental role will be more hands-on with adolescents and more distant with college students. Studies have been conducted to determine whether parenting styles have a direct effect on whether children develop substance use disorders as adults. The increasing number of young adults who return home after leaving home for the first time also increases the likelihood that parents will extend their time of direct involvement. In such cases, the parent and the returning young adult may disagree over what constitutes alcohol abuse.

The 2023 National Survey on Drug Use and Health reported that over 9 million young adults ages 18 to 25 reported binge drinking in the past thirty days. The same survey revealed that 2.4 million in the same age group reported heavy alcohol use in that period.

By the time young adults who drink alcohol reach their late twenties, many will have reduced their use of alcohol, often without clinical help or focused dialogue with their parents. These adult children often do not abstain from alcohol entirely, but are not likely to abuse alcohol. Those who do not emerge from this phase of alcohol use are more likely to be at serious risk because they have family members who are or who have been addicted to some substance, including alcohol.

Intervention Strategies for Parents

Parents should learn how to detect a true alcohol abuse problem with their teens and young adult children. The American Psychiatric Association’s fourth edition of the Diagnostic and Statistical Manual of Mental Disorders distinguished between alcoholic behaviors as abuse disorders and the more severe diagnosis, dependence disorders. However, in the DSM-5, published in 2013, these two disorders were combined as a single disorder called alcohol use disorder (AUD). The DSM-5-TR (2022), a text revision of the 2013 edition, retained this unified diagnosis but clarified inclusive language surrounding this diagnosis.

Research shows that some types of treatment for alcohol abuse by adolescents and young adults are more effective than others. Interventions identified as more effective are those that provide motivation, tools, and support to produce change. Effective treatments draw upon strengths, motivation, and existing support networks. Young people possess many assets that assist them in making the necessary changes. By recognizing and using the resources available, changes are more likely. A parent is a primary resource.

Two treatment strategies that are effective with young people are MDFT and motivational interviewing (MI). The MDFT model considers multiple areas of an adolescent’s life, including emotional and cognitive functioning and family and peer relationships. A carefully designed, family-based model will focus on the adolescent’s specific developmental stages and their position within the family system.

MI is designed for therapy in general, but has been especially effective for working with adolescents who abuse alcohol. MI is based on the premise that motivation to change should be elicited from the patient-client. Although MI does seek to “confront” clients with the reality of AUD, the technique differs substantially from more aggressive styles of confrontation over abusive behaviors.


Bibliography

"Alcohol and Young Adults Ages 18 to 25." National Institute on Alcohol Abuse and Alcoholism, Aug. 2025, www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-and-young-adults-ages-18-25. Accessed 20 Dec. 2025. 

Brown, Stephanie, and Virginia Lewis. The Alcoholic Family in Recovery: A Developmental Model. Guilford, 1999.

"Children of Addicted Parents Guide: The Impact of Substance Use on Families and Children." American Addiction Centers, 31 Mar. 2025, americanaddictioncenters.org/rehab-guide/guide-for-children. Accessed 20 Dec. 2025. 

Jay, Jeff, and Debra Jay. Love First. 2nd ed., Hazelden, 2008.

Lipari, Rachel N., and Struther L. Van Horn. "Children Living with Parents Who Have a Substance Use Disorder." The CBHSQ Report, 24 Aug. 2017, SAMHSA, www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html. Accessed 20 Dec. 2025.

Miller, W. R., and S. Rollnick, editors. Motivational Interviewing: Preparing People for Change. 4th ed., Guilford, 2023.

"Millions of U.S. Kids Live with Parents with Substance Use Disorders." National Institutes of Health, 3 June 2025, www.nih.gov/news-events/nih-research-matters/millions-us-kids-live-parents-substance-use-disorders. Accessed 20 Dec. 2025.

Mosel, Stacy. "Children of Alcoholics: Growing Up with an Alcoholic Parent." American Addiction Centers, 18 June 2024, americanaddictioncenters.org/alcohol/support-recovery/child. Accessed 20 Dec. 2025.

Mosel, Stacy. "Family Therapy for Substance Use Disorders and Addiction Recovery." American Addiction Centers, 9 Oct. 2025, americanaddictioncenters.org/therapy-treatment/family-therapy. Accessed 20 Dec. 2025.

Murray, Emily, and Hampton, David. "How Growing Up with Alcoholic Parents Affects Children." Addiction Center, 17 Dec. 2025, www.addictioncenter.com/alcohol/growing-up-alcoholic-parents-affects-children. Accessed 20 Dec. 2025.

"National Survey on Drug Use and Health (NSDUH)." Substance Abuse and Mental Health Services Administration, www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2024. Accessed 20 Dec. 2025.

Peele, Stanton. Addiction-Proof Your Child. Three Rivers, 2007.

Tirumala, Shreyas. "Parenting Style Linked to Alcohol Use." Yale Daily News, 14 Oct. 2014, yaledailynews.com/blog/2014/10/14/parenting-style-linked-to-alcohol-use. Accessed 20 Dec. 2025.

Full Article

DEFINITION: The connection between parenting and alsohol use disorder is two-pronged. One facet is the effect upon the family system when one or both parents abuse alcohol. A specific category, identified as the children of individuals with alcohol use disorder, incorporates both young children in the home and adults who grew up with parents who also abused alcohol. The second facet represents parents who have one or more children who abuse alcohol. The largest group of children in the home who abuse alcohol is teenagers, although college-age and young adult children, for whom parents feel partially responsible, also make up a large percentage.

Alcoholism and the Parental Role

Every person with alcohol use disorder (AUD) has a direct effect on several people, including spouses, children, and parents. This condition must be understood in context. As such, the most immediate and basic context is that of the family.

According to the Substance Abuse and Mental Health Services Administration's 2023 National Survey on Drug Use and Health, an estimated 12 million children under age seventeen were living in households with a parent or parents with alcohol use disorder. This condition is often destructive, evidenced by higher rates of domestic violence, child neglect, health problems, and alcohol-related death. Families with a parent who has a substance use disorder are more likely to experience conflict and to face financial challenges.

Many people, however, have coped effectively with the trauma of growing up with a parent with alcohol use disorder and have become competent adults. Longitudinal studies have noted that such persons relied on significantly more sources of support in their childhood and youth than was true of children who demonstrated coping problems. These notes highlight the importance of environmental and individual resilience factors that can assist in both prevention and adaptation.

Generally, substance use therapists and organizations assert that a biological vulnerability exists for AUD. Others disagree with the importance given to the genetic influence and prefer to focus on individual behaviors and environmental influences. Research has illustrated the importance of the home atmosphere; for example, families who ate dinner together (even families with one parent with AUD) were less likely to pass the disorder from parent to child. The sense of structure and of being cared for was assumed to be a contributing factor. In another longitudinal study, mothers who were warm and supportive were less likely to have children who grew up to develop AUD.

Parents Who Abuse Alcohol

Over time, parental patterns of behavior and communication are affected as a result of alcohol abuse, and these patterns often keep families from dealing with general parental and child problems because alcohol becomes the primary focus. In the recovery process, a parent becoming sober is a necessary but insufficient goal. Also needing to be addressed are the distorted behavioral and communication patterns that have developed in the family. Treatment is essential if the abstinence is to be maintained.

Research shows a link between substance abuse and child maltreatment. In effect, children of individuals with AUD are more likely to have behavioral problems and conduct disorders, and to report higher levels of depression, anxiety, and stress.

Studies have shown that children who grew up with at least one parent with AUD are more likely to experience adverse childhood experiences (ACEs). Research indicated that children of at least one parent with AUD reported, on average, 2.1 ACEs. Experiencing adverse childhood events increases several health risks, including smoking, obesity, depression, and development of a substance use disorder.

Alcohol use disorder in the family is not just about one person affecting others. All family members and persons in close relationships with the individual are affected. Possibly the ones most vulnerable are younger children, because of their small physical size and their dependent status. How effectively a family will function depends on the degree to which that family provides for the physical, social, emotional, and psychological well-being of family members.

When a parent has AUD, the family system becomes organized around the alcohol abuse. Therefore, an effective recovery process requires a change in the system itself, referred to as second-order change in family therapy, so that the family can develop patterns based on strengths, resiliency, and coping mechanisms.

Intervention

Fifteen years after Bill Wilson founded Alcoholics Anonymous, his wife, Lois Wilson, founded Al-Anon to help family and friends recover from the effects of someone else’s drinking. The preamble for Al-Anon Family Groups, as the organization is officially known, states that alcoholism is a family illness and that recovery is assisted by changed attitudes. Other organizations and approaches may state their purpose somewhat differently, but they all generally agree that the entire family benefits from inclusion in the recovery process.

The focus on adult children of parents with AUD started as a grassroots movement, initiated primarily by those who had experienced living with one or more family members who abused alcohol. Their desire to receive assistance for themselves was often overlooked by helping professionals who concentrated on the individual with AUD.

Family therapy, as a form of treatment and related intervention programs, has shown effectiveness in the treatment of families affected by alcohol abuse. One approach in particular, multidimensional family therapy (MDFT), has combined resources to treat issues related both to substance abuse and to conduct disorders. Other models include brief strategic family therapy (BSFT), functional family therapy (FFT), and community reinforcement and family training (CRAFT). The effectiveness of this therapeutic model lies in its careful design, which considers the chemical-dependent issue as being both family-based and multisystemic.

Parenting Children Who Abuse Alcohol

Viewed from the parental role, concern over a child’s alcohol abuse usually begins with adolescence and includes early adult years, especially the time when children are in college. In most family settings, the parental role will be more hands-on with adolescents and more distant with college students. Studies have been conducted to determine whether parenting styles have a direct effect on whether children develop substance use disorders as adults. The increasing number of young adults who return home after leaving home for the first time also increases the likelihood that parents will extend their time of direct involvement. In such cases, the parent and the returning young adult may disagree over what constitutes alcohol abuse.

The 2023 National Survey on Drug Use and Health reported that over 9 million young adults ages 18 to 25 reported binge drinking in the past thirty days. The same survey revealed that 2.4 million in the same age group reported heavy alcohol use in that period.

By the time young adults who drink alcohol reach their late twenties, many will have reduced their use of alcohol, often without clinical help or focused dialogue with their parents. These adult children often do not abstain from alcohol entirely, but are not likely to abuse alcohol. Those who do not emerge from this phase of alcohol use are more likely to be at serious risk because they have family members who are or who have been addicted to some substance, including alcohol.

Intervention Strategies for Parents

Parents should learn how to detect a true alcohol abuse problem with their teens and young adult children. The American Psychiatric Association’s fourth edition of the Diagnostic and Statistical Manual of Mental Disorders distinguished between alcoholic behaviors as abuse disorders and the more severe diagnosis, dependence disorders. However, in the DSM-5, published in 2013, these two disorders were combined as a single disorder called alcohol use disorder (AUD). The DSM-5-TR (2022), a text revision of the 2013 edition, retained this unified diagnosis but clarified inclusive language surrounding this diagnosis.

Research shows that some types of treatment for alcohol abuse by adolescents and young adults are more effective than others. Interventions identified as more effective are those that provide motivation, tools, and support to produce change. Effective treatments draw upon strengths, motivation, and existing support networks. Young people possess many assets that assist them in making the necessary changes. By recognizing and using the resources available, changes are more likely. A parent is a primary resource.

Two treatment strategies that are effective with young people are MDFT and motivational interviewing (MI). The MDFT model considers multiple areas of an adolescent’s life, including emotional and cognitive functioning and family and peer relationships. A carefully designed, family-based model will focus on the adolescent’s specific developmental stages and their position within the family system.

MI is designed for therapy in general, but has been especially effective for working with adolescents who abuse alcohol. MI is based on the premise that motivation to change should be elicited from the patient-client. Although MI does seek to “confront” clients with the reality of AUD, the technique differs substantially from more aggressive styles of confrontation over abusive behaviors.


Bibliography

"Alcohol and Young Adults Ages 18 to 25." National Institute on Alcohol Abuse and Alcoholism, Aug. 2025, www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-and-young-adults-ages-18-25. Accessed 20 Dec. 2025. 

Brown, Stephanie, and Virginia Lewis. The Alcoholic Family in Recovery: A Developmental Model. Guilford, 1999.

"Children of Addicted Parents Guide: The Impact of Substance Use on Families and Children." American Addiction Centers, 31 Mar. 2025, americanaddictioncenters.org/rehab-guide/guide-for-children. Accessed 20 Dec. 2025. 

Jay, Jeff, and Debra Jay. Love First. 2nd ed., Hazelden, 2008.

Lipari, Rachel N., and Struther L. Van Horn. "Children Living with Parents Who Have a Substance Use Disorder." The CBHSQ Report, 24 Aug. 2017, SAMHSA, www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html. Accessed 20 Dec. 2025.

Miller, W. R., and S. Rollnick, editors. Motivational Interviewing: Preparing People for Change. 4th ed., Guilford, 2023.

"Millions of U.S. Kids Live with Parents with Substance Use Disorders." National Institutes of Health, 3 June 2025, www.nih.gov/news-events/nih-research-matters/millions-us-kids-live-parents-substance-use-disorders. Accessed 20 Dec. 2025.

Mosel, Stacy. "Children of Alcoholics: Growing Up with an Alcoholic Parent." American Addiction Centers, 18 June 2024, americanaddictioncenters.org/alcohol/support-recovery/child. Accessed 20 Dec. 2025.

Mosel, Stacy. "Family Therapy for Substance Use Disorders and Addiction Recovery." American Addiction Centers, 9 Oct. 2025, americanaddictioncenters.org/therapy-treatment/family-therapy. Accessed 20 Dec. 2025.

Murray, Emily, and Hampton, David. "How Growing Up with Alcoholic Parents Affects Children." Addiction Center, 17 Dec. 2025, www.addictioncenter.com/alcohol/growing-up-alcoholic-parents-affects-children. Accessed 20 Dec. 2025.

"National Survey on Drug Use and Health (NSDUH)." Substance Abuse and Mental Health Services Administration, www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2024. Accessed 20 Dec. 2025.

Peele, Stanton. Addiction-Proof Your Child. Three Rivers, 2007.

Tirumala, Shreyas. "Parenting Style Linked to Alcohol Use." Yale Daily News, 14 Oct. 2014, yaledailynews.com/blog/2014/10/14/parenting-style-linked-to-alcohol-use. Accessed 20 Dec. 2025.

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