RESEARCH STARTER

Parenting and substance abuse

Parenting and substance abuse is a significant issue that affects families and children’s development. Substance use disorders, encompassing alcohol and drug abuse, can have dire consequences for both parents and their children. Pregnant individuals who abuse substances risk severe developmental issues for their fetuses, including fetal alcohol syndrome and addiction, necessitating medical intervention at birth. Children raised in homes with substance-abusing parents often experience impaired cognitive and social development, mental health challenges, and a higher likelihood of facing neglect or maltreatment.

Statistics indicate that a notable percentage of children live with substance-abusing parents, leading to increased risks of academic underachievement and behavioral problems. The chaotic environments associated with substance abuse can foster feelings of isolation, mistrust, and emotional trauma in children, affecting their ability to form healthy relationships. Moreover, these children may internalize substance use as a coping mechanism, perpetuating cycles of addiction into future generations. Addressing the impacts of parental substance abuse requires early education on prevention and the establishment of supportive outreach programs to help affected families.

Full Article

DEFINITION: Children of individuals with a substance use disorder are more likely to be physically or sexually abused, neglected, and injured, and are more likely to abuse drugs or alcohol as adults than are children of parents without a substance use disorder.

Introduction

In 2013, the American Psychiatric Association (APA) published the fifth edition of its handbook of classification of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), followed by a text revision in 2022 (DSM-5-TR). This manual sets forth the criteria used by mental health professionals in the United States to classify and diagnose any psychiatric disorder recognized within the US healthcare system. Substance use disorder (SUD) is assessed and diagnosed on a continuum from mild to moderate to severe, with each substance classified as a separate disorder (alcohol use disorder, opiate use disorder, stimulant use disorder, and so on). A diagnosis of substance use disorder is used when the recurrent and repeated use of drugs and/or alcohol causes impairment, such as failure to meet responsibilities at work, school, or home; physical or mental disability; and/or health problems. Furthermore, evidence of impairment of control or social impairment and/or risky or potentially life-threatening behavior is an additional indication that a diagnosis of SUD would be appropriate.

Alcohol and substance abuse during pregnancy has been definitively proven to be detrimental to the fetus. In addition to the well-documented damages caused by fetal alcohol spectrum disorders, both alcohol and drug abuse place the fetus at risk for intrauterine growth retardation, higher susceptibility to infectious disease before birth, and being physically dependent on a substance at birth, requiring medical detoxification before the baby can leave the hospital.

Children who are reared by a parent or parents with SUD have been shown to have impaired cognitive and social development skills, slowed learning skills, and a wide range of mental health problems, including depression and anxiety.

Alcohol Use Disorder

Data from the Substance Abuse and Mental Health Services Administration indicated that in 2023, 19 million American children, or one in four, were living with a parent with an SUD. The American Psychological Association estimated that between 2 and 5 percent of US school children may have been exposed to alcohol prenatally.

Young children of parents with alcohol use disorder (AUD) are habitually given less attention than the alcohol itself by their parents. This leads to low self-esteem and decreased self-worth in the children, fostering fears of helplessness and abandonment.

The mood swings and erratic behavior of parents with AUD can also lead to stress-induced nightmares, paranoia, and bedwetting in young children. These children are also at a much higher risk of injuries, which result from inadequate supervision in the home or vehicular accidents caused by alcohol-impaired drivers.

Instances of incest and domestic violence also occur with considerably higher frequency in families in which AUD is prevalent. Because young children are poorly equipped to handle the emotional trauma that results from these incidents, they are at higher risk of lifelong psychological and mental disorders, including anxiety and depression.

General alienation from and mistrust of adults can also lead young children to engage in deviant behavior at school and in their community. This mistrust acts as a barrier for the children of parents with AUD to seek solace or support from other adults, both outside the home and within their immediate families. The inability to relate and the lack of understanding in interactions with children from households unaffected by alcohol use can also lead to anger, hostility, and erratic behavior in peer interactions. This leads to further isolation and social abandonment.

Drug Use

Parental drug use is equally hazardous to the health and proper development of children as is parental alcohol abuse. As with AUD, the number of potential prenatal dangers is lengthy and widely documented by medical research.

Pregnant women with substance use disorders (SUDs), particularly those who ingest drugs intravenously, risk exposing the fetus to infectious diseases. Severe brain damage, stroke, low birth weight, and organ failure are also common problems associated with prenatal use of illicit drugs. Additionally, newborn children of individuals with SUD are at high risk for being born addicted to the drugs their mother ingested. The newborn must then be detoxed safely from the substance before being released to a family member or the department of social services.

Maltreatment such as sexual abuse and battery, and habitual periods of neglect are of higher prevalence in families with one or more parents with SUD. The lack of structure and routine in the lives of children of parents with SUD can also lead children to lash out at school and at daycare.

While alcohol can be acquired legally and is readily available, controlled substances must be obtained through illicit transactions, often in environments that are unsuitable or unsafe for children. These environments include violent and crime-ridden neighborhoods.

Children of individuals with a SUD are frequently exposed to these dangerous environments or experience lengthy periods of neglect in their own home while their parents seek drugs. Lengthy neglect is particularly challenging for the older siblings of young children, who often have the responsibility of parenting their younger siblings when they are themselves lacking in the proper emotional, physical, and psychological abilities to navigate everyday life.

Similarly, children preoccupied with concern for their drug-abusing parents place education at a lower priority, resulting in less-than-adequate academic development and achievement. Shame, mistrust, and fear also hinder the children of drug-abusing parents. The children have trouble building trusting relationships both with their own peers and with adults, which further perpetuates feelings of isolation and helplessness.

Troubled Adulthoods

Children raised in drug-free homes or by parents with normative behaviors toward drugs and alcohol may experiment with such substances themselves. Children of substance-abusing parents, however, are raised in an environment that models alcohol and drug use as ways to cope with stress, anger, pain, or a host of other negative emotions. Many children of individuals with SUD resort to the use of drugs and alcohol to ease the psychological and emotional pains of childhood, or they simply view such behavior as normal, leaving them vulnerable to developing SUDs themselves.

A large body of evidence exists to show a genetic connection between SUDs in the children of parents with AUD. According to the National Association for Children of Addiction (NACoA), biological children of parents experiencing addiction are much more likely to develop an SUD themselves.

Children of parents with an SUD face difficult circumstances even if they manage to avoid the patterns of alcoholism and drug use demonstrated by their parents. Academic underachievement is common among these children, and they repeatedly underperform on standardized assessments of academic skills, such as reading comprehension and mathematics. In one study reported by the NACA, 41 percent of children with drug- or alcohol-abusing parents repeat an academic grade because of poor performance or lagging academic comprehension. This lack of academic preparedness leaves children with fewer skills, interests, and motivations to apply toward careers and hobbies as adults.

The cyclical nature of damaging, abusive, and neglectful childhoods is perhaps the most severe consequence of substance abuse on parenting. Substance abuse can affect families for several generations. Early education on the dangers of alcohol abuse and illicit drug use has become a key tool in addressing the problem in the United States. Also critical is the establishment of effective outreach and social programs in which at-risk children can communicate about abusive behaviors and harmful home environments and can find support from their school or community.


Bibliography

Black, Claudia. It Will Never Happen to Me: Growing Up with Addiction as Youngsters, Adolescents, Adults. Hazelden, 2013.

Brouwer, Thomas P. Parents with Substance Use Disorders and Child Protection Issues. Nova Science, 2011.

Calhoun, Stacy, et al. "Improving the Outcomes of Children Affected by Parental Substance Abuse: A Review of Randomized Controlled Trials." Substance Abuse and Rehabilitation, vol. 6, 2015, pp. 15–24.

"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. 

“Children of Addicted Parents: Important Facts.” National Association for Children of Addiction, nacoa.org/important-facts. Accessed 20 Dec. 2025.

"Effects of Parental Substance Abuse on Children and Families." American Academy of Experts in Traumatic Stress, www.aaets.org/traumatic-stress-library/effects-of-parental-substance-abuse-on-children-and-families. Accessed 20 Dec. 2025.

Ghertner, Robin. "National and State Estimates of Children Living with Parents Using Substances, 2015-2019." U.S. Department of Health and Human Services, 14 Nov. 2022, aspe.hhs.gov/reports/children-living-parents-using-substances. Accessed 20 Dec. 2025.

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

"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.

"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.

Weir, Kirsten. "A Hidden Epidemic of Fetal Alcohol Syndrome." American Psychological Association, 1 July 2022, www.apa.org/monitor/2022/07/news-fetal-alcohol-syndrome. Accessed 20 Dec. 2025.

Full Article

DEFINITION: Children of individuals with a substance use disorder are more likely to be physically or sexually abused, neglected, and injured, and are more likely to abuse drugs or alcohol as adults than are children of parents without a substance use disorder.

Introduction

In 2013, the American Psychiatric Association (APA) published the fifth edition of its handbook of classification of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), followed by a text revision in 2022 (DSM-5-TR). This manual sets forth the criteria used by mental health professionals in the United States to classify and diagnose any psychiatric disorder recognized within the US healthcare system. Substance use disorder (SUD) is assessed and diagnosed on a continuum from mild to moderate to severe, with each substance classified as a separate disorder (alcohol use disorder, opiate use disorder, stimulant use disorder, and so on). A diagnosis of substance use disorder is used when the recurrent and repeated use of drugs and/or alcohol causes impairment, such as failure to meet responsibilities at work, school, or home; physical or mental disability; and/or health problems. Furthermore, evidence of impairment of control or social impairment and/or risky or potentially life-threatening behavior is an additional indication that a diagnosis of SUD would be appropriate.

Alcohol and substance abuse during pregnancy has been definitively proven to be detrimental to the fetus. In addition to the well-documented damages caused by fetal alcohol spectrum disorders, both alcohol and drug abuse place the fetus at risk for intrauterine growth retardation, higher susceptibility to infectious disease before birth, and being physically dependent on a substance at birth, requiring medical detoxification before the baby can leave the hospital.

Children who are reared by a parent or parents with SUD have been shown to have impaired cognitive and social development skills, slowed learning skills, and a wide range of mental health problems, including depression and anxiety.

Alcohol Use Disorder

Data from the Substance Abuse and Mental Health Services Administration indicated that in 2023, 19 million American children, or one in four, were living with a parent with an SUD. The American Psychological Association estimated that between 2 and 5 percent of US school children may have been exposed to alcohol prenatally.

Young children of parents with alcohol use disorder (AUD) are habitually given less attention than the alcohol itself by their parents. This leads to low self-esteem and decreased self-worth in the children, fostering fears of helplessness and abandonment.

The mood swings and erratic behavior of parents with AUD can also lead to stress-induced nightmares, paranoia, and bedwetting in young children. These children are also at a much higher risk of injuries, which result from inadequate supervision in the home or vehicular accidents caused by alcohol-impaired drivers.

Instances of incest and domestic violence also occur with considerably higher frequency in families in which AUD is prevalent. Because young children are poorly equipped to handle the emotional trauma that results from these incidents, they are at higher risk of lifelong psychological and mental disorders, including anxiety and depression.

General alienation from and mistrust of adults can also lead young children to engage in deviant behavior at school and in their community. This mistrust acts as a barrier for the children of parents with AUD to seek solace or support from other adults, both outside the home and within their immediate families. The inability to relate and the lack of understanding in interactions with children from households unaffected by alcohol use can also lead to anger, hostility, and erratic behavior in peer interactions. This leads to further isolation and social abandonment.

Drug Use

Parental drug use is equally hazardous to the health and proper development of children as is parental alcohol abuse. As with AUD, the number of potential prenatal dangers is lengthy and widely documented by medical research.

Pregnant women with substance use disorders (SUDs), particularly those who ingest drugs intravenously, risk exposing the fetus to infectious diseases. Severe brain damage, stroke, low birth weight, and organ failure are also common problems associated with prenatal use of illicit drugs. Additionally, newborn children of individuals with SUD are at high risk for being born addicted to the drugs their mother ingested. The newborn must then be detoxed safely from the substance before being released to a family member or the department of social services.

Maltreatment such as sexual abuse and battery, and habitual periods of neglect are of higher prevalence in families with one or more parents with SUD. The lack of structure and routine in the lives of children of parents with SUD can also lead children to lash out at school and at daycare.

While alcohol can be acquired legally and is readily available, controlled substances must be obtained through illicit transactions, often in environments that are unsuitable or unsafe for children. These environments include violent and crime-ridden neighborhoods.

Children of individuals with a SUD are frequently exposed to these dangerous environments or experience lengthy periods of neglect in their own home while their parents seek drugs. Lengthy neglect is particularly challenging for the older siblings of young children, who often have the responsibility of parenting their younger siblings when they are themselves lacking in the proper emotional, physical, and psychological abilities to navigate everyday life.

Similarly, children preoccupied with concern for their drug-abusing parents place education at a lower priority, resulting in less-than-adequate academic development and achievement. Shame, mistrust, and fear also hinder the children of drug-abusing parents. The children have trouble building trusting relationships both with their own peers and with adults, which further perpetuates feelings of isolation and helplessness.

Troubled Adulthoods

Children raised in drug-free homes or by parents with normative behaviors toward drugs and alcohol may experiment with such substances themselves. Children of substance-abusing parents, however, are raised in an environment that models alcohol and drug use as ways to cope with stress, anger, pain, or a host of other negative emotions. Many children of individuals with SUD resort to the use of drugs and alcohol to ease the psychological and emotional pains of childhood, or they simply view such behavior as normal, leaving them vulnerable to developing SUDs themselves.

A large body of evidence exists to show a genetic connection between SUDs in the children of parents with AUD. According to the National Association for Children of Addiction (NACoA), biological children of parents experiencing addiction are much more likely to develop an SUD themselves.

Children of parents with an SUD face difficult circumstances even if they manage to avoid the patterns of alcoholism and drug use demonstrated by their parents. Academic underachievement is common among these children, and they repeatedly underperform on standardized assessments of academic skills, such as reading comprehension and mathematics. In one study reported by the NACA, 41 percent of children with drug- or alcohol-abusing parents repeat an academic grade because of poor performance or lagging academic comprehension. This lack of academic preparedness leaves children with fewer skills, interests, and motivations to apply toward careers and hobbies as adults.

The cyclical nature of damaging, abusive, and neglectful childhoods is perhaps the most severe consequence of substance abuse on parenting. Substance abuse can affect families for several generations. Early education on the dangers of alcohol abuse and illicit drug use has become a key tool in addressing the problem in the United States. Also critical is the establishment of effective outreach and social programs in which at-risk children can communicate about abusive behaviors and harmful home environments and can find support from their school or community.


Bibliography

Black, Claudia. It Will Never Happen to Me: Growing Up with Addiction as Youngsters, Adolescents, Adults. Hazelden, 2013.

Brouwer, Thomas P. Parents with Substance Use Disorders and Child Protection Issues. Nova Science, 2011.

Calhoun, Stacy, et al. "Improving the Outcomes of Children Affected by Parental Substance Abuse: A Review of Randomized Controlled Trials." Substance Abuse and Rehabilitation, vol. 6, 2015, pp. 15–24.

"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. 

“Children of Addicted Parents: Important Facts.” National Association for Children of Addiction, nacoa.org/important-facts. Accessed 20 Dec. 2025.

"Effects of Parental Substance Abuse on Children and Families." American Academy of Experts in Traumatic Stress, www.aaets.org/traumatic-stress-library/effects-of-parental-substance-abuse-on-children-and-families. Accessed 20 Dec. 2025.

Ghertner, Robin. "National and State Estimates of Children Living with Parents Using Substances, 2015-2019." U.S. Department of Health and Human Services, 14 Nov. 2022, aspe.hhs.gov/reports/children-living-parents-using-substances. Accessed 20 Dec. 2025.

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

"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.

"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.

Weir, Kirsten. "A Hidden Epidemic of Fetal Alcohol Syndrome." American Psychological Association, 1 July 2022, www.apa.org/monitor/2022/07/news-fetal-alcohol-syndrome. Accessed 20 Dec. 2025.

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