Jul 18, This study reports that children whose parents use drugs and misuse and parents' or caregivers' substance use may affect their ability to. Jan 11, webob.info How Does Addiction Affect Family And Friends When a person compulsively uses drugs or alcohol, their behaviors do not exist in a vacuum. Losing The relationship — One of the hallmarks of substance abuse and In order to protect your spouse, parent, child or friend, you may. Parental use of tobacco or alcohol is a precursor of the onset of smoking or drinking The second European School Survey Project on Alcohol and other Drugs .. the family structure could affect attachment to parents, and relationships with.
Factors that minimize risk for children's social and emotional functioning include parental remission of alcohol use or having one not two problem-drinking parents. The presence of co-occurring parental psychopathology, such as depression, anxiety, and antisocial behavior, increases risk for children's internalizing and externalizing behavior in the context of parental alcohol and substance use disorders. Children of alcoholic parents show a specific and unique risk for earlier onset of substance use, faster acceleration in their patterns of substance use, and higher rates of alcohol and drug use disorders than do children of non-alcoholic parents.
Ongoing substance use disorders in caretakers can be highly impairing and impact financial, social, cognitive, health, and emotional functioning. These impairments, in turn, may interfere with the ability of the parent to care for his or her child. Below, we briefly review primary areas in which parents with a substance use disorder are vulnerable to deficits see Table 2 for key studies. Parenting styles Most of the research on parental substance abuse and parenting behaviors focuses on mother-child dyads during infancy and toddlerhood, though findings appear to be consistent in studies that follow youth into adolescence.
In general, these studies find that mothers who abuse substances typically are less responsive to their children and display less warmth, encouragement, and engagement during interactions with their children [ 5664 — 66 ].
Additionally, as these children enter adolescence, both maternal alcohol and drug abuse are associated with authoritarian, over-involved parenting styles; more harsh, commanding, and punitive discipline; and less parental monitoring [ 5666 — 69 ]. However, the type of substance being abused may be associated with the type and quality of interaction between the parent and child.
For example, according to Mayes and Truman [ 70 ], parents abusing alcohol, marijuana, heroin, or other anxiolytic drugs are more likely to display depressed or withdrawn behavior during interactions with their young children.
How Does Addiction Affect Family and Friends?
On the other hand, mothers abusing cocaine or other stimulants are more likely to be intrusive, impulsive, and even hostile with their children, though some studies do not show these differences in very young children [ 71 ]. Although most studies focus on maternal substance abuse, those studies that include fathers report similar results. For example, fathers with versus without an alcohol use disorder show higher negative affect, less sensitivity, low levels of positive engagement, and a lower quality and number of verbalizations during observed interactions with their toddlers and young children [ 6572 ].
Additionally, fathers' substance abuse is associated with poorer quality and less effective discipline in interactions with their sons during late childhood [ 73 ]. In adolescence, paternal alcoholism is associated with greater father-adolescent and mother-adolescent conflict, though not parent-child support [ 74 ], though contrasting results were also reported in a study of a small sample of adolescent girls [ 66 ].
When comparing the relative influences of maternal versus paternal alcoholism, Chassin and colleagues found that after controlling for co-occurring parental psychopathology i. Moreover, Curran and Chassin [ 75 ] showed that the parenting behavior of a non-alcoholic mother did not meaningfully reduce risk for externalizing symptoms, alcohol use or drug use in children of fathers with alcoholism i. Studies of young children aged 18—36 monthshowever, do show that mother-child relationship factors i.
In sum, the majority of studies find that mothers who abuse substances demonstrate less responsiveness and warmth and more authoritarian and punitive parenting styles with their children. Similarly, fathers who abuse substances show less sensitivity, engagement, and effective discipline during interactions with their children. These effects may vary depending on the age of the child. Evidence for compensatory parenting remains mixed and future research should seek to determine the circumstances under which the interactions of unimpaired parents can substantially reduce risk for negative outcomes in these children.
Although studies with young children largely relied on observational assessments of parenting style, such methods are rare with older children and adolescence. The extent to which these differences in parenting style are impacted by rater bias by parents or teens is unclear and the use of observational methods for older children may be an important direction for future research to clarify the nature of the actual versus perceived parenting environment associated with parental substance abuse.
Child maltreatment Inchild protective service agencies received 3. Children of substance abusing parents have a greater risk of maltreatment, including physical abuse, sexual abuse, and neglect. Although clearly not all parents who abuse substances engage in maltreatment, these families are over-represented in reported and investigated cases of maltreatment. These children are 2. In addition, substance abusing parents are at greater risk for multiple child maltreatment allegations, being more likely than other parents to have a second child maltreatment report filed against them [ 8081 ].
This risk may be particularly elevated in young children [ 80 ]. Parents with a lifetime substance use diagnosis reported significantly higher potential for physical child abuse, such as rigid beliefs about children and parenting difficulties, than parents without a substance use diagnosis [ 82 ]. No differences were found in child abuse potential among parents with a current diagnosis and parents with a past diagnosis [ 83 ], indicating that the risk for child maltreatment may not be affected by sobriety.
However, substance use diagnosis only predicted elevated child abuse potential in fathers, and not mothers, when other parent and child factors were controlled.
In sum, children of alcohol and drug abusing parents are over-represented in social services investigations and services for child maltreatment.
Findings are less consistent, however, regarding the extent to which factors commonly associated with child abuse potential are elevated in children of substance abusing parents. These findings beg the question of what factors are actually associated with risk for maltreatment in children of substance abusing parents. Attachment styles Attachment theory posits that infants obtain an understanding of the world and what to expect from their relationships with others based on whether their caregivers are consistent, sensitive, and responsive to their needs [ 84 ].
Attachment styles reflect the nature of the parent-child relationship and are considered to be secure i. Infants who are exposed to substances prenatally or whose parents abuse substances postnatally tend to develop insecure attachment styles e.
This risk may be particularly high in families where other mental health problems accompany parental substance abuse.
For example, Edwards, Eiden and Leonard [ 87 ] showed that families in which either parent had a drinking problem as well as co-occurring psychopathology i. Much of this work, however, confounds prenatal and postnatal exposure to parental substance abuse and it is unclear the extent to which having a substance abusing parent impacts attachment styles above and beyond prenatal exposure to substances.
Although the majority of infants were securely attached regardless of maternal substance abuse status, they found small effects for prenatal cocaine, opiate, and alcohol exposure to increase risk for insecure attachments. They also found larger but short-term effects for postnatal alcohol exposure that existed in mother-child dyads when children were 18 months of age but that dissipated by the time the children were 36 months of age.
These findings suggest that risk for insecure attachments in mother-infant dyads is greatest at the youngest ages and this pattern of findings may be related to risks associated with prenatal exposure. However, the impact of insecure attachment styles on children of substance abusing parents may depend on whether there is a non-substance-abusing caregiver in the family who can offset this risk.
This is an encouraging finding as infants with only one problem-drinking parent were less likely to be insecurely attached to both of their parents compared to infants with two problem drinking parents. Thus, the presence of a non-substance involved caretaker may create opportunities for secure relationships in children of substance abusing parents, and these secure relationships may in turn buffer risk for negative outcomes.
Regardless, some research indicates that confounding variables such as parenting quality and sensitivity may have a greater impact than parental substance abuse on attachment quality. For example, Bergin and McCollough [ 90 ] tested whether attachment patterns among infants prenatally exposed to multiple substances differed from those of a matched-control group of infants at equal social risk i. Results showed that observed patterns of attachment and maternal sensitivity were the same among both drug-exposed and non-exposed month old infants.
Moreover, the key predictors of attachment style were maternal sensitivity and involvement and not maternal drug abuse, though all of these factors were correlated.
These findings suggest that caregiving quality and social risk may be more predictive of attachment patterns than prenatal exposure to multiple substances. Although one strength of this study includes capturing several confounding variables related to social risk and parenting quality, a clear limitation is that postnatal substance exposure was not measured, leaving open the question of the effects of postnatal parental substance abuse on children's attachment style above and beyond the effects of caregiving quality and social risk.
These findings suggest that parental substance abuse is associated with insecure attachment in general.
How Does Addiction Affect Family and Friends?
However, a variety of factors other than parental substance abuse also impact attachment security, including social risk, general parenting style, sensitivity, and responsiveness. Thus, although children of substance abusing parents appear to show more insecure attachments to their caregivers then do their peers, factors other than the parents' alcohol and drug abuse may explain this association.
Continued research efforts will need to appropriately capture and control for these confounding factors that impact attachment in order to determine the unique risk associated with parental substance abuse.
Future researchers will also need to appropriately parse prenatal and postnatal exposure to parental substance abuse. Findings suggest that children may be in need of services very early in childhood, with support from treatment providers to develop positive parent-child relationships from birth.
Treatment providers can also support children and families by assessing for protective factors in the family that can offset risk, including the presence of a non-substance abusing caregiver. Summary Parental substance abuse is associated with a number of other family-based risk factors for negative outcomes in children, though other factors within the caregiving context may actually reduce this risk in some circumstances.
Thus, parents' substance abuse is a marker variable representing a complex environment of inter-related, co-occurring vulnerability factors. Much remains to be learned about the association between parental substance abuse and the caregiving environment, particularly concerning the relative risks for children associated with prenatal versus postnatal drug exposure and the mechanisms that underlie the association between parents' substance abuse and the maltreatment of children.
However, results from this emerging body of literature suggest the following conclusions about potential risk factors in the caregiving contexts of children whose parents abuse substances versus children whose parents do not. Substance abusing mothers typically show less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles with their children than non-substance abusing mothers.
The limited research on substance abusing fathers and young children suggests that they display less sensitivity, engagement, and effective discipline with their children than do non-substance abusing fathers. Parental substance abuse is associated with greater risk for child maltreatment and multiple child maltreatment allegations.
Children of substance abusing parents tend to develop less secure attachment patterns, but this trend may be due to other associated factors such as social risk, low-income status, comorbid parental psychopathology, sensitivity, and parenting style.
Children of substance abusing parents who have a secure relationship with a non-substance abusing parent show higher rates of positive adjustment compared to those who do not. We also identified important caveats, noting that not all of these children or families show such adjustment problems. In some cases, children of substance abusing parents did not differ from their peers. Factors that appear to influence this level of risk include the number of impaired parents, the recency of substance abuse and recovery status of the parent, co-occurring parental psychopathology, and the presence of other caretakers.
Other factors that likely play a role but are less well-documented include the type of drug abused and the timing of the parents' substance abuse in the child's life. Despite the large literature on children of substance abusing parents, few studies have focused on the extent to which deficits in parenting mediate the effects of parents' substance abuse on child outcomes.
Two examples that we highlight here indicate that parenting may be part of the reason for these negative outcomes. First, Chassin, Curran, Hussong and Colder [ 62 ] showed that parents' monitoring of their children accounted, in part, for the association between parental alcoholism and escalations in adolescents' substance use over time. Other contributors to this risk included increased greater life stressors within the family, resulting in greater internalizing symptoms in these youth and associations with deviant peers which directly predicted steeper escalations in adolescent substance use.
These studies represent an important body of literature indicating that parenting and family context may in part account for the risk for negative outcomes faced by children of substance abusing parents.
However, this conclusion requires greater attention to genetically informed samples that can differentiate such environmentally mediated risk mechanisms from shared genetic factors in parents and their children that also underlie this pattern of findings. Importantly, despite the noted association between parental substance abuse and these negative outcomes for children, parents' alcohol or drug abuse does not solely explain why these children are at risk.
Co-occurring risk factors including other forms of parent psychopathology and family adversity including poverty, conflict, and family structure sometimes better explained risk in these children than did the parents' substance abuse history. Acknowledging the incredible diversity in the level and form of risk for negative outcomes faced by children of substance abusing parents, we believe broad generalizations about these children and their families are unwarranted. Instead, we recommend focusing on those factors that may alter or explain levels of risk among these families.
First, the findings clearly indicate a great deal of variability in risk for negative outcomes among children of substance abusing parents, with many children exhibiting resilience and normal functioning. It will thus be critical for treatment professionals to consider the wide range of possible outcomes for these children and families.
Understanding the Diverse Needs of Children whose Parents Abuse Substances
Second, several key factors that increase children's risk include having two rather than one alcoholic parents, having alcoholic parents with comorbid psychopathology e. Given these factors that predict risk, it will be important for treatment providers to assess for these indicators of increased risk. Third, we emphasize that parental alcohol and drug use disorders are often associated with a variety of risk factors e. Thus, the context in which alcohol or drug use is occurring will be important for professionals to assess to determine which other co-occurring risk factors may be relevant to child functioning and may indicate appropriate treatment targets.
Fourth, deficits in child functioning and parenting behaviors among substance- and alcohol-abusing parents may emerge in early childhood. Treatment providers are advised to assess for and consider potential negative outcomes even among young children. Identifying deficits earlier in childhood will benefit children and families before problems continue to develop, and will also support prevention efforts in this area. Fifth, the findings suggest that both prenatal exposure and post-natal exposure uniquely increase risk for these children.
Thus, it is important to consider that even if a child was not exposed prenatally, any continued exposure beyond birth can still increase risk for negative outcomes. Although many children of substance abusing parents may show risk for negative outcomes, many are resilient and show normal functioning. Professionals should be mindful of the wide variability in risk for negative outcomes in children from these families. The nature of parental impairment impacts children's risk outcomes. Risk for negative outcomes is greater for children from families with two versus one alcoholic parents, alcoholic parents who have co-occurring depression or antisocial behavior, and, in some cases, parents who are currently abusing alcohol or drugs versus recovered.
Assessment of parental substance use history and current use are indicated to determine child risk. Parental alcohol and drug use disorders are non-specific risk factors.
These disorders are associated with a host of other negative risk factors for children including other forms of parental mental health disorders e. Moreover, children of substance abusing parents show a broad profile of risk. Assessments in these families should be sensitive to co-occurring risk factors and adopt a broad perspective on child functioning to more accurately characterize the strengths and weaknesses of these families.
Deficits in parenting behaviors and child functioning may be present in some children of substance abusing parents from early childhood. Attention to potential negative outcomes even in young children of substance abusing parents is indicated.
- Getting Help
- Substance Abuse Treatment and Family Therapy.
Although prenatal exposure to substances, including alcohol and illicit drugs, is one mechanism of risk for these children, studies show increased risk for negative outcomes in children of alcoholic parents who deny prenatal exposure from the mother relative to children of non-alcoholic parents from similar backgrounds.
Thus, regardless of whether children were prenatally exposed, they appear to be at increased risk for negative outcomes. We present several future research questions and guidelines to further advance our understanding. Future researchers should consider other factors within substance abusing populations that can impact child outcomes, including unique effects for different drugs of abuse and the timing of parental substance abuse patterns in their children's lives.
As noted above, few studies have explored deficits in parenting as mediators of the effects of parental substance abuse on child outcomes. Future studies that consider such mediating mechanisms will help us better understand pathways of risk.
Introduction A growing body of literature suggests that substance abuse has distinct effects on different family structures. Frequently, children may act as surrogate spouses for the parent who abuses substances. The effects of substance abuse frequently extend beyond the nuclear family. Extended family members may experience feelings of abandonment, anxiety, fear, anger, concern, embarrassment, or guilt; they may wish to ignore or cut ties with the person abusing substances.
Some family members even may feel the need for legal protection from the person abusing substances. Moreover, the effects on families may continue for generations. Intergenerational effects of substance abuse can have a negative impact on role modeling, trust, and concepts of normative behavior, which can damage the relationships between generations.
For example, a child with a parent who abuses substances may grow up to be an overprotective and controlling parent who does not allow his or her children sufficient autonomy. Neighbors, friends, and coworkers also experience the effects of substance abuse because a person who abuses substances often is unreliable.
Friends may be asked to help financially or in other ways. Coworkers may be forced to compensate for decreased productivity or carry a disproportionate share of the workload. As a consequence, they may resent the person abusing substances. People who abuse substances are likely to find themselves increasingly isolated from their families.
Often they prefer associating with others who abuse substances or participate in some other form of antisocial activity. Different treatment issues emerge based on the age and role of the person who uses substances in the family and on whether small children or adolescents are present. In some cases, a family might present a healthy face to the community while substance abuse issues lie just below the surface.
Reilly describes several characteristic patterns of interaction, one or more of which are likely to be present in a family that includes parents or children abusing alcohol or illicit drugs: Any communication that occurs among family members is negative, taking the form of complaints, criticism, and other expressions of displeasure.
The overall mood of the household is decidedly downbeat, and positive behavior is ignored. In such families, the only way to get attention or enliven the situation is to create a crisis.
This negativity may serve to reinforce the substance abuse. Rule setting is erratic, enforcement is inconsistent, and family structure is inadequate. Children are confused because they cannot figure out the boundaries of right and wrong. As a result, they may behave badly in the hope of getting their parents to set clearly defined boundaries. Without known limits, children cannot predict parental responses and adjust their behavior accordingly.
These inconsistencies tend to be present regardless of whether the person abusing substances is a parent or child and they create a sense of confusion—a key factor—in the children. Despite obvious warning signs, the parental stance is: My child does not have a drug problem! Children or parents who resent their emotionally deprived home and are afraid to express their outrage use drug abuse as one way to manage their repressed anger.
Either a parent or child will use drugs or alcohol to cope with intolerable thoughts or feelings, such as severe anxiety or depression. In all of these cases, what is needed is a restructuring of the entire family system, including the relationship between the parents and the relationships between the parents and the children. The next section discusses treatment issues in different family structures that include a person who is abusing substances.
Families With a Member Who Abuses Substances Client Lives Alone or With Partner The consequences of an adult who abuses substances and lives alone or with a partner are likely to be economic and psychological.
Money may be spent for drug use; the partner who is not using substances often assumes the provider role. Psychological consequences may include denial or protection of the person with the substance abuse problem, chronic anger, stress, anxiety, hopelessness, inappropriate sexual behavior, neglected health, shame, stigma, and isolation. In this situation, it is important to realize that both partners need help. The treatment for either partner will affect both, and substance abuse treatment programs should make both partners feel welcome.
If a person has no immediate family, family therapy should not automatically be ruled out. A single person who abuses substances may continue to have an impact on distant family members who may be willing to take part in family therapy. If family members come from a distance, intensive sessions more than 2 hours may be needed and helpful. What is important is not how many family members are present, but how they interact with each other. In situations where one person is substance dependent and the other is not, questions of codependency arise.
Codependency has become a popular topic in the substance abuse field. Codependent people are thought to have several patterns of behavior: They are controlling because they believe that others are incapable of taking care of themselves.
They are excessively compliant, compromising their own values and integrity to avoid rejection or anger.
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They often react in an oversensitive manner, as they are often hypervigilant to disruption, troubles, or disappointments.
They remain loyal to people who do nothing to deserve their loyalty CoDA Systematic research is needed to establish the nature of codependency and why it might be important Cermak ; Hurcom et al. Nonetheless, specifically targeted behavior that somehow reinforces the current or past using behavior must be identified and be made part of the treatment planning process.
Trust is a key child development issue and can be a constant struggle for those from family systems with a member who has a substance use disorder Brooks and Rice The children of women who abuse substances during pregnancy are at risk for the effects of fetal alcohol syndrome, low birth weight associated with maternal addictionand sexually transmitted diseases.
Older children may be forced prematurely to accept adult responsibilities, especially the care of younger siblings. In adolescence, drug experimentation may begin. Adult children of those with alcohol abuse disorders may exhibit problems such as unsatisfactory relationships, inability to manage finances, and an increased risk of substance use disorders.
Although, in general, children with parents who abuse substances are at increased risk for negative consequences, positive outcomes have also been described.