June 2006

I have heard that children of parents with alcoholism are at risk for developing mental health and substance use problems. What are the risks, and what can we do to help these families?

It is true that research shows that children of parents with alcoholism are at increased risk for depression, anxiety disorders, and behavior problems. Marital conflict, family stress and instability, parental depression, or financial strain can add to the negative effect of parental alcoholism on children 's emotional and behavioral functioning. In addition, these children are significantly more likely to suffer abuse or neglect. According to the American Academy of Child and Adolescent Psychiatry (AACAP) (1999), a child growing up in an alcoholic family may have the following problems:

Guilt	The child may see himself or herself as the main cause of the mother’s or father’s drinking.
Anxiety	The child may worry constantly about the situation at home. He or she may fear the alcoholic parent will become sick or injured, and may also fear fights and violence between the parents or abuse.
Embarrassment	Parents may give the child the message that there is a terrible secret at home. The ashamed child does not invite friends home and is afraid to ask anyone for help.
Inability to have close relationships	If the child has been disappointed by the drinking parent many times, he or she often may not trust others.
Confusion	The alcoholic parent may change suddenly from being loving to angry, regardless of the child 's behavior. A regular daily schedule, which is very important for a child, may not exist because bedtimes and mealtimes are constantly changing.
Anger	The child may feel anger at the alcoholic parent for drinking, and may be angry at the non-alcoholic parent for lack of support and protection.
Depression	The child may feel lonely and helpless to change the situation.

(The table above was adapted from the AACP's Children of Alcoholics Fact Sheet http://www.aacap.org/publications/factsfam/alcoholc.htm)

Children of parents with alcoholism are also four times more likely than other children to develop alcoholism or abuse alcohol later in life (AACAP, 1999). Because almost 5 million adults who have problems with substance abuse have at least one child under the age of 18 living at home, a great number of children are at risk for repeating their families’ alcohol-related problems (US Department of Health and Human Services, 2002).

Given these startling statistics, it is critical that we provide help and support to families with alcohol-related problems. Research shows that children’s psychosocial adjustment improves when parents receive treatment for their alcoholism (Andreas, 2006). Even if parents are not receiving treatment, children can benefit from help and support. In fact, studies have found that when these children receive support from a nonalcoholic parent, grandparent, teacher, or other caring adult, they are less likely to develop alcoholism or other serious problems in their lives (Werner & Johnson, 2004).

The Children of Alcoholics Community Action Guide (US Department of Health and Human Services, 2004) suggests the following actions you can take to help children of alcoholics (COAs):

• Simple acts of kindness and compassion can make a difference for COAs. By making yourself available to listen, discuss feelings, share interests, and support their efforts to make friends, you can help COAs cope with their present situations and develop the resilience and skills necessary for their futures.
• Tell them they are not alone, that responsible adults are available to help them, and that millions of others have had similar experiences and have grown up to lead healthy, satisfying lives.
• Remind them that their families’ problems are not their fault and not their responsibility to solve. Their jobs are to be children and help take good care of themselves; learn the facts about alcohol, tobacco, and drugs; recognize their risks; and learn how to avoid repeating their families’ alcohol abuse patterns.
• Encourage them to ask for help. Assure them that getting help is a sign of strength. Offer your own examples and be prepared to help them connect with caring, trustworthy adults and with student assistance programs and other services designed to provide them with further skill-building and support.

The following organizations provide support groups to help children of parents with alcoholism:

• Adult Children of Alcoholics (http://www.adultchildren.org)
• Al-Anon/Alateen (http://www.al-anon.alateen.org)

Online resources for families and communities:

• DOs and DON’Ts for a Young Person with an Alcoholic Parent http://ncadi.samhsa.gov/seasonal/coaweek/dosdonts.aspx
• Children of Alcoholics: A Guide for Community Actionhttp://store.health.org/catalog/productDetails.aspx?ProductID=16745
• A Guide for Caring Adults Working with Young People Experiencing Addiction in the Family http://csat.samhsa.gov/publications/youcanhelp.aspx
• Film: Lost Childhood: Growing Up in an Alcoholic Family http://ncadi.samhsa.gov/multimedia/mediaDetails.aspx?ID=390

Helpful Web sites for families and communities:

• Children of Alcoholics Foundation http://www.coaf.org/
• National Association for Children of Alcoholics http://www.nacoa.org/
• Al-Anon/Alateen For Families and Friends of Alcoholics www.al-anon.org

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References:

American Academy of Child and Adolescent Psychiatry (AACAP) (1999). Children of Alcoholics Fact Sheet. Facts for Families, No. 17. Washington, DC: Author. Retrieved June 07, 2006 from http://www.aacap.org/publications/factsfam/alcoholc.htm.

Andreas JB, O 'Farrell TJ, Fals-Stewart W. (2006). Does individual treatment for alcoholic fathers benefit their children? A longitudinal assessment. Journal of Consulting and Clinical Psychology, 74(1),191-8.

US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2004). Children of Alcoholics: A Guide for Community Action. Retrieved June 07, 2006 from http://store.health.org/catalog/productDetails.aspx?ProductID=16745

US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2002). National Survey on Drug Use and Health. Rockville, MD: Author. Retrieved June 13, 2006 from http://www.drugabusestatistics.samhsa.gov/2k4/ACOA/ACOA.cfm

Werner EE, Johnson JL. (2004). The role of caring adults in the lives of children of alcoholics. Substance Use & Misuse, 39(5), 699-720.