The effect of chemical dependency either alcohol or drugs in children is very great.  Parental alcoholism or drug abuse of a serious kind has a hugely detrimental effect on the family atmosphere and on the parent’s ability to rear their children. Children in these families live in a climate of anxiety and fear.  There is enormous unpredictability and uncertainty in the families.  The children never know what to expect or what is going to come next.  They are in a state of bewilderment.  A recent advertisement on the billboards asked why is mummy strange after she works late? This was the best that a child could make out of mother’s drinking.  These children live with constant fear of catastrophe. They develop a sense of the world as being catastrophic and dangerous.  They mistrust everybody and everything.  They are confused by what is going on.  They witness domestic violence, parental blackouts, and the whole paraphernalia of drug addiction with syringes, needles, rolling paper, and indeed they may have to assist in this process by holding, buying or giving drugs to a parent.  They suffer enormous shame and also indulge in a great deal of self-blame and guilt. Young children tend to blame themselves for things that happen in the family.  They may also be frightened by the families contact with drug dealers and the lack of finances.  They will lack money for school books, clothes, and experience poverty.

There are huge communication deficits in the family and this is increased by the denial about what is going on in the family and the denial by parents of their chemical dependency.  They are aware of the importance of secrecy and not disclosing what is happening in the family.  Timothy Rivinus in his book Children of Chemically Dependent Parents published by Brunner-Mazel, New York, 1991, states that children of alcoholics live “thousands of little debts of their parents each year”.  These children are often ‘shell shocked’ by the traumas that they witness and show symptoms of Post Traumatic Stress Disorder with repetitive fearful dreams and intrusive thoughts about events that they have witnessed in the family. It is not uncommon for parents suffering from addiction to be hostile, abusive, and critical of their children.  The children have massive unmet needs in terms of nurturing, empathy, and the experience of normal family life.

It is not surprising that these children often suffer from depression, hopelessness and low self-esteem.  They develop a false self to protect themselves from the outside world. They are often mistrustful of people and can become masochistic and self-destructive themselves in their later behaviour.  In later life they can engage with destructive partners.  Suicidal behaviour is also not rare in these circumstances as children.  They can also become pseudo-adults and heroic figures looking after their parents. This reversed parenting is not healthy and can lead to later difficulties if not talked out.  Sometimes it can be used in a more healthy fashion by these children as adults becoming therapists or engaging in the helping professions themselves. These children often show symptoms of Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, problems in attachment with human beings, as well as eating disorders, delinquency, substance abuse, and other acting out disorders.  In School they will often have educational problems and may engage in truancy. If mother drank very excessively during pregnancy they may show evidence of foetal alcohol syndrome.When these children grow up and become parents themselves they may either over indulge their own children and become enmeshed with them. As adults these children of alcoholics may not have a clear vision of their parents, they may not be aware of the positive aspects of their parents.  Recovering these positive aspects of their parents is of critical importance to mental health. When they marry they may expect their spouse to cure the hurt child in them and this is often an excessive and impossible demand.  They really have to come to terms with being a child of an alcoholic or chemically dependent parent but not become a victim.  This can be helped by them working out an accurate narrative of their life experience.

Protective factors for these children can include having a high I.Q., an easy temperament, support for these children from a sibling from a non-alcoholic parent, or from a mentor at School.  Al Teen where the secrets and denial in the family can be tackled and the child’s history can be spoken openly can be quite helpful.

Unfortunately professionals working with children do not often take sufficiently detailed drug and alcohol histories from parents. This can lead to very confused understanding of the family.  Unfortunately in Adult Psychiatry there is a huge denial of the impact of the alcoholic parent on the child and Adult Psychiatrists refer children for counselling or to a Child Psychiatrist only on the most infrequent occasions.  In addition the parents and indeed the children can have undiagnosed and untreated Attention Deficit Hyperactivity Disorder which may underlie many of the problems.  This lack of identification of this condition can also mean the treatment is either inadequate or misguided.  Early and proper early intervention with both psychotherapeutic behavioural and family interventions as well as active pharmacological treatment of Attention Deficit Hyperactivity Disorder can significantly reduce later problems.

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