Talking to kids or teens about a parent or grown-up going to treatment for a substance used disorder is undoubtedly a challenging conversation. And oftentimes it is overlooked entirely by adults who simply provide a quick story – which may or may not be true – about the absence. It is essential to provide youth with an explanation about what is happening to the parent they love, while providing the support and understanding they need, during this difficult time. Communicating openly and honestly can help alleviate so much of the confusion and fear that children may experience.

First Hurt, Last Helped

These children and teens are often the first in the family to become aware that substance misuse is impacting the family. So often, it is assumed that children are oblivious to the substance issues or that adults have successfully hidden the problem from the children. Yet the reality is children are aware, and are often afraid, alone, and frightened by all that is happening. Older children may have taken on parental roles and are responsible for cooking meals and cleaning instead of playing with friends. Older teens may be taking care of younger brothers and sisters, or missing school because they are afraid for the health of a very sick parent.

It’s important to remember that for many of these families, it isn’t always bad. Many parents with substance use disorders (SUDs) have moments when they are able to be still be loving and caring with their children outside of periods of active disease. It is this inconsistency that has a daily impact on kids. Children living with parental SUD maintain a hyperactive state, waiting in anticipation of any indication that problems are escalating so they can respond immediately, stay safe, and solve problems for the good of the family. When adults don’t talk honestly with children about the problems related to the substance misuse, these kids assume this kind of life is normal, they are all alone, and the problems in the family are their fault.

Explain the Disease and the Absence Age Appropriately

When a parent leaves for treatment, this can have a huge impact on the children. Younger kids may not understand in a detailed way what is happening, but are simply frightened that their parent may never come home. Older children may need a more thorough explanation about the disease. All children deserve a caring adult to explain the disease of addiction in a way that they can understand it, and how the absence while in treatment can help. Children are frightened for their parents and their health, and want to know that they will be OK.

As whenever discussing difficult topics, delicate conversations are best to be held in a quiet and comfortable space where you and the child(ren) can talk without interruption. Ensure that the atmosphere is conducive to open communication, where the child feels safe expressing their thoughts and emotions.

When explaining the situation, the language should always be age-appropriate and respectful of the child’s level of understanding. For children, the word addiction is the preferred simple way to refer to the disease. Avoid using terminology that is beyond their comprehension or sharing unnecessary details that might be overwhelming. For teenagers, use the clinical term substance use disorder (SUD) and explain the disease in a way that is helpful and non-stigmatizing. For all youth, it is important to be concrete, clear, and honest. And through a sensitive and gentle explanation, these conversations can help separate the parent kids love, from the disease that is hurting the family.

Frame the conversation in a way that assures children that the adult is taking steps to get better. When parents are receiving treatment for substance use disorder, it is similar to cardiac disease, cancer, or diabetes. Medical professionals will focus on the best methods to help manage their health while inpatient and under their care.

Let Them Know It Is Not Their Fault

It is also important to emphasize that the addiction was not something that the child had control over, nor was it the responsibility of the child to cure. Explain that addiction is a complex issue, and choosing to accept professional help is a big step in the journey of healing. We encourage people having this conversation to emphasize the Seven Cs and tell kids and teens that they didn’t cause the addiction, they can’t control it, and they can’t cure it. With these in mind, any potential blame manifested in their mind is shifted away from the child who is probably carrying a tremendous amount of guilt because of their parent’s addiction. Then it is important to empower children with what they can do: I can take care of myself, by communicating my feelings, making good choices and celebrating myself. By supporting them in these ways, you are taking important steps to replace blame and shame with hope and healing.

Be Prepared

The kids and teens you talk to may respond with a range of emotions and questions. Encourage the child to ask anything they want to know and reply with honesty and empathy. Reassure them that it’s okay to feel a mix of emotions, and that you are there to support them throughout the process. Also know that it is within a child’s right to take time to process and grieve.

It also is OK if children don’t have any immediate questions or want to just be alone. For youth who have not had safe adults to turn to for help and guidance, sharing the pain and worry of what is happening may not occur to them, nor feel comfortable. Sometimes time, patience, and continuing to be supportive over time demonstrates that a caring adult can be trusted and confirms that they are no longer alone.

Additional Considerations

• While it’s essential to be honest about the challenges of a substance use disorder, emphasize the positive aspects of seeking help. Explain that seeking treatment is a brave and responsible decision so a person can become healthier and happier. Share success stories of recovery to instill hope in the child’s mind.
• Let the child know that they have a support system, including family, friends, teachers, and possibly a counselor or therapist. Explore your area for children’s programs that support children and help them heal from the impact of SUDs. Emphasize and reassure that children are not alone and that various people are there to help them navigate through this difficult time.
• Create a routine. Predictability can help with the transition when a parent enters treatment. Establish the new routine while maintaining as much normalcy as possible. Discuss how daily routines may change slightly but reassure them that the basic structure of their lives will remain intact. This consistency can provide a sense of security during uncertain times.
• Reassure the child that they are loved and cared for and that the parent’s need to seek treatment does not diminish their love or commitment to the child. Reinforce that the ultimate goal is to create a healthier and happier family environment.

Discussing a parent going to treatment for a substance use disorder can feel awkward and uncomfortable, especially if you are a co-parent, family member, or older sibling. Make sure you are taking care of yourself as well, and seeking support throughout this process. Families who continue to be honest, realistic, and empathetic can help each other cope during unsettling times. This helps kids and teens understand that regardless of how treatment progresses for their parent, they can always come to you with questions and share how they are feeling with you.

Helpful Resources

• Tools for Parents and Caregivers: Helping Families Impacted by Substance Use Disorders 
• Language When Talking With Kids
• Tools for Kids
• Helping Kids and Teens Understand Abstinence, Sobriety, and Recovery
• NACoA’s Parents Guide: Talking to Kids and Teens About Alcohol and Other Substances
• Sesame Workshop: Parental Addiction
• Understanding the Seven Cs 
• Children Learn What they Live: The Recovery Version
• Addiction Policy Forum: Addiction Education