• • Children of addicted parents are the highest risk group of children to become alcohol and drug abusers due to both genetic and family environment factors.¹
  • Biological children of alcohol dependent parents who have been adopted continue to have an increased risk (2-9 fold) of developing alcoholism ²
  • Recent studies suggest a strong genetic component, particularly for early onset of alcoholism in males. Sons of alcoholic fathers are at fourfold risk compared with the male offspring of non-alcoholic fathers.³
  • Use of substances by parents and their adolescent children is strongly correlated; generally, if parents take drugs, sooner or later their children will also.⁴ Adolescents who use drugs are more likely to have one or more parents who also use drugs.⁵
  • The influence of parental attitudes on a child’s drug taking behaviors may be as important as actual drug abuse by the parents.⁶ An adolescent who perceives that a parent is permissive about the use of drugs is more likely to use drugs.

1. • Families affected by alcoholism report higher levels of conflict than do families with no alcoholism. Drinking is the primary factor in family disruption. The environment of children of alcoholics has been characterized by lack of parenting, poor home management, and lack of family communication skills, thereby effectively robbing children of alcoholic parents of modeling or training on parenting skills or family effectiveness.⁸
   • The following family problems have been frequently associated with families affected by alcoholism: increased family conflict; emotional or physical violence; decreased family cohesion; decreased family organization; increased family isolation; increased family stress including work problems, illness, marital strain and financial problems; and frequent family moves.⁹
   • Addicted parents often lack the ability to provide structure or discipline in family life, but simultaneously expect their children to be competent at a wide variety of tasks earlier than do non-addicted parents.¹⁰
   • Sons of addicted fathers are the recipients of more detrimental discipline practices from their parents.¹¹

1. • Three of four (71.6%) child welfare professionals cite substance abuse as the top cause for the dramatic rise in child maltreatment since 1986.¹²
   • Most welfare professionals (79.6%) report that substance abuse causes or contributes to at least half of all cases of child maltreatment; 39.7% say it is a factor in over 75% of the cases.¹³
   • In a sample of parents who significantly maltreat their children, alcohol abuse is specifically associated with physical maltreatment, while cocaine exhibits a specific relationship to sexual maltreatment.¹⁴
   • Children exposed prenatally to illicit drugs are 2 to 3 times more likely to be abused or neglected.¹⁵

1. • Three of four child welfare professionals (75.7%) say that children of addicted parents are more likely to enter foster care, and 73% say that children of alcoholics stay longer in foster care than do other children.¹⁶
   • In one study, 79% of adolescent runaways and homeless youth reported alcohol use in the home, 53% reported problem drinking in the home, and 54% reported drug use in the home.¹⁷
   • Each year, approximately 11,900 infants are abandoned at birth or are kept at hospitals, 78% of whom are drug-exposed. The average daily cost for each of these babies is $460.¹⁸

1. • Children of addicted parents exhibit depression and depressive symptoms more frequently than do children from non-addicted families.¹⁹
   • Children of addicted parents are more likely to have anxiety disorders or to show anxiety symptoms.²⁰
   • Children of addicted parents are at high risk for elevated rates of psychiatric and psychosocial dysfunction, as well as for alcoholism.²¹

1. • Inpatient admission rates and average length of stay for children of alcoholics were 24% and 29% greater than for children of non-alcoholic parents. Substance abuse and other mental disorders were the most notable conditions among children of addicted parents.²²
   • It is estimated that parental substance abuse and addiction are the chief cause in at least 70-90% of all child welfare spending. Using the more conservative 70 percent assessment, in 1998 substance abuse and addiction accounted for approximately $10 billion in federal, state and local government spending simply to maintain child welfare systems.²³
   • The economic costs associated with Fetal Alcohol Syndrome were estimated at $1.9 billion for 1992.²⁴
   • A sample of children hospitalized for psychiatric disorders demonstrated that more than 50% were children of addicted parents.²⁵

1. • One study comparing children of alcoholics (aged 6-17 years) with children of psychiatrically healthy medical patients found that children of alcoholics had elevated rates of ADHD (Attention Deficit Hyperactivity Disorder) and ODD (Oppositional Defiant Disorder) measured against the control group of children.²⁶
   • Research on behavioral problems demonstrated by children of alcoholics has revealed some of the following traits: lack of empathy for other persons; decreased social adequacy and interpersonal adaptability; low self-esteem; and lack of control over the environment.²⁷
   • Research has shown that children of addicted parents demonstrate behavioral characteristics and a temperament style that predispose them to future maladjustment.²⁸

1. • Sons of addicted parents performed worse on all domains measuring school achievement, using the Peabody Individual Achievement Test-Revised (PIATR), including general information, reading recognition, reading comprehension, total reading, mathematics and spelling.²⁹
   • In general, children of alcoholic parents do less well on academic measures. They also have higher rates of school absenteeism and are more likely to leave school, be retained, or be referred to the school psychologist than are children of nonalcoholic parents.³⁰
   • In one study, 41% of addicted parents reported that at least one of their children repeated a grade in school, 19% were involved in truancy, and 30% had been suspended from school.³¹
   • Children of addicted parents compared to children of non-addicted parents were found at significant disadvantage on standard scores of arithmetic.³²

• Studies have shown that exposure to cocaine during fetal development may lead to subtle but significant deficits later on, especially with behaviors that are crucial to success in the classroom, such as blocking out distractions and concentrating for long periods.³³
• Cognitive performance is less affected by alcohol exposure in infants and children whose mothers stopped drinking in early pregnancy, despite the mothers’ resumption of alcohol use after giving birth.³⁴
• Prenatal alcohol effects have been detected at moderate levels of alcohol consumption in nonalcoholic women. Even though a mother may not regularly abuse alcohol, her child may not be spared the effects of prenatal alcohol exposure.³⁵

1. • Children who coped effectively with the trauma of growing up in families affected by alcoholism often relied on the support of a non-alcoholic parent, stepparent, grandparent, teachers and others.³⁶
   • Children of addicted parents who rely on other supportive adults have increased autonomy and independence, stronger social skills, better ability to cope with difficult emotional experiences, and better day-to-day coping strategies.³⁷
   • Group programs reduce feelings of isolation, shame and guilt among children of alcoholics while capitalizing on the importance to adolescents of peer influence and mutual support.³⁸
   • Competencies such as the ability to establish and maintain intimate relationships, express feelings, and solve problems can be improved by building the self-esteem and self-efficacy of children of alcoholics.³⁹

1 Kumpfer, K.L. (1999). Outcome measures of interventions in the study of children of substance-abusing parents. Pediatrics. Supplement. 103 (5): 1128-1144.
2 Schuckit, M.A., Goodwin, D.A., & Winokur, G. (1972). A study of alcoholism in half siblings. American Journal of Psychiatry, 128: 1132- 1136.
3 Goodwin, D.W. (1985). Alcoholism and genetics. Archives of General Psychiatry, 42, 171-174.
4 Fawzy, F.I., Coombs, R.H., & Gerber, B. (1983). Generational continuity in the use of substances: the impact of parental substance use on adolescent substance use. Addictive Behaviors, 8, 109-114.
5 Skiffington, E.W. & Brown, P.M. (1981). Personal, home, and school factors related to eleventh graders’ drug attitudes. International Journal of the Addictions, 16(5), 879-892.
6 Barnes, G.M., & Windle, M. (1987). Family factors in adolescent alcohol and drug abuse. Pediatrician, 14, 13-18.
7 McDermott, D. (1984).The relationship of parental drug use and parents’ attitude concerning adolescent drug use to adolescent drug use. Adolescence, XIX(73), 89-97.
8 Moos, R.H. & Billings, A.G. (1982). Children of alcoholics during the recovery process: alcoholic and matched control families. Addictive Behaviors, 7:155-163.
9 el Guebaly, N. & Offord, D.R. (1997). The offspring of alcoholics: a critical review. American Journal of Psychiatry.134:4, 357-365.
10 Kumpfer, K.L. & DeMarsh, J. (1986). Family environmental and genetic influences on children’s future chemical dependency. In Ezekoye, S., Kumpfer, K., & Bukoski, W., eds. Childhood and Chemical Abuse, Prevention and Intervention. New York, NY: Haworth Press.
11 Tarter, R.E., Blackson, T.C., Martin, C.S., Loeber, R., & Moss, H.B. (1993). Characteristics and correlates of child discipline practices in substance abuse and normal families. The American Journal on Addictions, 2(1), 18-25.
12 Reid, J., Macchetto, P., & Foster, S. (1999). No Safe Haven: Children of Substance-Abusing Parents. Center on Addiction and Substance Abuse at Columbia University.
13 Ibid. page 2.
14 Famularo, R., Kinscherff, R., & Fenton, T. (1992). Parental substance abuse and the nature of child maltreatment. Child Abuse and Neglect, vol. 16.
15 Leventhal, J.M., Garber, R.B., & Brady, C.A. (1989). Identification during the postpartum period of infants who are at high risk of child maltreatment. The Journal of Pediatrics, 114(3), 481-487.
16 Reid, J., Macchetto, P., & Foster, S. (1999). No Safe Haven: Children of Substance-Abusing Parents. Center on Addiction and Substance Abuse at Columbia University.
17 Booth, R.E., & Zhang, Y. (1996). Severe aggression and related conduct problems among runaway and homeless adolescents. Psychiatric Services, 47 (1) 75-80.
18 U.S. Department of Health and Human Services. National estimates on the number of boarder babies, the cost of their care, and the number of abandoned infants. Found online at http://waisgate.hhs.gov/cgi-bin/ waisgate: U.S. Department of Health and Human Services.
19 Fitzgerald, H.E., Sullivan, L.A., Ham, H.P., Zucker, R.A., Bruckel, S., Schneider, A.M., & Noll, R.B. (1993). Predictors of behavior problems in three-year-old sons of alcoholics: early evidence for the onset of risk. Child Development, 64, 110-123.
20 Earls, F., Reich, W., Jung, K.G., & Cloninger, C.R. (1988). Psychopathology in children of alcoholic and antisocial parents. Alcoholism: Clinical and Experimental Research, 12:481-487.
21 West, M.O. & Printz, R.J. (1987). Parental alcoholism and childhood psychopathology. Psychological Bulletin,102,204-218.
22 Children of Alcoholics in the Medical System: Hidden Problems, Hidden Costs. New York, NY: Children of Alcoholics Foundation, 1990.
23 Reid, J., Macchetto, P., & Foster, S. (1999). No Safe Haven: Children of Substance-Abusing Parents. Center on Addiction and Substance Abuse at Columbia University.
24 The National Clearinghouse for Alcohol and Drug Information. Substance Abuse and Mental Health Services Administration. Available online at: http://www.health.org/govstudy/BKD265/Chapter4b.htm#4.4.
25 Rivinus, T.M., Levoy, D., Matzko, M., & Seifer, R. (1992). Hospitalized children of substance-abusing parents and sexually abused children: a comparison. Journal of the American Academy of Child and Adolescent Psychiatry, 31 (6), 1019-1923.
26 Earls, F., Reich, W., Jung, K.G., & Cloninger, C.R. (1998). Psychopathology in children of alcoholic and antisocial parents. Alcoholism: Clinical and Experimental Research, 12:481-487.
27 Jones, M.C. (1968). Personality correlates and antecedents of drinking patterns in adult males. Journal of Consulting and Clinical Psychology, 33:2-12.
28 Tarter, R.E., Blackson, T.C., Martin, C.S., Loeber, R., & Moss, H.B. (1993). Characteristics and correlates of child discipline practices in substance abuse and normal families. The American Journal on Addictions. 2 (1), 18-25.
29 Moss, H.B., Vanyukov, M., Majumder, P.P., Kirisci, L., & Tarter, R.E. (1995). Pre-pubertal sons of substance abusers: influences of parental and familial substance abuse on behavioral disposition, IQ, and school achievement. Addictive Behaviors, 20 (3), 345-358.
30 Sher, K.J. (1997). Psychological characteristics of children of alcoholics. Alcohol Health and Research World, Vol. 21. No. 3.
31 Kolar, A.F., Brown, B.S., Haertzen, C.A., & Michaelson, B.S. (1994). Children of substance abusers: the life experiences of children of opiate addicts in methadone maintenance. American Journal of Drug and Alcohol Abuse. 20:2; 159-171.
32 Johnson, J., Boney, T., & Brown, B. (1990). Evidence of depressive symptoms in children of substance abusers. International Journal of the Addictions, 25 (4-A), 465-479.
33 National Institute on Drug Abuse, National Institutes of Health. 25 Years of Discovery to Advance the Health of the Public. October 18, 1999. Page 42.
34 Gabrielli, W.F., & Mednic, S.A. (1983). Intellectual performance in children of alcoholics. Journal of Nervous and Mental Disease, 171:444- 447.
35 Larkby, C., & Day, N. (1997). The effects of prenatal alcohol exposure. Alcohol Health and Research World, vol. 21, no. 3:192-197.
36 Werner, E.E., & Johnson, J.L. (2000). The role of caring adults in the lives of children of alcoholics. Children of Alcoholics: Selected Readings, Vol.2.
37 Werner, E.E. (1986). Resilient offspring of alcoholics: a longitudinal study from birth to age 18. Journal of Studies on Alcohol, vol. 47, no. 1, 34-40.
38 Dies, R.R. & Burghardt, K. (1991). Group interventions for children of alcoholics: prevention and treatment in the schools. Journal of Adolescent Group Therapy 1(3):219-234.
39 Nastasi, B.K. & DeZolt, D.M. (1994). School Interventions for Children of Alcoholics. New York: Guilford Press.