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Introduction: Substance Abuse
In 2005, about 22 million Americans reported that they had a drug or alcohol problem which turned into addiction. About 95 percent of those people did not know that they had a problem. Of the people that knew that they had a problem, 273,000 made little to no effort to get treatment (Substance Abuse, n.d.). Substance abuse has a big impact on everyone who comes in contact with it. The effects contribute to social, physical, mental and public health problems. Problems such as: Teen pregnancy, STDS, domestic violence child abuse, motor vehicle crashes, physical fights, and crimes such as homicide and suicide. “Social attitudes and political and legal responses to the use of alcohol and other drugs make substance abuse one of the most challenging public health issues. It has also been a flash point in the criminal justice system and a major focal pint in discussions about social values: people argue over whether substance abuse is a disease or a choice” (Substance Abuse, n.d.). When a person abuses substances such as alcohol and other drugs, it is called parental substance abuse. Parental substance abuse is defined as “ a situation where a parent uses illegal or prescription drugs or alcohol to the extent where their judgement or behavior is impaired and results in a detrimental effect on the children in the family” (Parental Substance misuse and social worker intervention, 2018).
Warning signs of substance abuse can be a various number of things. The signs can range from physical symptoms to emotional symptoms to environmental symptoms to withdrawal symptoms. The physical symptoms of substance abuse can be injection marks from needles, confusion, slow breathing, inability to stay awake, and constricted pupils. Emotional symptoms can depend on the drug, the abuser can be vey very happy or just have dramatic mood changes. Environmental symptoms can be shown by the behavior of the abuser such as “doctor shopping”, large amounts of prescription medication bottles, financial issues and withdrawal from society. Withdrawal symptoms are anxiety, insomnia, sweating nausea, fatigue, vomiting and so on (Events, n.d.).
Impact of Parental Drug/Alcohol Abuse on Children
Many children that live in a home where there is an addiction become “parentified children” This happens when the parent is not able to meet the developmental needs of the child, so they begin to take care of themselves and if they have younger siblings they begin to take care of them too. There is something called “reversal of dependence needs” when the child starts to parent the parent (Lander, et.al, 2013). In reversal of dependence needs, this is when the parents needs become before the child’s. This is the start of a potential lifetime of the child not being able to set good boundaries in relationships and make important decisions. This makes it hard for them to have self-awareness and an over-awareness of other’s needs (Lander, et. al, 2013).
Some children experience bullying at school because of parental substance abuse. This puts a huge toll on them. Not only do they have to deal with what’s happening at home, but they also will have to face problems a school. Especially if they end up having to take care of themselves and others too. They may come to school one day with dirty clothes or they may smell bad or look very tired and kids will start to talk about them. When this happens, the child is being bullied which makes their life even harder than it already is. They then may not want to go to school anymore because of the other kids, or they may start to have behavior problems in school.
Bullying is connected to negatively impacts on mental health, substance use, and can lead to suicide. It is a very serious issue. Children who are bullied are more likely to experience depression, have poor health and low academic performance (Effects of Bullying. n.d.). They may also feel like they do not want to go to school anymore. When someone is mistreated, they seem to not want to be around anyone that had mistreated them. They may lack friends because they are socially withdrawn. There are many reasons as to why they may begin to have low self-esteem also. The issue of bullying is another problem within public health. It causes children to lose interest in school which means they will not get a decent education and in extreme cases, bullying leads to suicide (The Impact of Bullying, n.d.).
There is an estimate of more than eight million children ages younger than 18 live with at least one adult who has a Substance Use Disorder (SUD). Mathematically, that is a ratio of more than one per ten children. most of these children are younger than the age of 5. SUDs are characterized by the constant use of any substance that results in problems such as not being able to control the use of the substance, not being able to do normal tasks at home, work or school, poor health, and spending a lot of time with the substance such as getting it, using it, and recovering from it (SAMHSA,ND).
Parental substance abuse has been found to affect children’s lives in a number of areas. They have a high risk of abusing the substances themselves and behavior problems, it affects them psychologically, academically, physically, and socially. Compared to children that do not have a parent with a SUD, children who do have a parent with a SUD are more than likely from a lower socioeconomic status and high levels of difficulty in school and social settings (SAMHSA, ND). “There have been other studies of the influence of parental alcoholism on their children. The studies measured mortality, physiology, and general health in the children of alcoholic parents and it concluded that when mothers stopped drinking while they were pregnant, their children were healthier” (Johnson & Leff, 1999).
Not all children who grow up within these households develop mental or behavioral disorders. This is referred to as resiliency. Resiliency is having a positive outcome despite negative, challenging situations. Factors for these children being resilient are: older age, high self-esteem, positive family and friends support, the ability to believe in themselves, self-discipline, great cognitive abilities, positive extracurricular activities, and staying optimistic.
It is seen that there is a relationship between parental substance abuse and the probability of alcohol problems in their children. The children become more vulnerable to make bad decisions and show poor behavior like acting out because of their parent’s behavior. Children of substance abusers face a higher chance at being involved with drugs, as well as mental health and behavioral problems. In longitudinal studies, some children of substance abusers were compared to children who did not have parents as substance abusers. When compared, they observed certain factors between the two. These factors were parenting deficits, mistreatment of the child, family conflict, and patterns of being less secure with their parents. “Based on interviews with 30 parents who have recovered from an addiction to heroin, their children had to deal with material neglect as well as drug use and dealing and were at risk of violence and physical abuse” (Wlodarczyk, O., Rumpf. M.S., et. Al). “Non- Sexual child maltreatment was also found as a risk factor for mental disorders, drug use, suicide attempts, sexually transmitted infections, and risky sexual behavior in a review of 124 studies “(Wlodarczyk, O., Rumpf. M.S., et. al).” These factors increase the risk of the family becoming involved with child welfare serviced and out of home childcare i.e. foster care.” National Surveys on Drug Use and Health (NSDUH) is a survey done yearly of the people who are not in prison or institutionalized aged 12 and older. NSDUH asks their respondents questions designed to pick out and analyze symptoms of SUD. These symptoms included withdrawal, tolerance, use in dangerous situations, trouble with the law, and interferences in major tasks at work, school or home (Children Living with Parent Who Have a Substance Use Disorder, n.d.).
Impact on Academics
Parental alcoholism is associated with lower academic performances. Children of substance abusers are more likely to: have lower grade point averages, be retained in their grade, and to decide to not further their education after high school. They also show low performance in reading, spelling and mathematics during their early years of childhood. It seems as though boys are at higher risk for lower performance than girls (Solis , et al. 2012).
Substance abuse in the United States
There is more about children of alcoholics (COA’s), than children of other drug abusers. Data on the amount of children that are are affected by drug-using or alcohol abusing parents is largely unavailable. “In the united states, data from the National Survey on Drug Use and Health (NSDUH) indicate that 11.9% of children under the age of 18 live with at least one parent with alcohol of drug use disorders,”(Wlodarczyk, O., Rumpf, M.S., et al, n.d). The number of children under the age of 18 who live with at least one parent that is alcohol or drug-abusing is mostly based on estimates and depends on the definition of problematic alcohol or drug abuse (Wlodarczyk, O., Rumpf, M.S., et al, n.d.). The military puts a lot of strain on their personnel and their family. The strain can lead to families splitting apart, mental health disorders and even suicide. SAMSHA data shows that from 2004 to 2006, 7.1 percent of veterans have had a substance use disorder in the past year. That is an estimate of 1.8 million people ( Substance Abuse, n.d.).
Prevalence of Parental Substance Abuse In Alabama
Last year in October, President Donald Trump proclaimed an opioid epidemic and called it a Nationwide Public Health Emergency. Just two months before that, Governor Kay Ivey started the Alabama Opioid Overdose and Addiction Council to find out the causes and come up with a plan to address the abuse of prescription and non-prescription opiates. Alabamians have the highest opioid prescription usage rate in the entire country (Events n.d.).
According to the Centers for Disease Control and Prevention (CDC), there were an estimated 62 deaths per day that involved prescription opioids in 2015 which shows to increase from 2014( CDC, 2017).
What has been done and its success
Because there is a broad nature of parental substance misuse, it is not enough information or evidence to determine which intervention is the absolute best. To reduce feelings of shame and isolation in children of substance abusers, activities like group sessions can help the child feel better about the situation and to let them know that they are not alone when they share their experiences with children with the same circumstances. This way they are less likely to act out or become severely depressed.
What can be done?
For opioid abuse, professionals can provide information like how and where to be treated if they have a problem with substance use. For all other abuse three types of prevention programs can be used to prevent or stop drug abuse. The three types are universal, selective and indicated programs. In universal programs, professionals address the risk of substance abuse and they also address protective factors common in all children in the same school or community. In selective programs, there are groups of children and teens who have specific risk factors for increased drug use. These groups are used to educate the individuals of the path that hey are facing if they do not change some of their behaviors. Indicated programs are programs for children who have already started using drugs.
Recommendations for working with children of parents with Addictions
When the parents have motivation from other family members to go to and stay in programs for managing addictions, it really boosts the outcome positively. “Social workers can help create supportive environments, build nonjudgmental relationships, and implement evidence-based motivational approaches, such as motivational interviewing” (Child Welfare Information Gateway, 2014).
Routine screening, Individualized Treatment and Support
It is important that social workers work with behavioral/mental health professionals to do assessments and link children to be appropriate treatment (Child Welfare Information Gateway, 2014). Social workers can also provide their clients with evidence-based treatment programs and support services to help meet their specific needs. Individualized services should show the child’s strengths and needs, symptoms of trauma, and the risk of the children becoming substance abusers themselves. Social workers can also provide support to their clients while they are in treatment.
A service provider such as a social worker should be aware of drops in attendance of their program participants, changes in there living circumstances, changes in their mood, and reports of parenting issues from their child clients (Events, n.d.). These few actions of awareness can go along way and can be used to prevent more abuse from happening and can be used to start a treatment plan if something seems wrong. Further investigation in these situations when symptoms start to show can really help out a lot.
- Wlodarczyk, O., Rumpf, M. S., Metzner, F., & Pawils, S. (n.d.). Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179140#sec001
- Substance Abuse. (n.d.) https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse
- Johnson, J. L., & Leff, M. (1999, May 01). Children of Substance Abusers: Overview of Research Findings http://pediatrics.aappublications.org/content/103/Supplement_2/1085.short
- Parental Substance Use and the Child Welfare System. (n.d.). https://www.childwelfare.gov/pubPDFs/parentalsubabuse.pdf
- Children Living with Parents Who Have a Substance Use Disorder. (n.d.). https://www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html
- Lander, L., Howsare, J., & Byrne, M. (2013). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725219/
- Solis, J. M., Shadur, J. M., Burns, A. R., & Hussong, A. M. (2012, June). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676900/
- Effects of Bullying. (n.d.). https://www.stopbullying.gov/at-risk/effects/index.html
- The impact of bullying. (n.d.). https://www.education.vic.gov.au/about/programs/bullystoppers/Pages/impact.aspx
- Events. (n.d.). https://ctf.alabama.gov/opioid-epidemic/
- CDC, National Center for Health Statistics. (2017). Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA. http://wonder.cdc.gov.
- Parental substance misuse and social worker intervention. (2018, June 27). https://www.iriss.org.uk/resources/esss-outlines/parental-substance-misuse-and-social-worker-intervention
- National Institute on Drug Abuse. (n.d.). Preventing Drug Misuse and Addiction: The Best Strategy. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-misuse-addiction-best-strategy
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