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4.15 Parents with Drug or Alcohol Misuse


1. Introduction
2. Issues to Consider in Situations of Parental Substance Misuse
3. Assessing the Impact of Parental Substance Misuse on Children
  3.1 Overview
  3.2 Parental Drug or Alcohol Misuse
  3.3 Accommodation and the Home Environment
  3.4 Provision of Basic Needs
  3.5 Procurement of Drugs
  3.6 Health Risks
  3.7 Family Social Network and Support Systems
  3.8 Parents’ Perception of the Situation

1. Introduction

1.1 Problematic alcohol or drug use is strongly associated with significant harm to children, especially when combined with other features such as domestic violence. Increasingly, drugs which have not been prohibited or banned are being used to achieve ‘legal highs’ and need to be treated in the same way as misuse of alcohol.

Anyone who is aware of a parent who has a problematic use of alcohol or drugs should be alert to the following factors and, if any are present, should refer to Social Services:

  • Use of the family resources to finance the parent’s dependency, characterised by inadequate food, heat and clothing for the children;
  • Children exposed to unsuitable care givers or visitors, e.g. customers or dealers;
  • The effects of alcohol leading to an inappropriate display of sexual and/or aggressive behaviour;
  • Chaotic drug and alcohol use leading to emotional unavailability, irrational behaviour and reduced parental vigilance;
  • Disturbed moods as a result of withdrawal symptoms or dependency;
  • Unsafe storage of drugs and/or alcohol or injecting equipment;
  • Drugs and/or alcohol having an adverse impact on the growth and development of the unborn child.

The Significant Harm threshold is likely to have been reached when there is evidence that any of the following are present:

  • Parental drug and alcohol use is adversely impacting on the child’s health and development;
  • There is no one parental figure able to provide a stable secure environment for the child;
  • There is no evidence that parental behaviour will change within a time frame congruent with the needs of the child.

2. Issues to Consider in Situations of Parental Substance Misuse

2.1 There is now considerable research evidence that parental substance misuse, particularly when combined with domestic violence can have an adverse effect on outcomes for children. (Cleaver, H., Unell, I., & Aldgate, J (1999) Children’s Needs - Parenting Capacity. The impact of parental mental illness, problem alcohol and drug use and domestic abuse on children’s development. London:The Stationery Office).
2.2 During enquiries it will be important to use the expertise of professionals in substance misuse teams.
2.3 For the purpose of this section of this guidance the term alcohol refers to consumption where its use is considered problematic.

3. Assessing the Impact of Parental Substance Misuse on Children




Forrester (Social work assessments with parents who misuse drugs or alcohol’ Children exposed to parental substance misuse) suggests the following assessment principles:

  • Focus on the child

Do not become overly concerned about pattern of use as there is no simple relationship between what is taken, how much is taken, the behaviour of the carer and the effect on the child;

  • Adults’ management of their own lives is a good indicator of their ability to look after a child

Are the parents causing themselves harm through their failure to manage their own lives? If they are, then this indicates concern about their own ability to manage their child’s life;

  • The best predictor of future behaviour is past behaviour

It is important to collect an accurate Chronology through working with the parents and children rather than just collating this from files;

  • Information from a variety of sources is better than information from one

As well as working with professionals in the network it will be important to consider information that may exist within the wider family. The family network, and particularly grandparents, often takes on a caring role in relation to children of parents who misuse drugs or alcohol. Including them in the assessment (with permission) is important as they can provide both valuable sources of strength and support for children as well as vital evidence for the assessment.


Parental Drug or Alcohol Misuse

  • Is there a drug/alcohol free parent, supportive partner or relative?
  • Is the drug/alcohol use by the parent: Experimental? Recreational? Chaotic? Dependent?
  • Does the user move between categories at different times? Is there both drug and alcohol use?
  • Are levels of child care different when a parent is using drugs or alcohol and when not using?
  • Is there evidence of coexistence of mental health problems alongside the drug/alcohol use?  If there is, do the drugs/alcohol cause these problems, or have problems led to the drug/alcohol use.


Accommodation and the Home Environment

  • Is the accommodation adequate for children?
  • Are the parents ensuring that the rent and bills are paid?
  • Does the family remain in one area or move frequently?  If the latter, why?
  • Are other drug/alcohol users sharing the accommodation?  If they are, are relationships with them harmonious, or is there conflict?
  • Is the family living in a drug/alcohol using community?
  • If parents are using drugs or alcohol, do children witness the taking of the drugs, or other substances?
  • Could other aspects of the drug/alcohol use constitute a risk to children (e.g. conflict with or between dealers, exposure to criminal activities related to drug use)?


Provision of Basic Needs

  • Are there adequate food, clothing and warmth for the children?
  • Are the children attending school regularly?
  • Are children engaged in age-appropriate activities?
  • Are the children’s emotional needs being adequately met?
  • Are there any indications that any of the children are taking on a parenting role within the family (e.g. caring for other children, excessive household responsibilities, etc)?


Procurement of Drugs

  • Are the children left alone while their parents are procuring drugs or alcohol?
  • Because of their parent’s drug and/or alcohol use, are the children being taken to places where they could be “at risk”?
  • How much are the drugs and/or alcohol costing?
  • How is the money obtained?
  • Is this causing financial problems?
  • Are the premises being used to sell drugs and/or alcohol?
  • Are the parents allowing their premises to be used by other drug/alcohol users?
  • Are children being used to procure drugs/alcohol for their parents?


Health Risks

  • If drugs and/or injecting equipment are kept on the premises, are they kept securely?
  • Are the children aware of where the drugs are kept?
  • If parents are intravenous drug users: 
    • Do they share injecting equipment?
    • Do they use a needle exchange scheme?
    • How do they dispose of the syringes?
    • Are parents aware of the health risks of injecting or using drugs?
  • If parents are on a substitute prescribing programme, such as methadone: 
    • Are parents aware of the dangers of children accessing this medication? 
    • Do they take adequate precautions to ensure this does not happen?
  • Are parents aware of, and in touch with, local specialist agencies who can advise on such issues as needle exchanges, substitute prescribing programmes, detox and rehabilitation facilities? If they are in touch with agencies, how regular is the contact?


Family Social Network and Support Systems

  • Do parents and children associate primarily with:
    • Other drug/alcohol users?
    • Non-users?
    • Both?
  • Are relatives aware of the drug/alcohol use? Are they supportive of the family?
  • Will parents accept help from the relatives and other professional or non-statutory agencies?
  • The degree of social isolation should be considered particularly for those parents living in remote areas where resources may not be available and they may experience social stigmatisation.


Parents’ Perception of the Situation

  • Do the parents see their drug/alcohol use as harmful to themselves or to their children?
  • Do the parents place their own needs before the needs of the children?
  • Are the parents aware of the legislative and procedural context applying to their circumstances (e.g. child protection procedures, statutory powers)?