The ACE study demonstrated that growing up in a household where a parent suffers from a significant, unchecked addiction to alcohol or drugs is as damaging as direct childhood traumas. There are a lot of complexities with parental substance abuse as one of the ACEs (Adverse Childhood Experiences) in terms of policy and prevention, but first, we need to understand it from a child’s point of view.
Why is parental substance abuse a trauma?
When it comes to parental substance abuse, it’s important to point out that the ACE study found no difference in effects between parents suffering from addiction to alcohol vs. illegal drugs. This may be surprising to some; after all, we have all heard of people going to stressful and destructive ends to get the substance they need. While the illegality of street drugs poses additional risks for children, addiction itself is risky enough.
The impaired parent-child attachment
Substance abuse can complicate the parent-child attachment. A parent under the influence of a drug much of the time can pose a significant chance of abnormal or impaired attachment. The parent may not read the emotional cues from their baby correctly, and they may not feel the joy and connectedness they should feel from being with the baby.
Unfulfilled child’s needs
Abusing depressant substances can render a parent unconscious or unresponsive to a baby’s needs, further straining the relationship and potentially causing health and safety issues. Abusing stimulants can cause increased irritation, frustration, and anger, which can impede attachment and increase the odds of the parent responding to normal baby behavior with violence. In either case, the baby is learning that the person who is supposed to take care of them, protect them, soothe them, and make them feel loved won’t always do so. That constant fear and stress are enough to make parental substance abuse and addiction into an ACE from the child’s point of view.
The risks of neglect and lack of safety and stability
Parental substance abuse and addiction can also come with a host of adverse effects for children, including other ACEs. Since addiction doesn’t lend itself to stable relationships, the child’s other parent and possibly extended family will likely depart at some point in their childhood. Since a parent struggling with addiction is likely to struggle with consistent work or even struggle to access essential social services, the child is likely to experience physical neglect.
Poor attachment is likely to lead to emotional neglect. And between the illegality of most drugs themselves and the illegal means people often resort to acquiring them, there is an increased chance that the parent will be arrested, resulting in another ACE and increased instability for the child.
Parental substance abuse: Prevention & help
Good public policy to keep parental addiction from causing lifelong harm to children needs to incorporate some uncomfortable realities. We need to recognize that addiction is often a way adults cope with their own trauma, that punishment, shame, and stigma don’t prevent addiction, and that parents suffering from addiction can potentially be good, loving, protective parents with the right help.
Arbitrary regulations about how many times insurance will pay for someone to access drug treatment are an obstacle to ACE prevention. When a chemotherapy regimen doesn’t work for a particular cancer patient, we don’t assume the patient doesn’t want to be healthy; we believe the wrong therapy was used.
Maternal Home Visiting Programs and Baby Courts
There is some evidence that parents who suffer from addiction but participate in Maternal Home Visiting programs are able to experience normal attachment and bonding with their baby. It is still desirable for these mothers to achieve long-term sobriety, and this can be another goal they work on with a home visitor.
Residential substance abuse treatment facilities that allow mothers to bring their babies with them allow for the mother to bond with her baby as she achieves sobriety, and they seem to work well.
A newer twist on this is “baby courts,” special family courts a mother participates in if Child Protective Services believe, at the time of delivery, that she cannot safely parent, but is willing to do the necessary work to heal and change her circumstances.
In this case of baby courts, a foster parent will assume temporary custody, but the mother is expected to visit her baby every day, and her progress is closely monitored and encouraged by the judge. This spares the baby the crisis of disrupted attachment to enter foster care and potentially another attachment disruption if they are returned to a mother they no longer remember a few months later. It also spares the mother some of the pain, loss, guilt, and stigma that typically comes with having a baby removed—pain that can trigger a relapse.
What does not work
Things that do not work are criminalizing prenatal drug consumption or mandating a particular CPS outcome if there is prenatal drug consumption. This tends to discourage the mother from getting prenatal care, over-burdens CPS, and presents attachment disruptions for the baby.
Arresting parents for drug abuse has proven not to work, as have stigmatizing, shaming, and weaponizing the child protective system against them.
One thing that does seem to work, both for parents and their children, is helping the parents to break the cycle of addiction and trauma.
Resources for help
Alcoholics Anonymous (212) 870-3400
Crisis Text Line Text HOME to 741741
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Executive Director, Stop Abuse Campaign
A survivor of incest, psychological abuse and a host of other childhood trauma, Melanie now uses her talents to prevent Adverse Childhood Experiences. Melanie has over a decade of legislative advocacy regarding children’s issues, and she has been published in newspapers, magazines and blogs all across the country.