Living with an addict is an ACE (Adverse Childhood Experience)
The ACE study defined parental addiction in a fairly straightforward way “ Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?”
There are several layers to parental addiction that make it an ACE. The first is that someone who is addicted, not just a casual user, to a chemical is going to be in an altered mental state regularly. Depending on their chemical of choice, this may render them less aware of their surroundings, minimally responsive, overly responsive, irritable, aggressive, or with impaired judgement, sensory perception or motor skills. A chemical addiction of any sort can impair a parent’s ability to connect with their child.
It takes money for an addict to acquire their chemical of choice; an addicted parent may use money earmarked for food, rent or diapers to buy their drug of choice, or they may resort to drug dealing or other crime to satisfy their addiction. This exposes their children to potentially dangerous adults, and the increased risk of arrest, itself an ACE, also increases the child’s odds of foster care placement or other major disruption in their lives.
If there are two or more caregiving adults in the home, the drug abuse is likely to cause strife in the home and increases the odds of one parent divorcing or separating, which is another ACE.
The sad truth is that drug and alcohol addiction is strongly linked to childhood trauma. A parent who is struggling with addiction likely has a lot of trauma issues contributing to the addiction. They often want to be better parents than their own, and they may do many things to be “good parents”, but the addiction will impair their ability to parent.
In general, the odds of anyone achieving long-term sobriety after a bout of rehab is 10%; with new parents this rises to 40%. This shows how much motivation a child can give an addicted parent, but it also means achieving long term sobriety is not a guarantee. Preventing addiction from becoming an ACE involves leveraging this new motivation.
Ideally, addiction issues are identified and addressed during pregnancy, and comprehensive care is provided for the first few years of a child’s life. Prenatal use of most drugs, including alcohol and cigarettes, can cause significant health complications in the baby; these are not considered an ACE but they can be utterly devastating.
Women who participate in a maternal home visiting program are more likely to achieve long-term sobriety than women who don’t. A recent study also suggests that maternal home visitation programs directed at helping addicted mothers bond and parent better reduce some of the risk factors for abuse and neglect. This is interesting and positive, but addiction carries so many other risk factors for ACEs.
Since addiction usually is a coping mechanism for trauma, it is likely that the addicted parent has lots of other issues that need to be addressed in order to increase the odds of long-term sobriety. It is also important that as much is done to facilitate parent-child bonding during the parent’s addiction treatment as humanly possible.
Ideally, if inpatient rehabilitation is needed, it happens in a rehab facility that can accommodate babies. And if child protective agencies feel the need to remove the child from the parent’s custody, they need to give the parent a concrete plan for reunification, they need to come up with a way for the parent to maintain a connection and the parent should be provided with some sort of grief counseling.
It’s also important to note that laws penalizing pregnant women for using drugs are not helpful. They tend to discourage these women from getting prenatal health care, which can mitigate the health effects of prenatal drug use and can get the mother into rehab faster. No mother wants to be a junkie.