The Impact Of Substance Use Disorders On Family And Children

Medically reviewed by Arianna Williams, LPC, CCTP
Updated April 19, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Substance use and dependency can significantly impact the lives of the user and their family, including children witnessing a parent’s addiction. Although it may appear as though addiction is only damaging or potentially harmful if it is engaged in regularly and openly, there are several ways children of addicted parents are often impacted by their parents' use habits. Understanding these consequences can ensure your family's safety and help you find support if you live with a substance use disorder or challenge.

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Living alongside substance use disorder?

What are substance use disorders?

Substance use disorders are mental health conditions defined by the continued and compulsive use of a substance, despite potentially harmful consequences. Preoccupation with using a substance can significantly impact an individual's daily life. The immediate effects of substance use disorder may include but are not limited to the following: 

  • Declining physical health

  • Negatively impacted mental health

  • Impulsive behavior

  • Job loss

  • Community loss 

  • The potential for legal action or involvement

People currently experiencing dependency on drugs or alcohol may risk losing their homes, children, and support systems, which can cause a painful cycle that can lead to a lower quality of life.

Although the effects listed above are generally known to be potential effects of current, ongoing addiction, there may be less attention given to the effects of light, sporadic, or historic substance use and its potential impacts on children. Even in families where a substance use disorder has not been diagnosed or is not present, children may be impacted by a caregiver's usage.

Substance use vs. substance abuse

Substance use was once referred to as “substance abuse.” You’ll still see this term used in some areas for things like substance “abuse” treatment programs. You might see programs for parental “substance abuse problems” or counseling for parent’s “substance abuse issues.” 

However, the implication that a person can “abuse” substances may minimize the side effects of drug use, especially when referring to highly addictive substances. For the purpose of this article and most modern mental health information, the term “substance use” is preferred over “substance abuse.”

Children of parents with substance use disorders

Individuals of all genders, ages, ethnicities, socioeconomic statuses, and walks of life can develop a substance use disorder. No one type of person lives with the daily challenges of this serious condition or has the potential to develop substance use disorder over another. However, children affected by or living with a family member who has substance use disorder can create greater degree of difficulty living a sober life themselves. 

When an adult in the family struggles with substance use, other individuals, such as siblings or aging family members, may take on family roles in addiction to cope with the situation. Children who grow up with parents with a substance use disorder may have higher stress levels, greater dissatisfaction at home, and a lesser capacity to connect to and engage with others. How these symptoms manifest may be different for each child, occurring individually. 

For instance, a child who experiences significant privilege may be more inclined to rely on alcohol to relax and forge connections among peers in social situations. Conversely, a child who lives in an underserved community or is exposed to frequent substance use might feel inclined to use it for survival or a chosen coping mechanism. 

However, children can still be affected even when substance use seems to be carefully controlled or hidden away. Their physical and emotional safety and mental health can be impacted, and there may be a possibility of higher addiction occurrence rates as they grow up.

The Family Systems Theory approaches the whole family as a single emotional unit. Children of parents who use substances may experience disruptions in dynamics and the normal behavior of their caregivers. This may lead to adverse childhood experiences, increased risk of mental illness, and other emotional and psychological challenges. For example, a child who experienced or witnessed substance use, emotional abuse,* sexual abuse,* or any form of domestic violence* is at an increased risk of developing post-traumatic stress disorder. 

Many of the behaviors listed above, such as emotional manipulation and abuse, may be related to a family member who is using substances.

*If you or someone you love is experiencing abuse of any kind, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Free support is available 24/7.

Safety implications

Children of someone with a substance use disorder may experience a range of events in which they may be at greater physical or emotional risk. Below are a few examples of these risks. 

Higher than average exposure to strangers or acquaintances

Children exposed to substances may be in the presence of other using adults besides their parents or caregivers. People who specialize in procuring and distributing drugs, adult friends, and others with substance use disorder may be around a child more often than in households without substance use present, which can put a child at risk of being harmed. 

Higher potential for overdose

Children whose parents keep illicit substances in the house may be at greater risk of overdose. Children may open drawers, rooms, and cabinets containing dangerous materials or otherwise illicit substances in this specific risk area. Having alcohol or drugs in the home may increase the possibility of a child getting a hold of these substances and subsequently ingesting them, accidentally or intentionally. In either case, doing so can cause significant impairment or risk to a child's physical and emotional health.

Higher risk of inadequate care and support

If the parents or guardians in a child's home are impaired or otherwise distracted by substance use disorder, children may not be being watched carefully enough — and can fall into harm's way. For example, a passed-out parent might not hear a fire alarm after a child misuses a stove or might incorrectly identify their child as a threat and react accordingly. This reaction can cause lifelong adverse effects on a child's physical and mental health. In addition, it may not provide them with the support they need to thrive physically or emotionally.

Mental health implications

Children with a parent or caregiver with a substance use disorder may also be at a greater risk of developing psychological challenges. Below are a few causes of this risk. 

Confusion about the cause of substance use 

Children may be mentally inclined to accept the blame for their parent's behavior associated with substance use disorder. For example, if a child's parent is absent for long stretches as they combat their condition, children may feel that they did something to upset or offend them, which could have led to their departure. Conversely, children may feel as though they are too difficult to handle, which could, in their mind, be why their parent(s) continue to use substances.

Living on edge 

Children of parents with a substance use disorder may feel as if they live in a perpetual state of alarm, potentially unsure of how a parent may behave on a given day. This state can lead to a pattern of inconsistency, contributing to increased nervousness or comorbid anxiety disorders.

Impaired brain development

When a child cannot progress emotionally or physically according to standard metrics because of parent addiction, their neurological development can be impaired. When neurological development is impaired, emotional development may follow suit. This impairment can appear individually, potentially in the form of personality disorders, mood disorders, and social difficulties.

Risk of disorder reoccurrence

Perhaps one of the most dangerous implications involved in growing up with and around frequent substance use is the potential likelihood of children developing a substance use disorder themselves. 

Although a family history of substance use disorders is not the only factor in developing one, it can increase a child's risk of developing a substance use disorder as a teen or adult. This impact could be due to observation and exposure. If children see their caregivers turning to substance use to cope with life's difficulties, they may be inclined to do the same. 

Past substance use: Present-day effects and mental illness

Parents or caregivers who once experienced substance dependency but no longer do may believe their children might not experience adverse effects after the use has passed. Parents in recovery may see recovery as proof that their children are no longer in danger due to acute substance use in the home. However, this may not be the case. 

After recovery, family roles and behaviors might have changed, which can provoke children to act out, potentially in an attempt to re-enact or reinforce the roles and behaviors they've grown up with. This behavior is often not intentional and aligns more with a trauma response, possibly due to a lack of attachment or disruption within the childhood experience. 

With this understanding, recovery is often the most favorable outcome for those living with substance use disorders and their families — allowing many to actively rebuild the unhealthy patterns and dynamics that occurred during acute use. However, the family may still experience strain through the mountains and valleys of recovery as they work to process the potential trauma and unhealthy behaviors that could have occurred because of the use.  

Overcoming a substance use disorder has a wide-reaching and significant impact on children years after recovery. While the road can be complex in achieving this goal for many, the positive effects and healing it can bring to a group may outweigh the complications. 

Getty/Xavier Lorenzo
Living alongside substance use disorder?

Support options for parents of children and adult children

If you are living with a substance use disorder or have previously used substances and have noticed an impact on the health of your family unit, you may benefit from talking to a therapist. You're not alone in your experiences, and compassionate support is available. Consider looking for options with local group therapy, online support groups, online therapists, rehab programs, and school counselors.

It can be difficult to seek support with the dynamic that substance use can bring, and it may not seem safe or comfortable to do so in a traditional in-person setting. Online therapy can address this concern for many, allowing them to receive discreet support from the comfort of their home. Through an online therapy platform like BetterHelp, you can select between phone, video, or chat sessions with your therapist and use a nickname if you don't want to use your real name for sessions. 

Online therapy has been proven an effective resource for many in addressing the symptoms of alcohol use disorder. A recent literature review found that this form of therapeutic intervention showed symptom attrition in those frequently using cannabis and alcohol and those having difficulty controlling gambling behaviors. The change was gradual over three months, with clients self-reporting significant improvement. 


The behaviors of parents or caregivers with substance use disorders can significantly impact children. Children can be impacted into their adult years. They may be more likely to engage in substance use disorder or experience mood and personality disorders and other mental health conditions. 

Therapy can be a resource for parents with substance use disorders and their children, encouraging a more healthful lifestyle for families. If you're interested in getting started, consider contacting a provider online or in your area for guidance.

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