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. Author manuscript; available in PMC: 2013 Jun 9.
Published in final edited form as: Curr Drug Abuse Rev. 2012 Jun;5(2):135–147. doi: 10.2174/1874473711205020135

Table 3.

Considerations for Professionals Working with Children of Substance Abusing Parents

1. Although many children of substance abusing parents may show risk for negative outcomes, many are resilient and show normal functioning. Professionals should be mindful of the wide variability in risk for negative outcomes in children from these families.
2. The nature of parental impairment impacts children's risk outcomes. Risk for negative outcomes is greater for children from families with two (versus one) alcoholic parents, alcoholic parents who have co-occurring depression or antisocial behavior, and, in some cases, parents who are currently abusing alcohol or drugs (versus recovered). Assessment of parental substance use history and current use are indicated to determine child risk.
3. Parental alcohol and drug use disorders are non-specific risk factors. These disorders are associated with a host of other negative risk factors for children including other forms of parental mental health disorders (e.g., depression and antisocial behaviors) and family adversity. Moreover, children of substance abusing parents show a broad profile of risk. Assessments in these families should be sensitive to co-occurring risk factors and adopt a broad perspective on child functioning to more accurately characterize the strengths and weaknesses of these families.
4. Deficits in parenting behaviors and child functioning may be present in some children of substance abusing parents from early childhood. Attention to potential negative outcomes even in young children of substance abusing parents is indicated.
5. Although prenatal exposure to substances, including alcohol and illicit drugs, is one mechanism of risk for these children, studies show increased risk for negative outcomes in children of alcoholic parents who deny prenatal exposure (from the mother) relative to children of non-alcoholic parents from similar backgrounds. Thus, regardless of whether children were prenatally exposed, they appear to be at increased risk for negative outcomes.