Problematic alcohol and/or drug use is defined as:
"...when the use of drugs or alcohol is having a harmful effect on a person’s life, or those around them."
- Getting our Priorities Right: Updated Good Practice Guidance
Problematic parental substance use can involve alcohol and/or drug use (including prescription medicines and new psychoactive substances, sometimes misleadingly referred to as legal highs, as well as illegal drugs).
Not all parents who use substances experience difficulties with family life, child care or parenting capacity. Equally, not all children exposed to substance use in the home are adversely affected in the short or longer term.
That said, the impact of parental problematic alcohol and drug use can have a very detrimental impact on the health and wellbeing of some children.
Children can also be at increased risk of experiencing violence and maltreatment when living with parental problematic drug and/or alcohol use.
Children and young people who are affected by problematic parental alcohol and/or drug use are among the most vulnerable in our society and require particular care and support.
Alcohol and/or drug use during pregnancy can have a significant impact on the health and development of an unborn child and their early years. Some effects can be long term.
In Scotland, alcohol consumption in women of childbearing age is common and is recognised as a significant public health issue.
It is estimated that approximately 3.2% of babies born in the UK are affected by fetal alcohol spectrum disorder (FASD), which is three to four times the rate of autism, meaning that as many as 172,000 people could be affected by the disorder in Scotland.
Fetal Alcohol Spectrum Disorder (FASD) has been used to describe a range of harmful effects to a fetus’ and baby’s development when alcohol is consumed during pregnancy.
These effects can include brain damage as well as poor physical growth and a smaller head.
Fetal alcohol spectrum disorder (FASD) is the leading known preventable cause of intellectual disability and birth defects.
The detrimental effects of FASD are life-long and children and young people will require support with many aspects of their lives such as relationships, mental health, education and employment.
The impact of FASD continues into adulthood with evidence that individuals affected may be more likely to become involved in substance misuse, criminal activity and violence. (Healthcare Improvement Scotland)
Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn who was exposed to addictive drugs while in the mother's womb. These substances pass through the placenta that connects the baby to its mother in the womb. The baby becomes dependent on the drug along with the mother.
If the mother continues to use the drugs within the week or so before delivery, the baby will be dependent on the drug at birth. Because the baby is no longer getting the drug after birth, withdrawal symptoms may occur as the drug is slowly cleared from the baby's system.
Exposure to some types of drug during the pre-birth stage can lead to long term difficulties for the child. (Adult consequences of prenatal drug exposure)
For children and young people living in households where there is problematic alcohol and/or drug use, they may be impacted in a range of ways, including:
Some households where there is problematic alcohol and/or drug misuse can be characterised by poor physical conditions, visits by other adults under the influence of substances, debt problems and verbal and physical aggression. Children and young people may be exposed to frightening situations such as finding their parent unconscious.
All child and adult services have a part to play in helping to identify children that may be at risk from their parent's problematic alcohol and/or drug use and at an early stage.
Responses will be framed by local strategies, whose development in Scotland is led by Alcohol and Drug Partnerships working in conjunction with Child Protection Committees.
Local strategies for Young Carers are also important to ensure children and young people receive the right support.
All child and adult services should take account of the importance of recovery when addressing problematic alcohol and/or drug use. The recovery process was described in the 2008 National Drugs Strategy (The Road to Recovery) as:
“a process through which an individual is enabled to move-on from their problem drug use towards a drug-free life and become an active and contributing member of society.”
'Recovery capital' refers to the internal and external resources necessary for an individual to achieve and maintain recovery from substance misuse as well as make behavioural changes.
Recovery capital recognises that a variety of elements can support or jeopardise recovery; these include social networks, physical, human, cultural and community issues. Recovery capital differs from individual to individual, and may change over time.
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