Drugs can affect children at all stages of development. A child can be affected before they are born, right after they are born, as young children, and as teenagers. Children can also be affected by parental drug use. This guide will discuss the impacts of drugs at each of these stages of development and how to get children the treatment they need.

Neonatal Abstinence Syndrome

What Does Neonatal Mean?

Neonatal is defined as relating to or affecting a newborn infant during the first month after birth. Neonatal is a term used in many different areas of medicine. Addiction treatment is one field of medicine to use the term neonatal because of neonatal abstinence syndrome.

What is Neonatal Abstinence Syndrome?

Neonatal abstinence syndrome (NAS) is a group of medical problems faced by newborns who were exposed to addictive drugs during their mother’s pregnancy. Drugs the mother takes pass through the placenta to the baby. The baby becomes physically dependent on the drug at the same time as the mother.

If the mother continues to take drugs immediately before birth, the newborn will emerge entirely dependent on that drug. The newborn will experience withdrawal symptoms while its body is slowly getting the drug out of their system.

Neonatal Opioid Withdrawal Syndrome

NOWS is the blanket term to describe a newborn with NAS caused solely by opioids. This is the most common type of NAS.

NAS With Drugs Other Than Opioids

A newborn may experience NAS and withdrawal symptoms when exposed in the womb to:

Alcohol

Benzodiazepines

Barbiturates

Antidepressants

Although they won’t experience NAS or withdrawal symptoms, there may be long-term health effects on babies that were exposed to:

Nicotine

Amphetamines

Cocaine

Marijuana

What Are the Signs of NAS?

Signs of NAS may be different for every newborn, most occur within 3 days of birth, but some newborns may not show signs for up to 6 months. If your newborn is showing signs of NAS, contact a doctor as soon as possible. Signs may include:

Body shakes

Fussiness

Excessive crying

Poor feeding and low weight

Breathing problems

Fever

Blotchy skin

Sleep problems

Diarrhea

Throwing up

Stuffy nose

Sneezing

Initial Medical Complications for the Newborn

Babies with NAS are at increased risk of:

Sudden Infant Death Syndrome (SIDS). SIDS may cause the unexplained death of the baby while sleeping.

Low birthweight. If your baby weighs less than 5 lbs.

Jaundice. Your baby’s eyes and skin look yellow, meaning the liver hasn’t developed properly.

Seizures

How is NAS Diagnosed?

A medical provider can use a few different tests to diagnose NAS. There is a NAS scoring system that assigns points based on the severity of your baby’s symptoms. Urine can be tested for drugs. The baby’s first stool can also be tested for drugs.

00:07 I'm Dr. Phoebe Thorpe and here with me today is rear Admiral Wanda Barfield, the director of the Division of Reproductive Health here at CDC. 00:16 Wanda, thank you so much for joining us. [Wanda] Thank you, Phoebe. [Phoebe] Your session that from two years ago about neonatal abstinence will be running. 00:24 Part of the reason we're rerunning it is because the opioid epidemic continues to worsen in the United States. What is neonatal abstinence? 00:35 [Wanda] So, um, it, it's great that we're doing another opportunity to talk about Beyond the Data here. 00:42 Neonatal Abstinence Syndrome is something that I know very personally in addition to directing the division of reproductive health, I'm also a neonatologist, which is a specialist in pediatrics that focuses on the care of critically ill newborns. 00:58 Neonatal Abstinence Syndrome is a withdrawal syndrome that occurs for babies who've been exposed to opioids during pregnancy. 01:08 Now, this may occur under a variety of circumstances, 01:12 but the challenge here has been more recently we've seen it 01:15 as a result of the opioid crisis. 01:18 So Neonatal Abstinence Syndrome can occur when those withdrawal 01:23 that a pregnant woman has after her baby is born 01:26 and that baby has been exposed 01:28 to either prescription substances 01:31 that include subsistence's, like Vicodin, OxyContin, 01:35 or it can be illicit substances that can also include heroin. 01:41 Or it can be exposure to medication assisted treatment 01:47 such as Buprenorphine or Methadone. 01:50 And these infants have symptoms that occur about 48 to 72 hours 01:56 after birth and these symptoms are fairly distressing. 02:01 They include things 02:02 like excessive crying, inconsolability. 02:06 They may have difficulty feeding; 02:08 they may have watery stools or diarrhea. 02:12 They may also, um, have seizures and so these particular symptoms 02:18 and signs need to be treated and they need 02:21 to be treated in a gradual method. 02:24 [Phoebe] So when these newborns have the Neonatal Abstinence 02:27 Syndrome and are going through withdrawal what, 02:29 what needs to be done to treat them. 02:31 [Wanda] So the treatment can be somewhat complicated 02:35 and protracted. 02:36 So these infants need time in terms of a gentle weaning 02:43 from these medications. 02:45 And so as a result, they're given medications 02:49 so that they can reduce these symptoms that we're seeing 02:52 when they're initially having withdrawal symptoms. 02:55 Most infants may show signs of withdrawal anywhere between 48 03:00 to 72 hours after birth. 03:03 Because it takes time for these infants to recover, 03:07 it means that they need close and careful monitoring 03:11 in either a newborn intensive care unit 03:15 or they may need very close monitoring 03:18 in a special care nursery. 03:19 And so as a result, that means they've got prolonged 03:23 hospitalization and as you know, that can be expensive. 03:27 They also need to be closely monitored for these signs 03:31 and symptoms that could potentially get them 03:34 into a lot of trouble. 03:35 We know that in the United States, in fact, that the cost 03:39 of Neonatal Abstinence Syndrome is about 2.5 billion dollars 03:44 with the major burden being born by Medicaid 03:48 at about $2 billion dollars. 03:50 [Phoebe] Each year. 03:51 [Wanda] Each year. 03:52 [Phoebe] Wow. 03:53 What, what are we doing? 03:54 So I would imagine that if you, um, the increase use 03:59 of opioids while use and abuse of opioids in women 04:02 who are pregnant is part of the reason 04:04 that the Neonatal Abstinence Syndrome is going up. 04:08 What are some of the important things to help the moms, uh, 04:12 with the women who are pregnant 04:13 to prevent Neonatal Abstinence Syndrome? 04:16 [Wanda] Yes. 04:16 Phoebe, you bring up an important point. 04:18 It's important to note that we, we coined the issue 04:22 of Neonatal Abstinence Syndrome 04:24 as really the tip of the iceberg. 04:26 This is really sort of the final result 04:28 of a much more complicated issue and for every baby that we see 04:34 with Neonatal Abstinence Syndrome, there's a mom who's 04:37 in great need of support. 04:39 But it goes beyond that. 04:40 This is really a life course issue and we really need 04:43 to think not only of the care and concern of the baby, 04:48 but the care and concern for mothers and even 04:50 for women prior to pregnancy. 04:53 You know, many women may not even know 04:56 that they're pregnant during the time 04:57 that they may be using a prescription drug 05:01 and as a result, they then may find themselves pregnant 05:05 and treatment during that time maybe more challenging. 05:08 However, there is an opportunity for us 05:11 to better monitor pregnancies and help women 05:15 with medication-assisted therapy. 05:19 [Phoebe] Yeah. 05:19 You bring up a point that, that was one 05:21 of the things I was going to ask about and it came 05:22 out in a session about medication, medicated, 05:26 medication assisted therapy. 05:28 What? What is that and how, what, what is being done 05:32 to help women during their pregnancy? 05:34 [Wanda] So medication assisted therapy is an opportunity 05:38 to treat women during pregnancy, 05:41 but so that they can also be monitored in terms of the use 05:46 of these substances that include either Methadone 05:49 or Buprenorphine. 05:51 And it also allows an opportunity to not only monitor 05:55 that woman during her pregnancy, 05:57 but to help to identify an infant 06:00 who may potentially have Neonatal Abstinence Syndrome. 06:04 However, it may be a much more controlled path rather than sort 06:10 of a quick withdrawal. 06:12 [Phoebe] Yeah, so it's very important to, 06:14 to try to get the women that the treatment they need while 06:17 they're pregnant. 06:17 [Wanda] Yes. 06:18 And I've had opportunities to, you know, talk with women 06:21 and talk with families who may be 06:23 on medication assisted therapy and what they might anticipate 06:28 in terms of the days of, you know, during delivery 06:31 in those subsequent days following delivery. 06:34 And I think that's a really helpful approach. 06:37 [Phoebe] What else needs to be done to reduce 06:39 or prevent Neonatal Abstinence Syndrome in the United States? 06:42 [Wanda] So when we were thinking about prevention, again, 06:45 you know, that's an important role that CDC plays 06:49 in terms of prevention. 06:50 More broadly we're really looking 06:53 at how we can collectively as an agency address the opioid crisis 07:00 and that's really through our combined efforts. 07:04 So just thinking about what we can do at CDC here, 07:08 we are really focusing on work collectively. 07:11 As you know, CDC has produced a lot of information 07:15 about appropriate prescribing and so CDC has guidelines 07:19 on appropriate prescribing guidelines for physicians 07:22 and that's a very important component that we need 07:26 to disseminate and help educate providers. 07:29 You know, the other component is surveillance. 07:31 It is so important, not only that we have good 07:34 and accurate surveillance, but that it's as rapid as possible. 07:38 And CDC is really working toward making the data available much 07:43 more rapidly. 07:44 Whether that's, you know, and this is more broadly, 07:46 I'm not just talking about Neonatal Abstinence Syndrome, 07:50 but you know, what can we do in terms of addiction, 07:52 emergency room, um, related issues, um, 07:56 the unfortunate event of overdose. 07:59 So how can we get that information out more quickly 08:02 so that people can respond? 08:04 For states, there's a lot of exciting work that's going 08:08 on in the area of what's called perinatal quality collaboratives 08:12 and these are teams of healthcare providers as well 08:15 as public health providers that are working together to think 08:19 about evidence based interventions 08:22 to really improve the care of infants 08:25 with Neonatal Abstinence Syndrome as well 08:27 as improving the care for mothers. 08:29 So specifically for example, the challenge that we have now is 08:34 that our treatment protocols are still somewhat subjective 08:39 when we're trying to treat infants with NES, 08:42 but in the context of a quality improvement framework, 08:46 we might be able to do a more standardized, regimented process 08:53 of identifying infants at risk, appropriately treating them 08:57 and then perhaps reducing those hospital lengths 09:01 of stay for those newborns. 09:03 There's also better techniques, for example, promoting um, 09:08 maternal infant bonding 09:10 and promoting breastfeeding is also a good way 09:13 to help reduce the length of stay for newborns with regard 09:17 to Neonatal Abstinence Syndrome. 09:19 [Phoebe] So what I hear is surveillance 09:21 so they can help figure out where the problem is. 09:23 [Wanda] Yes. 09:24 [Phoebe] And then also quality improvement so that they, 09:26 the solutions that we offer are better too. 09:30 And combining those to, make it better. 09:33 [Wanda] Yes. 09:34 [Phoebe] Um,prevention..If other people are interested 09:38 in knowing more about clinicians or others about, uh, 09:43 the opioid use, misuse or NAS, where can they find that? 09:48 [Wanda] Well, there are several resources. 09:50 So first for providers there, there's great opportunity 09:54 through the CDC guidelines in terms of prescribing practices, 09:59 but there's also clinical groups that are very helpful. 10:03 For example, the American Academy 10:05 of Pediatrics has guidance on the care of infants 10:09 with Neonatal Abstinence Syndrome as well 10:12 as the American Association of Obstetricians and Gynecologists 10:17 or the American College of Obstetricians and Gynecologists 10:20 and they have guidances for the treatment 10:23 of women during pregnancy. 10:26 [Phoebe] Thank you so much for joining us. 10:27 This is such an important topic and it's like you said, 10:30 it's the tip of the iceberg and so it isn't always seen well. 10:33 I really appreciate your efforts to make it better now and, 10:37 and to help these children. 10:38 [Wanda] Well thank you too Phoebe 10:39 for raising this important issue. 10:41 [Phoebe] And thank you for joining us for Beyond the Data.

Treatment for NAS

Newborn Intensive Care Unit (NICU)

A newborn with NAS is likely to require treatment in a NICU to stabilize its condition and manage the withdrawal symptoms. A NICU is a nursery in a hospital that provides 24-hour care for newborns that are sick or premature.

Medication-Assisted Treatment (MAT)

MAT involves giving the newborn medications to treat or manage withdrawal symptoms. The dosages of the medications will be tapered as their system gets rid of the dependent drug and withdrawal symptoms ease.

Medications used may include:

Morphine

Methadone

Buprenorphine

Phenobarbital

Non-Medication Interventions

Non-medication interventions may include:

Swaddling is the age-old practice of tightly restricting a newborn’s limbs with blankets

Rocking is slowly moving your newborn back and forth while holding it

Skin-to-skin contact calms both the mother and newborn

Sensory limitation is keeping the newborn in a dark room without loud sounds

Consistent temperature to avoid having the newborn system work to adapt to different temperatures

Bottle feedings alternating with a pacifier is the sucking is excessive

Breast milk feedings Have many health benefits for the newborn

Long-Term Effects of NAS

Developmental delays are when a child doesn’t meet developmental milestones when expected. The milestones include things like walking, sitting, talking, and social skills

Speech problems when a child has trouble communicating and being understood due to trouble making the appropriate sounds.

Ear infections are common in children, but children with NAS may have more frequent and more severe infections

Visions problems can include the inability to focus and can include things like balance and orientation

Sleep problems which can impact a child’s overall health in many ways

Motor problems are issues with the child’s development of muscle, bones, and movement

Behavior problems which impact the education and socialization of the child

Hearing problemsincluding hearing loss and language delays

Cognitive problems include poor memory, poor perceptual skills, and poor learning skills

Child abuse and neglect are more likely to occur when a parent struggling with drugs identifies the child as difficult to deal with, or even a “bad” child

Low self-esteem which impacts many areas of a child’s development

We are still learning about the long-term effects of NAS. Many other effects could be found after more studies are concluded, and researchers have more data.

Drug Endangered Toddlers

Many toddlers are exposed to direct or indirect exposure to illegal drugs. Drug endangered toddlers gained visibility with the rise of methamphetamine use, but meth isn’t the only drug that causes issues; cocaine is the other top contributing drug.

A drug endangered toddler is defined as a toddler who suffers from physical harm or neglect when living in a house where illegal drugs are used or manufactured.

Exposure to Meth

Toddlers can be exposed to meth either by finding pieces of meth, or powdered meth, and ingesting it. Toddlers can also be exposed through second-hand meth smoke in the home.

Symptoms of a toddler exposed to meth can include:¹

Increased heart rate

Agitation

Irritability

Muscle breakdown

Fever

Ataxia

Seizures

Exposure to Toxic Chemicals Used to Manufacture Meth

Almost every illegal meth lab contains toxic substances. Many of these substances can cause contact burns and damage the lungs when inhaled. Several of the substances can cause fires and explosions.

Substances used to make meth can include:²

Hydrochloric acid

Sulfuric acid

Sodium hydroxide

Diethyl ether

Acetone

Ethanol

Neglect and Abuse

Parents who are addicted to drugs, or who are illegally manufacturing drugs, pose a significant risk to their toddlers. The toddler may not receive the nurturing or emotional contact that are needed for development. This can lead to developmental delays, depression, or attachment disorder.

A drug endangered toddler may also be malnourished, have poor hygiene, and not receive the medical attention they need. These can all contribute to serious health concerns.

Teen Drug Abuse

In 2019, the National Institute on Drug Abuse completed a large-scale survey of more than 42,500 students from public and private schools in the United States. The results of this survey, called Monitoring the Future, have revealed important information about adolescents, their drug abuse patterns, and the drugs they choose to abuse.³

The overall theme of the survey is that drug use, specifically cigarettes and prescription opioids, is at an all-time low.³ The following describes the results by each category of substance abused:

Alcohol

Alcohol use and binge drinking have decreased among 10th-12th graders, according to the National Institute on Drug Abuse.³ In 2019, an estimated 29.3% of 12th graders reported using alcohol in the last 30 days. This is a decrease from 37.4% of 12th graders in 2014.³

In addition, the amount of teenagers who report drinking at all has decreased since previous years’ surveys. In 1994, an estimated 55.8% of eighth-graders reported drinking alcohol at some point in their lives. In 2019, an estimated 24.5% of eighth-graders reported drinking alcohol at some point in their lives.

Most of the alcohol that teenagers consume is in a binge drinking situation.⁴ This can particularly place a young person at risk for motor vehicle accidents, risky sexual behaviors, and more.

Marijuana

According to the National Institute on Drug Abuse, an estimated 35.7% of teenagers in 8th-12th grade reported using marijuana in the last 30 days.³ A vast majority of students (86.4%) report using marijuana by smoking it compared to alternate options, such as edibles.³

While marijuana use overall has decreased since the early and mid-2000s, daily marijuana use has increased slightly over time, particularly among 10th-grade students surveyed.³

Club Drugs

“Club” drugs, such as amphetamines and LSD, have either maintained their previous levels of abuse or slightly increased, particularly in LSD, according to the National Institute on Drug Abuse.³

Prescriptions

An estimated 2.7% of high school seniors reported using prescription painkillers, such as hydrocodone, oxycodone, or morphine, in 2019.³ This number is a drop from previous numbers in 2014. Oxycontin was the most-named prescription medication of use in the United States among those surveyed.

Reasons Why Teens Use Drugs

According to the American Academy of Pediatrics, alcohol is the first substance that most young people try.⁴ By eighth grade, an estimated 28% of young people have tried alcohol. What’s more, an estimated 12% have been drunk at least once.⁴

The National Institute on Drug Abuse has identified several potential reasons as to why young people may start using drugs or may become addicted to drugs.⁵ These include:

Desire to fit in with their peer group: when others are experimenting with drugs, a young person may feel like they want to be a part of the group and that they’ll be excluded if they don’t participate.

To feel better: some young people use drugs to try to escape their mental health concerns, family life, or school pressures.

To increase performance: some young people may try to use prescription medications to overcome an injury or to be able to stay awake and study longer.

Out of curiosity: whether they’ve seen a parent or someone on television or in a movie use drugs, some young people are simply curious about using drugs.

How to Spot Drug Use in Children

Children may be exposed to drug use at school, with friends, or in their homes. While a vast majority of children who try drugs don’t become addicted, using drugs can still impact them in several different ways. Drug use can affect a young person’s physical and emotional well-being. It can get them in trouble at school and with the law.

Some of the signs that a child may be abusing drugs or alcohol include:

Changes in their personal appearance, such as appearing messy or unkempt

Changes in their pupil size, such as very large or very small pupils

Exhibiting hostile behavior around the house

Showing sudden or unexplained weight loss

Finding drugs or drug accessories (pipes, straws, etc.)

Lying or seeming paranoid when asked where they are going or who they are going to be with

If they seem to be very influenced by their peers or very preoccupied by what their friends think

If their breath smells of unusual substances, such as alcohol or smoke

Exhibiting behavioral problems at school

Struggling with grades

Showing different behaviors, such as depression, fatigue, or isolation

It Can Be Hard to Tell the Difference Between Normal Teen Behavior and Drug Abuse

Adolescents go through many changes at this stage that can make it hard to tell the difference between typical “teenager” behavior and drug abuse. However, if a parent notices sudden changes in personality, appearance, or overall well-being, it’s important to consider that a young person could be going through physical or emotional problems. According to the American Academy of Pediatrics, issues with school performance is often one of the later signs that a young person is abusing drugs or alcohol.⁴

Risk Factors

According to Stanford Children’s Health, some adolescents are at greater risk for substance abuse. Examples of these risk factors include:⁶

History of attention deficit hyperactivity disorder (ADHD)

History of anxiety or toher mental health disorders

History of struggles with school and academic performance

History of the child being chronically impulsive

Children whose parents have a low socioeconomic status are also at higher risk for substance abuse or substance experimentation.

How to Deal with a Child Who is Addicted to Drugs

Intervening, even on a low level, can help to reduce substance use and abuse in young people, according to the American Academy of Pediatrics.⁴ This could include simply talking to a young person about their drug use. However, if a young person shows signs of full-blown dependence to a substance or suicidal thoughts related to their substance abuse, a parent should help their child seek either rehabilitation or professional help from a therapist or counselor.

How to Help a Child Experiencing Addiction to Drugs

If a parent isn’t sure where to begin when helping a child struggling with addiction or experimentation, a good place to start would be to talk to the child’s pediatrician or school counselor. Teenagers are traditionally opposed to the idea of seeking help for their problems. This could be for several reasons. Some young people don’t think their drug abuse is a serious problem. Others are afraid of losing their friend group, or that other people will find out they are struggling.²

What researchers do know is that the earlier a young person can receive treatment for substance abuse, the better their chance of recovery. Seeking out a family counselor or other community resource can help a young person recover from their substance abuse problem and learn to make more positive life choices.

Communication

Examples of ways to communicate with a young person about their substance use:

Provide clear advice. Being very direct and clear with a teenager is important.

Example: “I think you should stop drinking, and the time to stop is right now.”

Share educational materials that come directly from reputable sources.

Example: Provide the young person with information on the harmful effects of smoking, alcohol, or other illegal substances.

Reinforce the education by showing how it affects each aspect of a young person’s life.

Example: Explain how they may not be able to stay on a sports team or participate in school, work, or other group-related activities.

Help a young person make a plan to quit, and discuss how they may deal with issues that arise, such as peer pressure from friends.

Sometimes, a family member may have to reach out to a therapist or a child’s doctor to start these conversations and to help hold a young person accountable.

00:06 The way that the teenagers are communicating have changed dramatically over the past 10 00:10 to 15 years, and it has been accelerated as of the past five years. 00:15 Social media has permeated the life of all the teenagers and we now know that teenagers 00:20 spend much more time with these devices and in front of the computer that they had ever, 00:25 ever done before, and that they are communicating much more electronically done in our face-to-face 00:31 perspective. 00:33 we knew from all of the epidemiological studied and the studies and lessons that mirror behavior 00:39 of observing other teenagers and the dynamic that exists on peer pressure when you are 00:45 with other teenagers contributes significantly to the initiation and repeated drug use among 00:51 adolescents among teenagers…a very powerful driver. 00:54 So the question that emerges, and we don't have answers 00:57 because this has not been investigated but the question comes to mind could these changes 01:03 in interaction be playing a role on that decreasing consumption of drugs by teenagers? 01:10 Because the probability of them being in physical presence of other teenagers has been decreased 01:16 by the fact that now they are more interacting through the web than in person, that's one. 01:21 I also think that we need to do research in terms of understanding how other types of 01:27 reinforcers that teenagers are picking up that did not exist to the same extent amongst 01:32 teenagers are actually substituting for the culture of taking drugs. 01:37 And in particular, for example the use of video games which have actually just skyrocketed 01:43 in terms of technology and the power and drive they have to capture the behavior of teenagers 01:50 to the point that in certain countries like China, Taiwan, Korea…they have established 01:56 clinics for treating addiction to these video games among teenagers. 02:00 Cause teenagers get compulsive about it and they relinquish their school activity their 02:07 social life and they stopped sleeping and then it can be quite harmful. 02:13 So you are you are changing the pattern of requiring compulsive options to teenagers 02:21 that were not there in the past.

Substance Use Disorder Treatment for Children

Treatment for a young person struggling with addiction to drugs can include therapy (both individual and family therapy) as well as rehabilitation programs, such as inpatient or outpatient therapy. If friends and family have tried to get a young person to quit abusing drugs or alcohol and the young person can’t or won’t stop on their own, they may need more intensive professional help to quit.

A parent can ask their child’s doctor or contact area rehabilitation facilities to find out more about services offered. Some programs around the country are explicitly geared toward young people. This may help an adolescent feel more comfortable in treatment.

Drug abuse treatment for young people involves breaking the early habits that have led to a young person’s dependence on drugs and trying to help them get on a healthier, safer path as soon as possible.

This may include cognitive-behavioral therapy, motivational interviewing, and other therapies that help a young person learn how to relieve stress and express themselves in a manner that isn’t through drugs or alcohol. Following a rehabilitation program, a young person and their family may need to continue their recovery through participation in support groups, whether online or in person.

Help for Parents of Children Who are Addicted to Drugs

Some of the resources that can help a parent whose child is struggling with substance abuse include the following:

Partnership for Drug-Free Kids: The Partnership offers a parent hotline that parents can call at 1-855-378-4372 to share their story with experts who can help them find solutions for their child. A parent can also text their questions to 55753 for help.

Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA offers a free and confidential National Helpline that people can call to receive information about treatments. This number is 1-800-662-HELP (4357).

Effects of Substance Abuse on Child Development

According to the American Academy of Pediatrics, there is no “safe” amount of substance use for young people, because there are numerous effects on young people who use different substances.⁴

Short-Term Effects

In the short-term, substance abuse can affect young people because it can lead to injuries and accidents. Some examples of short-term effects on child development include:

Violence and Accidents

Motor vehicle accidents

Falls

Intimate partner violence

Suicidal behavior

These factors can all lead to unintentional injuries and even death.⁴

Academic and Social

Young people can also experience problems with their academic and social interactions, which can impair their future.⁴ One study from the American Academy of Pediatrics found that adolescents who use marijuana experience diminished lifetime achievement compared to young people that do not use marijuana.⁴ This may be in part because marijuana use in adolescence can cause potentially irreversible impairment in brain functioning, even if they stop smoking marijuana at a later time.

Long-Term Effects

Researchers have also identified the long-term effects of early substance use (including illegal consumption of alcohol). The American Academy of Pediatrics found that people who drink before age 15 are five times more at risk for alcohol dependence or abuse later in life.⁴ Adolescents who try marijuana before age 14 are also six times more likely to meet the criteria for drug dependence or abuse.

Parental Drug Use

The following section will address parental substance abuse, and how a parent who is addicted to drugs may impact a child.

Statistics on Parental Drug Abuse

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated 1 in 8 children who are ages 17 and younger live in a household where at least one parent struggles with a substance use disorder.⁷ This is an estimated 8.7 million young people in the United States.

Parent with AUD

The most significant number of children who live with a parent who struggles with substance abuse have a parent who is addicted to alcohol. An estimated 7.5 million American children (about 10% of children) live with at least one parent who has an alcohol use disorder.⁷ SAMHSA further breaks down this group by ages:

Ages 0 to 2: 10.1% of the age group 10.1% 10.1%
Ages 3 to 5: 9.9% of the age group 9.9% 9.9%
Ages 6 to 11: 10.2% of the age group 10.2% 10.2%
Ages 12 to 17: 11.3% of the age group 11.3% 11.3%

Parent Who Abuses Illegal Drugs

An estimated 2.1 million American children live in a household where at least one parent abuses illegal drugs. This is about 1 in 35 children.⁷ The following is the percentage breakdown of the 2.1 million children:⁷

Ages 0 to 2: 4% of the age group 4% 4%
Ages 3 to 5: 3.5% of the age group 3.5% 3.5%
Ages 6 to 11: 3% of the age group 3% 3%
Ages 12 to 17: 2.1% of the age group 2.1% 2.1%

While a significantly higher amount of parents abuse alcohol compared to illegal drugs, both have the potential to cause long-lasting and harmful effects on the lives of their children.

How Parental Drug Use Affects Children

According to SAMHSA, a child whose parent struggles with a substance abuse disorder is more likely to have a substance abuse problem later in life.⁷

Research indicates that children of parents who use drugs are more likely to experience several concerns related to drug use. For example, children of parents who abuse drugs are more likely to experience behavioral and mental health problems compared to children whose parents do not struggle with drug addiction.⁷

Children of parents who drink alcohol are more likely to experience symptoms such as:

Anxiety disorders

Challenges in cognitive and verbal skills

Depression

Parental abuse and neglect

Children whose parents struggle with alcohol abuse are four times as likely to struggle with alcohol abuse as a child whose parents do not, according to SAMHSA.⁷

Long-Term Problems from Parental Drug Use

Increased risks for mental health problems and substance abuse can lead to long-term behavioral problems in a child. A child never has the time to develop proper coping mechanisms for challenges in daily life because they have been so overloaded from an early age.⁸ This can lead to long-term substance abuse, violence, and a lifetime struggle with mental illness.⁸

Parental Neglect Due to Substance Abuse

When a parent struggles with substance abuse, the time, effort, and energy, they may have otherwise spent on their child is often replaced by whatever substance they are abusing. This can lead to neglect and abuse, such as when a child doesn’t have food, a safe or clean home, or the school support they need to develop.

Factors that may contribute to child neglect and mistreatment related to substance abuse include:

Domestic violence

Financial instability

Food and housing insecurities

Ineffective control of childhood behaviors

Children whose parents struggle with substance abuse are more likely to live in households that have unique problems like mental illness, low socioeconomic status, and domestic violence. These challenges can create a very negative environment for a child, and they often require a child to grow up very quickly.

Parental Abuse

According to the journal Pediatrics, children of parents who abuse drugs and alcohol are three times more likely to experience physical, emotional, or sexual abuse.⁸ Also, children whose parents struggle with substance abuse are four times more likely to be emotionally or physically neglected.

An estimated 27% of children born to women with a substance abuse disorder require child protective services during their preschool years.⁸ Also, an estimated 20% of child neglect or child abuse cases are related to a parent that has a substance use disorder.⁸

Help for Children of Parents Who are Addicted to Drugs

Children whose parents struggle with substance abuse are often faced with different roles growing up than most children their age. They may feel they’ve had to take on the role of “parent” instead of being allowed to be a child. These young people may have had to care for a parent who is hungover, high, or withdrawing from substances. They may have had to work or help find the money for food and basic needs around the house.

It is exceptionally complicated to grow up with a parent who struggles with substance abuse. A parent may be dependent on a child for love and support instead of the other way around. A child may fear to share with others that their parent has a problem because they don’t want to go into the foster system or live with anybody else.

Ways for a Child to Deal with the Stress of a Parent Who Abuses Drugs

Some of the ways that a young person can start to work through these feelings include:

Keeping a journal of their feelings so they can start to learn how to recognize their emotions. An alternative to a journal is a creative outlet, such as music, art, dance, or other avenues that allow a person to express themselves.
Keeping in touch with friends. Sometimes, children of a parent who struggles with addiction may avoid making too many friends because they are embarrassed or concerned that other people will recognize that their parent has a problem. However, friends are vital to supporting a young person and also allowing them to grow up and develop.
Finding activities to enjoy. A young person participating in activities like sports, extracurricular clubs, or volunteer work can all provide a safe and supportive outlet outside of their parents’ substance abuse.

Resources to Help

Trusted Adult

If a young person has a parent who struggles with addiction, there are often resources in their communities to help. They should begin by talking to a trusted adult. Examples can include a teacher, pediatrician, coach, guidance counselor, or clergy member. A trusted adult can help a young person find who they should speak with that can help not only themselves but can potentially help their parent too.

Support Groups

There are support groups specifically designed for young people who have a parent who struggles with addiction. An example is Alateen, a division of Alcoholics Anonymous. Through the Alateen website, young people can find local meetings or online support groups.

National Suicide Prevention Lifeline

If a child or parent struggles with suicidal thoughts, another vital support line to know is the National Suicide Prevention Lifeline. The number is 1-800-273-TALK (8255) and is available 24 hours a day, seven days a week, to help people who are struggling with suicidal thoughts.

Treatment for Substance Use Disorder

Treatment programs exist specifically for parents who struggle with substance abuse who may not be able to leave their homes on a full-time basis to seek care. These programs may include going to a substance abuse treatment center for the equivalent amount of time as a part-time or full-time job. These programs can be vital in helping a parent receive necessary therapy and support to recover.

Rehabilitation may involve taking medications to avoid using prescription opioids or alcohol. Parents may also be able to receive social work help, such as help identifying how to find a job, pay for bills, and find safe housing after rehabilitation.

Following addiction treatment, a parent must participate in some form of an addiction aftercare program. These programs (such as Alcoholics Anonymous or SMART Recovery) help a person continually engage in their sobriety. Through these programs, many people find parents just like them who have struggled but are committed to overcoming their problems for their children and themselves.

Resources

https://www.ncbi.nlm.nih.gov/pubmed/9881979
https://epdf.pub/handbook-of-forensic-drug-analysis.html
https://www.drugabuse.gov/publications/drugfacts/monitoring-future-survey-high-school-youth-trends
https://www.aap.org/en-us/Documents/substance_use_screening_implementation.pdf
https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/frequently-asked-questions/why-do-adolescents-take-drugs
https://www.stanfordchildrens.org/en/topic/default?id=how-to-spot-drug-use-in-kids-1-2409
https://www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html
https://pediatrics.aappublications.org/content/138/2/e20161575