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    Commentary: The Most at Risk: The Most Ignored

    All children wake up in a world that is not of their own making, but children of alcoholics and other drug addicted parents wake up in a world that doesn’t take care of them. No matter what we name their risk factors, they still have to make their own breakfast and find their own way.

    — Jeannette Johnson, PhD

    The addiction prevention and mental health problem literatures are replete with examples and data that describe the childhood and adult problems and disorders of individuals who have addicted parents.

    The National Institute on Alcohol Abuse and Alcoholism reports that as many as 1 in 4 children younger than age 18 is exposed to family alcohol abuse or dependence. Countless other children are growing up in homes where there is parental drug abuse. These are the children who are more likely to develop depression or anxiety disorders in adolescence, use alcohol or other drugs early and – for both genetic and environmental reasons – to become tomorrow’s addicted youth, the children in foster care, troubled youth in the juvenile justice system and the adults most likely to seek mental health therapy for depression, anxiety disorders, marital problems, and struggle with parenting their own children.

    From the plethora of reports flowing out of the 10-year Adverse Childhood Experiences (ACE) Study, we know that growing up in the chronic emotional stress of families impacted by parental addiction negatively affects children’s brain development from the earliest days of life. Unaddressed mental illness, physical or emotional violence or having a parent in prison are also negative factors.

    Today the alcohol/drug use prevention field is focusing on “environmental strategies,” which is an important part of preventing alcohol and drug use among our youth. Yet the primary environment that influences, for good or ill, the alcohol and drug use choices of today’s and tomorrow’s youth is the family, and most specifically the parents. This is the environment that nurtures both society’s contributing adults and society’s most costly problems in education, health care, mental health, the work place, the justice system and the prison system.

    The medical profession and the addiction disease prevention advocates have been successful in conceiving, testing and promoting screening and brief interventions and referrals to treatment (SBIRT) for adolescents and adults, in order to identify and stop the progression of alcohol abuse in clients. We know that the family members of persons suffering from alcohol or drug use problems have much higher medical costs than the norm. Yet, despite strategies developed over 10 years ago to identify the children in these families through primary care providers, there is no effort to develop codes to allow caring physicians to be paid for addressing such early interventions in medical settings to help prevent the medical and emotional consequences of living with abusive use; the focus is entirely on the user.

    We know that school-based student assistance programs have successfully identified troubled youth before they have become a burden on the system or developed serious and costly problems. They have helped countless children living in families with addiction disorders, and provided them with early education and supportive interventions that have made it possible for them to succeed and even thrive. Yet, this year the Department of Education again recommended eliminating the state’s portion of the Safe and Drug Free Schools and Communities funding, which supported these successful programs. The President’s budget zeroed out this funding. We are quickly reverting to the professional staffing teams in schools to address problems that have escalated out of control, rather than catching them early and saving the child and the school costly negative consequences.

    We know what works to help children of addicted parents navigate through their confusing and difficult lives, devastating to them and so costly to society across all our systems. Why are we so reluctant to step up? Is alcohol abuse so pervasive in our society that we don’t want to touch the pain and suffering it pours over its children? A civilized society looks for and supports its most vulnerable children. Why are we missing the mark on 25 percent of ours?

    Sis Wenger
    National Association for Children of Alcoholics (NACoA)


    November 2011