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)

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    Lisa Frederiksen –

    November 18, 2011 at 7:50 PM

    Raising awareness about this crucial problem as Ms. Wenger does in this piece is critical.
    Two approaches that I am having success with in the work I do with children, teens AND the adults in their sphere of influence are: 1) raising awareness early on in a child’s life about the five key risk factors for developing a dependence on alcohol – not as they related to dependence but rather a something to prevent, treat and/or avoid early on, and 2) raising awareness about the 21st century brain and addiction-related science to better understand why the teen brain is not the same as that of an adult’s and therefore why the teen brain is affected differently by binge drinking than the brain of an adult’s.
    With regards to the risk factors, it is important for all concerned to understand that during childhood, children in chaotic homes – like those with untreated alcohol abuse/alcoholism can easily develop four of the five key risk factors, namely: social environment, childhood trauma (verbal, physical and/or emotional abuse), mental illness, and genetics. The fifth key risk factor is early use. Thus long before a child considers having their first drink, the other four may well already be in place.
    With regards to early use, this article, “How Teens Become Alcoholics Before Age 21,”, helps to explain this relatively new brain research and why alcohol is harmful to the teen brain in a way it is not necessarily harmful to the adult brain.

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    cathy golas

    November 16, 2011 at 9:33 AM

    Thank you Ms Wenger for exposing the dirty little secret of prevention. I was an elementary school social worker in the 90″s–I remember the principal with whom I worked felt that our students were negatively impacted by moms working outside the home- thus the referrals for service I was receiving. I sat down with my list of referred students to that date and found that the most significant factor they had in common was a familial history of substance abuse (usally alcohol)– most of the students I worked with did not have a mom working outside the home. I agree with the devastating effects of th loss of SDFS funding on programming. Since our current program is state funded, we are not allowed to do any type of counseling–as that is not seen as an effective strategy. Thank you for valdating my experiences.

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