children living with carers who use alcohol and other drugs€¦ · • guilt, shame, stigma •...

Children living with carers who use alcohol and other drugs

Katherine Wadbrook,

Service Manager,

CGL West Sussex Young Persons & Families Services

Change Grow Live 2019

What we will look at today

What is the prevalence of this as an issue

What is the impact of substance use?

How do we assess impact?

Safe storage

What do children need

What do parents/carers/families need

What support is available

NOTE: please do not share or use the images in this presentation – they are the property of the children we work with. We will be sending round a version without these images


Parental substance use falls into the remit of anyone working with children, parents and families, therefore no professional is immune to the need for knowledge in this area.


Prevalence

• Up to 2.6 million children are living with parents who are

drinking hazardously

• 705,000 are living with dependent drinkers

• 1 in 3 under 16s are living with at least one binge drinking

parent (that’s 3.3-3.5 million children) Journal of Public Health, 2009

An estimated 250,000 to 350,000 children

are affected by parental substance misuseAdfam, 2015


65% of alcohol in England is being sold through the off-trade (supermarkets and other off-licences). https://www.childrenssociety.org.uk/sites/default/files/families-first.pdf

https://www.childrenssociety.org.uk/sites/default/files/families-first.pdf


The 2011 Munro Review of child protection

found that many services (including

substance misuse agencies) were too focused

on adults and not enough on the children

affected by adults’ problems

‘Parents with drug problems: How treatment helps’ (2012)


There is evidence of

parental substance misuse

in

57% of serious case

reviews

‘Swept under the carpet’ (2011)


Most parents and carers who drink alcohol or use drugs do so in moderation and don't present an increased risk of harm to their childrenCleaver et al, 2011

However, parents and carers who misuse substances often have chaotic, unpredictable lifestyles and may struggle to provide their children with safe care and clear boundaries. NSPCC website

https://www.nspcc.org.uk/preventing-abuse/child-protection-system/parental-substance-alcohol-drug-misuse/#pageref1727


The impact of problematic substance use

What is problematic/dependent?

1. Loss of control over the drug’s use.

2. The use of alcohol or drugs becomes the most important thing. This is even over things that were once important like family, health, career.

3. Compulsion to use. The person gets locked into only seeing the benefits and not the harm it will do.

4. Withdrawal. The person’s body reacts to the drug leaving the body.

5. Personal losses or major life consequences as a result of drinking or using drugs.

6. Continue using in the face of serious consequences.


Impact on children and young people

• feeling ‘different’

• guilt, shame, stigma

• loss

• sadness, depression

• loneliness, isolation

• stress, fear and anxiety

• caring role

• neglect of needs

• trauma

• financial impact

• impact on relationships

• mistrust

• behavioural difficulties

“Daddy In the Sky” Child aged 6 –

dealing with grief and loss

“Being brought up in an alcoholic family I was used to living in chaos and fear and learnt many coping strategies to help me to survive.”

Angela, 25


The impact of non problematic substance use – is there any?

Children who see their parents drunk are

twice as likely to get drunk themselvesJoseph Rowntree Foundation, 2011


Research highlighted recently in the media (non-dependent drinking):

The children surveyed, aged between 10 -17,

reported negative experiences that included

• being given less attention than usual

• being put to bed earlier or later than their usual

time

• having arguments with parents more than normal

• being at the receiving end of increased

unpredictability

Parents in the upper consumption group were around three times more likely to have been asked by their child to drink lesshttps://academic.oup.com/alcalc/advance-article-abstract/doi/10.1093/alcalc/agz086/5611882?redirectedFrom=fulltext

https://academic.oup.com/alcalc/advance-article-abstract/doi/10.1093/alcalc/agz086/5611882?redirectedFrom=fulltext


How do we assess impact – risks and protective factors

Practitioners need to work with children and families to identify, assess and,

where necessary, intervene to minimise the impact of substance misuse (Bogg, 2013).

This will involve a holistic assessment of the child’s development, the parents’

ability to meet the child’s needs and the impact of broader family and

environmental factors.

Practitioners must be able to recognise the family’s strengths and distinguish

between immediate concerns for the child’s safety and wellbeing and risks

which can be mitigated with appropriate support (Bogg, 2013; Cleaver et al., 2011).

Assessments of parental substance users and their children must take into

account the support structures in place within the wider family context, as well

as the needs that these other relatives may have (for example grandparent

carers). (Adfam)





Zinberg gives us the best description of the complexity of drug use experience as being a subjective and conditioned individual experience.

He identifies three key factors in establishing a drug –using pattern:

This can also be used to assess risk and protective factors

Drug, Set and Setting – Zinberg

SUBSTANCE

CONTEXTPERSON


Although parental substance use is often identified as the primary

problem within these families, decades of research clearly

indicate that substance use is typically just one dimension in a

matrix of problems that represent a threat to the wellbeing of

parents and children.

Innovations in the Assessment and Treatment of Families with Parental Substance Misuse: Implications for Child Protection.

Child Abuse Review Vol. 27: 261–265 (2018) Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/car.2531

Recovery and reorganisation can and does happen. Family

members can begin to recover, address their needs whether the

drinking or drug use stops or not. (Taking The Lid Off, 2008)

Assessment


It is essential that we only make judgements on the impact of substance use on behaviour, or when that behaviour might harm others (Galvani,2008)


“Through all those times of fear, embarrassment, we acted as if nothing was wrong. I wished that someone would see the pain behind the façade and would care. We knew not to talk about Dad’s drinking. If we ignored it, we could all pretend it wasn’t happening. I’m still haunted by my memories.” Anon

How can we support children and families experiencing issues with alcohol and other drugs?


What children need

Children tell us they are confused when parents deny that an alcohol problem exists, despite evidence to the contrary.

They often take on responsibility for the problem, believing that if it is connected in some way to them, that they caused it, they can find a way to stop their parent from drinking.

When they know that this is not possible – that only the person drinking can make that choice – the burden of ‘failing’ is lifted from their shoulders, giving them the opportunity to live their own lives irrespective of whether their parent continues to drink.NACOA


Many research studies suggest that children of alcohol and other

drug dependent parents are at greater risk of developing

problems later in life.

However, studies also show that the sooner

children are given information and support

about alcoholism, the better able they are

to develop resilience and able to make

healthy choices for themselves.

NACOA leaflet

What children need


What children need:

From Taking The lid Off, 2008

Substance use in families


What children need

Children coping with parental addiction can benefit from celebrating themselves and building their self-esteem.


A heart warming story about identity and courage,

and a tremendous young girl who cares for her

alcoholic mother. Age 8+

Many children live in homes where

things are chaotic and parents or

carers are distracted and

emotionally unavailable to them.

This storybook, designed for children aged 2 to 6, includes

feelings based activities to build a

child's emotional awareness and

vocabulary. A helpful tool for use

by parents, carers, social workers and other professionals to enable

young children to begin to name

and talk about their feelings.

“A world where bad people get taken away and made good”

Child aged 11 – processing parental drug use and domestic violence


What parents/carers with alcohol or other drug problems need

Anyone can change when they make committed, deliberate

effort and get the support they need.

(Taking The Lid Off, 2008)

Many people recover from drug or alcohol problems. However

it is rarely as simple as just deciding one day to stop drinking or

using. Recovery can be a long and winding road and

navigating it can take a lot of patience for all concerned.

Adfam website


Safe storage and reduction of risk to children

West Sussex deaths of children 2018-19

There has been an increase in the number of cases

where the taking of Class A drugs by a parent or carer

has been a factor.

In the UK:

• accidental poisoning from all substances in young

children is common

• severe or fatal events are rare

• Methadone remains the most common

pharmaceutical causing fatal poisoning and a

common cause of ICU admissions in young children


What practitioners need

“a perfect system can only ever minimise risk: it cannot eliminate it. With issues as complex as parental substance use and the nature of addiction… a good outcome for every family cannot be guaranteed”

“finding the balance between protecting children from

harm and keeping families intact is hugely challenging”

1. Support and supervision

2. Joint working and information sharing

3. Understanding of the nature of dependency,

relapse and substance use


Resources


Our Services

Support for children affected by carers alcohol and other

drug use – CYP Therapeutic Service 0300 303 8677, option 1

[email protected]

Support for parents and carers (24.5yrs+) with alcohol and other drug

issues 0300 303 8677, chose option for area person lives

Support for Under 25s with alcohol and other drug issues 0300 303 8677

option1 [email protected]

Child age 5,

looking at what

makes her happy

and sad at home

mailto:[email protected]

children living with carers who use alcohol and other drugs€¦ · • guilt, shame, stigma •...

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