Meeting the Needs of Children in Families Affected by Parental Substance Misuse

Neil McKeganeyCentre for Drug Misuse Research

University of Glasgow

Parental Drug Dependence

• Hugely controversial

• Subject to widespread denial

• Children invisible

• Services preference for orienting to the needs of adult drug users

The Policy on Children Affected by Parental Drug Use

Serious and chaotic drug abuse is incompatible with effective parenting” (Hidden Harm: Next Steps 2006).

Estimates of Prevalence

• Estimate of between 200,000-300,000 children of problem drug using parents in England and Wales (2-3% of all children under 16)

• Estimate of between 41,000 59,000 children in Scotland of problem drug using parents (4-6% of all children under 16)

Family Breakdown and Parental Drug Use

• In the Hidden Harm report of 77,928 drug-using parents, 54% had their children living elsewhere.

• In the Drug Outcome Research in Scotland study 57% of male drug users interviewed were parents, only 16% were living with their dependent children.

What has research shown about the impact of drug use on

parents?• Parenting capacity is inversely related to

increasing drug use.• Parental attachment to child likely to be

impeded.• Drug dependent parents more likely to parent

through negative commands.• Parents lives characterised by chronic

adversity, troubled family history, co-morbidity.

What has research shown about the impact on children?

• Less obedient, more withdrawn, more aggressive, less confident in coping with difficulties.

• Depressive symptoms more common.• Increased social isolation.• Increased truanting.• Increased drug use and other problem

behaviours.• Poorer educational performance.• Deviant peer networks.

The Views of Parents and Children

Violence

• “My eldest son had bruises on the side of his face and I think it was my partner that hit him, but I was too out of my face to notice. I just hold on to things like that, what could have happened and in fact what has happened”. (Parent recovered heroin addict)

Exposure to Drugs Use and Dealing

• “I was running about with folk that were injecting and I was injecting myself. I was taking temazepam, valium, acid, really just anything at all. Not eating or sleeping, my house was a mess, folk coming into my house at all hours having parties, it was really disgusting the lifestyle I was leading was disgusting and it was scary as well cause I had my wee boy with me and he was seeing everything that was going on around him.” (Parent recovered heroin addict)

Neglect

• “Its like the only thing that was at the front of my mind was drugs, where am I going to get this where am I going to get that. Whereas in actual fact I should have been thinking what am I going to give the bairn for his breakfast, his lunch, his tea, what’s he doing, who’s he out playing with”? (Parent recovered heroin addict)

The Reversal of Family Roles

• It was as if she was the child and I was the mum…It was a nightmare an absolute nightmare. I don’t think that I had a childhood at all. (Parent recovered heroin addict)

The Lack of Interest

• I knew they (parents) loved me but they just didn’t care that I was there and I needed stuff as well. I needed things and they were just away taking drugs and stuff. (Child of heroin dependent parents)

The Focus of Dependent Parents

• You only care about yourself, you think you care about everybody else but number one comes first and that’s yourself and if you’re lucky, if you’ve got anything left, they get it, but you would take it off them to give to you and anybody that says otherwise is kidding themselves. At the time I wouldn’t admit that, but now I would…(Parent recovered heroin addict)

Danger to Children

• One time I went and fell asleep and I went and left a chip pan on and the place …the whole house was full of smoke and the kitchen was on fire and she was the one that woke me up. …The Fire Brigade and the Ambulance said “you were very lucky to get out of that” but she didn’t move from the bed until she woke me up and I kept wakening up and going “it’s alright, just go back to sleep” and she was screaming the place down, but I got her out…(Parent recovered heroin addict)

Drug Exposure

• I mean the two of us [parents] were leaving the needles lying about and people were coming in and saying “is it alright if I have a hit?” And “aye, no bother, batter in, on you go” and that’s just not right…Sometimes even the house would be full…(Parent recovered heroin addict)

Sense of Being Alone

• When my mum is using drugs it just makes me feel as if I am here myself-not got anyone else here. (Child of drug using parents: Age 15 years)

Is Provision Improving for Vulnerable Children?

• Clearer policy with regard to Hidden Harm in relation to impact of parental drug abuse.

• Increased investment of resources in meeting the needs of vulnerable children.

• Greater visibility of this issue.

Key Questions

• Whilst we can provide intensive support for families in which all or most of the key parental responsibilities are being provided by professionals is this sustainable in the long term and is it in the child’s best interests?

Key Questions

• What level of adversity are we prepared to accept for children growing up in families affected by parental drug use?

Key Questions

• Is it possible for a services seeking to develop harmonious relationships with their adult clients to be sufficiently vigilant to identify the various ways in which the lives of children may be being compromised as a result of their parents drug use?

Key Questions

• Stabilising addicts continuing drug use may not be good enough for children. If this is the case why do we provide so few services with a drug free focus?

Key Questions

• What level of compulsion should we bring to bear upon drug dependent parents with regard to meeting the needs of these children?

• Whilst we can talk in terms of protecting children borne to drug dependent parents how well equipped are we to meet the long term needs of those children over and above our capacity to protect them from risk?

Key Questions

• How do we meet the needs of those children whose parents have a drug problem but who are not in contact with services?

• Whose time frame should apply that of the recovering addict who may take many years to change his or her behaviour or that of the child who can suffer long term harm within a matter of months?

Ornoy et al 1996/2004

• The children born to heroin dependent mothers were divided into two groups, children raised at home and those raised by adopting families. We found that the adopted children were not different from the control children while the children raised at home had significantly lower mental and motor scores.

Key Question

• When do we say enough is enough for the child and seek to place that child with another family who can meet his or her needs?