Perinatal Substance Abuse : Characteristics of Parents at Risk, Part 3

by Child Welfare Information Gateway

(Page 6 of 7)

Frequently, the emotional and protective needs of parents who experienced early deprivation also were neglected. Adults who grew up in such homes may have difficulty remembering occasions when warmth and affection were freely and consistently expressed. Parents often report feeling that their needs for protection, comfort, reassurance, and support were met infrequently, if at all. During early childhood, their fears were often disregarded. When they were teenagers, their parents were often inattentive or incapable of maintaining the delicate balance between structure and freedom that adolescents need as they negotiate their way from childhood to responsible adulthood.

Finally, significant numbers of substance-abusing parents report histories of severe neglect, physical abuse, and/or sexual abuse during their childhood and teenage years. As adults, such parents are more likely to become involved in unhealthy and abusive relationships. As one might predict, spousal abuse and domestic violence are, in fact, common occurrences in the lives of adults who seek treatment for alcohol and other drug abuse. Moreover, having grown up in homes in which parenting was unpredictable and discipline often abusive, chemically involved parents frequently are ill equipped to provide effective parenting for their own children. The risk that they will perpetuate the cycle of abuse or neglect with their offspring is considerable.

Survival Needs

Regardless of socioeconomic status, substance-abusing parents commonly have a range of basic unmet survival needs. Substance abuse among low-income parents often quickly leads to impoverishment, but even successfully employed individuals may eventually find themselves homeless or facing homelessness. As a result of their alcohol and/or other drug use, many substance-abusing parents lack stable housing, food, clothing, and basic personal necessities for themselves and their children. They may live on the street, in temporary shelters, in substandard housing, or be on the brink of eviction. Furthermore, as noted above, chemically involved parents may have extensive and chronic medical and/or psychiatric problems that require immediate care and often long-term intervention. Often, such parents have little knowledge of how to locate and mobilize needed resources on their own behalf.

Psychiatric Disorders

A significant percentage of chemically dependent adults suffer from a psychiatric disorder of sufficient severity to require intervention. Post-traumatic stress disorder is not uncommon, particularly in substance abusers with histories of child sexual abuse or alcoholic parents. Alcohol and other drugs may be used to medicate the intrusive symptoms associated with the disorder (panic attacks, obsessive ruminations, flashbacks, nightmares). For some individuals, another underlying condition such as a depression, personality disorder, or psychotic illness preexisted the chemical dependency, and the drug and/or alcohol use was essentially an ill-advised attempt to self-medicate. For other chemically involved adults, the psychiatric disorder may be the consequence of long-term addiction or alcoholism. In any case, a psychiatric disorder may profoundly impact the sufferer's ability to function as well as to benefit from services offered to the family.

As children, many chemically involved parents experienced periods of parental absenteeism or even parental death. Many of these parents recall having been moved frequently from caregiver to caregiver. Such experiences of loss, inconsistency, and perceived abandonment can create feelings of anger, mistrust, low self-esteem, and confusion that complicate relationships well into adulthood.

Denial

It is virtually a given in the field of substance abuse treatment that most clients, particularly those who are involuntary, will deny the extent of their abuse of alcohol and/or other drugs. Thus, the chemically involved parent more often than not minimizes the problem, denies its impact on the family, and is resistant to treatment.

Often, parents will emphatically deny any drug or alcohol use whatsoever. In cases of prenatal substance abuse, parents may explain that positive toxicology reports are lab errors or reflect a one-time lapse that occurred, unfortunately, just prior to delivery. At the time of assessment and sometimes well into the course of treatment, it is commonplace for both clients and families to deny the reality of a parent's devastating, long-term, polydrug abuse.

Frequently, this denial is tenaciously held and will not readily be relinquished, particularly in a setting that is felt to be adversarial. For example, substance-abusing parents who have reasonable fears about losing custody of their children may not admit to any alcohol and/or drug abuse. Given the stressful circumstances that surround allegations of child abuse and the power agencies have to disrupt parents' and children's lives in profound and painful ways, professionals should neither be surprised nor take it personally when they are met with a wall of denial and resistance.

Denial and resistance, however, are not necessarily insurmountable obstacles to treatment. Professionals need to understand the function and importance that these defenses have played in the lives of parents. By building meaningful relationships with parents and taking the time necessary to work through denial and resistance, it is often possible for professionals to form a supportive and mutually respectful treatment alliance with the parent and the family.

In summary, chemical dependency has a profound impact on virtually every area of individual and family functioning. Personal drug and alcohol use can seriously impair judgment and limit the users' abilities to take care of themselves and their children. The history of deprivation, inconsistency, loss, and abuse that many chemically dependent parents experienced during their childhood years bodes poorly for their own ability to parent and, without intervention, predisposes these individuals to repeat similar patterns with their own children.

The Needs of Children and Parenting Tasks

Different types of families (e.g., two-parent families, grandparent/grandchild families, single-parent families, stepfamilies, adoptive families, and foster care families) are capable of assisting children to become competent and self-assured adults, as long as the caregivers assume primary responsibility for both the life support and socialization needs of family members. This goal can be accomplished in a variety of ways, depending on family configuration, resources, and cultural background. However, when one or both caregivers abuse alcohol and/or other drugs, basic parental responsibilities can be profoundly affected.

Children need to live in a home with sufficient and well-managed income so that the family's basic economic needs are met. Chemically involved parents may spend money on alcohol and/or other drugs and fail to provide for their children's basic needs. Thus, these parents may not meet their children's nutritional, housing, and medical requirements. Chemically involved parents may care deeply about their children, but the special relationship they have with their drug(s) of choice can dominate family finances in a way that is detrimental to all family members.

About the Author

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