In This Article Expand or collapse the "in this article" section The Harms and Prevention of Drugs and Alcohol on Children

  • Introduction
  • General Overviews

Childhood Studies The Harms and Prevention of Drugs and Alcohol on Children
Briony Enser, David Foxcroft
  • LAST REVIEWED: 29 May 2019
  • LAST MODIFIED: 29 May 2019
  • DOI: 10.1093/obo/9780199791231-0216


Children risk harming themselves when they consume drugs or alcohol, as these psychoactive substances are associated with numerous adverse effects on their physical and psychological health and well-being. Children may also be profoundly affected by the misuse of drugs or alcohol by the people responsible for their care, most often parents. This too can also seriously affect their health and well-being, and all aspects of family life can be severely affected by substance misuse. The potential harms to children are both short and long term, and may have irrevocable consequences, whether these arise from consumption by the children themselves or from the collateral harms caused by their carers’ consumption. The range of psychoactive substances used recreationally is extensive in type and strength and thus in relative potential harm. It includes opioids, cocaine, LSD, ecstasy, cannabis, alcohol, and tobacco. Alcohol, tobacco, and cannabis are the substances most commonly used by both adults and children. Across the world, psychoactive substances other than alcohol and tobacco are widely illegal, although many so-called legal highs (Novel Psychoactive Substances) can be found in countries where legislation has not kept up with the pace of development of novel substances. Moreover, some legally prescribed drugs, such as benzodiazepines, may be used illegally without a prescription. None are without attendant risks. While alcohol and tobacco are widely legal, most countries regulate their production, purchase, and use, in part with a view to protecting children. A minimum age is usually specified for their legal purchase and, for tobacco, many developed countries now ban smoking in all enclosed public spaces to protect both the adults and children around the users. Broadly speaking, around three quarters of adults, outside “dry” countries, consume alcohol, so most children grow up in an environment where alcohol use by parents is normalized. Around a quarter of adults smoke tobacco, so proportionately fewer children are similarly exposed to parental use. Figures for adult use of illicit drugs vary, but around 1% of children probably grow up with parental drug use. This article addresses the use and known harms to children from legal and illegal substances. The readings included provide a selection of the available literature. For the purposes of these readings, “children” is interpreted to address individuals aged up to 18 years of age, including fetuses in utero, and the known effects of alcohol and drugs on this age group. However, the citations used may define “children” in other ways and may include age ranges that extend beyond 18.

General Overviews

The topic of alcohol, drugs, and children is many faceted and far reaching, and the range of relevant literature is correspondingly extensive. Government publications around health, education, welfare, and crime all contribute, alongside reports produced by agencies with an interest in children’s welfare, and both draw on a wide range of academic research by individuals or collaborative groups working in the field. This section collates a selection of key publications that provide overviews of the issues in this arena. Velleman and Orford 1999 provides a strong historical starting point, illustrating the sound long-standing qualitative research base around substance misuse harms to the family and the consequential stresses in the family unit. Orford, et al. 2005 provides an in-depth cross-cultural overview of relevant issues arising in three different countries, and Orford, et al. 2010 summarizes findings of several studies conducted during the previous twenty years. Adamson and Templeton 2012 highlights the largely hidden nature of the harms experienced by children when parents or carers misuse alcohol and/or drugs. In Australia, Laslett, et al. 2010 explores the complex range and extent of harms that drinkers cause to other people, including the effects of drinkers on children. In the family arena, Velleman and Templeton 2016 provides a review of the previous decade of developments in knowledge and interventions on the effects of parental substance misuse. Turning to overviews of the issues raised by the consumption of drugs and alcohol by children themselves, Donaldson 2009 provides an excellent and comprehensive overview of the issues around the use of alcohol by children and young people. The author underpins UK guidelines on the consumption of alcohol by adolescents with evidence-based analyses of the epidemiological issues, the risks, and the concomitant harms. In the United States, Centers for Disease Control and Prevention 2017 reports on a ten-year longitudinal study of use by high school students of illicit drugs, injected illegal drugs, and the nonmedical use of prescription opioids.

  • Adamson, J., and L. Templeton. 2012. Silent voices supporting children and young people affected by parental alcohol misuse. London: Office of the Children’s Commissioner.

    Extensive and authoritative overview of the impact of parental substance misuse on children and young people. The authors include summary lists of impacts on children in several areas and identify factors that increase the risk of negative experiences and factors that might be protective. The authors conclude that, where there is parental substance misuse, there is a need for services to reach out proactively and intervene to protect children.

  • Centers for Disease Control and Prevention. 2017. National Youth Risk Behavior Survey: Data summary & trends report, 2007–2017. Atlanta: Center for Disease Control and Prevention.

    Comprehensive ten-year trend overview of risky behaviors by high school students across the United States. Includes percentages for use of illicit drugs (14%), injected illegal drugs (1.5%), and, since 2017, nonmedical use of prescription opioids (14%). Drawing on national data surveys, it makes linked observations that 15–24-year-olds account for half of the new STDs reported each year and 13–24-year-olds account for 21% of all new HIV diagnoses in the United States.

  • Donaldson, L. 2009. Guidance on the consumption of alcohol by children and young people: A report by the chief medical officer. London: Department of Health.

    This comprehensive report goes well beyond the guidance in the title. It draws on an extensive review of the literature and includes an epidemiological review of harms to children and an extensive evaluation of the available evidence. The accompanying supplementary report summarizes the acute and long-term effects of consumption by children, effects of age of initiation, and protective factors.

  • Laslett, A. -M., P. Catalano, T. Chikritzhs, et al. 2010. The range and magnitude of alcohol’s harm to others. Deakin West, Australia: Alcohol Education and Rehabilitation Foundation.

    Far-reaching investigation that brings together data on adults and children from health, child protection, law enforcement, and other systems. The authors’ analyses provide insights into the complex and interrelated ways that alcohol generates adverse effects in families and across communities. A disturbing picture of the cumulative cost of such harms across Australian society, including almost twenty thousand children who were the victims of substantiated alcohol-related child abuse in a single year.

  • Orford, J., G. Natera, A. Copello, et al. 2005. Coping with alcohol and drug problems: The experiences of family members in three contrasting cultures. Hove, UK, and New York: Routledge.

    This book comprises an expansive in-depth qualitative resource on harms to the family associated with alcohol and/or drug misuse. The authors examine commonalities and differences in three cultures: the most deprived parts of Mexico City, the towns and villages of Southwest England, and among the indigenous people in Australia’s Northwest Territory.

  • Orford, J., R. Velleman, A. Copello, L. Templeton, and A. Ibanga. 2010. The experiences of affected family members: A summary of two decades of qualitative research. Drugs: Education, Prevention and Policy 17 Suppl. 1: 44–62.

    Concise distillation of twenty years of research. The authors describe the key aspects of their research findings around the stresses of living with a family member who is misusing alcohol and/or drugs, including the overall threat to the home and family life. The authors conclude with their belief that, cultural differences notwithstanding, the core adverse experiences of such families are universal. Available online for purchase or by subscription.

  • Velleman, R., and J. Orford. 1999. Risk and resilience: Adults who were the children of problem drinkers. Amsterdam: Harwood Academic.

    Analysis of empirical retrospective data provided by adults whose parents were substance misusers. Reports on several negative impacts on a child or young person when parents misuse substances. Findings include that parents’ need for their substance of choice may eclipse the needs of their children, children may be pressured to grow up too early to take on adult responsibilities, and are seven times more likely to become substance users themselves.

  • Velleman, R., and L. J. Templeton. 2016. Impact of parents’ substance misuse on children: An update. BJPsych Advances 22.2: 108–117.

    DOI: 10.1192/apt.bp.114.014449

    Article reviewing the previous decade of developing knowledge around risk and protective factors for children living with parents who misuse substances. The authors reflect on how poor outcomes for children might be mitigated and highlight the challenges that this population of children represents for policymakers, commissioners, service providers, and practitioners.

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