Children affected by parental substance use

http://www.eurekalert.org/pub_releases/2016-07/bidm-cab071516.php

Public Release: 18-Jul-2016
Children affected by parental substance use
Pediatricians positioned to break multigenerational cycle of addiction
Beth Israel Deaconess Medical Center

BOSTON - Children whose parents or caregivers misuse alcohol or use, produce or distribute drugs face an increased risk of medical and behavioral problems. According to a new clinical report by experts at Beth Israel Medical Center (BIDMC) and Boston Children's Hospital, pediatricians are in a unique position to assess risk and intervene to protect children. The report, "Families Affected by Parental Substance Use," is available online today and slated for publication in the August print edition of Pediatrics, the journal of the American Association of Pediatrics.

"Alcohol misuse and substance use are exceedingly common in this country, and parents' or caregivers' substance use may affect their ability to consistently prioritize their children's basic physical and emotional needs and provide a safe, nurturing environment," says co-author Vincent C. Smith, MD, MPH, a neonatologist at BIDMC and Assistant Professor of Pediatrics at Harvard Medical School (HMS). "Because these children are at risk of suffering physical or emotional harm, pediatricians need to know how to assess a child's risk and to support the family to get the help they need."

An estimated one in five U.S. children grows up in a home in which someone misuses alcohol or has a substance use disorder, the authors write. Whether from the toxic effects of exposure to these substances or from the neglect of their basic needs by parents or caretakers struggling with substance use disorders, children in these households commonly experience developmental and educational delays and, later, are at higher risk for mental health and behavioral problems. They also are more likely than their peers to have substance use disorders themselves later in life.

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Citing studies that say children whose parents use drugs and misuse alcohol are three times more likely to be physically, sexually or emotionally abused and four times more likely to be neglected than their peers, the authors urge all pediatricians to include questions about caregivers' substance use as part of the routine family assessment. Some warning signs of abuse and neglect include: frequent injuries and bruises, especially in clusters or in patterns that could indicate contact with a hand, belt or other instrument; children who are withdrawn, fearful or flinch at sudden movements; a lack dental care or immunization; or ill-fitting, filthy or inappropriate clothing.

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