Addiction is a family problem

Treatment for opiate use disorder makes life better for everyone in the household.

Substance abuse is a family problem

"When I was using heroin, it seemed like my baby was far away; even though she was in the same room. I just didn't think about her." This is a quote from a mother who began treatment for heroin addiction shortly after relapsing when her baby was only a few months old. Thankfully, there were other family members in the household to take care of the baby. Some children, however, are not so fortunate.

There are far too many households where mom and/or dad are parenting and battling addiction at the same time. Ready access to treatment for mom and dad is associated with better outcomes for the entire family. Substance abuse isn't just an individual's struggle; it's a family crisis that ripples through generations, hitting children the hardest. As a Psychiatric Mental Health Nurse Practitioner who's lived this reality firsthand, growing up in an alcoholic home where chaos and secrets were the norm, I know the scars it leaves. I was that scared little girl, jumping between my parents during fights, begging my dad to stop, and carrying the weight of "fixing" everything at just 6 or 7 years old. It taught me fear, worry, and a perfectionism that followed me for years. And sadly, my own sons faced their battles with alcohol, heroin, cocaine and fentanyl, forcing me to confront how my unresolved trauma might have played a role. If you're a parent in the throes of addiction, or a clinician treating them, understand this: the kids are paying a price we can't ignore.

Research shows that nearly 19 million U.S. children—about 1 in 4—live with at least one parent or caregiver who has a substance use disorder (SUD). Of those, around 7.6 million are exposed to moderate or severe cases, where the addiction severely disrupts daily life. These kids aren't just bystanders; they're directly harmed in ways that can alter their futures. Emotionally, parental addiction often leads to neglect—parents physically present but mentally absent, like the mom in the quote who couldn't "see" her baby through the haze of heroin. Children feel invisible, unloved, and abandoned, breeding anxiety, depression, and low self-esteem that can last a lifetime. In my childhood, the constant fear of what might happen next—fights, suicide threats, drunk driving—left me hypervigilant and afraid of everything. Studies confirm this: kids in these homes are more likely to develop mental health issues, with higher rates of PTSD from witnessing violence or instability.

Physically and developmentally, the impacts are just as devastating.

Without consistent caregiving, children might face malnutrition, poor hygiene, or unsafe environments—think unsupervised toddlers or school-aged kids fending for themselves. Cognitive delays creep in too; these kids often struggle academically, with lower test scores and higher dropout rates, because home isn't a stable place for learning or routine. Socially, they withdraw or act out, facing bullying or isolation because of family stigma. And economically? Families battling addiction often cycle through poverty, job loss, or housing instability, leaving kids without basic needs met.

The cycle doesn't stop there—it's intergenerational. Children of addicted parents have over 50% increased odds of developing substance use disorders themselves as adults, perpetuating the pain. Trauma from neglect or abuse rewires their brains, making them more vulnerable to addiction as a coping mechanism. I saw this in my own family: my upbringing normalized chaos, and despite my best efforts, my sons grappled with similar demons. But here's the hope—breaking the cycle starts with treatment. When parents get help, like through medication-assisted treatment (MAT) with Suboxone integrated into primary care, outcomes improve for everyone. Kids in treated families show better emotional health, school performance, and family bonds. In rural areas like Maryland's Eastern Shore, where resources are limited, accessible care—like what I provide at Nurse RX, an NHSC-approved SUD site—can be lifesaving.

If you're a parent fighting addiction, reach out; you're not alone, and recovery heals the whole family. As clinicians, let's prioritize family-centered approaches, offering therapy for kids alongside parental treatment. Remember, substance abuse is a family problem, but so is the solution—love, support, and timely intervention can rewrite the story for these vulnerable children.