Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697750954935.pdf (Ireland)
Submission to Committee on Future of Healthcare (Senator Frances Black) The wide range of harms that are caused to children, as a result of parental alcohol misuse, is known as ‘Hidden Harm’, as the harm is often not publicly visible.

This means that these children are often not known to the appropriate services and that they suffer harm in a number of important ways that can impede their physical, emotional and social development.
These children can suffer in silence, they often do not know where to turn for help, and the impact of the parent’s harmful drinking has a deep and long-lasting impact on their lives, which may not fully emerge until young adulthood and beyond.

For a child, harmful parental drinking can shape their every moment from the time they wake up to the time they go to bed.

Will Mam drink or Dad drink today?

What mood will they be in?

Will I go to bed hungry?


A child can take on the role of parent in the family, making sure brothers and sisters are fed, getting them dressed and out to school.

In the most severe cases, a family situation can deteriorate to the extent where children are emotionally abandoned, physically or sexually abused or neglected – dirty nappies going unchanged, children going without regular meals.
According to Dr Stephanie Brown from Stamford University the developmental impact of parental alcohol misuse on children’s attachment and identity formation and the impact of alcohol misuse-related trauma on all aspects of development.

The earliest research emphasizes the link between parental harmful drinking and mental health issues.
Many researchers found that children with parents who misuse alcohol were more likely to experience symptoms of anxiety and/or depression, antisocial traits, relationship difficulties, behavioral problems, and/or alcohol abuse themselves.

Children living with this trauma may develop a sense of self that is equated with defense (Brown, 1993; Brown & Schmid, 1999).
These defenses are designed to keep the enemy out, to minimize anxiety, fear and the threat of humiliation.The “defensive self” or “false self”creates a deep sense of inauthenticity and a barrier to connectedness with others that exacerbates isolation and loneliness.The defensive mantle tends to be brittle, inflexible, and selfreinforcing, with the potential to break down under stress.
Over time this “cumulative” trauma can engender trauma related symptoms such as depression, anxiety, hypervigilance, low self worth and somatic disturbances (head and body aches, chronic tension and so forth).

These symptoms, if they go untreated can become full blown PTSD.

They can lead to all sorts of life, learning, health, psychological and relationship complications and a desire to self medicate.

This is how the insidious baton of addiction gets handed down through the generations.
Impact Problematic use of alcohol and other drugs is a complex issue and continues to be one of the most significant health and social challenges facing Irish society today.

Approximately a third of the people of Ireland are engaged in harmful drinking .

This affects families and communities and can have serious implications for the welfare and safeguarding of children from conception right throughout their lifespan.
Children living with the everyday experience of problematic use of alcohol may experience incipient or traumatic neglect, physical and emotional abuse, a lack of appropriate nurturing and adverse outcomes which may affect their adult lives.

Mental health issues are observed in some children and life may hold little which is fulfilling and productive.

Adverse outcomes will be compounded when domestic and gender -based violence and mental health issues are experienced in families.
A wealth of international evidence attests to the fact that many parents presenting for treatment in addiction services have experienced post-traumatic stress as a result of various forms of trauma.

The cognitive and emotional impact of trauma on parents and children requires recognition if families are to be appropriately supported and services are to be resourced to respond.

Next Steps 1) Effective prevention and early intervention for children living in homes with Alcohol/substance misuse.
The children who live with parents who have drug and alcohol problems are amongst the most vulnerable in society.

It is imperative that we ensure the best possible start in life for every child through effective prevention and early intervention.
2) A Holistic, Recovery-Based Education and Therapeutic Programme for Adult Children of Alcoholics (ACOA’s) The development and maintenance of a Therapeutic Alliance, or quality treatment relationship based on mutual respect, is an essential component of effective treatment for individuals who are adult children of alcoholics.
Empathy, respect and belief in the individual’s capacity for recovery are fundamental service provider attitudes and values 3) Peer support and Continuing Care must be explicitly recognised and supported in treatment planning.

Funding should be made available for people who have been impacted by parental alcohol and substance misuse.

This will prevent the legacy of mental health and addiction issues been passed down through the generations.
Finally there should be a consensus that integration between mental health and addiction services is sorely needed and long overdue.

There is now an equally pressing need for transformation to recovery-oriented care in both systems.