As a result of substance abuse, children may be left alone or unsupervised for long periods of time. Often young children make a valiant effort to parent even younger children. Some children care for their incapacitated parents. Family resources needed for food and other necessities may be bartered for drugs. In extreme cases, children are offered for drugs.
Alcohol abuse appears to be the drug most often associated with physical abuse.
Greater degrees of alcohol abuse appear to correlate with increased physical violence. Cocaine abuse by parent puts children at increased risk for sexual abuse due to a lack of boundaries, and to exposure to non-family contacts in houses where drug dealing takes place. Iowa legislation passed in 1993 states that if a child tests positive for the presence of illegal substances in the body, this constitutes a founded child abuse report. 3,467 of these children were in foster care due to abuse or of parenting issues that included alcohol or substance abuse. Each will change foster homes an average of four times during their childhood.