What Happens to Children of Alcoholic Parents?

Erin L. George, MFT
Erin L. George, MFT
Medical editor

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According to the National Association for Children of Alcoholics, around 30 million children are born to parents with alcohol use disorder.[1] The term adult child of an alcoholic (ACoA) was derived in an attempt to describe the unique characteristics of individuals who grew up with a parent who struggled with alcohol misuse.[2]


This early alcohol exposure can significantly impact their emotional, cognitive, and social development, often carrying into adulthood. Erin L George, MA-MFT, explains that growing up in a family that engages in hazardous alcohol use can be a lonely experience. "Many kids feel they are the only ones going through this because it's not often talked about at school or with peers. These kids often miss out on normal activities like sleepovers and play dates due to their parent or parents' alcohol use. This puts them in the position of higher risk of bullying and can lead to childhood depression and more."

ACoAs may face a unique set of challenges, including increased risk for substance use, mental health disorders, difficulties in forming healthy relationships, and challenges coping with unresolved trauma or emotional distress.

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Understanding the impact of growing up in a household that misuses alcohol is crucial for recognizing the need for targeted support and treatment. It's essential for ACoAs and those supporting them to be aware of the resources available, including therapy, support groups, and strategies for developing healthier coping mechanisms. This brief overview addresses concerns regarding the impact of parental alcohol addiction on children, highlights the importance of support systems, and outlines effective treatment approaches for overcoming the challenges faced by ACoAs.

  1. Risks in Adulthood
  2. The Home Environment: What it is Like Living with Alcoholic Parents
  3. Psychological Effects
  4. Interpersonal Effects: How Alcoholic Parents Impact Your Relationships
  5. Biological Impact
  6. Treatment Options

Children Who Grow Up in Households With Alcoholic Parents

According to the National Association for Children of Alcoholics, around 30 million children are born to alcoholic parents. 1 The term adult child of an alcoholic (ACoA) was derived in an attempt to describe the unique characteristics generally found among individuals who grew up with parents, where either one or both, struggled with alcohol abuse. 2
Children Who Grow Up in Households With Alcoholic Parents

Risks in Adulthood

Recent evidence has suggested that children of parents who struggle with alcohol addiction are at significant risk for a variety of cognitive, emotional, and behavioral challenges when compared to peers who were not raised by parents with alcohol use disorder. [2,4,5,6] Children with parents who are addicted to substances are the group most at risk for later developing problems with drugs and alcohol, likely due to both genetics and environmental factors. [7, 8] Children of parents who misuse alcohol are also most likely to suffer child abuse and neglect, compounding existing predispositions toward mental illness and substance use. [2,9]

The Home Environment: What it is Like Living with Alcoholic Parents


The family environment where alcohol is misused is typically marked by a significant degree of chaos. These families tend to have inflexibility and arbitrary rules, which predispose children to develop a sense of being overwhelmed or confused.[10] This response is marked by feelings of fear that remain unexpressed or unresolved, which can lead to a shutdown of emotions and detachment from loved ones. [2,5]

At times, children of parents with alcohol use disorder may feel as though they are responsible for their parent's addiction.[3]

For example, the child may feel responsible and needlessly guilty for needing new shoes or clothes because they believe that this in some way contributes to the family's stress over finances. They might assume the role of needing to take care of their parent, a role that can sometimes remain intact in later relationships.

Children of parents who engage in unhealthy alcohol use endure chronic and extreme levels of tension and stress.[10]

Very young children may exhibit symptoms of:

  • Nocturnal enuresis (bed-wetting)
  • Separation anxiety
  • Nightmares
  • Tendency to become unusually upset or cry excessively

Older children exhibit symptoms of:

  • Depression, which can manifest as apathy, excessive guilt, or feelings of hopelessness and helplessness
  • Obsessiveness, which can manifest as being overly rigid, having an intense need for perfection, hoarding, isolating, or experiencing excessive self-consciousness

Psychological Effects

Growing up in a chaotic and unpredictable environment causes the adult child of a parent who misuses alcohol to internalize messages of distrust, insecurity, and belief that they should suppress their emotional responses. [10,12] These maladaptive beliefs can lead to symptoms of mental health problems over time.[13]

Studies have shown that adult children of parents with alcohol use disorder are more likely to exhibit symptoms of generalized anxiety disorder, panic disorder, agoraphobia, dysthymia, and social dysfunction.[13]

Children who grow up in homes with an addicted parent are also more likely to experience episodes of trauma, neglect, or abuse.[9] As such, the rates of Posttraumatic Stress Disorder (PTSD) are also higher in this population compared to peers who grew up in more functional homes.[19] Children of parents who misuse alcohol exhibit higher rates of antisocial personality traits than what would be expected in the general population. This finding is most significant for male children of fathers with alcohol use disorder. [13,15]

On top of experiencing these struggles, adult children of parents who engage in unhealthy alcohol use are at significant risk for developing problems associated with addiction. [7,8] Male children of fathers with alcohol use disorder are more at risk for developing later problems with substance misuse than are female children of fathers who misuse alcohol. This propensity to use substances is affected by both genetic and environmental factors, in addition to the influence of mental health struggles.

Interpersonal Effects: How Alcoholic Parents Impact Your Relationships

It is widely accepted that early experiences can shape how we interact with others later in life.[16] Adult children of parents with alcohol use disorder have significant difficulty recognizing their own needs and often struggle to find appropriate balance in their relationships with others.[3]

For example, they are more likely to exhibit patterns of an insecure attachment style than their peers who were not in homes with addiction.[9] Insecure attachment refers to a maladaptive pattern of relating to others, which stems from fears related to the potential for rejection or abandonment. Individuals with insecure attachment are at greater risk for developing psychopathology throughout adulthood.[12]

Adult children of parents who engage in alcohol misuse may exhibit the following insecure attachment patterns in their relationships with friends, coworkers, romantic partners, family members, and even their children:[3]

  • Avoidance of intimacy or emotional closeness/connection.
  • Difficulty or being unable to share vulnerable thoughts and feelings.
  • Limited or lack of emotional response to others.
  • Limited or lack of empathetic response.
  • Neediness along with emotional distance.
  • Overly critical.
  • Excessively rigid and perfectionistic.
  • Intolerant of uncertainty or changes in the environment.

  • Chronic anxiety and sense of insecurity.
  • Feelings of helplessness.
  • Feelings of excessive guilt.
  • Controlling towards others.
  • Excessively blames others.
  • Erratic, impulsive, and unpredictable.
  • Superficially charming or engaging.
  • Insensitive.
  • Abusive.

These patterns of behavior with interpersonal relationships can prevent the adult child from appropriately developing positive relationships.

They may lack appropriate social skills, be unable to demonstrate appropriate guilt or remorse, and exhibit an impaired ability to consider cause and effect.[16] 

Biological Impact

The chronic stress of growing up in a chaotic and unpredictable environment can lead to significant alterations in:

  • The structure and function of the brain
  • The way the body responds to and manages stress
  • The expression of the individual's genes, including what is eventually passed down to later generations

Treatment Options

Growing up with a parent who struggled with alcohol misuse is stressful and can lead to many negative long-term effects.[2]

Erin L George, MA-MFT, says, "Children of parents with alcohol use disorder may find comfort and support in group therapy or individual therapy where they can work with a therapist one-on-one to learn more about their unique family of origin (FOO) experiences. Alcohol addiction impacts everyone in a family unit, and families with alcohol addiction often isolate to keep the family secret or due to shame. Talking about this experience with a trusted professional or others who have similar stories can be a great first step in reducing the risk of repeating the cycle and healing."

If you or someone you love is struggling with psychological distress, relationship problems, trouble at work or school, or other problems that may be related to being the adult child of a parent with substance use disorder, it is important to seek help from a trained professional.

Participating in outpatient psychotherapy can help you understand the impact that growing up with a parent who engaged in hazardous alcohol use had on development, as well as how these impacts may present themselves on a day-to-day basis now. Outpatient psychotherapy can also help you learn and practice ways of recognizing maladaptive behavior patterns, improve critical thinking skills and impulse control, strengthen stress management capabilities, and enhance your ability to develop secure and intimate attachments with others.

Additionally, you could join a support group, such as:

  • Adult Children of Alcoholics & Dysfunctional Families
  • Al-Anon Family Groups

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Treating Both Addiction and Underlying Mental Health Problems

If you are struggling with both addiction and symptoms of a psychiatric condition, there is help. Depending on the severity of the substance use, both inpatient and outpatient options are available. Outpatient options include:

Inpatient options may include rehab centers that treat dual-diagnoses (mental health + substance use disorder) or other inpatient mental health facilities.


1. Eigen L, Rowden D. Section 1: Research - A methodology and current estimate of the number of children of alcoholics in the United States. In Abbott, Stephanie's: "Children of Alcoholics: Seleceted Readings (Volume II ed.). Rockville, MD: National Association for Children of Alcoholics (NACoA), pp. 1-22.

2. El Guebaly N, Offord DR. The offspring of alcoholics: A critical review. Am J Psychiatry 1997;134(4):357-365.

3. Fisher GL, et al. Characteristics of adult children of alcoholics. J Subst Abuse 1992;4:27-34.

4. Christoffersen MN, Soothill K. The long-term consequences of parental alcohol abuse: A cohort study of children in Denmark. J Subst Abuse Tr 2003;25:107-116.

5. Kroll B. Living with an elephant: Growing up with parental substance misuse. Child Fam Soc Work 2004;9:129-140.

6. Lieberman DZ. Children of alcoholics: An update. Curr Op Pediatrics 2000;12:336-340.

7. Stone AL, Becker LG, Huber AM, Catalano RF. Review of risk and protective factors of substance use and problem use in emerging adulthood. Addict Behav 2012;37(7):747-775.

8. Obot IS, Wagner FA, Anthony JC. Early onset and recent drug use among children of parents with alcohol problems: Data from a national epidemiologic survey. Drug Alcohol Dep 2001;65:1-8.

9. Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH. Growing up with parental alcohol abuse: Exposure to childhood abuse, neglect, and household dysfunction. Child Abuse Neglect 2001;25:1627-1640.

10. Nodar M. Chaotic environments and adult children of alcoholics. Professional Counselor 2012;2(1):43-47.

11. Fulton AI, Yates WR. Adult children of alcoholics. J Nervous Mental Disord 1990;178:505-509.

12. Wyrzykowska E, Glogowska K, Mickiewicz K. Attachment relationships among alcohol dependent persons. Alcohol Drug Addict 2014;27(2):145-161.

13. Mathew RJ, Wilson WH, Blazer DG, George LK. Psychiatric disorders in adult children of alcoholics: Data from the Epidemiologic Catchment Area project. Am J Psychiatry 1993;150(5):793-800.

14. West MO, Prinz RJ. Parental alcoholism and childhood psychopathology. Psychol Bull 1987;102:204-218.

15. Sher KJ. Psychological characteristics of children of alcoholics. Alcoh Health Res World 1997;21(3):247-254.

16. Masten AS, Best KM, Garmezy N. Resilience and development: Contributions from the study of children who overcome adversity. Devel Psychopathol 1990;2:425-444.

17. Windle M. Concepts and issues in COA research. Alcohol Health Res World 1997;21(3):185-191.

18. Thompson RG, Lizardi D, Keyes KM, Hasin DS. Childhood or adolescent parental divorce/separation, parental history of alcohol problems, and offspring lifetime alcohol dependence. Drug Alcohol Dep 2008;98:264-269.

19. Hall, C. W., & Webster, R. E. (2002). Traumatic symptomatology characteristics of adult children of alcoholics. Journal of Drug Education, 32(3), 195-211.

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