What Happens to Children of Alcoholic Parents?

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  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 alcoholics are at a significant risk for a variety of cognitive, emotional, and behavioral problems when compared to peers who were not raised by alcoholic parents. 2, 4-6 Children from 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 addicted parents are also most likely to suffer child abuse and neglect, compounding existing predispositions towards mental illness and substance abuse. 2, 9


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

mentalhelp_shutterstock-90689560-alcoholic-parents-arguing-with-child-in-same-room-sadnessThe family environment of alcoholics is typically marked by a significant degree of chaos. Alcoholic families tend to be driven by a system of rigidity, such as lack of flexibility and arbitrary rules, that predispose children to develop a sense of overwhelm or confusion. 10 This response is marked by feelings of fear that remain unexpressed or unresolved, which can lead to emotional shutting down and detachment from loved ones. 2, 5

At times, children of alcoholics may begin to feel as though they are responsible for the problems associated with their alcoholic parent.At times, children of alcoholics may begin to feel as though they are responsible for the problems associated with their alcoholic parent. 3 They may even believe that they created the problem. For example, the child of an alcoholic 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 "sick" parent - a role that can sometimes remain intact in later relationships.

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Children of alcoholics endure chronic and extreme levels of tension and stress as the result of growing up in the home with a parent struggling with alcohol abuse. 10

Very young children may exhibit symptoms of:

  • Nocturnal enuresis (i.e., bed wetting).
  • Separation anxiety.
  • Frequent nightmares.
  • Crying or problems with becoming unusually upset.

Older children of alcoholics exhibit symptoms of:

  • Depression (e.g., apathy, excessive guilt, feelings of hopelessness and helplessness).
  • Obsessiveness (e.g., overly rigid, intense need for perfection, hoarding, isolation and withdrawal, excessive self-consciousness). 9

Psychological Effects

Growing up in a chaotic and unpredictable environment causes the adult child of an alcoholic 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 alcoholics are more likely to exhibit symptoms of generalized anxiety disorder, panic disorder, agoraphobia, dysthymia, social dysfunction.Studies have shown that adult children of alcoholics are more likely to exhibit symptoms of generalized anxiety disorder, panic disorder, agoraphobia, dysthymia, social dysfunction. 13 Children who grow up in homes with an alcoholic parent are 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 did not grow up in an alcoholic home. 19 Children of alcoholics 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 alcoholic fathers. 13, 15

Adult children of alcoholics are also more likely to abuse substances and are at significant risk for developing problems associated with addiction to a substance. 7, 8 Male children of alcoholic fathers are most at risk for developing later problems with substance abuse than are female children of alcoholic fathers. The propensity to abuse substances is affected by 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 have the ability to shape the ways in which we interact with others later in life. 16 Adult children of alcoholics have significant difficulty recognizing their own needs and often are not able to have appropriate balance in their relationships with others. 3 They are more likely to exhibit patterns of an insecure attachment style than their peers who were not raised in alcoholic homes. 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 have been found to be at greater risk for developing psychopathology throughout adulthood. 12 Thus, adult children of alcoholics may exhibit the following insecure attachment patterns in their relationships with friends, coworkers, romantic partners, family members, and even their own 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 of an alcoholic from appropriately developing positive relationships. Are you constantly doubting yourself due to overthinking? Take our overthinking quiz to identify potential areas for growth. They may lack skills in appropriate social contact, be unable to demonstrate appropriate guilt or remorse, and exhibit impaired ability to consider cause and effect. 16 

Biological Impact

The chronic stress of growing up in a chaotic and unpredictable environment, such as the one adult children of alcoholics experience can lead to significant alterations in:

  • The structure and function of the brain.
  • The way the body responses 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 abuse is stressful and can lead to many negative long-term effects. 2 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 an alcoholic, then it is important to seek help from a trained professional.

Participating in outpatient psychotherapy can help the individual understand the impact that growing up with an alcoholic parent had on their development, as well as how these impacts may present themselves on a day-to-day basis in their current lives. Further, outpatient psychotherapy can also help the individual learn and practice ways of recognizing maladaptive behavior patterns, improve critical thinking skills and impulse control, strengthen stress management capabilities, and enhance their ability to develop secure and intimate attachments with others.

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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 available. Depending on the severity of the substance abuse, both inpatient and outpatient options are available. Outpatient options include:

Inpatient options may include rehab centers that treat dual-diagnoses (mental health + substance abuse 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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