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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.
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.
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 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:
Older children exhibit symptoms of:
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.
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]
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]
The chronic stress of growing up in a chaotic and unpredictable environment can lead to significant alterations in:
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:
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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.
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