8.34 Parental Substance Misuse

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Postnatal Care – NICE Clinical Guideline 37


In September 2015, a link was added to Postnatal Care – NICE Clinical Guideline 37 in the Related Guidance section.




Substance misuse may include experimental, recreational, poly-drug, chaotic and dependent use of alcohol and / or drugs.


Parental misuse of drugs or alcohol becomes relevant to child protection when misuse of substances impacts on the care provided to child(ren).



Misuse of drugs and/or alcohol is strongly associated with Significant Harm to children, especially when combined with other features such as domestic abuse and parental mental illness.


The risk to child(ren) may arise from:

  • Use of the family resources to finance the parents' dependency, characterised by inadequate food, heat and clothing for the children;
  • Exposing children to unsuitable care givers or visitors - e.g. customer or dealers;
  • Effects of alcohol which may lead to disinhibited behaviours e.g. inappropriate display of sexual and/or aggressive behaviour;
  • Chaotic drug use which may lead to increased irritability, emotional unavailability, irrational behaviour and reduced parental vigilance;
  • Withdrawal symptoms including mood disturbances;
  • Unsafe storage of drugs or injecting equipment;
  • Adverse impact of growth and development of an unborn child including foetal alcohol syndrome and FASD. These conditions can have profound effects on a child’s brain structure and executive function, speech, emotional regulation and behaviour. These may have significant implications for parenting and support and progress in the educational system.  

Response - Importance of Working in Partnership


Working in partnership across agencies and services is vital for an effective assessment of risk and to ensure the safety of child(ren).


Professional staff in drug and alcohol services must exchange information with child care social workers, health visitors, school nurses and midwives to be able to assess risks for the unborn baby and child - see Information Sharing and Confidentiality.


Care programme meetings regarding drug or alcohol abusing parents must include consideration of any needs or risk factors for the children concerned. Children's Social Care must be given the opportunity and should contribute to such discussions.


Strategy Discussions and Child Protection Conferences must include workers from any drug and alcohol service involved with the family in question.

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