8.35 Parental Substance Misuse

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).

Maternal substance misuse in pregnancy can have serious effects on the health and development of the child before and after birth. Many factors affect pregnancy outcomes, including poverty, poor housing, poor maternal health and nutrition, domestic abuse and mental health. Assessing the impact of parental substance misuse must take account of such factors. Pregnant women (and their partners) must be encouraged to seek early antenatal care and treatment to minimise the risks to themselves and their unborn child.

Newborn babies may experience withdrawal symptoms (e.g. high pitched crying and difficulties feeding), which may interfere with the parent / child bonding process.  Babies may also experience a lack of basic health care, poor stimulation and be at risk of accidental injury.

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:

• Substance misuse affecting their parent/s' practical caring skills: perceptions, attention to basic physical needs and supervision which may place the child in danger (e.g. getting out of the home unsupervised);
• Substance misuse may also affect control of emotion, judgement and quality of attachment to, or separation from, the child;
• Parents experiencing mental states or behaviour that put children at risk of injury, psychological distress (e.g. absence of consistent emotional and physical availability), inappropriate sexual and / or aggressive behaviour, or neglect (e.g. no stability and routine, lack of medical treatment or irregular school attendance);
• Children are particularly vulnerable when parents are withdrawing from drugs;
• The risk is also greater where there is evidence of mental ill health, domestic abuse and when both parents are misusing substances;
• There being reduced money available to the household to meet basic needs (e.g. inadequate food, heat and clothing, problems with paying rent [that may lead to household instability and mobility of the family from one temporary home to another]);
• Exposing children to unsuitable friends, customers or dealers;
• Normalising substance use and offending behaviour, including children being introduced to using substances themselves;
• Unsafe storage of injecting equipment, drugs and alcohol (e.g. methadone stored in a fridge or in an infant feeding bottle). Where a child has been exposed to contaminated needles and syringes;
• Children having caring responsibilities inappropriate to their years placed upon them (see Young Carers Policy 
• Parents becoming involved in criminal activities, and children at possible risk of separation (e.g. parents receiving custodial sentences);
• Children experiencing loss and bereavement associated with parental ill health and death, parents attending inpatient hospital treatment and rehab programmes;
• Children being socially isolated (e.g. impact on friendships), and at risk of increased social exclusion (e.g. living in a drug using community);
• Children may be in danger if they are a passenger in a car whilst a drug / alcohol misusing carer is driving.

Children whose parent/s are misusing substances may suffer impaired growth and development or problems in terms of behaviour and / or mental / physical health, including alcohol / substance misuse and self-harming behaviour.

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.