There have been some major international reviews, as well as some smaller studies in a range of countries, which make it clear how children can be affected by living with parental alcohol misuse. The types of problems that children can face as a result of being in a family environment where alcohol is a problem can be grouped into 6 main categories:

1. Physical and psychological health

Children can suffer from stress and anxiety, and have problems with eating and sleeping. They can feel a wide range of negative emotions, such as feeling helpless, lonely, nervous, anxious, irritable, ashamed, guilty, frightened and embarrassed. Mental health problems such as depression and mood disorder are possible. Often children blame themselves for what is happening at home, and spend a lot of time worrying about their parents and other family members and what they, the children, can do to make things better.

2. Impact on family life 

Family roles, routines, rituals and celebrations are often spoiled. There can be overall disharmony within the family illustrated, for example, by problems with communication, relationships and the routine of everyday family life. Families may not do things together or spend time with other family members or friends. Special occasions may be spoiled and promises broken. There may also be a lack of money. As a result, children can be affected as a result of neglectful, inconsistent or ambivalent parenting from one or both parents. There is strong evidence that the extent of the impact of parental problem drinking on everyday family life has a greater impact upon children than the drinking itself.

3. Impact on relationships

The situation at home may negatively influence the child's relationship with one or both parents, and also with siblings, other family members and friends. Often the mother or father are not able to adequately or consistently meet their children’s needs, and the child can suffer as a result. Trying to keep the problems a secret may mean that there is less contact with other family members or with friends. Disrupted family life, and children who often find themselves caring for their siblings or a drunk parent, means that children’s relationships with other children can be affected.

4. Impact on education

Due to stress, anxiety, worry and tiredness the child may not be able to perform as well at school as they otherwise might do. Sometimes the child may be caring for a parent or a sibling and this can mean less time for schoolwork, erratic school attendance, and minimal or no involvement in out of school activities. Parents may also not be able to get so involved with the school or with their child's work, perhaps by not attending parents evenings or other events.

5. Behaviour

Children can be at risk of a range of behavioural, emotional and cognitive difficulties, such as offending behaviour, substance misuse, bullying (being a bully or being a victim of bullying), truancy and mental health problems.

6. Being a child

Overall, the child may miss out on vital childhood years and experiences – through having to take on responsibilities beyond their years, perhaps from caring for a sibling or drunk parent. Linked to this, the child may not be able to, or may not want to, form close childhood friendships due to feeling different to other families.

A major review in New Zealand summarised the impact on children’s well-being in terms of health, behavioural issues, educational performance, and early onset/alcohol use by children. The review also identified the primary mechanisms which are involved in influencing how badly children might be affected. These mechanisms include parental conflict, violence against children, parental absence, living standards and parental control / supervision.

A Danish study (Christensen, 1995) interviewed 32 children and their parents where there were alcohol problems. The interviews highlighted that the children, often at very young ages and often before the problem has been articulated as such by the parents or anyone else, were aware of the problem drinking and were able to describe incidents and how they felt. It is significant that children as young as 4-5 years can remember and speak about memories related to parental problem drinking. The study also highlighted that, “Family type is….seen to be crucial to the visibility of the problems of alcohol, and crucial to the visibility of the children as children with problems” (page 19).

As part of Spain’s Program Alfil (focused on research with, and the development of intervention programmes for, ‘children of alcoholics’), over 500 children (371 who were children of alcoholics from families in treatment and the rest a control group), aged 6-17 years old, were evaluated with a semi-structured interview covering socio-demographic, familial characteristics, medical, psychopathology, drug use and school data.

Questionnaires about alcohol (knowledge, attitudes and expectancies), life events and family environment were also administered. Comparative analyses showed that the children had significantly higher rates of psychopathology symptoms (especially attention deficit, hyperactivity, depression and anxiety) and lower cognitive and school performance than the control children, even after extracting the effects of possible confounding variables like age, gender, socioeconomic status and family cohesion.

How do children copen?

There is no standard way in which children will respond to parental alcohol misuse; each child will react as an individual, shaped in part by their personality and other factors influencing the environment in which they are living.

Coping will vary by gender and age [add text here]. Siblings will not necessarily cope, respond or be affected in the same ways.Children’s responses can vary over time and can include opposite behaviours at different times as they struggle to find a way to cope with what is going on that makes them feel better and safer.

Many children’s coping strategies will also be shaped by their desire to protect others in their family (and also to hide what is going on from others); for example, to look after a drunk parent, protect or support the other parent or a sibling, pets or even valuable possessions in the home.

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To understand more about identifying children who are living with parental alcohol misuse and who may need help, you can follow the link given below to find out more about common signs to look out for, and ideas of how to talk to children to find out if they are living with parental alcohol misuse.

›› Read more under 'What can i do?'

›› See also 'Useful reading' for further resources