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Children of Alcoholics

How many children of alcoholics are there?

More than 6 million children live with at least one parent who abuses or is dependent on alcohol or an illicit drug.1

How does alcoholism affect the family?

Alcoholism affects the entire family. The level of dysfunction or resiliency of the non-alcoholic spouse is a key factor in the effects of problems impacting children. Children raised in alcoholic families have different life experiences than children raised in non-alcoholic families. Children raised in other types of dysfunctional families may have similar developmental losses and stressors as do children raised in alcoholic families.

Families with alcoholism have higher levels of conflict than other families. Lack of adequate parenting and poor home management and family communication skills often leave children without effective training and role modeling.3,6,7

Families with alcoholism often lack structure and discipline for their children; as a result, the children often are expected to take on responsibilities normally assigned to older youth or adults.3,6

Why should we be concerned about children of alcoholics?

Alcoholism tends to run in families. Children of alcoholics (COAs) are four times more likely than non-COAs to develop alcoholism or drug problems.2

COAs are at higher risk than others for depression, anxiety disorders, problems with cognitive and verbal skills, and parental abuse or neglect. They are significantly more likely than other children to be abused or neglected by their parents or guardians and are more likely to enter foster care.2,3,4,5

If not prevented, the difficulties faced by COAs can place increased burdens on state and local Governments. These include increased costs for health care, mental health services, child welfare, education, police and juvenile justice, and lost economic opportunity.

How can we help prevent children of alcoholics from repeating their families' alcohol-related problems?

Although they are at increased risk, many COAs do not develop alcohol or drug use disorders or other serious problems in their lives. Often, they appear to be resilient, bolstered by protective factors and the support of caring adults in their lives.3,4,5,6,8,9,11

COAs can be helped, whether or not the alcohol-abusing family members are receiving help. Prevention programs often help COAs reduce stress; deal with emotional issues; and develop self-esteem, coping skills, and social support.8 Children who cope effectively with alcoholism in their families often rely on support from a nonalcoholic parent, grandparent, teacher, or other caring adult. Support groups, faith communities, and trained professionals also are available to help.8,9

What can others do to help children of alcoholics avoid alcohol abuse and other serious problems?

Simple acts of kindness and compassion can make a difference for COAs. By making yourself available to listen, discuss feelings, share interests, and support their efforts to make friends, you can help COAs cope with their present situations and develop the resilience and skills necessary for their futures.11

Tell them they are not alone, that responsible adults are available to help them, and that millions of others have had similar experiences and have grown up to lead healthy, satisfying lives.12 Remind them that their families' problems are not their fault and not their responsibility to solve. Their jobs are to be children and help take good care of themselves; learn the facts about alcohol, tobacco, and drugs; recognize their risks; and learn how to avoid repeating their families' alcohol abuse patterns.10

Encourage them to ask for help. Assure them that getting help is a sign of strength. Offer your own examples and be prepared to help them connect with caring, trustworthy adults and with student assistance programs and other services designed to provide them with further skillbuilding and support.10


1. Office of Applied Studies. (2002). Results From the 2001 National Survey on Drug Abuse. (DHHS Publication No. SMA 02-3758). Rockville, MD: Substance Abuse and Mental Health Services Administration.

2. Grant, B.F. (2000). Estimates of U.S. children exposed to alcohol abuse and dependence in the family. American Journal of Public Health 90(1): 112-115.

3. National Institute on Alcohol Abuse & Alcoholism. (2000). Alcohol and Health: 10th Special Report to the U.S. Congress. Washington, DC.

4. National Center on Addiction and Substance Abuse at Columbia University. (2004). Criminal Neglect: Substance Abuse, Juvenile Justice and the Children Left Behind. New York.

5. U.S. General Accounting Office. (1998). Foster Care: Agencies Face Challenges Securing Stable Homes for Children of Substance Abusers. Washington, DC.

6. National Institute on Alcohol Abuse & Alcoholism. Alcohol and Health: 9th Special Report to the U.S. Congress. Washington, DC.

7. Johnson, J.L. & Leff, M. (1999). Children of substance abusers: overview of research findings. Pediatrics 103(5) Supplement: 1085-1099.

8. Emshoff, J.G. & Price, A.W. (1999). Prevention and intervention strategies with children of alcoholics. Pediatrics 103(5) Supplement: 1112-1121.

9. Werner, E.E. & Johnson, J.L. (2004). The role of caring adults in the lives of children of alcoholics. Substance Use and Misuse 39(5): 699-720.

10. Nastasi, B.K. & De Zolt, D.M. (1994). School Interventions for Children of Alcoholics. New York: Guild Press.

11. Werner, E.E. & Johnson, J.L. (2000). The role of caring adults in the lives of children of alcoholics. Children of Alcoholics: Selected Readings, Vol. 2.

12. Dies, R.R. & Burghardt, K. (1991). Group interventions for children of alcoholics: prevention and treatment in the schools. Journal of Adolescent Group Therapy 1(3): 219-234.

SAMHSA: Children of Alcoholics: A Guide to Community Action (2004)

Page last modified or reviewed by on February 1, 2014