6.8 Children of Drug and/or Alcohol Misusing Parents

AMENDMENT

This chapter was reviewed and amended in June 2023 to add detail in relation to local guidance.

1.	Drug or alcohol misuse of a parent or carer does not necessarily have an adverse impact on a child, but it is essential to assess its implications for any children involved in the family. These children are recognised as being vulnerable and it is this vulnerability that needs to be assessed.
2.	Drug or alcohol misuse of a parent can have an impact on children in a number of ways, including: Substance misuse in pregnancy may impair the development of an unborn child; A parent's practical caring skills may be diminished by substance misuse; Children taking on the role of carer to their parent/s and/or any siblings; Substance misuse, or withdrawal from substance misuse, may give rise to mental states or behaviour that put children at risk of injury, psychological/emotional distress or neglect. Children of parents experiencing withdrawal are known to be at increased risk of Significant Harm. (LGDF 1997); Substance misusing parents may find it difficult to prioritise the needs of the children over their own; Money available to the household to meet basic needs may be reduced; Members of the family, including children, may be drawn into criminal activity; Children may be at risk of physical harm, or death, if drugs and drugs paraphernalia are not stored safely and children have access to them; Children may be endangered if they are carried as passengers in vehicles driven by a parent or carer under the influence of drugs and/or alcohol; Children may also be stigmatised as a result of their parents substance misuse; Parental substance misuse, domestic abuse (see Domestic Abuse and Reduction Strategy, and / or mental health problems (see Mental Ill Health of a Parent or Carer Procedure) are known to be a factor in child protection concerns (Working Together to Safeguard Children 2010: 3.10 - archived). Substance misuse combined with one or more of the above factors should give rise for professionals to be more alert to the safety and welfare of the child or young person.
3.	Substance misuse by parents does not automatically indicate child abuse or neglect; therefore the children of parents who misuse substances should not automatically be the subject of a Child Protection Conference. Such an approach may deter the parents, or other members of the family from approaching Children's Social Care, substance misuse services or other agencies, for help and advice. If neglect is a concern in such circumstances a graded care profile 2 should be completed (see Knowsley Safeguarding Children Partnership Multi-Agency Neglect Strategy (2023 - 2026)).
4.	The risk of physical injury to a child sleeping next to an adult, occurring as a result of the adult lying over or against the child (over lay), is recognised. The risk is increased if the adult is sedated due to the effects of alcohol and/or prescribed or illicit drugs. It is therefore essential that professionals working with the parents or carers of babies or young children educate parents and carers about safe sleeping arrangements, particularly those known to misuse substances where such risk to children will be higher. Practitioners should seek advice and guidance from appropriate agencies such as the Change Grow Live Integrated Recovery Service (Tel: 0151 546 9557).
5.	It is therefore important that any professional involved with a parent or pregnant woman who also misuses substances is able to identify those factors which may have an adverse impact on the ability of the parents to safely care for and meet the needs of the children, and refer such concerns appropriately to Substance Misuse Services, Health Visitors, Specialist Midwives and to Children's Social Care in accordance with Multi Agency Safeguarding Hub (MASH). Pre-Birth assessments should reflect the current plans to safeguarding child on birth, in line with midwifery plans, if substance misuse is a concern either alcohol or drugs in line with the Pre-Birth Policies. For younger children health visitor support/BABs should be engaged with C&F assessments to ensure that safety of child is central to decision making.
6.	Those parents who are misusing substances but who are not accessing treatment services should be referred to services who will work with them to help break down the barriers to their accessing treatment services. Change Grow Live Integrated Recovery Service (Tel: 0151 546 9557).
7.	Children's Social Care will undertake a children and family Assessment if required following MASH decision making. If neglect is a feature a graded care profile 2 should accompany the MARF, Multi agency referral form. Early Help support should always be considered as part of neglect concerns to consider a graduated response (see Early Help Assessment Framework in Knowsley Procedure). However, as with any other situation where there is concern that a child is at risk of Significant Harm urgent section 47 referrals should be made.
8.	Assessment of the risk of Significant Harm to children where one or both parents, or other member of the household, misuses substances, should consider the following: Previous concerns regarding the care or safety of children; Family relationships; whether both parents or other members of the household are misusing substances; whether the parents associate primarily with other substance misusers; whether members of the extended family are aware of the substance misuse and are supportive; whether Domestic Abuse is apparent in any of the household relationships - see Domestic Abuse and Reduction Strategy Procedure; The pattern of drug use; including the drug used, the amount used and the method of use; whether the substance misuse is stable, chaotic or includes the misuse of a number of substances; Safety within the home; whether drugs, including alcohol and methadone, and also drugs paraphernalia, including syringes, are stored safely or whether the children have access to these items; The accommodation; whether the accommodation is stable or the household is transient; whether the accommodation is used by other substance misusers; The procurement of drugs; whether the accommodation is used for dealing drugs or for prostitution; whether the children are left alone whilst drugs are procured, or taken out and exposed to dangerous circumstances; Household finances; whether the substance misuse takes priority in the allocation of household finances over the provision of adequate food, clothing and a suitable home environment for the children; Health implications; whether the effect of substance misuse on the health of the parents affects their ability to meet the needs of the children; Parental perception; whether the parents have insight into the effects on the children of their drug use, or deny any negative impact on the children and place their own needs before those of the children.