Children Of Alcoholics: Genetics, Symptoms And Risks

Alcoholism affects all members of the family, not just the alcoholic. The damage is pernicious and inescapable, and has long-term negative consequences for all concerned.

An estimated 27.8 million children in the U.S. are affected by or exposed to a family alcohol problem, and preliminary research suggests that more than 11 million of them are under the age of 18.

These numbers do not include children who are affected by or exposed to other drug problems.

What happens to these children as they grow up? Are they doomed to repeat the pattern of alcohol abuse they see in their alcoholic parent? Or are they fighting to be free?

How parental alcoholism impacts children

Research shows that children of alcoholics are at greater risk for a range of problems: physical illness, emotional disturbances, behavioral problems, lower educational performance, and a susceptibility to develop alcoholism or other addictions later in life.

Genetics and family behavior

There is strong, scientific evidence that alcoholism runs in families. Children of alcoholics are at more risk of developing problems with alcohol and other drugs than children of non-alcoholic parents. In fact, many scientific studies, including twin studies of children of alcoholics, show that children of alcoholics (COAs) are four times as likely to become alcoholics themselves as children whose parents are not alcoholics. Thus, genetic factors play a major role in the development of alcoholism. But it isn’t an automatic sentence. Research also shows that more than half of children of alcoholics do not become alcoholics.

Not only is there a heritable basis for alcoholism running in families, but the children of alcoholics form their beliefs about drinking from perception of their parents’ drinking patterns — how much they drink and how often. It is no surprise, then, that COAs often emulate this drinking pattern when they begin to experiment with alcohol themselves.

Children first learn about alcohol by watching their parent drink. When drinking to excess becomes an everyday phenomenon, children perceive this is the norm. They begin to formulate their expectations about alcohol at a very early age. In other words, they see what alcohol does to their drinking parent or parents. They cannot, however, escape the influence, since it is all around them. This can be very damaging to children, especially younger children and adolescents.

Factors that make parental alcoholism worse for children

According to research from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a person’s risk increases if he or she comes from a family where:

• Both parents abuse alcohol and other drugs
• An alcoholic parent is depressed or has other psychological problems
• Parents’ alcohol abuse is severe
• Family conflicts lead to aggression and violence


Family members — children and spouses — of an alcoholic frequently become co-dependent. That is, they are addicted to another person’s alcoholic behavior.

Sometimes, the alcoholic (parent or spouse) will discontinue drinking for a short period of time. This leads the COAs and spouse into a falls sense of security. They believe that everything’s okay, the problem is solved. It isn’t.

Children of alcoholics often feel responsible for the problems of the alcoholic, believing, wrongly, that they somehow created the problem. They internalize these feelings, ultimately suffering tremendous guilt, shame, and sense of helplessness and hopelessness. They may try to hide the evidence of their parent’s alcoholism, or make excuses to others for parental absence at functions, lie to friends, school, employer or others about the parent.

They may either serve the alcoholic parent drinks or try to get rid of the stash of alcohol. Both are attempts to stave off the problems that may ensue from an alcoholic parent getting out of control, erupting into violence — or to just keep the family together.

This is co-dependency. The co-dependent children and spouse of an alcoholic soon forget about their own needs and desires. They’re too busy looking out for or covering up the problems of the alcoholic family member. They may attempt to cure or control the drinker — to no avail.

COAs learn how to tiptoe around their alcoholic parent. Fearing reprisals, they try hard to please the parent in a never-ending and fruitless attempt to get the parent to stop drinking. By denying the problem exists (parental alcoholism), the COAs and spouses enable the alcoholic to continue his or her drinking and not face up to the troubles such drinking causes.

Drinking during pregnancy

Studies have shown that the rate of drinking during pregnancy seems to be increasing — despite the known dangers to the fetus from such exposure to the effects of alcohol. Even moderate alcohol consumption during pregnancy affects the developing fetus. The mother who drinks may not be an alcoholic, but her fetus cannot escape the effects of the alcohol.

Approximately 6% of women who drink during pregnancy bear children who have Fetal Alcohol Syndrome (FAS). For those siblings born to a mother who drinks subsequent to the birth of an FAS infant, there is an almost 70% chance that those offspring will also have FAS.

The more severe the mother’s drinking during pregnancy, the more severe the FAS in the child. According to Drinking and Your Pregnancy, from the NIAAA, FAS children tend to:

• Weigh less and be smaller at birth than non-FAS infants
• Have problems eating and sleeping
• Have problems seeing and hearing
• Have trouble following directions and learning how to do simple things
• Have trouble paying attention and learning in school
• Need special teachers and schools
• Have trouble getting along with others and difficulty controlling their behavior
• Need medical care all their lives

Severe FAS children may exhibit facial deformities, mental retardation, slow growth, and persistent behavioral difficulties. Secondary effects of FAS among adolescents and adults include mental health problems, school disruptions (getting suspended or expelled from school or dropping out), getting in trouble with the law, having problems securing or maintaining employment, and dependent living as an adult.

Crime and violence

Incest and battering are common in alcoholic families. An estimated 30% of father-daughter incest cases and 75% of domestic violence cases involve a family member who is an alcoholic. COAs are more likely to become targets of family abuse and/or to witness family violence at the hands of an alcoholic parent.

What often happens is that the victims of such violence and abuse shoulder the blame for what has happened to them. They often turn to alcohol themselves as a way out of the pain of guilt, shame and helplessness they feel. Their childhood has been ripped from them, and they are robbed of normal childhood experiences. How can this not negatively impact COAs?

How it all plays out has a lot to do with whether or not they receive treatment while they are still children. COAs, if not treated when they are young, will carry their problems with them into later life.

Alcoholism is a key factor in 68% of manslaughters, 62% of assaults, 54% of murders and attempted murders, 48% of robberies, and 44% of burglaries.

Young and adolescent COAs

Living with alcoholic parents is particularly devastating on young children. Youngsters often show symptoms of depression and anxiety such as being afraid to go to school, bed-wetting, having nightmares, crying, and not having friends.

When they’re a little older, adolescent COAs may stay in their rooms for extended periods of time, become secretive, and have difficulty relating to other children or say that they have no one to talk to. Teen COAs may begin to show depressive symptoms such as perfectionism, hoarding, isolation, and becoming extremely self-conscious. Some teen COAs may start to develop phobias.

Inpatient admission rates for COAs are triple that of other children. Inpatient admission rates for COAs with mental disorders are almost double that of other children. Studies show that total healthcare costs for COAs is 32 percent greater than for children from non-alcoholic families.

Other problems that COAs experience

• Lower cognitive and verbal skills — Tests of COAs show a lowered cognitive ability and poor verbal skills. They may find their ability to express themselves is impaired, which can, in turn, affect school performance, peer relationships, the ability to develop and sustain intimate relationships, and hinder their performance at job interviews. This does not imply that COAs lack intellectual ability – just that their ability to express themselves suffers.

• Difficulties in school — COAs are more likely to be truant, to drop out of school, repeat grades, or be referred to the school counselor or psychologist. This may not be due to intellectual ability, but may be more because of performance-related anxiety, difficulty bonding with teachers and peers, fear of failure, or other reasons yet to be determined. More research is needed in this area. What is known is that COAs often feel they will be a failure – even if they do well in school. Raised in an environment lacking stimulation, and with alcoholic parents, who may themselves have poor cognitive or verbal skills, affects COAs in measurable and predictable ways. For example, pre-school COAs exhibit poorer reasoning and language skills than non-COA children. Poorer quality of stimulation at home predicts poorer performance among COAs versus non-COAs. Later on, COAs have difficulty with abstract concepts, and may require specific instructions and concrete explanations.

Adult COAs

When they mature, adult COAs often fail to relate their problems to their growing up with alcoholic parents. Many adult COAs have problems with aggression, depression, and impulsive behavior.

Studies show adult COAs often abuse psychoactive substances, in addition to or independent of alcohol. They’re also likely to have difficulty establishing healthy relationships with others. They have problems with intimacy. Since they don’t trust others, they fear if they try showing love to another, they will be hurt just as their alcoholic parent hurt them as a child.

COAs frequently fail at being parents, having poor role models to emulate. Career decisions are often poorly made. Nearly all adult COAs have a negative self-image and describe feeling worthless and a failure. Almost one-third of any sample of alcoholics has at least one parent who is an alcoholic. Children of alcoholics are also more likely to marry into families with alcoholism than children of non-alcoholics.

How to help young COAs

Adults — other than the alcoholic parent — can help young COAs by efforts to:

• Help the children develop autonomy and independence
• Develop a close bond with a care-giver
• Successfully cope with potentially hazardous or devastating emotional experiences
• Develop coping strategies for day-to-day living
• Engage in acts to help others
• Develop strong social skills and social orientation
• Perceive their experiences constructively — even if those experiences have caused them pain or suffering — so that they can gain positive attention from other people early in their lives

There is hope for COAs in families with parental alcoholism, if:

• Family rituals and traditions (such as holidays, vacations, or mealtimes) are maintained and highly valued
• The alcoholic parent is confronted with his or her problem
• There are consistent and significant others in the life of the child or children
• There is moderate to high religious observance

If these conditions exist, the COAs may be protected from many of the consequences of parental alcoholism.

Advice for children of alcoholics

Just because the parents drink to excess doesn’t mean the children of alcoholics need to grow up to become abusers of alcohol and drugs themselves. It only means the risk is greater. But there are things that COAs can do to minimize the risk.

• Avoid underage drinking — Research shows that the earlier a child begins to drink, the more likely they are to become an alcoholic or to abuse other substances as an adult. Drinking that starts before the age of 14 puts children at higher risk of becoming alcoholics — both due to genetics and environmental factors. And, underage drinking is also illegal.

• Talk to a health professional — Children whose parents drink to excess should seek help from a health professional. This can start at school by talking with a school counselor or nurse, the family doctor, or member of the clergy. These people can recommend groups or organizations to help children avoid problems with alcohol. Adult COAs who have already begun to drink can use the assistance of a health professional to assess their drinking patterns and determine if they need to cut back and, if so, get help on how to do so.

• Adult COAs should drink moderately, if at all — Guidelines from the U.S. Department of Health and Human Services and the U.S. Department of Agriculture suggest that moderate drinking for an adult should be no more than 2 drinks per day for men and 1 drink per day for women. This is true whether or not the parents were alcoholics. Naturally, there are some people who should not drink at all. These include pregnant women, alcoholics in recovery, people who take certain medications or have certain medical conditions, and people who plan to drive or engage in activities requiring attention or skill. Adult COAs, if they plan on drinking moderately, should pay careful attention to alcohol consumption. It may be harder for them to moderate their drinking, and they can easily pass from a casual drinker to a heavy drinker or even a hard-core alcoholic. As drinking increases, so does the risk of alcohol-related social problems such as violence and trauma, and drinking and driving, and medical problems associated with alcohol, including liver disease, brain damage, and cancer.

Alateen, Al-Anon and Alcoholics Anonymous

Children of alcoholics can get help by attending meetings of an organization known as Alateen, which, along with Al-Anon for the spouses and other affected family members of alcoholics, is affiliated with Alcoholics Anonymous (the organization for persons dependent upon or addicted to alcohol and other substances). The fact is that children and spouses of an alcoholic require treatment just as much as the alcoholic. Alateen and Al-Anon are the two most successful organizations for helping children and spouses of alcoholics. They are based on the 12 step A.A. principles. Their goal is to help family members understand that they are not responsible for the alcohol dependency of another family member. Their own recovery does not depend on the alcoholic getting better.

A school counselor, nurse, or nurse practitioner can give support and information to COAs on how to find Alateen meetings.

Children of alcoholics come to a fork in the road

In the end, children of alcoholics have a rough road to travel. On the one hand, they may have a solid support system independent of the family and avail themselves of help to overcome the myriad problems of family alcoholism. On the other, they may lack either the will or the necessary ongoing support to lift themselves out of the misery of their childhood environment and parental alcoholism.

Caring adults and friends can help by encouraging COAs to seek professional counseling or to attend Al-Anon or Alateen (or Alcoholics Anonymous, if the COAs have become dependent on alcohol themselves). While the damage that’s already done may be substantial, there is always hope. But COAs, just as alcoholics, can’t do it on their own. The baggage that goes along with alcoholism in the family is just too great a burden for an individual to overcome without constant encouragement and support.

COAs each come to a fork in the road, albeit at different times and for different reasons. At some point, each child of an alcoholic has the opportunity to make an important decision: Repeat the pattern of parental alcoholism or fight to be free.

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