Supporting children and young people with alcohol and substance use disorder

What is alcohol and substance misuse?

Alcohol and substance misuse can be seen when someone takes illegal or legal drugs, including prescription medication, or alcohol too much or in the wrong way. The more a person takes something, the more likely it is that they can develop a tolerance and need even more to feel the same effect.  The danger of becoming hooked increases with some substances, such as nicotine or opioid drugs like heroin, being extremely addictive. 

Being addicted to something means you are physically and mentally dependent on it. When you’re addicted, instead of enjoying something, you need it to function normally. At this point, things can quickly spiral out of control.

• Physical addiction

   is when a person craves something to the point that their body depends on it, and going without can make them experience withdrawal symptoms

• Psychological addiction

   is when a person craves something for emotional reasons, and they suffer without it

• Withdrawal symptoms

   can be very painful, and include things like problems sleeping, anxiety, digestive issues, difficulties concentrating, shaking and feeling depressed

Alcohol and substance misuse is more common between the ages of 20-25 years old, and can be a response to personal issues or trauma, or might have started as a way to experiment.

People can experience stigma and discrimination to do with drug and alcohol misuse, and it’s common to want to play down or hide how bad things really are. Initiating conversations can prove challenging but parents and carers can play an important role in supporting a child or young person through treatment as they will often know how their child is feeling and reacting to treatment. 

Signs that your child might be misusing alcohol or substances

The signs are both physical and psychological. Physical changes will relate to whether they have recently taken any drugs. Their eyes may be red, heavy, with constricted pupils. If they have had alcohol, their pupils may be dilated and they may have difficulty focusing. You may notice tremors, shakes or sweating or be able to smell alcohol or smoke on their breath, clothing or hair.  

Psychological changes include mood swings, withdrawn and more secretive behaviour. They may seem out of character in their behaviour, especially if they have been out with their friends for the evening and you may have noticed that their friendship circle has changed dramatically with new sets of friends appearing and old friends disappearing. They may also seem more tired, less motivated and lose their appetite.  

These are examples of behavioural traits for those who may have grown dependent on alcohol or substances.  Please note that stopping some substances suddenly, such as alcohol or benzodiazepines, can be very dangerous if significant physical dependence has developed and so advice should be sought from your GP or the local substance use services before making reductions.  Many areas will have a young person's substance use service and many accept self-referrals - please see Additional Support at the bottom of this page or search for local services on the Youth Wellbeing Directory.

Common issues parents and carers may have to contend with

Children and young people who have a dependency on alcohol or drugs may experience a radical shift in how they behave and communicate with their parents or carers.  They could become more confrontational, especially if requests for money are rejected, and they may start to steal from family members or others in order to help feed their addiction.  This can be very distressing for the entire family, especially if the police become involved, and it may be hard to maintain discipline and boundaries.  Seeking advice and support for the whole family is therefore advisable even if your child refuses treatment.  Parents and carers will need to practice patience as it can take several attempts before their child may recover and the risk of relapse may be something they have to remain aware of.

How to support a child or young person misusing alcohol or substances

Parents and carers can help a young person who is struggling with alcohol and drug misuse. It is important that they know you love them and understand they are going through a difficult time and give them continued support. It is good to offer help but be cautious about giving money as this may be how they are obtaining drugs and alcohol. They may not take up your offer of help straight away but continue to support them as then it is there for them when they are ready. 

Try to be supportive and positive. If you bring rules into the home, they are more likely to rebel and want to escape, close-up or become withdrawn. It is important to remember the difference between confronting your child and having a conversation with them.  

It is also important for parents and carers to take time to look after their own wellbeing during what can sometimes be a long and difficult process.  Young people may reject or resist help, be confrontational, or may even steal from you and others.  Finding support groups can help you feel less isolated and talking to other parents and carers about their experiences may help you through your own. (For details of support groups, please scroll down to Support for parents and carers)

What to say to schools and colleges

Schools and colleges can be a good support during this time. If you speak to them about your concerns, they may be able to keep an eye on your child to see if they have noticed any behavioural changes. Importantly, they can observe friendship groups and influences your child may have around school. It is good to in keep contact with a school or college and work together to see how you can support your child.  

Parents and carers should also familiarise themselves with their schools or colleges policies on drugs or alcohol which will try to balance the needs of an individual student against the wider school community and highlight issues around confidentiality, safeguarding, sign-posting to services and the schools exclusion policy. 

What to say to siblings 

It is important to recognise the impact of alcohol and substance misuse on all members of the family including siblings who may be confused and concerned about their brother or sister, for you, as a parent or carer, and worried about how others may view them and your family. 

If siblings are close it is likely they know more than you think and may have an idea of what is going on. A sibling relationship is different from a parent or carer relationship and it may be easier for your child to speak to their sibling. They may feel less judged and less pressure; this is normal and not something any parent or carer should be ashamed of or worried about.  

This may be difficult for the sibling as there is a lot of responsibility on them. However, the important thing is that you tell them that their sibling is going through a difficult time and needs support. Warn them that their sibling may have mood swings including irritable and withdrawn behaviour and remind them that you can also support them through this time. It is key to have family support through this time, especially so the siblings do not feel neglected.  

A few things to remind them to try not to do include; shouting, yelling or lecturing their sibling about their behaviour, blame them, criticise or judge.  

What to say to extended family 

Alcohol and drug misuse can impact the entire family and it is important that extended family are aware of the situation. It is up to you and your child as to how much information you tell them; this depends on the closeness of your family and how much your child wishes for them to know. 

Additionally, if they wish to visit it is important they are supportive, non-judgmental and calm about your child’s behaviour and mood. The more they understand the situation the more they will be able to do this.  

It is also important for you to have support and your extended family may be able to provide this. Try to talk to them about how you’re feeling and how the experience is for you, hopefully, this will help you cope and support your family.  

Additional support for parents and carers

• ADFAM offers information to families of drug and alcohol users, and the website has a database of local family support services. 

• Alcohol Change UK works to reduce the incidence and costs of alcohol-related harm and to increase the range and quality of services available to people with alcohol-related problems 

• Drinkaware - An independent charity that promotes responsible drinking through innovative ways to challenge the national drinking culture, helping reduce alcohol misuse and minimise alcohol related harm. 

• Drinkline - A free and confidential helpline for anyone who is concerned about their own or someone else’s drinking. Tel: 0300 123 1110 (lines are open 24 hours a day)

• FRANK is the national drugs awareness campaign aiming to raise awareness amongst young people of the risks of illegal drugs, and to provide information and advice. It also provides support to parents and carers, helping to give them the skills and confidence to communicate with their children about drugs. 24 Hour Helpline: 0300 123 6600 

• Re-Solv (Society for the Prevention of Solvent and Volatile Substance Abuse) A national charity providing information for teachers, other professionals, parents and young people.

• Smokefree - NHS Smoking Helpline: 0300 123 1044; Website: https://www.nhs.uk/smokefree