By Andrew Malekoff

The problematic use of alcohol, drugs and tobacco is unquestionably the nation’s number one health problem. While all segments of society are affected, the future of young people is most severely compromised by this epidemic. There has been increased media exposure and public education on the rise of young people’s abuse of pharmaceuticals – prescription drugs – that often leads to heroin use and addiction. Parents have been alerted to the fact that the most likely source of prescription drugs is the medicine cabinets of friends and family, where the pharmaceuticals can be easily attained at no cost; and, that the cost for a bag of heroin is less than that for a six-pack of beer. Despite enhanced media coverage on these drugs, what the public hardly hears about anymore is the fact that there are millions of children who grow up in homes with parents who are addicted to alcohol and other drugs. It has been estimated that approximately one in four children in the US is exposed to alcohol abuse and drug dependence in the family at some point before age 18. There are multiple impacts on children growing up in these homes. These young people are likely to become alcohol or drug abusers themselves without intervention. Children who grow up in families with alcohol and drug addiction learn to distrust to survive. They learn how to walk on eggshells. The behavior and attitude of the addict and the related emotional tone in the home is a day-to-day mystery. When unpredictability dominates a child’s life, they are likely to be perpetually wary, always sensing disappointment or danger lurking nearby. Children who grow up in addicted families become uncomfortably accustomed to living with chaos, uncertainty, unpredictability and inconsistency. These children have no idea what is normal. They live vastly different internal lives than their peers from homes where coping with addiction in the family is not a daily challenge. Denial and secrecy are common for children who live in alcoholic or addicted families. Their lives are organized around concealing the truth. Asking for help is out of the question as that would trigger exposure to the outside world, disloyalty inside the family and it would evoke intense feelings of embarrassment and shame. In an addicted family there is an ongoing and, most often, unspoken agreement to hide the problem to prevent exposure that will erode the image of a “perfect family.” Children may avoid bringing friends home and cringe at the thought of having the family secret 2 revealed. Their own needs and desires take a back seat to fronting for their family and preserving the image that belies the reality. It is hard to be a child in an alcoholic or addicted family. It takes a lot of energy just to get through the day. Growing up in such a family leaves children with little hope that things will ever change. Children who live in these homes often feel trapped, depressed, alone and desperate. There are no simple answers, but there is help. Family members, friends, pediatricians and school personnel who are attuned to this problem can help to break the conspiracy of silence. Understanding the barriers, gently inviting trust and seeking professional support is the first step to overcome the problems involved. If you need guidance about how to proceed, call Tyrone Anthony, coordinator of chemical dependency services at the Leeds Place, a branch of North Shore Child and Family Guidance Center, at 516-997-2926.