Child Abuse and Drugs

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In the United States, on average, about twelve out of every 1,000 children are abused or neglected each year. A precise number may be impossible, as many cases are never reported, but the U.S. Department of Health and Human Services estimated that 826,000 children were abused or neglected in 1999 in the United States. This abuse can take the form of physical abuse, neglect, sexual abuse, and emotional maltreatment. In addition, each year a higher percentage of American children are being raised in poverty, often by overstressed and drug-abusing parents.

Child-welfare authorities consider parental substance abuse to be a major risk factor for child abuse. In other words, when parents abuse drugs, they are more likely to engage in child abuse as well. Under the influence of alcohol and other drugs, adults are less inhibited—they feel free to act on their desires and wishes. They lose a sense of good judgment and emotional control. For these reasons, some adults who abuse alcohol or drugs are more likely to hurt their children or behave in harmful ways.

Researchers have noted that families in which child abuse occurs and families in which substance abuse occurs have certain features in common:

• parents often have poor parenting skills—parents spend little time with children, speak harshly and critically to them, discipline them in extreme ways or not at all
• family disorganization—the family members do not communicate with each other, the children's needs are not met, and there is frequent conflict and possibly violence
• parents are more likely to resort to criminal activity, often to obtain illegal drugs
• high rates of mental illness, such as depression, psychosis, and antisocial personality disorder
• high rates of physical illness due to chaotic lifestyle, lack of health care, and the risks of intravenous drug use

Child abuse takes different forms: prenatal exposure to drugs, postnatal exposure to drugs, physical abuse, and sexual abuse.

Prenatal Drug Exposure. The laws of several states define exposure of a fetus to alcohol and other drugs as child abuse. In some states the law requires that a child be removed from the mother when drug tests show that she has abused drugs during pregnancy. Laws also require medical or social services personnel to report such cases to state agencies. Unfortunately, because of this rule, pregnant, drug-abusing women may avoid getting prenatal care for fear that they will be punished or lose their children. For this reason, a number of states have placed a priority on making drug treatment more readily available to pregnant women.

The abuse of alcohol or drugs by a pregnant woman can result in abnormalities in the fetus. In addition, substance-abusing women are likely to have poor nutrition, to have more illness and stress, and to fail to get medical prenatal care, all of which can harm their babies. Babies born to alcoholic mothers can suffer from fetal alcohol syndrome (FAS), which causes facial deformities, retarded growth, and abnormalities of the heart, kidneys, ears, and skeletal system. The long-term effects of FAS appear to include reduced intelligence, attention deficits, learning disorders, hyperactivity, and more antisocial behaviors than the norm.

When the pregnant mother has abused drugs such as cocaine, heroin, and phencyclidine (PCP), babies can suffer from withdrawal symptoms in infancy. Their development is often delayed, and some have long-term damage to the central nervous system. The major effects at birth of most drugs, including alcohol and tobacco, are premature birth, low birth weight, and a slowed rate of growth that may affect both brain and physical development. Sudden infant death syndrome is also two to twenty times higher in infants exposed to cocaine and opiates.

If babies exposed to drugs come home to a nurturing environment, where a caregiver responds to their needs and provides stimulation and early childhood education, these babies can overcome the problems of drug exposure. But if the baby is in the care of a mother who returns to taking drugs, the baby's needs are unlikely to be met.

Postnatal Exposure to Drugs. Children can be hurt by inhaling cigarettes or cigarette smoke, by accidentally swallowing drugs, by being given drugs by a minor, and by deliberate poisoning. In addition, alcohol, nicotine, and other drugs are all present in the breast milk of women who use these substances, so nursing infants may be exposed to these drugs. Some parents who abuse drugs allow their children to drink alcohol or use the drugs they find lying around the house. In a disturbing form of child abuse, some parents deliberately give their children alcohol or other drugs (such as tincture of opium) to make them stop crying, to sedate them, or to make the children intoxicated to amuse the parents.

Physical Abuse. Physical abuse can involve any of a variety of violent acts against a child, including beatings, burns, strangulation, and biting. Children who are physically abused have unfulfilled needs and low self-esteem. They distrust others and have problems with aggression and anxiety. Research on the physical abuse of children shows a strong overlap between physical abuse and parental alcoholism.

Unfortunately, less research has been conducted on the role of other kinds of drug abuse in child abuse cases. However, according to the Child Welfare League of America, substance abuse exists in 40 to 80 percent of families in which the children are victims of abuse. Furthermore, children whose parents abuse alcohol and other drugs are three times more likely to be abused and more than four times more likely to be neglected than children from non-abusing families. Drug abusers often belong to social groups in which violence is common. Children raised in violent homes are more likely to become abusers as adults, thus continuing the cycle of violence.

Child Sexual Abuse. Child molesters are often intoxicated when they commit the acts of abuse. Research shows that in about 30 to 40 percent of child sexual-abuse cases, particularly when girls are abused, the abuser had been drinking. A study of incest victims and perpetrators showed that 48 percent of fathers who had committed incest were alcoholic, and that 63 percent of this group were drinking at the time of the abuse.

A very high percentage of drug abusers in treatment programs report being sexually abused as children. In fact, childhood sexual abuse is often a hidden factor contributing to drug abuse and relapse into drug abuse after treatment. Sexually abused children find it difficult to maintain a sense of themselves that is separate from other people. As a result, survivors of childhood sexual abuse often do not see themselves as individuals separate from the desires or demands of others. They may not know how to refuse another person access to their bodies,and in later life, to their privacy, time, physical space, and possessions. They are especially vulnerable to the coercion of others, and may begin to use drugs or keep using them because they are unable to say no to the urgings of another person.

Because of the high overlap between child abuse and drug abuse, drug treatment agencies should routinely ask their clients if they have been or are being physically or sexually abused. Similarly, child welfare agencies should routinely investigate whether substance abuse by a parent or caregiver is contributing to the maltreatment of children.

Because it is not possible to remove all children from risky family environments, both government-funded and private agencies must find other ways to protect children. Caregivers and professionals can help maltreated children learn how to avoid abuse. Social welfare agencies need to teach parenting skills to addicted mothers and fathers, who must be made to understand that their chaotic street lives damage their children. Positive steps include parent-and-family-skills training programs, locating good early-childhood education for the child and outside child care, and considering foster care or adoption.

Babies, Addicted and Drug-Exposed; Childhood Behavior and Later Drug Use; Families and Drug Use; Fetal Alcohol Syndrome (Fas); Poverty and Drug Use.

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