Abstract
BackgroundParental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to address conceptual and methodological problems in estimating the number of children affected by parental substance misuse (CaPSM) and offer a novel approach based on survey data.MethodsData came from the 2018 German Epidemiological Survey of Substance Abuse (ESA) among 18- to 64-year-olds (n = 9267) and from population statistics. DSM-IV diagnostic criteria were used to assess substance use disorder (SUD) related to tobacco, alcohol, cannabis, cocaine or amphetamine. Based on the number of household members, the number of children below age 18 years and the information on SUD status of the respondent living in this household, the number of children currently living in households with at least one member with SUD was estimated.ResultsIn 2018, there were 13,597,428 children younger than 18 years living in Germany. Of these, 6.9–12.3% (935,522–1,673,103) were estimated to currently live in households where at least one adult had a tobacco use disorder, 5.1–9.2% (688,111–1,257,345) in households where at least one adult had an alcohol use disorder and 0.6–1.2% (87,817–158,401) in households where at least one adult had a disorder related to the use of illicit drugs. The total number of children currently living with SUD adults in their household was estimated at 11.2–20.2% (1,521,495–2,751,796).ConclusionsAvailable estimates are difficult to interpret and to compare due to a lack of clear case definitions and methodological approaches with various biases and limitations. Future estimates need to provide precise case definitions and standard approaches.
Highlights
Parental substance misuse is reported to endanger the health and psychological development of children and adolescents
As case definition of children affected by parental substance misuse (CaPSM), we focus on current substance use disorder (SUD) problems of cohabitating adults including biological and social parents as well as other adults living in the same household, such as older siblings
More than two thirds (72.5%) of non-SUD respondents were married or had a partner, whereas the proportion was significantly lower in respondents with SUD status (49.4%) and lowest among respondents with illicit substance use disorder (20.0%; Table 2)
Summary
Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. A lifetime approach assesses how many children were exposed to substance-misusing (SM) parents or other carers during childhood and adolescence, resulting in a prevalence until maturity This can be achieved using a retrospective approach by asking young adults older than, for instance, 18 years about their experience with PSM during childhood and adolescence. The number of people who were affected by PSM in the course of their childhood and adolescence as well as the number of people not affected can be directly assessed and the percentage of children affected by PSM can be calculated (see [19, 20]) Such approaches need to account for the time-varying nature of exposure, e.g. parents’ or carers’ substance use may be episodic, or they may episodically be present and absent from their children’s lives as a result of parental desertion, child removal or otherwise. A current approach quantifies the number of CaPSM who are exposed to PSM by parents or other adults they are presently cohabiting with (see, [21, 22])
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