Family Secret No More

Silhouette of mother and daughter on a bench at sunset

Source: Mohamed Hassan / Pixabay

With opioid overdoses highlighted in the media, and most families impacted by alcohol or drug use disorder in one way or another, it is important to consider how to discuss addiction with kids and teens.

Whether you’re a parent, stepparent, grandparent, aunt, or uncle, it can be really hard to know how to explain addiction and recovery in ways that are age-appropriate. How you do this or don’t do this, affects your relationships with the kids and their parents (or a co-parent if it’s your child).

Ignoring or minimizing substance abuse or addiction-related behavior that your children have noticed can make them question their own perceptions and can cause anxiety or distrust.

One of your primary roles as a parent or caregiver is to help your kids interpret their world and use appropriate and healthy skills to handle life situations.

Since about 50 percent of addiction risk is genetic, one of the best ways to reduce addiction risk is to let kids with genetic vulnerability know that substance use is riskier for them than it is for their friends, who don’t have addiction in their family.

Based on my 20 years of experience working with families impacted by addiction, here are my top tips for navigating these discussions.

1. These discussions need to be planned thoughtfully, and discussing it with your own therapist/sponsor/recovery coach, and the children’s parents (or co-parent) can be very helpful.
2. If the child has noticed substance abuse or behavior changes of someone under the influence of alcohol or drugs, then you need to address it to help them understand their world and the risks of substance use.
3. Your goal is to help them understand why people under the influence act so differently sometimes—it’s your difficult and important job to help them make sense of it.
4. Some people think their children are too young for these types of discussions, but it’s a mistake to assume that young children don’t notice the impact of substance abuse that impacts their loved ones. If you don’t help them understand what’s going on, they will make up their own story to help them understand their world. And their created story may have a bad impact on their sense of safety, confidence, and security.
5. One way to address addiction and substance abuse with kids and teens is to consider how you would explain something like severe depression, bipolar disorder, or schizophrenia. Those are similar to addiction in that they include unexpected and temporary impairment of a person’s mindset, behavior, and emotions. Can you use some of the language you would use in explaining those disorders to help your kids understand addiction and periods of substance-related impairment?
6. These discussions can be very emotional, so make sure you’re ready, and that the other parent is included if you think it would be helpful for you or the child.
7. You might want to talk with the child about your desire to keep information about addiction private or within the family since there’s so much public stigma about addiction.
8. Ask if they have questions and make sure they know that they can always talk to you about it.
9. Make sure to offer another support person besides yourself (such as the other parent, another family member, or the child’s therapist, if they have one) in case they have questions and don't feel comfortable asking you.
10. With older children, preteens, and teenagers, use the actual terms addiction, substance abuse, or substance use disorder. It’s also important to help them understand the continuum of substance use, particularly if other family members use alcohol or cannabis in ways that are not problematic. Try to avoid the all-or-none framework for alcohol and drug use.
11. With children in elementary school or preschool, your tactics need to be a bit different. You need to be honest but use simpler language. You may choose to use the term addiction, or you may choose to use a term that is better understood, like sickness, disease, disorder, or substance use problem. But if you choose one of these terms, make sure to differentiate between addiction sickness and other types of sickness (like colds and viruses), so that the child doesn’t get anxious each time you talk about feeling “sick” or having a “problem.”
12. For discussions with very young kids, a Sesame Street episode that addresses addiction could be helpful.
13. How much you share about your own substance use history and specific drugs depends on what they have noticed. Have they seen you impaired from substance use? Have they seen you or someone use drugs? Have they seen personality or temper changes in you or others under the influence? Have they overheard conversations about addiction or substance use?
14. Whatever your personal situation, it’s important to acknowledge what the children have seen and how they feel about it. Help them understand that substance-induced behavior changes are caused by alcohol/drugs, not something they caused or could have prevented.

Genuine and honest discussions about substance use and addiction can be powerful teaching moments, effective prevention efforts, and opportunities to build trust and secure emotional connections.

Copyright 2023 Kelly E. Green, PhD

This post includes selected excerpts from Relationships in Recovery: Repairing Damage and Building Healthy Connections While Overcoming Addiction. New York: Guilford Press, July 2021