Starlings Community: A Commitment to Children

By Starlings Community

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Children have a right to be protected from substance use stigma and its harmful effects on families: an opinion article on the perspective of children’s rights in the field of addictions

Mother and child

Parental substance use, including the misuse of drugs and alcohol, can have severe and long-lasting effects on children. The consequences can be physical, emotional, and psychological, affecting a child’s overall development and well-being – Photo by Bruno Nascimento on Unsplash

By Starlings Community – In 1989, The Convention on the Rights of the Child (CRC) was adopted by the United Nations, ratifying an international agreement to honour and protect the fundamental rights of every child1. However, how these rights are interpreted and applied varies, ultimately exposing some children to systemic barriers and structural discrimination. One such example of this includes children who are exposed to the stress and stigma of a parents substance use disorder (SUD) and who are at a substantially increased risk for adverse health outcomes.

Agnes Chen, a Canadian registered nurse and the founder of Starlings Community has recognized the policy and support gap that exists for youth whose parents have a substance use disorder. Having been exposed to the stigma of a parent’s substance use as early as age 6, Agnes explains that she did not feel ashamed of her circumstances or afraid of reaching out until she repeatedly saw the reaction of the community and service providers towards her family. Over time, it became apparent that stigma was an unacknowledged contributing factor to her mental health challenges, and to those of generations of families.

As a peer to the many children who are exposed to a parent’s substance use disorder, Agnes invites us to explore: do we apply the same considerations for human rights to children who are exposed to a parent’s SUD, and does stigma perpetuate the violations of those children’s rights.

“Stigma has a perverse effect of silencing. It creates taboos and results in issues not being addressed. Stigma renders some people and their needs invisible in society” United Nations General Assembly, 2012

Raising the children

“We are all a part of the village that is raising the children of Canada, how we contribute today will impact their health and well-being for generations to come” – Agnes Chen, Starlings Community Founder – Image from “A New Path forward“, all rights reserved

In Canada, approximately 1 in 5 children have a parent with a SUD 2,3 with similar rates seen in other parts of the western world, such as the United States and the United Kingdom 4. Evidence indicates that impacted youth are at increased risk for lifelong adverse health outcomes, including up to triple the risk for a substance use disorder, mental illness, and suicide 5-11. In addition, there is overrepresentation of children whose parents have a SUD within the child welfare system13 and parents with a SUD within the criminal justice system14 , both of which are known to cause harm to families. Despite this prevalence and risk, however, there continues to be a gap in policy, practices, and supports aimed at protecting the health of impacted youth.

Agnes believes that a large part of the issue is that when evaluating the adverse health outcomes in impacted children, the sole responsibility and blame is primarily directed at a parent’s substance use, without consideration for the systemic barriers and discrimination parents and their children experience. Parental behaviours and emotions connected to problematic substance use can contribute harm to impacted children, however, substance use disorder is known to be rooted in the social determinants of health, such as experiences with childhood trauma, systemic racism, and chronic poverty15. Without access to support, as can be the case due to the presence of stigma on substance users, we must acknowledge these circumstances which, when left unaddressed, can influence a parent’s mental health, substance use, and capacity for nurturing parenting practices.

Burdens of the past

“I see myself recerating my parent’s behaviours but find myself unable to reach out for help while I still have a chance. The self-hate is a vicious cycle.” – Anonymous, Hamilton, Canada – Image from “The Path Forward“, all rights reserved

In addition to witnessing discriminatory behaviours toward a parent, children are known to be on the receiving end of stigma, which can contribute to feelings of shame, anxiety, as well as decrease their trust within current systems, such as the healthcare system 16, 17, 18.

“It’s not always safe to tell someone, especially when the systems can’t always guarantee your safety.” Anonymous, age 18-24, Canada.

“I want people to know the level of shame the entire family feels, the struggle of loving someone who hurts you but doesn’t want to, how much criminalization hurts.” Anonymous, Age 18-24, Canada

 

“The stigma surrounding addiction has affected me and my healing greatly. Whenever I share my story people have a changed view of me as if I chose to be in that situation as a child. And this makes it extremely difficult to open up to mental health professionals because of the fear of judgment.” Anonymous, age 18-24, Toronto, ON

“I want people to have compassion. If my parents had community support, felt they could get help without losing us, maybe they would have gotten help” Anonymous, Age 24-35, Canada;

Starlings Community Questionnaire: Impacts of Stigma on Canadians Exposed to Parental SUD, 2021

 

Since 1989 when the CRC was first ratified, advocates around the world have pushed to ensure our leaders uphold children’s rights including the right to access information, to be free from harm, to access community supports which could support parents and prevent harm, and to access physical, mental, and spiritual health support that would enable them to recover from harm1. However, stigma has left many children deprived of these fundamental rights.

Today, Agnes invites each of us to challenge our own biases towards people with a SUD, while considering how our beliefs may contribute to the lack of supports for parents, and ultimately, their children. Our communities not only have an opportunity but also an obligation to ensure we uphold the rights of every child, including children who continue to be silenced and disadvantaged by the stigma of a parent’s substance use.

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Read a comprehensive report at: Starlings Community INC. (2022, February). A NEW PATH FORWARD: A Starlings Community Report Highlighting the Harm Imposed on Children Who are Exposed to the Stigma of a Parent’s Drug or Alcohol Use, and Recommendations for a New Path Forward.

https://www.starlings.ca/

CAPSA invites Agnes Chen to participate in “Conversations of Substance”

References:

  1. (1989b). Convention on the Rights of the Child. Retrieved June 20, 2022, from https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-child
  2. Langlois, K. A., & Garner, R. (2013, March). Trajectories of psychological distress among Canadian adults who experienced parental addiction in childhood (Statistics Canada Catalogue 82-003-x, Health Reports, Volume 24, Number 3, pp. 14–21). https://www150.statcan.gc.ca/n1/pub/82-003-x/2013003/article/11774-eng.htm
  3. Garner, A., & Yogman, M. (2021). Preventing childhood toxic stress: Partnering with families and communities to promote relational Pediatrics, 148(2). https://doi.org/10.1542/peds.2021-052582
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  8. Titlestad, K. B., Mellingen, S., Stroebe, M., & Dyregrov, K. (2020). Sounds of silence. The “special grief” of drug-death bereaved parents: A qualitative study. Addiction Research & Theory, 29(2), 155–165. https://doi.org/10.1080/16066359.2020.1751827
  9. Alonzo, D., Thompson, R. G., Stohl, M., & Hasin, D. (2014). The influence of parental divorce and alcohol abuse on adult offspring risk of lifetime suicide attempt in the United States. American Journal of Orthopsychiatry, 84(3), 316–320. https://doi.org/10.1037/h0099804
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  11. Smith, J. C., Alderman, L., Attell, B. K., Avila Rodriguez, W., Covington, J., Manteuffel, B., DiGirolamo, A. M., Snyder, S. M., & Minyard, K. (2021). Dynamics of parental opioid use and children’s health and well-being: An integrative systems mapping approach. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.687641
  12. Anda, R. F., Whitfield, C. L., Felitti, V. J., Chapman, D., Edwards, V. J., Dube, S. R., & Williamson, D. F. (2002). Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 53(8), 1001–1009. https://doi.org/10.1176/appi.ps.53.8.1001
  13. Barker, B., Kerr, T., Alfred, G.T. et al. High prevalence of exposure to the child welfare system among street-involved youth in a Canadian setting: implications for policy and practice. BMC Public Health 14, 197 (2014). https://doi.org/10.1186/1471-2458-14-197
  14. Government of Canada. (2014). Annual report of the office of the correctional investigator 2013–2014. https://www.ocibec.gc.ca/cnt/rpt/annrpt/annrpt20132014-eng.aspx
  15. Health Canada. (2018, September 5). Strengthening Canada’s Approach to Substance Use Issues – Canada.ca. Government of Canada. Retrieved June 14, 2022, from https://www.canada.ca/en/health-canada/services/substance-use/canadian-drugs-substances-strategy/strengthening-canada-approach-substance-use-issue.html
  16. Lewis, Q. J., Smith, B. D., Offiong, A., Prioleau, M., & Powell, T. W. (2021). When a house is never a home: Housing instability among youth affected by parental drug abuse. Child Abuse & Neglect, 118, 105131. https://doi.org/10.1016/j.chiabu.2021.105131
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  19. Park, S., & Park, K. S. (2014). Family stigma: A concept analysis. Asian Nursing Research, 8(3), 165–171. https://doi.org/10.1016/j.anr.2014.02.006