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
Children affected by parental substance use disorders are at increased risk for child maltreatment or child welfare involvement compared to other children, in addition they are likely to be impacted the the stigma that surrounds drug and alcohol use – Image: Unsplash
In 1989, The Convention on the Rights of a Child (CRC) was adopted by the United Nations, ratifying an international agreement to honour and protect the fundamental rights of every child (Ohchr,1989). 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, as well as to the well-being 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
In Canada, approximately 1 in 5 children have a parent with a SUD (Yogman y Garner, 2021) with similar rates seen in other parts of the western world, such as the United States and the United Kingdom (Roy,2020). 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 (Leyton y Stewart, 2014). In addition, there is overrepresentation of children whose parents have a SUD within the child welfare system (Government of Canada, 2014) and parents with a SUD within the criminal justice system (Health Canada, 2018) , 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.
We are all 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
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 poverty (Lewis, Smith, Offiong, Prioleau, Powell, 2021). 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.
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 (McCann, Lubman, 2017). .
“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 harm (Ohchr,1989). 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.
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.
Starlings Community (SC) is a not-for-profit in Alberta, Canada whose mission is to protect the health and promote the healing of children who have been impacted by the stress and stigma of a parent’s substance use. Through advocacy, knowledge mobilization, and programming, their focus is on dismantling the harmful effects of substance use stigma on children, while simultaneously increasing the community protection offered to impacted children through community.
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