The Children’s Rights Perspective in Addiction Services

Dianova conducted a survey to gather information about how children’s needs are being addressed in addiction services for adults


Children affected by parental drug use tend to feel lonely and lack the conditions that would enable them to grow up safely, receive after-school tutoring, and spend adequate time with their parents for playing or learning purposes – Photo by Keren Fedida on Unsplash

  • Author: Caroline Fuller
  • Co-author: Gisela Hansen Rodríguez, PhD.
  • Complete study in: EnglishEspañolFrançais

Executive Summary

Caroline Fuller

Caroline Fuller

Drug use is on the rise worldwide, affecting not only users but also their families, and interfering with children’s wellbeing and human rights. Children who live with drug using or dependent parents are more likely to develop a range of health, social, physical and psychological problems. Drug use may impact children quite early: taking drugs during pregnancy increases the chance of birth defects, premature babies and other health problems such as the Foetal Alcohol Syndrome (FAS) which may lead to intellectual and physical disabilities (Roebuck, Mattson and Riley, 1998).

Gisela Hansen

Gisela Hansen

Addiction services, such as harm reduction or treatment programmes, have proved effective in addressing the needs of people who use drugs, however it is not clear whether or not they are capable of providing clients’ children with the interventions they need. These services need to adapt to the realities of each person, this is why it is now established that a gender-sensitive approach ought to be developed to address the specific needs of women. In the same way, we thought it would be interesting to look at how addiction services take children’s rights into account, and how to promote the children’s rights perspective in these services.

With this in mind, Dianova conducted a survey to gather information about how children’s needs are being addressed in addiction services for adults. Out of the 39 people that answered the survey, most respondents were directors or coordinators of drug-related services. Participants provided information about service users in outpatient and residential treatment programmes, as well as in harm reduction services.

Participants note that service users talk about their children on a regular basis and half of the respondents mention having discussed the issue of children’s custody with their beneficiaries. They also say that men and women tend to behave differently with their children. In addition, mothers are usually stigmatized for using drugs despite being the primary caregivers for children. Conversely, fathers appear to be often absent, and when they happen to take child rearing initiatives, they tend to receive more praise for doing so than women. With regards to violence, it appears to be committed by both genders, with women being more prone to neglect, and men to physical violence.

Parents with substance use disorders usually spend less time caring for their children who, as a result, tend to lag behind in terms of education, social life and hygiene standards. What these children experience most is neglect, followed by the necessity of taking care of themselves and their siblings due to their parents’ incapacity to assume their responsibilities. Some families however do seek help from third parties to meet their children’s needs – acknowledging their inability to do so – showing therefore a willingness to give them a fair chance in life. Mothers are more willing to ask for help than men, as they tend to behave more responsibly with their children. As a result, grandparents are often those who end up taking care of the latter.

63% of respondents state that it is relatively easy to identify child abuse, and more than half of them say that there is enough time in their daily tasks to assess the risks faced by children and adolescents. Most believe that identifying risk situations faced by children is an integral part of their work. When professionals witness a situation of neglect, violence or abuse towards a patient’s child, they are likely to contact child protection services. As a matter of fact, 89% of respondents say that they would report a situation of child abuse, and 53% agree that their staff have been trained to identify risk situations.

At the same time however, respondents report that half of the services do not provide professionals with parenting training and those trained do not exercise this training during their daily work. Furthermore, in most addiction services, there are no protocols to identify possible risk situations for children. All in all, 45% of respondents mentioned that, in their service, no initiative had been taken to promote the protection of children during the previous year.

Another big obstacle is that half of the people interviewed tend to refrain from asking personal questions as they believe their primary focus should be on the use of drugs. When confronted with child abuse, whether actual or potential, respondents say that they have to face a double challenge: protecting the child while providing their parents with adequate support. Professionals do not want to imperil the therapeutic alliance on which their relationship with clients is founded, while it is their responsibility to protect children. In line with this, 47% of respondents are preoccupied about the possibility of retaliation by service users should a situation of abuse or neglect be revealed.

Some services implement proposals aiming at better responding to the needs of clients’ children by increasing parents’ parenting abilities and by supporting children through regular therapy sessions dedicated to fostering their emotional and intellectual development. It should be noted that these services could also implement support programmes for pregnant women who use drugs, and prevention programmes for adults and adolescents within educational and treatment settings.