When soundbites don’t help addicted parents …or their children

Sarah Nelson, Author of Care and Support Needs of Male Survivors of Sexual Abuse (February 2009)

The poignantly short life and brutal death of the toddler Brandon Muir, violently killed by his mother’s boyfriend in Dundee, has provoked renewed debate and soul-searching among politicians, media and many of the public. Not just about apparent failings in child protection generally, but in particular about how to safeguard children in the estimated 50,000 Scottish families where one parent at least is addicted to drugs.

As three separate child protection reviews get underway in Dundee, drastic “solutions” have been touted, as they are each time such deaths happen. These range from taking all or most addicts’ children into care - unrealistic without huge resources, given the large numbers of children and the hard-pressed, shrunken fostering and residential sectors – to giving addicts contraception along with their methadone. (A eugenic “solution” familiar to historians, it is unclear exactly what type of contraception is being dreamt of, and how it will be given: as so often happens, the restraint seems to apply only to females).

It’s understandable that concerned people feel despairing at times about the problem, and about the suffering of some addicts’ children, and are therefore tempted by the sound and fury of such drastic solutions. Angry feelings against addicted parents, and renewed blaming of social workers and health visitors, may be merited in individual cases; but when generalised, do they help vulnerable children, or distract attention from measures that will be more constructive for them?

Does it make sense for instance to spend more on the children and less on the adults?
Some recent research suggests that putting more resources into supporting addicted adults may actually make the children benefit from better, safer parenting. One issue which has consistently been neglected in policy, despite much research and practice evidence is the very damaging trauma in the backgrounds of many addicted parents.

Those who have been addicted for a long time, or who have found it impossible to remain “clean” from substance misuse, are often using drugs and alcohol as a kind of self medication- in a sometimes desperate effort to blot out very distressing experiences and memories. That kind of misuse is much harder to stop, because the cost to them, without support, is to resurrect sometimes unbearable flashbacks and memories.

These bad experiences can include childhood beatings and sexual abuse, neglect, emotional cruelty and for adults domestic abuse from violent partners. For example my own Beyond Trauma research, published in 2001, with women who experienced childhood sexual abuse trauma revealed that a high percentage had sought refuge in drink and drugs, even as children or teenagers, and needed skilled support to help them cope with the trauma once this “crutch” was removed.

In my latest study, Care and Support Needs of Male Survivors of Sexual Abuse, a quarter of the interviewees were addicted even before their teens, and half of them by their teenage years. The prisoner and ex-prisoner group were addicted very young to a variety of drugs, after experiencing extreme forms of trauma.

Of course, not all drug addicted parents are victims of abuse. However, many are – for example in 2004, one specialist drugs counsellor in a large and busy Edinburgh health centre found that 85 % of her client group had suffered childhood sexual abuse. In fact a growing number of international studies had already revealed links between substance misusers and a history of child abuse when Dr Jane Wilson of Stirling University carried out her Scottish research , with colleagues Susan Morris and Rowdy Yates, more than ten years ago.

Her research team found even higher figures than existing studies suggested. They used the Childhood Trauma Questionnaire with male and female addicts at three Scottish treatment units. The average age when these had first misused more than one substance was only 15.

Among the women, two-thirds had experienced childhood sexual abuse and more than half childhood physical abuse. Almost half of the men had experienced childhood physical abuse, and more than a third sexual abuse. Wilson and her colleagues called for a wider look at young people and adults with poly-drug use. They warned that in most cases trauma histories may not have been shared with health and social care professionals, and that their needs may have been “unidentified and unmet”. They urged more staff training and recommended “integrated programmes, which address both trauma and substance misuse.”

Those recommendations have made little headway in those ten years, despite further recommendations from major Scottish Executive reports like “Mind the Gaps” in 2003. Specialist, dedicated resources to help addicted adults recover as far as possible from childhood sexual trauma and other violence are still tiny, particularly (and ironically) in major cities like Edinburgh where there have long been serious addiction problems.

Yet research and practice experience indicates that they can actively enable addicted adults to become both more secure and competent as parents, and equally important, to regain the self-esteem which has usually been severely undermined or lost altogether. That loss is one key reason why women in particular often feel they are worth no more than to accept a violent and abusive partner, who is dangerous not only to themselves but to their children.

Obviously, the most basic aim in child protection has to be preventing children being abused in the first place. But creating safer less neglectful home environments for those children, free of possibly dangerous people who may wander in and out to collect or to deal in drugs, will be one part of that primary prevention exercise. Boosting post- trauma services for desperate, addicted parents, and giving staff the training and confidence-building to deliver these services on a wide scale, would prove a small cost in terms of potential benefits to both vulnerable parents and their children.

For more information about the project that led to the report Care and Support Needs of Male Survivors of Sexual Abuse see http://www.crfr.ac.uk/Research/malesurvivors.html