Parents Who Misuse Substances
As agreed by LSCB: June 2015
Update required: June 2016
Parents who Misuse Substances
Referrals
Where there is concern that a parent’s drug or alcohol use is placing his or her child at risk of
significant harm, the concerns must be referred to Children’s Social Care or the Police,
preferably in partnership with the parent.
This includes concerns about the drug or alcohol use of a pregnant woman where the
unborn child is considered to be suffering or at risk of significant harm.
It will not be for those working with the drug-using parent to assess the need for child
protection, but only to refer the child to Children’s Social Care.
Communication with parents
Where a referral is made by an agency worker who is working with a parent in relation to his
or her drug or alcohol use, the parent should be advised that the referral is to be made and
their consent obtained if possible, unless to do so would increase the risk to the child. The
parent should already be aware of the circumstances in which the agency worker would
consider that a referral to Children’s Social Care would be necessary.
Assessment
Children Services must involve in their Assessment those from specialist agencies working
with the parents in relation to their drug use.
The Assessment will need to consider the effect of the drugs on:
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The needs of the child
Whether there is a risk or evidence of the child having suffered significant harm
The parents’ skills in caring for the child
The family and its support network, and how it copes with the drug or alcohol use
How help can be provided and how willing the parents are to accept and to benefit
from help
Child protection conferences
If a Child Protection Conference is called, those from agencies who have worked with the
parents in relation to their drug or alcohol use must be invited to attend.
If the Child Protection Conference is called in relation to an unborn child, the maternity
services must also be invited to attend.
Guidance
Drug and alcohol use in itself is not a reason for considering a child to be suffering or at risk
of significant harm although it may be a contributing factor. Professionals working with
children need to understand the complexity of the lives of drug users and gain confidence in
working with people who use drugs or alcohol.
Adult agencies need also to be aware of the needs of children and these procedures, and be
able to identify where a child may be at risk and how best to deal with it.
Impact of substance misuse on parenting
The circumstances surrounding dependent, heavy or chaotic drug use may inhibit
responsible child care, for example, drug use may lead to poor physical health or to mental
health problems, financial problems and a breakdown in family support networks.
Where there is concern that a parent is involved in drug use, the effect on the child needs to
be considered including:
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The child’s physical safety while drug (and alcohol use) is taking place
Possible trauma to the child resulting from changes in the parent’s mood or
behaviour
The impact of the parent’s drug use on the child’s development including the
emotional and psychological well being, education and friendships
The extent to which the parent’s drug use disrupts the child’s normal daily routines
and prejudices the child’s physical and emotional development
The impact on the child of being in a household where illegal activity is taking place
particularly if the home is used for drug dealing
How safely the parent’s drugs and equipment are stored
Confidentiality
Confidentiality is important in developing trust between drug or alcohol using parents and
staff in agencies working with them in relation to their drug or alcohol use.
Families with a drug or alcohol -using parent need to be able to ask for advice from
appropriate agencies and to work together with them to safeguard their children. Services
need to be accessible and attractive to drug or alcohol using parents and pregnant women
who use drugs or drink alcohol. Parents may be reluctant to seek help if they think
Children’s Social Care will be informed and their competence as parents scrutinised.
No agency can guarantee absolute confidentiality, however.
All agencies, both statutory and non-statutory, should have written procedures on
confidentiality, which include provision for informing Children’s Social Care where there is
concern about the welfare of a child who may be suffering or at risk of suffering significant
harm. When agencies start any work with drug alcohol -using parents or with pregnant
women who use drugs or alcohol, these procedures must be explained to them.
Pregnant women who use drugs or alcohol
All maternity services should have procedures for pregnant women who use drugs or alcohol
that encourage them to go to antenatal services and help them to stabilise, reduce or stop
their drug use.
When a woman with a drug alcohol problem attends for antenatal care, she should be
encouraged to contact a specialist community resource for assessment and advice on the
treatment options available to her.
Appropriate drug or alcohol treatment will depend on past history, the amount and type of
drugs used or alcohol drank, the combination of drugs used and the method of use as well
as the woman’s motivation and current situation.
Planning meetings attended by staff from the maternity and neonatal services and specialist
drug or alcohol agency should be held during the pregnancy to review the management of
the mother’s drug or alcohol use. Consideration will also need to be given to how the
mother’s drug or alcohol use will affect the baby both before and after birth and, if there is
concern about the effect of the drug or alcohol use on the mother’s child care abilities, a
referral should be made to Children’s Social Care under these procedures.
Because of the increased risks of complications, drug-using women should have their babies
in hospital and should be encouraged to visit the special care baby unit before the birth.
The parent or parents should be given information before the birth about the health problems
the baby may have and offered support both before and after the birth.
The effects of drug use on new born babies
Babies may experience withdrawal symptoms or exhibit signs of maternal drug or alcohol
use after birth. Symptoms include a high-pitched cry, rapid breathing, hunger but difficulty
feeding, inability to establish sleep patterns, fast heart rate, sweating, fever, vomiting,
diarrhoea and seizures. Withdrawal symptoms normally appear within 24 to 48 hours of
delivery but this varies and can be longer depending on the type of drug used.
Babies may also have a low birth weight and/or impaired growth.
HIV
Services should offer information and counselling to women on the implications of being HIV
positive, both for themselves and their babies.
Response to children and young people involved in substance misuse:
Definition:
A young person is any one under the age of 18 years as defined in the Children Act 1989.
Drug (illegal substance, prescribed medication and solvents/aerosols and alcohol use in
itself does not necessarily indicate that a young person may be suffering or likely to suffer
significant harm. The risks arising from substance misuse should always be assessed from a
holistic standpoint and in light of the facts of each case.
Assessing Substance Related Need
At the first point of contact with children and young people, working should ensure that they
follow confidentiality and information sharing and policies and procedures. Competency to
consent should also be assessed and recorded.
The aim is to encourage children and young people to approach services for support and
advice in relation to their substance related to need.
Wherever possible it is essential the child/young persons, parents/carers are involved in the
intervention and decision-making. Even where parents/cars may state they do not wish to be
involved workers should ensure they are advised, in writing of planned meetings and their
outcomes. This provides them with information about their child and enables them to
become involved if they wish.