The Psychological Development and Welfare of Children of Opiate and Cocaine Users: Review and Research Needs

Abstract

Parental dependence on illicit drugs is a growing concern across a number of disciplines. It has implications that are at once medical, political, social, and psychological. In recent years, researchers from the U.S.A. (Austin & Prendergast, 1991; Deren, 1986; Johnson, 1991) and the U.K. (Burns, O'Driscoll, & Wason, 1996) have called for greater attention to be paid to social and psychological, rather than solely physical, effects of parental drug use on children. In Ireland, against the backdrop of an intractable and escalating intravenous opiate problem, the issue of how children are affected by parental drug dependence is emerging as a new social and clinical concern. A recent government report, for example, recognises that children of drug users may be in need of clinical interventions and special care arrangements (Rabitte, 1996). But what form should such services take? Are these children at greater risk than other children from similar socioeconomic backgrounds for experiencing social and psychological problems? Is the nurturing environment provided to children whose parents are dependent on illicit drugs less adequate than that provided to children whose parents do not use drugs? At present research does not provide conclusive answers to these questions. Research that focuses on the effects of postnatal parental drug use on children's social and psychological well-being is strikingly scarce, with the majority of child-oriented research concentrating instead on the effects of prenatal exposure to drugs. The small amount of research that has been conducted on the caregiving environments of children of drug users has produced largely inconclusive findings.

The aims of the present paper are to review and analyse existing research on the social environments provided to children of drug users, and on the developmental outcomes for this group. A further aim is to provide pointers to gaps and shortcomings that need to be addressed in future research. The focus is on parental addiction to “hard drugs”, namely opiates (primarily heroin and methadone) and cocaine. Studies dealing exclusively with the impact on children of prenatal exposure to drugs and of parental alcohol use are excluded, as are studies of a primary addiction to amphetamines and other illicit substances, although it is recognised that these are frequently used in addition to opiates and cocaine.