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The Fact is...
Tends to Run in Families

What's important about Children of Alcoholics? Children of alcoholics (COAs):

  • are at high risk for alcohol and other drug problems
  • often live with pervasive tension and stress
  • have higher levels of anxiety and depression
  • do poorly in school
  • experience problems with coping

The good news is that they can be helped to bounce back from the effects of their families' problems.

When family members (parents, grandparents, aunts/uncles), guardians, or other adults in charge of children are alcoholics, there is strong evidence that children in these families are more likely to develop the disease of alcoholism as well. The fact is, alcoholism tends to run in families.

What causes COAs to have increased risk?

Children of alcoholics may or may not be raised by alcoholics. Either way, every COA is at risk for alcoholism or alcoholism-related problems.

  • Children living with alcoholics

    Children who live with alcoholics are at increased risk because of genetic and/or environmental factors. They may be at more risk for alcoholism just as children of diabetics are at higher risk for diabetes. Children living with alcoholics often develop unhealthy living patterns. They may not learn how to trust themselves or others, how to handle uncomfortable feelings, or how to build positive relationships. COAs who lack these skills are also at higher risk for school failure, depression, increased anxiety, as well as trouble with alcohol and other drugs.

  • Adopted and foster children

    Even COAs adopted by non-alcoholics (or do not live with their alcoholic parents for other reasons), may have a genetic predisposition to alcoholism, just as children born to parents with a history of heart disease are more at risk for heart disease.

Alcoholism can skip a generation. Some COAs never drink, but may pass on a genetic vulnerability and/or unhealthy living pattern to their own children.

COAs do not have to develop problems -- You can help!

Genes can't be replaced. But unhealthy living patterns can be countered by the consistent caring of others. COAs can learn to trust, handle their feelings in healthy ways, and build positive, nurturing relationships. Anyone can help COAs understand their risks and learn better social and coping skills.

How many COAs are there? How many become alcoholics?

There were an estimated 28.6 million COAs in the U.S. in 1991, nearly 7 million of them under age 18. Of the under-18 group, almost 3 million will develop alcoholism, other drug problems, and/or other serious coping problems. About half of COAs marry alcoholics and are likely to recreate the same kinds of highly stressful and unhealthy families in which they grew up.

What about the other COAs?

Based on stories from adult COAs in professional treatment and self- help programs, it appears all children are affected by family alcoholism. But, going back to the good news, many of them make positive adjustments to their families' alcoholism. Even COAs in high- risk environments with other chronic sources of stress -- including poverty, racism, disrupted marriages, serious emotional problems, and histories of abuse and neglect -- are often able to overcome these painful beginnings and create healthy, fulfilling lives for themselves.

How can COAs be helped to "bounce back?"

This is where the good news is really exciting:

The child in an alcoholic home may be helped whether the alcoholic stops drinking or not! It is not necessary to do anything to change the adult's drinking behavior. And helping a COA does not require special training or skills.

Simple acts of kindness and compassion can make a big difference in the lives of COAs. Just by "being there," to lend an ear, share normal interests and activities, talk about feelings, accept their mistakes, and support and encourage their friend-making efforts, YOU will be helping.

What else helps COAs?

Tell them that they did not cause alcoholism and cannot cure or control it. But they can learn to cope with it. Make clear that children are not responsible for solving grown-up problems.

Understand that COAs often build up defenses against the pain, shame, guilt, or loneliness they may feel. They may show off, act tough, keep secrets, or hide. You may help by just accepting them for who they are. Encouraging them to share their thoughts and feelings will help them learn to trust others and accept and adjust to their lives.

Get them involved in something about which they feel good. It can be something small like taking care of a pet; or a hobby such as collecting rocks, or stamps, or comic books; or a sport. Go slow, don't push, but keep trying.

Do something with them on a regular basis, even if it's only twice a year, such as on the 4th of July or Martin Luther King's birthday. Providing some consistency and showing that adults can be counted on are important assurances for young people who may have experienced many broken promises and unpredictable parental behavior.

Gently help them get positive attention from others. Let them know they are wonderful, special, and cared about just because they are who they are. Again, go slowly, but tell them often.

Help them see life as really living even though there are times and situations that may be very painful. Help them see beyond their present circumstances. Help them feel connected to nature, art, and history; to heritage, culture, religion; to their community. Help them build a larger picture of their lives and their world than their families' current problems.

Help them understand that it is okay to ask for help. Assure them that getting help is a sign of strength. Offer some examples from your own life so they'll know how it's done and that it really is okay.

More things to DO:

Follow through if a child asks for help, because it probably required a lot of courage for her/him to do so. Know the local number for Alateen and other sources of help you can offer as needed. Let them know they aren't alone; there are approximately 7 million COAs under the age of 18. Collect information about alcoholism to discuss with the child when it's comfortable for both of you to do so. Be aware and respectful of cultural differences, such as family structure, customs, values, and beliefs. Be aware that some COAs may have been mistreated and may be threatened by displays of affection, especially physical contact. Help them make discoveries, positive connections; instill enthusiasm for life and all its many possibilities.

AND, when talking with anyone under 21 about alcohol and other drugs, urge them to "Be Smart! Don't Start!"--

COA Intervention/Treatment Referrals:
National Association for Children of Alcoholics (NACoA)
11426 Rockville Pike, Suite 100
Rockville, MD 20852
(301) 468-0985

National Association for Native American Children of Alcoholics (NANACoA)
611 12th Avenue South, Suite 200
Seattle, WA 98144
(800) 322-5601

National Black Alcoholism Council (NBAC)
1629 K Street NW, Suite 802
Washington, DC 20006
(202) 296-2696

National Council on Alcoholism and Drug Dependence (NCADD)
12 West 21st Street, 7th Floor
New York, NY 10017
(800) NCA-CALL

Self-help groups for COAs:Al-Anon/Alateen Family Groups
P.O. Box 862, Midtown Station
New York, NY 10018-0862
(800) 344-2666 (U.S.)
(800) 433-4525 (Canada)

Adult Children of Alcoholics (ACA/ACoA)
P.O. Box 3216
Torrance, CA 90510
(310) 534-1815

Alcohol/other drug prevention information for volunteers, professionals, and the general public:Children of Alcoholics Foundation
P.O. Box 4185
Grand Central Station
New York, NY 10163-4185
(212) 754-0656

National Clearinghouse for Alcohol and Drug Information (NCADI)
P.O. Box 2345
Rockville, MD 20847-2345
(800) 729-6686

DHHS Publication No. (ADM) 92-1914
Printed 1992, reprinted 1993 and 1995