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Resource | Lessons Learned

Lessons Learned: Talking to Young Children about a Loved One’s Substance Use

SAFE Project encourages families to start talking about substance use and mental health challenges with children at a young age. But those conversations are especially important for families that may already be experiencing substance use challenges with a loved one — whether it’s a parent, grandparent, relative, or sibling. Having these conversations is critical to the child’s development and family attachment.

According to SAMHSA, nearly nine million children in this country live with at least one parent who has a SUD, which is more than 12% of all children in the U.S. Keep in mind that substances include alcohol and over-the-counter medications as well as synthetic opioids including fentanyl, psychostimulants, cocaine, benzodiazepines, heroin, prescriptions, and other substances.


For this resource, we refer to the family member with substance use disorder as “the parent,” but this can represent any family member of any age living in the home, a relative, or an unrelated person who is close to the child.

Is My Child Old Enough to Understand?

No matter what age they are, children are very perceptive when it comes to their own families. Young children can withdraw, act out, feel confused or insecure, and struggle at daycare or school. Older children may try to take on more responsibility — more chores, staying alert for disputes, or protecting other siblings.

Each developmental stage is different. Preschoolers and kindergarteners may not fully understand what is happening but can overhear or witness behaviors in the home that are worrisome to them. They can also sense if something is different.

School-age children ages six to 10 may be more aware of changes at home but may need help to understand their own emotions, fears, and feelings. They will also be focused on your emotions and reactions, and take their cues from you.

Why Should I Tell My Child?

It’s natural for parents to want to protect a child from a difficult conversation, but relationships in the early years set the stage for a child’s healthy development. Family is where we first learn how to connect with others. In short, it affects a child’s normal development when relationships and/or life at home are either unpredictable or inconsistent.

As hard as this may feel, talking with your young child helps build a foundation for your own family’s recovery and creates healthy family relationships.

How Do I Talk To My Child About It? I Don’t Even Understand It.

If a parent with substance use disorder has gone into treatment, the conversation with the child may fall to the spouse, partner, or caregiver. If the parent is in an outpatient program and is living at home, it can be a conversation with one parent, both parents, or another family member.

One more point: if your loved one is already in a treatment program, they may have peer specialists or other support in place to help you talk to your child. Some treatment centers also offer a family day or week that includes children or offers group and/or one-on-one support to children. If not, visit our Family Support Locator to find support resources and programs.

Discussions By Age Group

PRESCHOOLERS: Simple and Honest (Ages 3-6)

For preschoolers, remember that the younger the child, the simpler the explanation. Rather than sitting them down to have a long discussion, keep it short and to the point. An activity involving play can help your child feel comfortable. It may be easier to talk with a young child while you join them while coloring, using building blocks, or doing whatever activity that can engage both of you.

When not to have the talk? First, remember the airplane analogy about putting on your own oxygen mask before helping others. You need to be in a place where you can focus on your child and just your child. Second, try to find a quiet time when you have each other’s full attention. Try to avoid carving out time just before naptime, bedtime, or when they are hungry or out of sorts.

How Much Will A Young Child Understand?

You probably know by now that addiction is defined by experts as a chronic, relapsing brain disorder or a disease. Even at a very young age, children will understand what it means to get sick, be sick, or get better.
Explain the parent’s substance use as an illness, but it’s one that you can’t catch. Here are examples:

  • Substance use (or addiction) is something that can make people feel very sick.
  • It makes people take alcohol or drugs because it makes them feel better for a little while, but then they don’t feel very good again.
  • Sometimes it can also make them feel very sad.
  • That’s the kind of sickness Mommy (Daddy) has — and that’s why they need to get help and treatment to feel better.
  • It’s not the kind of sickness that we can catch, like a cold.

If part of your child’s daily routine will change due to their parent’s treatment or recovery, let them know.

Young children process information very differently, so they may want to go right back to playing. You can ask if they want to ask you questions – and respond as simply and honestly as you can. Continue to provide a nurturing environment for them, and be prepared to repeat the conversation when needed.

SCHOOL AGE (Ages 6-11): Straightforward and Reassuring

You may not need to focus on playing when first talking to school-age children, but you’ll still want to find a comfortable place like a quiet time at home, sitting on a park bench, or on a walk.

At this age, it’s also very possible they will come to you before you go to them. They are likely more aware of a change in the family member, and may already have concerns — even if they don’t talk about it. For this age group, this may be the first of many conversations about what’s happening.

How Much Will a School-age Child Understand?

In your first conversation and over time, they need honest answers in age-appropriate language. They need to be able to express their feelings, feel heard by you, and be reassured.

Again, it’s important to teach them that substance use is a disease to help them separate their feelings about their parent or loved one from the disease. As with talking about other diseases or illnesses, you can explain that recovery is the treatment for the disease. You can share basic information about their treatment, and answer any questions honestly and in an age-appropriate way.

Children at this age can worry that something they did caused this issue for their parents or family and feel guilty. They can become anxious about their own health and safety, fear change, and worry about separation from their loved one. So, if a parent doesn’t provide sufficient information in age-appropriate language, the child may make up reasons to fill in the gaps.

For younger children in this age range, their questions will be much more concrete. They may just want to know when they can see the parent or who is picking them up at school.

At the older end of this age range, they will likely have more abstract questions. They may ask “why” or “how” it happened, and want more detail on what’s going on at home or with the loved one. You may not have the answer to every question they ask, so remember that you can say, “I don’t know” or that you’ll try to find an answer for them. If it’s a question you’re not prepared to answer, you can also ask them, “What made you think of that?”

Consider incorporating the “Seven C’s” concepts when talking to children at this age. The National Association for Children of Addiction (NACoA) created this tool and affirmation to help children learn both self-care and how to understand their feelings. In simple language, it covers the issues commonly experienced by children — and adults — in this position.

What If They Don’t Want to Talk?

There are many what-ifs when it comes to these types of conversations with young children. As adults, we know when we aren’t ready to talk — so you may need to take your cues from your child.

Preschoolers may be too distracted or tired. School-aged children may be surprised and not ready to talk, or they may deny anything is wrong. They may have also been told not to talk about what’s happening at home or with a loved one.

You can also slightly change the conversation by giving them the words to help describe what they are feeling or thinking. You can also try to let them direct the conversation for a bit, and then try again with more open-ended questions. Reassure them that it’s okay for you both to talk about what’s going on.

Remember that families recover too. So be sure to get support for yourself that helps you and your children stay resilient. Together, your family will discover self-care and new ways to navigate as a family.

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