Studies have shown that families with substance use disorders (SUD) will increase a child's
likelihood to struggle with emotional, behavioral, or substance use problems (Lander et al.,
2013). Families where there is parental substance use disorder often lead to home
environments of secrecy, loss, conflict, violence, and emotional abuse (Lander et al., 2013) One
study found that a parent with SUD is about three times more likely to physically or sexually
abuse their child (Lander et al., 2013). Children exposed to parents with SUD will often have
impaired attachments which could explain the patient's child appearing cold and lacking
maternal bonding (Lander et al., 2013). It is important to recognize that a parent with a SUD
who spends the majority of their time recovering from the effects of substances may miss the
opportunity to form a healthy attachment (Lander et al., 2013). Children under these
circumstances experience high levels of abuse and neglect (Lander et al., 2013).
It is important to note that healthcare professionals are required by law to report any
reasonable suspicion of child abuse and neglect (Pietrantonio et al., 2013). Given that the child
was yelled at during the visit, the patient has a history of violence, and the forceful grab of the
arm, it would be enough of a reasonable suspicion to report the parent. Healthcare
professionals are in a unique position to intervene on behalf of a child and help prevent adverse
outcomes (Pietrantonio et al., 2013). One barrier that healthcare professionals often face is a
lack of knowledge and recognition of abuse (Pietrantonio et al., 2013). Poor recognition and
suspected maltreatment will often leave a child vulnerable to continued victimization and the
potential for resulting morbidity and mortality (Pietrantonio et al., 2013). Child abuse is a public
concern. Due to these reasons, it is important that providers educate their patients of this risk
and follow proper reporting in order to prevent further maltreatment (Pietrantonio et al., 2013).
References:
Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families
and children: From theory to practice. Social Work in Public Health, 28(3-4), 194–205.
https://doi.org/10.1080/19371918.2013.759005
Pietrantonio, A. M., Wright, E., Gibson, K. N., Alldred, T., Jacobson, D., & Niec, A. (2013).
Mandatory reporting of child abuse and neglect: Crafting a positive process for health
professionals and caregivers. Child Abuse & Neglect, 37(2-3), 102–109.
https://doi.org/10.1016/j.chiabu.2012.12.007
