Parental Substance Misuse


Drug and alcohol problems affect people’s lives in different ways. The effects vary according to the individual, their physical and psychological state, the drugs used, the amount, and pattern of use and the circumstances in which the substance is used.

Drug and alcohol use in itself neither automatically indicates a problem with parenting nor is it automatically an issue of child protection. However substance misuse by parents may affect parenting and childcare. Children may be exposed to risks which could result in them suffering significant harm.

Agencies must ensure that a child’s needs, including the need for protection, are thoroughly assessed. The focus of assessment should be the impact of the parent’s behaviour on the child i.e. on whether the child is suffering or likely to suffer significant harm because of the parent’s behaviour and lifestyle.


Substance Misuse - Drug, solvent, and/or alcohol taking that may cause harm to the individual, their children, or those for whom they have responsibility.

Throughout this Guidance, ‘Substance Misuse’ will be the term used to describe alcohol, solvent, and drug misuse.


No service can guarantee absolute confidentiality. Staff should explain the need for appropriate information sharing and its benefits for the whole family, but in particular if there is a concern that a child may be at risk of harm, information will be shared. 

If a child may be at risk of harm this will always override legal, professional or agency requirements to keep information confidential. Professionals have a responsibility to act to make sure that a child whose safety or welfare may be at risk is protected from harm.

Parents accessing treatment/ agencies should always be informed about the above exception to confidentiality at the assessment stage. The North Yorkshire & York DAT assessment tools should be used for drug treatment agencies.

Children affected by parental substance misuse may initially be recognised by adult services in health, social care, or voluntary organisations. Those agencies working with the child may not be aware of the parental substance misuse. Agencies working with the adult should seek parents consent to pass information that may have a bearing on how well parents are coping to agencies working with the child so that they can make a proper assessment of the child’s needs

If any agency is concerned that the parent’s substance misuse places a child at risk of significant harm a referral should be made to Children’s Social Care.

When a drug and alcohol misuse assessment identifies a client as a parent, the agency should record this on the client’s file. Consideration should then be given as to whether the substance misuse affects their ability to parent. It is the adult service providers’ responsibility to make a referral to Children’s Social Care if they become concerned about the child. Whilst a referral must be made under these circumstances this should be done with the parent’s consent, unless to do so would place the child at risk. 

If the child is not in need or is not suffering or likely to suffer significant harm, the services should work with parents and other agencies with regard to the child’s ongoing and future needs, as a future referral to Children’s Social Care for a child in need or a child in need of protection may be required.

There is a need to balance the information and exercise professional judgment as to whether there is a need to refer to Children’s Social Care. The following are circumstances that would give cause for concern:

  • Needles, syringes, medication or alcohol left within reach of children;
  • Children living in environments where there are high levels of drug dealing, violence, and criminality;
  • Children assuming inappropriate responsibilities in the household;
  • Children being left alone inappropriately or being taken to places where they might be at risk;
  • Parents intoxicated whist driving/transporting children
  • Parents’ chaotic drug, alcohol use (i.e., swings between states of severe intoxication and periods of withdrawal and/or polydrug use);
  • Parents’ lack of insight into their misuse of substances and the impact on children.

If there is uncertainty as to whether a referral should be made to Children’s Social Care consultation must take place with your line manager/ lead for Safeguarding/Child Protection and /or Children’s Social Care.


Existing (Health) Care Pathways for Maternal Drug Dependency are not replaced by this Guidance, which relates specifically to the joint working arrangements between Health, Drug Services, and Social Workers.

When a pregnant substance misuser presents at a drug treatment agency, she should be referred to the local maternity services and GP, she should be encouraged to attend for antenatal care. Confirmatory substance testing should be undertaken as required.

When a pregnant drug user attends for antenatal care, she should, with her consent, be referred to the local drug treatment agency and encouraged to engage with its services to reduce the harm to herself and her baby. North Yorkshire DAT protocols indicate that such referrals should be fast tracked for immediate provision of drug and/or alcohol service to manage substance misuse. Where appropriate the partner should be fast tracked as well.  

Failure to engage with services designed to support substance misusers should be viewed as a potential risk to the unborn baby and referral to Children’s Social Care must be considered.

In circumstances where a woman is pregnant and misuses drugs or alcohol consideration should be given to the impact on the unborn child. If it is assessed that this and/or the parent’s lifestyle places the unborn child at risk of significant harm then a Section 47 enquiry must consult with your appropriate lead for Safeguarding/Child Protection and /or Social Care.