Documents to download

Parental alcohol misuse (PAM) refers to a spectrum of problem drinking by those with parental responsibility for children. This POSTnote outlines what is known about the number of children affected by PAM in the UK and reviews evidence about its effects. It describes the services available for children affected by PAM and effective interventions.

Summary of Key Points

  • The majority of evidence on the effects of parental drinking on children focuses on parents drinking at or above harmful or dependent levels. However, it is unclear at what level of drinking parenting capacity is impaired.
  • There are no systematic national data on children affected by parental drinking. It is estimated that between 189,000 and 208,000 children in England live with an alcohol-dependent adult, while 15,500 children live with an adult receiving treatment for alcohol dependence. Estimates are likely to underestimate the scale of the issue due to under-reporting of alcohol consumption, and the unknown number of children whose parents are not in treatment, and who are not known to social services themselves.
  • The effects of parental alcohol misuse (PAM) can start before birth and continue into adult life. Heavy drinking during pregnancy may lead to Foetal Alcohol Spectrum Disorder (FASD), an under-diagnosed condition that is associated with behavioural and learning difficulties, and increased risk of mental health issues and involvement in crime.
  • Parental alcohol misuse disrupts everyday routines and leads to inconsistent and unpredictable parenting. Children may feel isolated, stigmatised, and guilty, and may have to take on caring responsibilities. Experiencing PAM is associated with a greater risk of mental and physical health problems, including eating disorders and depression. PAM is also associated with neglect and domestic abuse, and child protection cases involving PAM have poorer welfare outcomes for children.
  • A number of protective factors, including self-esteem and having a trusted adult role model, help children to be resilient and to have positive outcomes despite experiencing PAM. Family-focused services improve outcomes for alcohol misusers as well as children, and are cost effective.
  • The APPG for Children of Alcoholics and the Office of the Children’s Commissioner have called for greater awareness around the effects of PAM among practitioners and those working with children. Recommendations include producing a national strategy, increasing the availability of support for families affected, and improving data collection on families accessing support.


POSTnotes are based on literature reviews and interviews with a range of stakeholders and are externally peer reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:

  • Professor Richard Velleman, University of Bath*
  • Professor Petra Meier, University of Sheffield*
  • Professor Yvonne Kelly, University College London*
  • Oliver Standing, Adfam*
  • Professor David Foxcroft, Oxford Brookes University
  • Department of Health*
  • Ministry of Housing, Communities and Local Government’s *
  • Local Government Association*
  • Department of Education*
  • Public Health England*
  • Ms Lorna Templeton, Independent Research Consultant, Bristol*
  • Dr Luisa Zuccolo, University of Bristol*
  • Professor Judith Harwin, University of Lancaster*
  • Dr Raja Mukherjee, Foetal Alcohol Spectrum Disorder Clinic*
  • Charlotte Vincent, Vincent Dance Theatre
  • Michael Simpson and Janaya Walker, NSPCC*
  • Katherine Brown and Lucy Bryant, Institute for Alcohol Studies*
  • Rob Davies, CLOSER, University College London*
  • James Nicholls, Alcohol Research UK*
  • Office for National Statistics
  • Hannah Chetwynd, The Children’s Society*
  • Michael O’Toole, Mentor UK*
  • Mike Shaw, Family Drug and Alcohol Court National Unit*
  • Emily Lowthian, University of Cardiff*
  • Office of the Children’s Commissioner*
  • Northern Ireland Assembly*
  • Scottish Government*
  • Public Health Wales

*Denotes people who acted as external reviewers of the briefing.

Documents to download

Related posts

  • Some occupational groups have experienced higher rates of both COVID-19 infections and related deaths. Many people who work within these groups are involved in caring for people or patients that are more likely to be infected, or have otherwise been unable to work from home during the peaks of transmission. Which occupations have been most affected, what factors are contributing to this risk and are some sectors of the population being impacted more than others?

  • During the first 6 months of the pandemic, people from ethnic minority groups were more likely to have COVID-19 disease and also more likely to experience severe outcomes from infection, including death. Lockdown measures have also disproportionately affected some communities more than others. What is driving this increased prevalence and death rates in ethnic minority groups? To what extent is it due to biology or pre-existing health? Or does it represent a continuation and exacerbation of social inequalities?

  • On 9 September, the Prime Minister announced a moonshot plan for mass COVID-19 testing. Recently there have been capacity issues in the NHS Test and Trace programme and current technologies cannot be scaled easily to millions of tests per day. So, how is COVID-19 testing undertaken, how reliable are current tests, and what technologies or strategies are emerging that would make this moonshot feasible?