Substance abuse negatively affects the youth who use substances, their families and especially their parents. The use of substances impairs the health of the youth and is linked to an increase in noncommunicable diseases. Parents become stressed and they need help. Parents fail to carry out daily plans and routines because they are not sure what the substance abuser can do or what can happen to the substance abuser. When the parents’ well-being is taken care of, they will be able to take care of their youth when they need help. Unfortunately, little is known about the psychosocial needs of the parents, especially when their child abuses substances.
This article aims to review the literature to explore the need for support for parents of youth abusing substances.
The study adopted the narrative literature review (NLR) methodology. Literature was retrieved from the following databases and search engines: electronic databases, search engines and hand searches.
Substance abuse has been found to affect the youth abusing substances and their families negatively. The parents, being the most affected, need support. The involvement of health professionals can assist the parents in feeling supported.
Parents need support programmes that will give support and strength to their existing abilities.
Focusing on the support needs of the parents of youth abusing substances will help to ensure parents are supported and mentally healthy.
The reality is that substance abuse affects millions of parents across the world (Meadows
Substance abuse negatively affects the youth who use substances, their families and their communities. The use of substances impairs young people’s health and is linked to increased physical and psychological disorders. These effects are also visible in their family members. The abuse of substances by adolescents exposes them to violent crimes as victims or perpetrators. They will be in conflict with the law and may suffer loss of employment (Moore
Dealing with a youth who drinks or uses drugs can limit the time and attention parents give to their other children at home. Feeling ignored, the siblings may act out as a means of being noticed. An older sibling may also be a negative role model for the younger youth. The younger child may engage in alcohol or drug use to be like the older sibling (Moore
The impact of youth substance abuse causes a significant change in the family cycle. In addition, there is a severe conflict between the restructuring and readjustments to the new realities (Breiner et al.
Hospitalisation because of substance abuse can be demanding for the substance abuser and their families. The family will need to frequently visit the hospital to check on their beloved family member, as they want to know how they are recovering (Root et al.
The literature review methodology adopted for this study is the narrative literature review (NLR). Narrative literature review is a method of review that assists the reviewer to identify, assess, analyse and interpret the body of knowledge on the support needed by the parents of youth abusing substances. It places and rationalises the choice of the topic within the framework of existing literature and finds gaps in existing knowledge (Coughlan & Cronin
Literature was retrieved from the following databases and search engines:
Electronic databases: Ethno Med, Public Library of Science (PLOS ONE), British Medical Journal (BMJ) Open, BioMed Central (BMC), Sabinet and ScienceDirect.
Search engines: Google Scholar, University of Limpopo (UL) E-Libraries, Chrome and Google Books.
Hand searches: Reference lists from retrieved literature.
The keywords used in the literature search were multiple combinations of ‘substance abuse’, ‘youth and substance abuse in youth’, ‘substance abuse in adolescents’, ‘experiences of parents in substance abuse in youth’, ‘substance abuse effects in the family’, ‘parenting a substance abuser’, ‘parents needs about substance abuse’, ‘support needs of parents’, ‘effects of substance abuse on the parents’, ‘contributory factors to substance abuse’.
Only publications meeting the following criteria were included in the literature review:
full articles related to support of parents of youth abusing substances
English publications available by the time of the literature review
articles published from 2012 to July 2022.
The literature review excluded articles that were not written in English.
Two review mechanisms were considered in this analysis. The first review entailed locating the relevant studies and screening. The screened publications were re-evaluated following the predetermined eligibility criteria in the second review. The publications were found using a variety of electronic databases.
Review process.
Databases searched | Total publications |
---|---|
Identification of publications | 1 050 |
Publications remaining after duplications were removed | 750 |
Excluded publications after screening abstracts | 554 |
Publications remaining after rescreening | 330 |
Publications assessed for the second review | 198 |
Publications remaining after 151 articles excluded | 51 |
Overall publications used in the study | 47 |
Included publications in this review | 20 |
The findings of the literature search are summarised as follows: 51 sources were reviewed for the study literature, including websites, journals and books.
The review of the literature was performed and yielded the following themes:
the effects of substance abuse on the youth
the effects of substance abuse on the siblings
the effects of substance abuse on the family
the effects of substance abuse on parents
the need to support the parents
the healthcare professionals’ involvement
the need for a support programme.
Themes and references.
Theme | References |
---|---|
The effects of substance abuse on the youth | Hartney Eds. Kaye, Vadivelu & Urman Ewing et al. Moore |
The effects of substance abuse on the siblings | Morrill et al. Moore Ye et al. |
The effects of substance abuse on the family | Morrill et al. Moore Dykes & Casker |
The effects of substance abuse on parents | Tollefson et al. Gadsden, Ford & Breiner 2016 Purcell et al. Cousino & Hazen Conn et al. |
The need to support the parents | Curtis et al. 2016 Gates et al. Wiseman et al. Both et al. |
The healthcare professionals’ involvement | Golsäter et al. 2016 Nightingale et al. Dunst & Trivette |
The need for a support programme | Dunst & Trivette Bray et al. Smith |
The literature review has indicated that substance abuse affects the youth. The indicators of substance abuse include taking more substances for a more extended period than the person wants; using substances continuously even when one knows it puts their life in danger and affects their physical and mental health; having a need to stop using the substance but failing; using more of the time in trying to acquire, use or recover from substance abuse; having solid cravings for substances; failing to do what one is supposed to do at home, work, or school because of use of substances; ongoing use, even though it creates social problems; not enjoying what one used to do before starting to use substances; requiring more substances to feel good and developing withdrawal symptoms, which need one to take more of the substance (Hartney
The literature review has indicated that siblings can also be affected when their fellow sibling abuses substances. The use of substances by one sibling may lead to other children or siblings missing out on the attention and time of their parents. If the parents are not careful, the other children will start to build resentment towards them and their substance-abusing siblings. Commonly, most of the attention will be given to one child without considering the effects the status quo has on the health of the other family members (Morrill et al.
Dealing with a teen who drinks or uses drugs can limit parents’ time and attention to their other children at home. Feeling ignored, those children may act out as a means of being noticed. An older sibling may also be a negative role model for the younger youth. The younger child may engage in alcohol or drug use to be like the older sibling (Moore
The use of substances by a family member has an impact on the whole family; however, the impact varies according to family members. Some effects include unmet developmental requirements, poor attachment, financial difficulties, legal issues, emotional pain and even violence (Dykes & Casker
Many parents feel depressed and anxious because of their child’s substance abuse. They compromise their activities, including their families, to accommodate the affected child. They may also put their careers on hold. This leads to poverty, as poverty constitutes a risk for parenting. The lack of finances in the family will affect the ability of parents to give food, keep their youth healthy and take them to good schools. Parenting at this stage becomes more complex; the life of compromising even their happiness becomes a regular part of their lives (Gadsden et al.
According to Purcell et al. (
Parents are essential in the recovery of their youth. The parent’s ability to cope with the stress associated with substance abuse in their youth can affect the family’s quality of life (Curtis et al.
There is a need for healthcare providers to be involved and assist the parents with coping strategies (Dunst & Trivette
Parents need support programmes that will give support and strength to their existing abilities. The support programmes can encourage the development of new capabilities so that parents will know and have the skills needed to perform child-rearing responsibilities efficiently and give their youth opportunities and experiences that will endorse learning and development (Dunst & Trivette
Substance abuse is a disease that kills individuals, harms families and cripples society. When youth engage in substance abuse, the parents as primary caregivers will be affected by the situation. This is because parents expect only the best out of their youth from birth. One thing that does not cross the parents’ minds is that their youth can abuse substances at some point in their lives (Meadows
The use of substances by the youth is a challenge; this is because, according to Dykes and Casker (
The family and the siblings are affected when one family member abuses substances. The use of substances by an adolescent member of the family can leave unaddressed bitterness and anger from other siblings. This is because the parents may shift their attention from their other children to focus on the child who now uses substances. This may cause the parents to feel inadequate and can lead to parent dissatisfaction (Dykes & Casker
The parents must make sacrifices for their youth. Some of the sacrifices the parents go through include financial sacrifices. They take the little money they have to finance the well-being of their child by paying hospital bills or rehabilitation centres. They even go to the extent of battling with medical aid companies to ensure that their youth’s healthcare needs are met. This leads to incredible frustration as the parents have to assume new roles such as nursing their youth by making sure that they take the medications as they are supposed to and also assuming the role of being a psychologist to the child (Meyers
Parents are essential to family life. Decent parenting can promote well-being, health and physical and emotional development of the family, in addition to prohibiting ill health in succeeding generations. Parents’ confidence in managing their children, especially youth, determines a healthier quality of family life (Moen, Opheim & Trollvik
Most parents who come to the hospital bringing their youths who abuse substances have low health literacy, making it difficult for them to make health decisions for their admitted child. Health literacy occurs when the individual can obtain, process and comprehend the simple health information and services needed to make suitable health decisions. It is difficult for adults with low health literacy to understand what is required to obtain maximum health for their children; they sometimes make wrong treatment decisions. Low health literacy leads to parents bringing their youth to the hospital when the situation is worse (May et al.
In the study carried out by Sim et al. (
Mothers, as the parents of youth abusing substances, are most affected by substance abuse of their youth. According to Xu et al. (
Parents reported that they have high stress levels and receive little help regarding this from healthcare providers. The stress levels of the parents increase as their children grow into adulthood. The first manifestation of abuse of substances in the family leads to the process of family adaptation. Whether the youth can adapt adequately to their recovery process from substance abuse also depends on the ability of their family to cope with the stress caused by substance abuse (Both et al.
Parenting stress is common and challenging to parents of all types and structures of families. The stress can even be high for the caregivers of substance abusers. At the same time, there may be other children in the house who are younger and need the intervention and attention of the parent. The parents feel a loss of a child who abuses substances because they were born ordinary but may have mental health problems because of substance abuse. There may be experiences of family conflicts, and financial strains may result from the youth abusing substances (Richardson et al.
Some of the challenges faced by the parents include having to deal with the diagnosis of their youth, being able to manage youth abusing substances from day-to-day or additional need, being able to maintain family life and commitments at work and having to deal with unforeseen changes in their youths’ condition and family circumstances (Bray et al.
When parents lack knowledge about their child’s condition, they do not become very involved in caring for their youth. They fear complications for their child, which limits the involvement of the parents in caring for the child. There is a need for healthcare providers to be involved and assist the parents with coping strategies. When the nurses do not interact with the parents, the latter are discouraged and afraid to ask questions. Nurses and other health professionals appear to allocate care duties to them without adequate explanation. When a professional fails to give the information to the parent, it is the same as denying the parents an opportunity to care for their youth (Valizadeh, Ahmad & Zarea
The parents have indicated that they need to be informed about health matters relating to their admitted youth. They need this information to understand what is going on with their youth and what needs to be performed as a way forward. In the process of being informed, they also want their families to be involved collectively to assist each other in helping the admitted family member. They need family intervention therapies instead of individual ones to deal with the problem of their youth being admitted for substance abuse (Gates et al.
Parents need to know about parental monitoring, that is, knowing where their children are at a particular time and what they are doing. That way, the parents will have an idea of the whereabouts of their youth, the activities they are engaging in and how they are coping. This means that the parents will be intentional in the care of their children, and they will be able to seek information about any change in their youth. When the parents are aware of their youth’s movements, it will be easy for them to notice any difference in behaviour, and they will be able to immediately seek help (Hernandez, Rodriguez & Spirito
Botzet et al. (
The parents want to know about their youth when their children abuse substances and are admitted to the hospital. They want to know if they could one day quit substances. Furthermore, they want to know if there is anything they could do to help their young ones abstain from substances, and they also want to know how they will live when they are at home after being admitted. They must be equipped with skills to manage their youth, especially at home after discharge (Nightingale, Friedl & Swallow
Parents suffer anxiety and fear about the illness of their admitted children. They may feel emotionally exhausted to have a child in the hospital. Some feel guilty, particularly when their adolescent is admitted for substance abuse (Golsäter et al.
Healthcare professionals are experts, from the parents’ view. They are the experts in the hospital system and medical care of their youth. Parents appreciate the expertise of healthcare professionals; hence, they try to build the parent–healthcare professional relationships around the medical care of the admitted youth. The relationship between parents and healthcare professionals involves two key behaviours, namely learning how things work and ensuring survival (Butler, Copnell & Helen
The healthcare provider has to support the parents, but they sometimes fail to provide needed support to the parents because of the high workload. Participation of the parents in the delivery of care is a well-recognised way of engaging the parents. However, there is a need to understand the family’s needs during the youth’s admission. Nurses find it challenging to deal with both the patient and the parent. Parents, on the other hand, find themselves lacking confidence in communicating with healthcare professionals (Curtis et al.
There are other behaviours that parents need to learn to cooperate with healthcare professionals. They need to learn how to step back and allow healthcare professionals to do their work. They must learn to accept the restrictions and defer to medical advice. They also need to acknowledge that their skills are limited. Otherwise, most parents know that they have limited medical knowledge to make informed decisions regarding the care of their admitted youth. They know that they have no idea of examinations that need to be performed and the risks involved. As parents do not know much about medical procedures, they often submit to the advice given by medical practitioners to make sure their youth receive the relevant prescription (Butler et al.
Support programmes can be necessary for the parents as they provide the parents with the ability to give an account of their worries and anxieties and engage with other parents who had the same experiences and have been through a similar situation. What other parents have been through is the most important distinguishing factor of support the parents may need. Parents need to be in contact with the parents who have the same problem of children abusing substances to learn the ways of managing a child who abuses substances, which will help them to grow and have meaningful relationships with their youth (Bray et al.
Support programmes for the parents may include topics such as overall access for families, support for families from an early stage and the family’s involvement at every level of operation of the programme. Parenting programmes sometimes include different parenting activities such as parent information classes and parent–child sessions and support sessions, which include parenting materials. Individualised supports for parents are provided in response to specific child-rearing problems or particular questions that the parents can raise. This will provide, or help parents to access, different kinds of resources and supports, such as childcare resources and medical resources (Dunst & Trivette
Smith (
Nightingale et al. (
It is therefore essential for the nurse to acknowledge that the parents need to be informed, and they need to be reassured to have confidence in healthcare professionals providing care to their youth who is abusing substances. The nurses also need to be aware that parents have other needs that are related to their parenting roles that are not related to their admitted youth that are part of daily life, such as running a household, taking care of other family members and managing finances. Parents, on the other hand, need to know that the healthcare professionals are trustworthy and are concerned about their admitted youth (Feeg et al.
For the parents of youth abusing substances to feel supported, the following steps are recommended.
For the parents:
Parents must not hesitate to seek help for their youth abusing substances.
They must also seek help for themselves so that they receive support while they are helping their youth who abuse substances.
Parents need to be available when there are information sessions related to their youth abusing substances or any information related to substance abuse.
For the healthcare providers:
As much attention is given to the youth abusing substances, further attention should be given to the parents so that they continue being healthy enough to take care of their child abusing substances.
Healthcare providers should be available to share information with the parents; the information will help in reducing worries for the parents.
Healthcare professionals can organise awareness programmes for the parents so that they know more about substance abuse and how to manage it.
Workshops and support groups organised by the healthcare provider can assist the parents with relevant skills to manage their youth abusing substances.
The findings of the review of literature have revealed that substance abuse has devastating effects on the youth abusing substances, their siblings, their families and the parents. Parents are found to be on the receiving end in all the effects, as they are supposed to show effective parenting to the whole family. Studies have shown that parents suffer emotional and physical health problems and they need support. One of the reasons they suffer is because they lack knowledge regarding substance abuse. It is essential that the health providers can come in to provide the needed support to the parents; parents can benefit from the support programmes that are tailor-made to enhance their knowledge of substance abuse. Further research is recommended on how to support the siblings and the whole family when one family member abuses substances.
The authors would like to acknowledge Tirisano Track A project under the University of California (UCLA).
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
L.S.H., C.N. and T.M.M. participated in the drafting of the manuscript. L.S.H. conducted the literature review, wrote the original draft, reviewed and finalised the manuscript. C.N. assisted in reviewing, analysing and editing the document. T.M.M. supervised the review and also reviewed and edited the document.
This article followed all ethical standards for research without direct contact with human or animal subjects.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Data sharing is not applicable to this article as no new data were created or analysed in this study.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.