This is a big concern for many parents. After all, about 7 million children in the U.S. have a parent suffering from alcoholism or a drug dependency. You may know that a family history of alcoholism may put your children at risk for problems, including alcoholism. However, you may not be sure why this is, or what steps to take to prevent it. The following information should help you.

If they drink alcohol, they may be. There is a wealth of evidence that one of the greatest risk factors for developing alcoholism is to be the son, daughter, or sibling of an alcoholic. If they drink, children of alcoholics are four to nine times more likely to develop severe alcohol problems than others. The risk may be even higher if the parent with alcoholism is the same gender (father-son), if the family history goes back more than one generation (grandparents), or if there are several blood relatives with alcoholism (aunts, uncles, brothers, sisters).

Nobody knows for sure, but it's probably a complicated combination of the child's genetics and the environment he/she lives in. Let's look at each area, and what to do about it, separately.

This may be a very strong influence for children of alcoholics and their reaction to alcohol may be different.. For example, they often have high tolerance (able to drink more than others without getting the same level of impairment) and may experience a greater reduction of stress when using alcohol. These differences may be apparent after only a few drinking episodes. These unusual responses may be tied to the reasons for increased risk for alcoholism.

Are all children of alcoholics at high-risk for alcoholism?
No. Some may have little (or maybe no) genetic susceptibility and their reaction to alcohol may be normal. Some may have moderate levels of susceptibility and others very high levels. The levels of susceptibility may vary from child to child within the same family; some children may inherit genetic susceptibility and others not.

Is alcoholism inevitable for some children of alcoholics?
Are some "born" alcoholic? No child is "born" to become alcoholic. Even children at the highest genetic risk can't develop alcoholism if they do not drink!

Should I tell my children about the risk?
Absolutely. Teaching kids about their possible risk is very important and can greatly affect their future drinking decisions. For example, one study asked people if they had parents with alcoholism. Among those who said "yes" (family histories of alcoholism), few (only about one in twenty) knew they were at higher risk for alcoholism. This is scary, but on the bright side, those who did know drank much less alcohol on the average than those who didn't. This study (and others) tells us that making children of alcoholics aware of their risk status can significantly reduce how much alcohol they drink and the less they drink the better!

What do I say to my child?
While it will depend on their age and level of understanding, you might say something like this: "Certain illnesses run in certain families: some families have heart disease, or diabetes, or types of cancers, for example. The illness that runs in our family is alcoholism. Some of us may have bodies that react unusually to alcohol and we may develop alcoholism if we drink. As you are growing up, our family rule is no drinking, and when you become an adult I (we) hope you will make the decision to abstain from drinking alcohol. Alcoholism is a dangerous and often deadly disease. Even though we may be at risk, we can't get it if we don't drink!"

The second area of risk is environmental. This means what goes on in their family, and how they are parented. Research shows that alcohol problems among children are more likely when there are high levels of family disorganization, lack of nurturing, lack of role modeling and low levels of discipline and supervision. There are five parenting practices that are protective and can lower the risk of children developing alcoholism and other problems. They are:

• Non-concordance. This means the parent without alcoholism has different drinking patterns and attitudes about drinking than the alcoholic parent. For example, the nonalcoholic parent doesn't drink (or drinks very little), doesn't see alcohol as a solution to problems and role models healthy behaviors in contrast to the alcoholic parent. Children who adopt these healthy attitudes from the nonalcoholic parent tend to drink less in their teen years and as adults.
  
• Warmth and Nurturance. The closer and more attached a child feels toward parents the better. This means listening, touching, hugs, time together, and genuine interest and caring. The lower the family conflict (including violence) and the stronger the parent-child attachment, the better.
  
• Rituals. The extent that drinking disturbs family rituals is a good predictor of future problems. So it's very important to start and maintain family rituals (holiday celebrations, church attendance, family meals, bedtime stories, etc.) regardless of the presence of the drinking parent.
  
• Discipline and Supervision. When children of alcoholics (like all children) are provided rules to guide behavior, are given corrective consequences for breaking rules, and are supervised or monitored (checked on regularly when they are not with you) they are much less likely to have alcohol problems and other problems as well.
  
• No-Use Rules. One of the most effective "prevention" tools is a rule (often a formal agreement) that your child will not drink, smoke, or use other drugs. This rule should include your expectations (no drinking!) and the consequences of breaking this rule (no driving or social events for example). If possible, involve the child in a discussion of appropriate rules and consequences. If the rule is broken, the consequence must be enforced. Children who know that their parent(s) disapprove of alcohol or other drug use, are less likely to do it.

These suggestions, if implemented, will lower the risk of alcohol problems (including alcoholism) among children. There is no magic solution, but you can shift the odds to the healthy side. Of course, the younger your children are when you start, the better, but these recommendations work for children of all ages.

• Remember, it's consuming alcohol that causes alcoholism among children of alcoholics. They can't develop alcoholism if they don't drink!
  
• The younger children are when they begin to drink, the more likely they will have serious problems.
  
• Many children of alcoholics are remarkably resilient and grow to become outstanding leaders. Expect the best from your children.
  
• Recovery of the alcoholic parent is usually very helpful, but even if that never happens, children can end up just fine especially if they get needed support from the other parent.
  
• And last but not least, consider outside support for you and your children: Alanon, Alateen, a drug-free youth group, or some counseling.

Kenneth J. Sher. Children of Alcoholics: A Critical Appraisal of Theory and Research. The University of Chicago, 1991.
National Institute on Alcohol Abuse and Alcoholism. Alcohol World Health & Research, Vol. 21, Number 3, 1997.