Some issues are uncomfortable to discuss. Alcoholism—specifically how it affects children of alcoholics— is one of those issues. And the abuse of alcohol and other addictive substances is a problem that spans socioeconomic barriers and affects all kinds of families.

While any individual living around an alcoholic is a victim, children are most often harmed because they don’t have control over a parent’s addiction. To learn more about this topic, I consulted my colleague, Dr. Duru Sakhrani, medical director of child and adolescent psychiatry at Mercy Children’s Hospital.

According to the American Academy of Child and Adolescent Psychiatry, alcoholism runs in families, and children of alcoholics are four times more likely than other children to become alcoholics. Dr. Sakhrani explains that this is because children of alcoholics think that alcohol consumption to unreasonable levels is acceptable. This increases their tendency to begin early use and eventually end up as alcohol abusers.

Unfortunately, when children grow up in a home where one or both parents are alcoholic, they sense the family conflict and may even witness a parent intoxicated or passed out. They are forced to fend for themselves at a much younger age than they otherwise would have to, and sometimes are forced to accept responsibilities that should be handled by parents.

Dr. Sakhrani says the child of an alcoholic can develop a variety of problems, such as guilt, anxiety, embarrassment, inability to have close relationships, anger and depression.

Many children of alcoholics try to keep their parent’s addiction a secret to protect both their parents and themselves. However, other adults who are frequently around these children (such as teachers, relatives or friends) might notice a problem. Behaviors that can signal a parental drinking problem or other problems at home include:

◆ Failure in school; truancy

◆ Lack of friends; withdrawal from classmates

◆ Delinquent behavior, such as stealing or violence

◆ Frequent physical complaints, such as headaches or stomachaches

◆ Abuse of drugs or alcohol

◆ Aggression towards other children

◆ Risk-taking behaviors

◆ Depression or suicidal thoughts or behavior.

So, if you or someone you know is an alcoholic, how can you help make sure children are shielded? Here are some tips from Dr. Sakhrani:

◆ Use alcohol only in limited amounts and social settings.

◆ Practice what you preach: don’t drink and drive, drink in moderation, do not tolerate underage drinking.

◆ Recognize alcohol use in children instead of rationalizing and tolerating use.

◆ Admit alcohol is a problem and start getting involved in treatment.

◆ Understand that just because you ‘do not drink’ in front of the children, does not mean that children are oblivious to active alcoholism. ◆ Realize the impact alcoholism has on children.

◆ Shield children from alcoholism by recognizing early use and getting involved in treatment.

Alcoholics and their families need professional help to control the addiction and address the resulting conflicts, stress and emotional upheaval. Families will require counsel to help them deal with the change in dynamic when parents get healthy and want to resume responsible parenting roles. Only by understanding the effects of alcoholism on family members, and seeking healing while maintaining abstinence, will families overcome their problems.

Dr. Joseph Kahn is Department of Pediatrics Chair at Mercy Children’s Hospital,