Applying ambiguous loss theory to children of parents with an opioid use disorder

Abstract

Problem: Opioid use disorder (OUD) has reached epidemic proportions in the United States. Children of parents with OUD are an unrepresented population, who often suffer consequences from their parent's substance abuse disorder. Such children may incur numerous psychosocial and physical losses. Without intervention, they are more likely to be diagnosed with a mental illness and/or substance use disorder (SUD). Methods: This paper examines the experiences of children of parents with OUD usingBoss's theory of ambiguous loss (AL) as a lens.Findings: Children growing up with a parent who has an OUD experience AL through that parent's physical absence and psychological presence (e.g., the parent is out opioid-seeking or in rehab or jail) and psychological absence but physical presence (e.g., the parent is high or in withdrawal, or is preoccupied with obtaining opioids).Evidence supports the fact that OUDs affect parenting, produce changes in the parent-child relationship, and often impact child development. Interventions that are child-focused are lacking. Conclusions:The application of AL theory to this problem can enhance health professionals' understanding and need for developmentally specific interventions to care for this population. Interventions should focus on diminishing stigma and promoting psychosocial wellness and resiliency for children of parents with an OUD.

“I Grew Up Amidst Alcohol and Drugs:” a Qualitative Study on the Lived Experiences of Parental Substance Use Among Adults Who Developed Substance Use Disorders Themselves

“…Previous studies showed that also among parents with SUDs, other mental health difficulties often co-occur (115). Our study supports the need for systemic and stigma-reducing interventions to support children of parents with SUDs (60,116,117).…”

Parental opioid use disorder: Examining their children's experiences, needs, and road to resilience

“…There is shame and guilt attached to having a parent with SUD and it can be difficult for children to reach out to the right resources for information and assistance (Dayton, 2012). Children are often afraid to ask questions about their parent's SUD as they may fear making their parent angry at them or getting them into trouble with others (Mechling et al, 2018). Findings have shown that when children do communicate about a parent's SUD, they either minimize what is happening or describe it in a code language (e.g., using slang terms vs. speaking directly; Fraser et al, 2009).…”

“…They are susceptible to adverse childhood experiences (ACEs), which can include poverty, domestic violence, child neglect, physical, sexual and emotional abuse as well as developmental complications (e.g., learning difficulties/academic struggles; Austin & Shanahan, 2017; Baglivio et al, 2017; DeLisi & Beauregard, 2018). These children can encounter other traumatic experiences like witnessing their parent using, overdosing, or their incarceration or death (Mechling et al, 2018; Mirick & Steenrod, 2016). Separations while a parent resides in treatment facilities can also be traumatic (DeLisi & Beauregard, 2018).…”

Promoting resilience for children of parents with opioid use disorder: A pilot study of a directed intervention

“…These children may grapple with having a mother and/or father who is physically or emotionally absent to them (Mechling et al, 2018; Wiig et al, 2018). They encounter confusion and may feel having lost the parent they once knew or just experienced not under the influence or in withdrawal.…”

“…Children with a parent with OUD face accompanying childhood adverse experiences (ACEs), including but not limited to; domestic violence, child abuse, poverty, and academic struggles (Austin & Shanahan, 2017; Baglivio et al, 2017). Other ACEs that children of parents with OUD can encounter include loss and trauma when parents enter treatment, go to jail, become homeless, lose parental rights, or overdose and die (Mechling et al, 2018; Mirick & Steenrod, 2016).…”