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.