Children of alcoholics: helping a vulnerable group.

There are 28 million children of alcoholics in the United States--1 of every 8 Americans. They are more likely than others to suffer from alcoholism and a wide range of physical, emotional, and mental health problems. It is probable that an inherited predisposition for the disease of alcoholism exists. Most children of alcoholics do not become alcoholic, but they are at increased risk for many other health problems. Records of the use of services provided by health maintenance organizations and of health insurance claims show that children of alcoholics use more medical and hospital services than other children. Children of alcoholics are more likely to have problems in school and to abuse alcohol and other drugs. Their mental and physical health problems persist into adulthood. Clinical findings show that life in an alcoholic family is often characterized by pain, guilt, fear, tension, and insecurity. Children do not know that alcoholism is a disease which they cannot cause, control, or cure. Because alcoholism is a family secret, children rarely seek help, even as adults. Because the children of alcoholics are in many medical and social service systems, greater awareness and understanding by health and human service professionals can lead to identification and help for this vulnerable group. It is critical for family physicians, obstetricians, pediatricians, nurses, social workers, hospital staff, and others to incorporate questions about family alcoholism in routine screening procedures for youth and adults. Recommendations and useful materials are discussed.