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Child Safety Practice Manual

Characteristics of substance use

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This page was updated on 11 February 2026. To view changes, please see page updates

A parent with problematic substance use can struggle to manage their day-to-day lives and to meet the needs of their children. It impacts their ability to prioritise their child’s:

  • safety, belonging and wellbeing
  • cognitive, emotional and behavioural development.

A child’s safety, belonging and wellbeing can be compromised when a parent is experiencing problematic substance use by:

  • not developing a secure attachment to the parent or carer, or learning to self-regulate
  • not having appropriate supervision, support, and stimulation for their age
  • being exposed to unsafe situations, people, and paraphernalia associated with alcohol and other drugs use or criminal activities
  • having a higher risk of developing their own problematic alcohol and other drugs use as they grow older
  • having an inability to learn, develop relationships and cope with their own emotions
  • having their development affected prior to birth and throughout their childhood and adolescent development.

A parent with problematic substance use can:

  • struggle to maintain a budget due to spending money on alcohol and other drugs instead of on child or family needs
  • engage in theft or other criminal activity to support their substance use
  • be isolated from family, friends and community
  • have other co-occurring factors, such as domestic violence or mental health
  • experience varied mood swings throughout their use and withdrawal from alcohol and other drugs
  • have overly authoritarian or permissive parenting styles and unrealistic expectations of children’s abilities
  • be inconsistent in showing warmth and affection towards their child
  • provide their children with less supervision, and have a lack of judgement and priorities
  • lack stability and quality in the care of their children and in parenting (Smith and Wilson).

Characteristics of substances, parental behaviour and effects on children

Substance Characteristics How it can appear in parents Potential effects on children 
Alcohol    
 

Slows down the central nervous system, impairing judgement, coordination, reaction times, and emotional regulation.

Short-term effects:  Relaxation, lowered inhibitions, mood swings, slurred speech. 

Long-term effects:  Dependency, liver damage, cognitive impairment, and mental health issues.

Frequent intoxication:  Slurred speech, smell of alcohol.

Mood swings: Irritability or aggression.

Neglect of responsibilities: Missed appointments, unclean home.

Erratic behaviour: Sudden anger or euphoria.

Physical signs:                Bloodshot eyes, unsteady gait.

Social withdrawal or isolation.

Physical harm: Increased risk of accidents or injuries due to impaired parental supervision.

Emotional harm: Exposure to unpredictable behaviour, leading to fear, anxiety, or attachment issues.

Neglect: Failure to meet basic needs for example, food, hygiene, medical care.
Cannabis

Contains THC, which alters perception, mood, and cognition.

Short-term effects: Euphoria, relaxation, impaired memory, and coordination.


 

Lethargy or lack of motivation:  sleeping          excessively,  avoiding responsibilities missing appointments forgetting children's meals.

Impaired memory or forgetfulness: missing appointments, forgetting meals for children. 

Physical signs:  Red or glassy eyes, dry mouth (‘cotton mouth’). 

Social withdrawal or reduced engagement with children.

Physical harm: Exposure to second-hand smoke, leading to respiratory issues for example, asthma, bronchitis.

Developmental harm: Normalisation of addictive behaviours, potentially influencing future choices.

Health risks: Increased risk of sudden infant death syndrome (SIDS) in infants exposed to smoke.

Neglect: Failure to meet basic needs for example, food, hygiene, medical care.
Stimulants

Includes cocaine, methamphetamine, and amphetamines. 

Increases dopamine levels, leading to heightened energy, alertness, and euphoria.

Short-term effects: Increased heart rate, reduced appetite, hyperactivity, and risk-taking behaviour.

Long-term effects: Dependency, paranoia, aggression, cardiovascular issues, and mental health problems.

Hyperactivity or excessive energy:  Inability to sit still, rapid speech. 

Aggressive or erratic behaviour:  Sudden outbursts, paranoia.

Financial instability:  Inability to pay bills, selling household items. 

Physical signs:  Dilated pupils, weight loss, poor hygiene.

Sleep disturbances:  Staying awake for long periods, then ‘crashing’.

Unsafe behaviours:  Leaving children unattended, engaging in illegal activities.

Physical harm: Unsafe living conditions due to parental risk-taking or financial instability.

Emotional harm: Exposure to aggression or erratic behaviour, leading to fear or trauma.

Neglect: Lack of consistent care and supervision due to focus on substance use.

Developmental harm: Disruption of routines, schooling, and social connections.
Opioids

Includes prescription painkillers, heroin. 

Depresses the central nervous system, reducing pain and inducing euphoria.

Short-term effects: Drowsiness, slowed breathing, and relaxation.

Long-term effects: Dependency, overdose risk, and severe withdrawal symptoms.
 

Drowsiness or ‘nodding off’: falling asleep mid-conversation or while supervising children.

Neglect of responsibilities: unclean home, missed meals for children.

Financial/legal troubles:  unpaid bills, involvement in criminal activity. 

Physical signs:  constricted pupils, track marks (if injecting), slurred speech. 

Withdrawal symptoms:  sweating, shaking, irritability.

Presence of drug paraphernalia:  needles, spoons, pill bottles.

Physical harm: Lack of supervision leading to accidents or injuries. Exposure to drug paraphernalia.

Emotional harm: Feelings of abandonment or insecurity due to parental unavailability. Exposure to overdose incidents.

Neglect: Inadequate provision of food, clothing, or medical care. 
Prescription drugs

Includes misuse of sedatives, stimulants or painkillers.

Varies by drug type:  sedatives cause relaxation, stimulants increase energy, and painkillers reduce pain.
 

Short-term effects: Drowsiness, euphoria, or hyperactivity.

Long-term effects: Dependency, cognitive impairment, and health issues.

Over-reliance on medication: frequent drowsiness, inability to function without medication. 

Mood swings: irritability, depression, or euphoria.

Impaired ability to care for children: forgetting meals, missing school drop-offs. 

Physical signs: slurred speech, unsteady gait, excessive drowsiness.

Hoarding or hiding medications in the home.

Financial strain due to over-purchasing medications.

Physical harm: Risk of accidental ingestion of medications by children. Unsafe storage of medications in the home.

Emotional harm: Confusion or fear due to parental mood swings or erratic behaviour. 

Neglect: Failure to maintain routines or meet basic needs 
Hallucinogens

Includes LSD, psilocybin. 

Alters perception, mood, and cognition by disrupting serotonin levels.

Short-term effects: Visual/auditory hallucinations, paranoia, and disconnection from reality.

Long-term effects: Flashbacks, psychosis, and cognitive impairment.

 

Disconnection from reality: talking to themselves, appearing unaware of surroundings.

Erratic or unpredictable behaviour: laughing or crying without reason, paranoia.

Neglect of responsibilities: forgetting to feed or supervise children.

Physical signs: dilated pupils, sweating, trembling.

Unsafe behaviours: leaving children unattended, engaging in risky activities.

Emotional harm: Fear or confusion due to parental detachment or unpredictable behaviour.

Neglect: Inability to provide consistent care or supervision.

Safety risks: Exposure to unsafe environments or behaviours during hallucinations.

Emotional harm: Disruption of routines and emotional stability.
 
Inhalants

Includes glue, paint thinners.

Produces short-term euphoria by depriving the brain of oxygen.

Short-term effects: Dizziness, slurred speech, and disorientation.

Long-term effects: Brain damage, organ failure, and death.

Dizziness or disorientation: Slurred speech, stumbling.

Neglect of responsibilities:  Unclean home, lack of supervision.

Physical health decline: Sores around the mouth/nose, chemical smell on breath or clothing. 

Erratic behaviour: Sudden mood changes, confusion.

Social isolation or withdrawal.    

Physical harm: Unsafe home environment due to toxic substances. 

Emotional harm: Fear or anxiety due to parental health decline or erratic behaviour.

Neglect: Failure to meet basic needs or provide a safe environment.

How parents use substances

Understanding how a parent uses drugs helps practitioners identify how child's vulnerability to harm in the context of their parent's problematic substance use. For example, a parent may tell you they smoke or inject heroin; however, practitioners need to understand how a child sees and experiences this.

Method of drug use The child’s experience
Smoking—Parents who smoke drugs inhale the smoke or fumes through a cigarette or pipe, or inhale fumes from a substance that is heated on aluminium foil (such as heroin).

Is the child watching their parent prepare and smoke drugs?

What do they smell and breathe in?
Is the child sleeping or playing in the same room where parents are smoking?
Snorting—Parents who snort drugs chop the drug into a fine powder first. They may use a razor blade to cut the drug on a mirror or other hard surface. The powder is then divided into ‘lines’ and snorted using rolled-up paper or a straw.    

Are razor blades or other cutting tools left in easy reach of the child?

Are there drugs or drug residue left on tables and household items?

Injecting—Parents who inject drugs dissolve the drug in water or heat it in a ‘cooker’ so it is ready to inject. A cooker could be a spoon, a bottle cap or some tin foil. Needles may be reused and shared with others. People inject into veins or just under the skin.

To hide needle marks, they may inject in less visible areas of the body, such as between toes or in the groin area. Sometimes people are not able inject themselves and get others to inject them.

Is a child breathing in the fumes when a parent cooks drugs?

Are they seeing their parent heating or injecting drugs?

Are needles and cookers left within reach of the child or for the child to pick up, stand on or crawl on?

Inhaling—People who use inhalants breathe them in through the mouth (huffing) or through the nose in various ways, such as:

  • sniffing or snorting fumes from a container or dispenser, such as a glue bottle or a marker pen
  • spraying aerosols, such as computer cleaning dusters, directly into the nose or mouth
  • ‘huffing’ from a chemical-soaked rag in the mouth
  • sniffing or inhaling fumes from chemicals sprayed or put inside a plastic or paper bag (‘bagging’)
  •  inhaling from balloons filled with nitrous oxide (often called laughing gas).

Although the high that inhalants produce usually lasts just a few minutes, people often try to make it last by inhaling continuously over several hours.

Are children breathing in the fumes or copying their parents by huffing with everyday household products?

Are aerosol cans, glue bottles or marker pens left within reach of the child?
 

Manufacturing—Meth labs can be created in a house, garage or outdoors area, or created in smaller area using an esky or trunk.

No matter where the lab is set up, it is dangerous. Explosions and fires are common. People can get painful chemical burns if there is an explosion, or blisters on their lungs if they inhale the fumes while meth is cooking.

Once cooking is done, there is a lot of toxic waste left over. Some of the odours related to a meth lab have been described as smelling like lighter fluid, ether, ammonia, auto parts cleaner and rotten eggs.

Is a child living, sleeping or playing near a meth lab that could explode?

Are they living, sleeping or playing near harmful fumes?

Do they have access to the dangerous chemicals used in meth labs?

Practitioners need to have conversations with parents about the way they use drugs. The following points provide some example questions and conversation starters:

Types of drugs
  • What drugs do you usually use? How often do you use each of those substances?
  • How do you take the different drugs you use?
  • What implements or items do you need to use them like that?
How and where they use
  • Where do you usually take drugs? Who is around you?
  • Where were you the last time you took drugs? Where were the children?
  • When you take them like that, if your child was to walk in, what would they see or smell?
  • Are there usually strong smells or fumes in the home?
Storage of alcohol and drugs
  • Where do you store your drugs and paraphernalia—at home, in the car, in your bag, or somewhere else?
  • What happens after you have taken drugs—would there be any bits left over on the table or elsewhere?
  • Would there ever be needles, razor blades, cooking equipment or anything like that left out? 
  • How do you ensure that the children can't access the drugs or equipment?
  • When you have finished with needles, spoons or cookers, how do you get rid of them or where do you throw them out?
Dangers of meth labs
  • Do you know the dangers for children being around a meth lab or other dangerous fumes from drug use?

Talk to the parent about any observations you have of their appearance or home that may indicate drug use to further understand what and how they use. For example, physical signs such as track marks or skin sores that may be from drug use, or needles or mirrors with razor blades observed in the home. (Refer to Respectful engagement.)

Attention

Children living, sleeping or playing near a meth lab are at extremely high risk of poisoning, accidental deaths and burns due to home-based methamphetamine lab fires and explosions. They are also exposed to the highly psychoactive (mind-altering) stimulants and the toxic chemicals that come from methamphetamine production. 

Tip

Access child protection specific eLearning course on crystal methamphetamine, it's attributes and effects to learn to recognise and respond to the signs of use: [CS-CST] GRO-O: Crystal methamphetamine.

 

Living with substance use

A parent may hide, deny or minimise their alcohol and other drug use. They do so, not because they want to be deceitful or malicious, but in response to deep feelings of shame, fear, and worry. A parent may hide, deny or minimise:

  • what they are using
  • how much they use
  • how often they use
  • how much they spend to buy  or what they will do to get what they need
  • where they buy drugs or alcohol
  • the people who encourage and enable their use 
  • who is with them when they use.

Look deeper to see what is getting in the way when a parent is unwilling to be up-front and open about their substance use. For effective ways of responding to parents statements about their drug use refer to Listening and responding to parents.

Many parents hold some self-denial about their substance use. This denial is one way to avoid the need to confront how problematic their substance use has become. For many, the pain of acknowledging this, coupled with the fear of what will happen if they acknowledge or attempt to address their use, is overwhelming. Self-denial helps them keep things the way they are.

Practice prompt

Dovetail provide a range of helpful resources to support discussions with parents about  ways to reduce harm when using specific substances.  Insight, Dovetail: Resources (Search for Ways to reduce harm).

Dependence, intoxication and managing the effects

When a parent is dependent on substances, it can consume every waking thought and feeling. Much of their time, effort and emotion goes into having the money to buy what they need; and thinking about how they will get it, where they will use, using, coming down, coping and starting all over again.

Dependence on substances can occur over time for some people. Often, people are not concerned they have increased the amount or frequency of their substances use. For example, a person who drinks alcohol may start drinking much more at social occasions or in concentrated periods of time (‘binge drinking’). They may also start to drink more frequently and larger amounts over time and for longer periods during the day. In this stage, it may not seem problematic. As this pattern continues, they need more of the alcohol or substance to get the effect that they are looking for or to feel like they can function. 

To help understand a parent's use and dependence on substances, ask a parent:

  • What is it like when you use?
  • What is the best part of it?
  • What is the worst part of it?
  • How do you think your feelings and behaviours change?
  • What would others notice?
  • What is it like when the effects are diminishing?
  • How long does it last?
  • How do you cope with the physical and emotional reactions?

Withdrawal, relapse and lapse

Withdrawing from alcohol or drugs can be physically and emotionally painful. Withdrawal can make someone fixated on getting their next dose to alleviate their symptoms or soothe themselves with prescription or other drug types to mask the effects of withdrawal.

For a parent, focusing on their child’s needs may be more difficult at these times. Parenting tasks might feel harder and they may feel agitated, irritable or take it out on their child. Sudden withdrawal (completely stopping all alcohol and other drugs use at once) can also be risky for a parent’s health, particularly if they are dependent on a substance.

When parents use alcohol or drugs as a way of coping or surviving, withdrawing can bring deep feelings of pain and suffering back to the surface in a fierce and confronting way that they may not be ready for. This can lead to lapse or relapse or can stop a parent from taking that first step to recovery.

Tip

A relapse is when a person returns to previous levels of use of alcohol or drugs. A lapse is a brief return to use of alcohol or drugs. 

Treatment and recovery can be a lifelong challenge, and lapse and relapse are seen as a normal part of the recovery process. Recovery involves changing the way someone thinks, feel and behaves. A relapse means that a parent may have returned to their unhelpful of ways of thinking, feeling and behaving.

Relapse is most often triggered by stressful or high-risk situations or when the person is having trouble using positive coping strategies learned in recovery. Relapse does not mean treatment or recovery has failed, but it may be an indicator that a parent’s treatment plan needs to be adjusted. The best ways to minimise relapse are to plan for it with parents, treatment providers and the safety and support network.

Further reading

Black dog institute Stages of change.

Mixing drugs

Mixing drugs, also known as polydrug or polysubstance use, is when a parent uses: 

  • two or more drugs at the same time
  • one drug to counteract the effects of another
  • prescription medication and illicit drugs at the same time
  • different drugs at different times over a short period of days or weeks.

A person may mix drugs for different reasons, such as:

  • to increase the effect of another drug or to bring on its desired effects
  • to try and reduce the negative effects of a drug, usually when coming down from that drug
  • to substitute for the drug, they were really looking for—the next best thing
  • to use drugs alongside other prescribed or available drugs so they will treat or support specific wants or needs
  • because it seemed like a good idea at the time.

Sometimes people who are trying to cut down their use of one drug find they start to use more of another drug to substitute or help manage withdrawal symptoms.

Effects of mixing drugs

It is not always possible to predict the exact effects of a single drug or a single dose of a drug. Everyone is affected by drugs differently. The same person can even use the same amount of the same drug on different occasions and have different effects each time.

Note

When a person mixes drugs, the impact on the person depends on:
  • the drug itself—its purity, amount used, frequency of use, how the drug is used, whether the drug has been cut or mixed with another drug or something else
  • the person who is using the drug—their mood, expectations, personality and individual characteristics
  • the combined effect on the physical and cognitive functioning—including the result different combined chemicals and ingredients
  • the setting—where the person is who they are with.

Combining drugs with similar physical effects (two or more stimulants or two or more depressants) is especially dangerous as this increases the impact on the normal functioning of the brain and body.

Mixing drugs can:

  • affect the body by increasing heart rate, blood pressure and body temperature
  • increase the likelihood of increased emotional and mental disturbances, such as panic attacks and paranoia.

When the same drug types are mixed, the risk of accidents, overdose and death significantly increases. 

Attention

Most fatal overdoses occur when there is polydrug use. 

Further reading

 Australian Indigenous Health Infonet.

Prescription shopping

Dependence on prescription drugs is a rising problem in Australia. A child’s safety is compromised when a parent develops a dependence on prescription drugs, sells prescription drugs or their parenting ability is impacted by prescription drugs. A person may be prescribed medication by a doctor to address a medical issue and over time, can develop a dependence on the drug.

When a person visits several doctors and chemists with the aim of getting prescription drugs in quantities greater than their therapeutic need, this is called ‘prescription shopping’ or 'doctor shopping'. The drugs may be for personal use or sold to others.

The two classes of prescription drugs most often associated with dependency are: 

  • benzodiazepines (often used as tranquilisers and sleeping pills) 
  • opioids (often used for pain relief). 

Other drugs with potential to be misused include:

  • stimulants such as ephedrine 
  • amphetamine
  • appetite suppressants such as phentermine. 

Practice prompt

Ask parents to explain what medication they are taking, for what purpose, and what impact this medication has on them and their role as a parent. If required, seek additional information from their GP or health practitioner in relation to the prescriptions they are using and the illness or conditions for which they are taking them. 

Accidental deaths or overdose

An overdose occurs when there is an excessive amount of one or more drugs in the body and it cannot cope. A person can overdose from alcohol (through alcohol poisoning), illicit substances or prescription medications.

An overdose is not always fatal, but deaths by drug overdose claim an extraordinary number of lives in Australia. In 2021, there were 1,878 unintentional drug-induced deaths. Between 2002-2022, drug-induced deaths increased by an average of 3.2% and unintentional drug-induced deaths increased by an average of 3.3% per year. Such deaths are more likely to occur in regional and rural areas than in capital cities (Pennington Institute).

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  • Date: 
    Alcohol and Other Drugs practice kit re-launch
  • Date: 
    Alcohol and Other Drugs practice kit re-launch
  • Date: 
    Alcohol and Other Drugs practice kit re-launch