What you may see

What you may or may not see

It is important that you consider not only what you see directly before you when you visit a family's home, but also consider the things you do not directly see.

Drug use, dealing or manufacturing

These are some of the signs of drug use, drug dealing or drug manufacturing:

drugs or empty alcohol bottles in the home
pipes, bongs, foil, spoons, lighters, scissors, alcohol swabs, plastic bags, syringes, fit cases or fit packs for needles (compact anonymous container to hold a clean supply of hypodermic syringes and to lock away used needles)
the home smells like drugs or alcohol, strong ammonia or bleach (methamphetamine labs)
other people who use drugs coming, staying or living in the home
lots of people or cars coming and going at different times.

Current use, intoxication or withdrawal

These are some of the signs parents may be showing if they are currently using or experiencing withdrawal:

smelling of alcohol or drugs
feeling really hot or cold; dressing themselves or their child in a way that does not suit the temperature
sweating or shaking excessively
having glassy, glazed, pinned (small) pupils or dilated (wide open) pupils
talking fast, nodding off, being paranoid, agitated, drowsy, aggressive or talking about things that are not real or possible or having delusions (psychosis).

Looking and listening for problematic alcohol and other drugs use

Remember that dangers for children can be obvious or can be well-hidden and subtle.

Here are some of the worries about problematic alcohol and other drugs use for you to consider in your safety assessment.

Your worry for the child	What to look and listen for
Current presentation	Do the parents appear intoxicated or experiencing the after-effects of alcohol and other drugs use? Are they able to look after and supervise their child? Does the way they act and talk suggest they may not be able to consent to or participate in developing an immediate safety plan?
Attention span and memory	Does alcohol and other drugs use impact on the parent’s ability to focus on the conversations and recall any agreements you might make with them?
General health	Is the parent’s alcohol and other drugs use impacting on their physical or mental health and in turn their ability to parent?
History of drug or alcohol use	What does the parent’s history of alcohol and other drugs use mean for their ability to stop using or plan ahead? What is their history of drug use? Are things escalating? Has polydrug use (the use of more than one drug) been a problem in the past?
Current drug use treatment	Is their current use part of a lapse or relapse or ongoing? Has it been triggered by something traumatic? What drugs are being used? How are they being used? How are they stored? Is polydrug use a current concern? Is the parent in alcohol and other drugs treatment or do they have supports?
Parenting, bonding and attachment	How does alcohol and other drugs use (intoxication, withdrawal, buying and using drugs) impact on parenting tasks? What becomes harder for parents? How do their behaviour and feelings towards their child change? How do they feel about being a parent at different times? Is the parent: co-sleeping with a young child while under the influence of alcohol and other drugs? driving under the influence of alcohol and other drugs with a child or young person in the car? able to help a child or young person in an emergency while under the influence of alcohol and other drugs? What level of supervision does the child need and what is being provided? How is alcohol and other drugs use affecting this?
Relatively stable or chaotic drug use	Is the parent drinking or using more than they usually do? Are they spending more money on alcohol or other drugs? Do they have enough money for essentials such as food and electricity?
Drug use planning	Do the parents plan their substance use? What arrangements are made for the children when they use? Is their level of care different when they are not using?
Supervision	Is there a parent or other adult who do not use drugs in the home? Is this person responsible and capable of supervising the child or young person? At what times is the child unsupervised or supervised by others? Who is looking after the child if the parent is not able to? Are these safe options?
Accommodation	Is the home safe and appropriate for a child or young person? Is there any evidence of drug paraphernalia around the home that could cause harm to children or young people? Are there other people who use alcohol and other drugs sharing the home? Is the parent aware of safe sleeping practices? Are there sufficient safe sleeping options in the home? Have you observed these directly?
Transience	Is alcohol and other drugs use impacting on stability? Is the family ‘transient’ or homeless?
Financial commitments	Do parents have money right now to buy what their child needs? How is alcohol and other drugs use affecting their finances?
Provision of basic necessities	Is there food, clothing and bedding for the child? Who cooks the meals, gets the child dressed and puts them to bed? Are there nappies and formula for babies? Is the child attending childcare or school regularly?
Procurement of drugs	Is the child being left alone while their parents get drugs? Is the child present when their parents buy drugs? Is the child being used to sell or buy drugs?
Criminal activity	Is the parent dealing drugs? Are they dealing drugs from home? Do they engage in sex work or crime to support their alcohol and other drugs use and, if so, is the child or young person with them when they do this?
Injecting/smoking drug use	Is the parent an intravenous drug user? If so, how are the needles disposed of and are they sharing syringes? Can you see needles, syringes, other drug equipment and cigarette lighters around the home that could be a source of harm to a child?
Take-away methadone or buprenorphine	Is the parent receiving takeaway methadone or buprenorphine? If so, can they show you where they store it? *Methadone must be stored in a locked box that is not easily accessible and not in the fridge. All medication should be kept out of reach of children.
Family social network	Does the family’s social network revolve around other people who use? Is there violence or a high degree of criminality in the social network? Are family, friends or relatives aware of the substance use and do they support or condone it? Could they provide support to the child or young person? Have they historically done this?
Willingness to accept support	Will the parent accept help from their support network or other agencies? Can they contact people in their safety and support network or service now and ask for support?
Perception of the situation	What worries does the parent associate with their substance use? Do they consider their substance use to be harmful to their child? Do they understand why you are talking with them today? How do they feel about the worries you have identified?
Vulnerabilities	Are there any reasons a child or young person may be more at risk, such as age, health, medical, behavioural or developmental needs? How is alcohol and other drugs use affecting a parent’s ability to meet these?

Protective factors

You will need to determine whether a parent is capable of protecting their child and can follow the safety plan. There are ways you can assess their protective abilities. These are explored in the following paragraphs.

Listening for change talk

Knowing which stage a parent is at in the change cycle can be useful in understanding how ready they are to make changes for recovery. Listen to parents to see how willing (ready), motivated (their intention) and able they are to do what is needed to keep their child safe.

Read more about Prochaska and Diclemente’s The Cycle of Change to see what you can do help parents change and move forward.

The safety and support network

The Circles of Safety and Support Tool is designed to help families identify people who could be included in their safety and support network. (Refer to the practice guide Safety and support networks and high intensity responses.)

This tool also helps practitioners to engage with and have conversations with family members about why a safety and support network is necessary, about the harms and worries, and about the role a network can play in keeping the child safe.

Problem-solving abilities

Does the parent understand they have an alcohol and other drugs problem that affects the safety of their child?

Have a discussion with them about:

the times in their life when alcohol and other drugs use was not a problem
times of the week or day that alcohol and other drugs use in not a problem now
who they have called on to help
who their child could call on
whether the parent has sought treatment or worked with alcohol and other drugs services before.

What you may or may not see

Drug use, dealing or manufacturing

Current use, intoxication or withdrawal

Looking and listening for problematic alcohol and other drugs use

Protective factors

Listening for change talk

The safety and support network

Problem-solving abilities

Related forms, templates and resources

Circles of Safety and Support Tool

Safety and support networks and high intensity responses

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