Children of Alcoholics

An estimated 27.8 million children of alcoholics (COAs) live in the United States. Of those, about 11 million are under the age of 18. Clearly this is a serious problem, particularly when you consider the netative consequences that alcoholism has on children. For example, children of alcoholics exhibit symptoms of depression and anxiety more than children of non-alcoholics. COAs score lower on tests measuring verbal ability and sometimes have difficulties in school. And they are more at risk for being the victims of physical abuse.

This guide lists resources and organizations that can provide help to COAs, (both adults and children, their parents,) and prevention, treatment, and intervention professionals. Our hope is that more peole will recognize the consequences that alcohol abuse can have on the family and that our efforts will help prevent children from feeling responsible for their parent's addiction. Together let's keep our children safe and happy and give them all the opportunities to become emotionally and educationally successful adults.

Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration

Ruth Sanchez-Way, Ph.D.
Acting Director, Substance Abuse and Mental Health Services Administration

MS417

The listing of materials of programs in this resource guide does not constitute or imply endorsement by the Center for Substance Abuse Prevention, the Public Health Service, the Substance Abuse and Mental Health Services Administration, or the Department of Health and Human Services. The materials have been reviewed for accuracy, appropriateness, and conformance with public health principles.

This Substance Abuse Resource Guide was compiled from a variety of publications and data bases and represents the most current information to date. It is not an all-inclusive listing of materials on this topic. This guide will be updated regularly, and your comments or suggestions are welcome. To suggest information or materials that might be included in future editions, please write to SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville, MD 20847-2345.

Produced by SAMHSA's National Clearinghouse for Alcohol and Drug Information, Christy Botsford, editor.

For further information on alcohol, tobacco, and illicit drugs, call 800-729-6686, 301-468-2600, or TDD 800-487-4889. Or visit us on our World Wide Web site at http://ncadi.samhsa.gov.

Books

For Concerned Adults

Support Groups That Work: Planning and Running Support Groups for Young People From Alcohol and Other Substance Abusing Families

This manual helps educators, clergy, social workers, and other professionals to plan and implement short-term educational support groups for children and adolescents from alcoholic and substance-abusing families. Support Groups That Work takes the reader step-by-step through the process of planning and implementing a support group.

Authors: Richardson, B., and Weinstein, N.
Year: 1997
Format: Paperback book
Length: 57 pages
Target Audience: Educators and prevention professionals

Availability: Children of Alcoholics Foundation, 33 W. 60th Street, 5th Floor, New York, NY 10023; 212-757-2100
Internet: http://www.coaf.org
Cost: $10

Children of Alcoholics: Selected Readings

This monograph represents a variety of perspectives and professional experience on children of alcoholics. Article subjects include the role of the primary care physician; healing the pain of abandonment, fear, and shame; current estimates of the number of children of alcoholics in the United States; and moral development in COA's.

Authors: Adger Jr., H.; Black, C.; Brown, S.; et al
Year: 1996
Format: Paperback book
Length: 190 pages
Target Audience: Prevention professionals and general public

Availability: National Association for Children of Alcoholics, 11426 Rockville Pike, Suite 100, Rockville, MD 20852; 888-554-COAS
Internet: http://www.nacoa.org/
Cost: $12.95

Children, Families, and Substance Abuse: Challenges for Changing Educational and Social Outcomes

Dispelling the notion that children exposed to drug and alcohol abuse are permanently damaged for life, this book provides educators and child development professionals with the accurate information and innovative strategies they need to help children reach their growth and potential. Children, Families, and Substance Abuse examines the characteristics and needs of children and families exposed to substance abuse, environmental factors and their impact on educational achievement, and effective teaching strategies to address the needs of children exposed to drug and alcohol abuse.

Authors: Smith, G.H., Coles, C.D., Poulsen, M.K.; Cole, C.K.
Year: 1995
Format: Paperback book
Length: 268 pages
Target Audience: Prevention professionals and educators

Availability: Paul H. Brookes Publishing Co., Inc., Customer Service Department, P.O. Box 10624, Baltimore, MD 21285-0624; 800-638-3775
Internet: http://www.pbrookes.com
Cost: $26.95

Conducting Support Groups for Elementary Children K-6: A Guide for Educators and Other Professionals

Conducting Support Groups discusses how support groups encourage children to become aware of their feelings, learn to express these feelings, develop interactive skills, and develop self-confidence. This guide provides an overview of support groups and offers suggestions on starting a first group. Chapters include "Developing a Support Group Program," "Selecting Potential Group Leaders," "The Training Process," and "Leading Support Groups."

Authors: Moe, J., and Ways, P.
Publisher: Johnson Institute
Year: 1991
Format: Spiral-bound book
Length: 161 pages
Target Audience: Educators and prevention professionals

Availability: Hazelden Foundation, P.O. Box 11, Center City, MN 55012-0011; 612-257-4010; 800-328-0098
Internet: http://www.hazelden.org
Cost: $14.95

For Children

Bottles Break

In Bottles Break, a child describes how it feels when his mother drinks. Children learn that their parent's drinking isn't their fault and that they can't solve the problem themselves. This book is designed for children ages 4-8.

Author: Grande Tabor, N.M.
Year: 1999
Format: Paperback book
Length: 32 pages
Target Audience: Elementary youth and high-risk youth

Availability: Bookstore
Cost: $6.95

The Children's Place…At the Heart of Recovery

Through drawings, letters, and poems, children illustrate how their young lives have been adversely affected by a family member's addiction. This book shows alcoholism and drug abuse through the eyes of the children who live with it and expresses their anger, sadness, and hope.

Authors: Moe, J., and Ziegler, R.
Year: 1998
Format: Paperback book
Length: 64 pages
Target Audience: Elementary youth, jr. high youth, high-risk youth, and school and community organizations

Availability: Acid Test Production, 1370 Industrial Avenue, Suite G, Petaluma, CA 94952; 800-983-3352
Cost: $12.95

My Dad Loves Me, My Dad Has a Disease. A Child's View: Living with Addiction

Children ages 5 through 14 wrote stories and created illustrations for this book. My Dad Loves Me, My Dad Has a Disease explores addiction from the viewpoint of children with at least one addicted parent. The book is separated into sections-Addiction, Feelings, and Getting Well-and is in a workbook format so that readers can draw pictures or write stories about their own experiences. Topics covered include addiction as a disease, blackouts, relapse, personality changes, and recovery.

Author: Black, C.
Year: 1997
Format: Book
Length: 84 pages
Target Audience: Elementary youth, jr. high youth, general public, and prevention professionals

Availability: MAC Publishing, 321 High School Road, #346, Bainbridge Island, WA 98110; 206-842-6303; 800-698-0148
Internet: http://www.claudiablack.com
Cost: $12.95

Daddy Doesn't Have to be a Giant Anymore

In Daddy Doesn't Have to Be a Giant Anymore, a little girl gets scared when her dad drinks because he turns into a stranger with a giant's voice and rough behavior. Her mother gathers friends and family together to confront her father about his alcoholism and the little girl discovers she's not alone in her fear and that her voice counts.

Author: Thomas, J.R.

Year: 1996
Format: Hardcover book
Length: 48 pages
Target Audience: Elementary youth (grades K-3), parents, and prevention professionals

Availability: Bookstore
Cost: $14.95

Kids' Power Too! Words to Grow By

Kids' Power Too! offers a page a day-sort of a "One Day at a Time" for young children-providing messages of hope and encouraging children to take care of themselves, have fun, and make informed choices. The book contains reminders that alcoholism is not the fault of the child and that it is important to take care of oneself.

Authors: Brown, C., LaPorte, B., and Moe, J.
Year: 1996
Format: Paperback book
Length: 386 pages
Target Audience: Elementary youth and jr. high youth

Availability: ImaginWorks, 5307 East Mockingbird Lane, Suite 300, Dallas, TX 75206
Cost: $12.95

Think of Wind

Think of Wind is written from the point of view of a little boy whose father is an alcoholic. The boy describes how his father acts when he drinks and how alcoholism affects the family.

Author: Mercury, C.
Year: 1996
Format: Paperback book
Length: 28 pages
Target Audience: Elementary youth, prevention professionals, and general public
Availability: One Big Press, 38 Irvington Road, Rochester, NY 14620; 716-473-6592
Cost: $14.95

An Elephant in the Living Room: The Children's Book

An Elephant in the Living Room is designed to help children understand and cope with the problem of alcoholism or other drug addiction in their family. This workbook contains many activities for children of alcoholics to complete, either individually or in a support group.

Authors: Hastings, J.M., and Typpo, M.H.
Year: 1994
Format: Workbook
Length: 88 pages
Target Audience: Elementary youth, high-risk youth, and general public
Availability: Hazelden Foundation, P.O. Box 11, Center City, MN 55012-0011; 612-257-4010, 800-328-0098
Internet: http://www.hazelden.org
Cost: $10.95

I Can Talk About What Hurts: A Book for Children in Homes Where There's Chemical Dependence

This book is written and illustrated for children whose lives are affected by someone else's chemical dependency. It is useful for stimulating discussion between children and adults.

Authors: Sinberg, J., and Daley, D.
Year: 1993
Format: Paperback book
Length: 48 pages
Target Audience: Elementary youth (grades 3-5), jr. high youth, educators, parents, and prevention professionals

Availability: Hazelden Foundation, P.O. Box 11, Center City, MN 55012-0011; 612-257-4010, 800-328-0098
Internet: http://www.hazelden.org
Cost: $7

For Adolescents and Young Adults

Courage to Be Me: Living With Alcoholism

Adolescents in Alateen groups share their experiences as children of alcoholics/addicts in Courage to Be Me. The book educates youth about alcoholism and how Alateen functions. It also serves as a meditation for youth and adults on many topics, including "How important is it?" and "Keep it simple."

Year: 1996
Format: Paperback book
Length: 326 pages
Target Audience: Jr. high youth, sr. high youth, and school and community organizations

Availability: Al-Anon Family Group Headquarters, Inc., 1600 Corporate Landing Parkway, Virginia Beach, VA 23454-5617; 757-563-1600 or 800-356-9996
Internet: http://www.al-anon.alateen.org
Cost: $9

Resources for Adult Children of Alcoholics

My Mama's Waltz: A Book for Daughters of Alcoholic Mothers

The confusion and pain experienced by daughters of alcoholic mothers is explored in My Mama's Waltz. The stories in this book come from more than 200 daughters of alcoholic mothers and the book brings with it the force of truth in numbers.
Authors: Agnew, E., and Robindeaux, S.
Year: 1998
Format: Hardcover book
Length: 288 pages
Target Audience: General public and prevention professionals

Availability: Bookstore
Cost: $24

Treating Adult Children of Alcoholics: A Developmental Perspective

This book describes the psychopathology and treatment of adult children of alcoholics (ACA's). It discusses family dynamics, the effects on the child's development in the early and later years, the ACA as parent, the etiology and dynamics of psychopathology in the ACA, therapeutic strategies, and implications for the mental health professional dealing with ACA's.

Author: Brown, S.
Year: 1996
Format: Paperback book
Length: 333 pages
Target Audience: Prevention professionals

Availability: Bookstore
Cost: $39.95

Changing Course

This book focuses on the turning points to recovery; healing the pain of abandonment, fear, and shame; and personal recovery.

Author: Black, C.
Year: 1994
Format: Paperback book
Length: 213 pages
Target Audience: General public
Availability: MAC Publishing, 321 High School Road, #346, Bainbridge Island, WA 98110; 206-842-6303, 800-698-0148
Internet: http://www.claudiablack.com
Cost: $15.95

From Survival to Recovery: Growing Up in an Alcoholic Home

In From Survival to Recovery, Al-Anon adult children tell their stories-with pathos, humor, courage, and rigorous honesty-revealing the pain, recovering the past, and renewing the hope for all of us.

Organization: Al-Anon Family Groups
Year: 1994
Format: Book
Length: 302 pages
Target Audience: General public and prevention professionals

Availability: Bookstore
Cost: $13

Silent Sons: A Book For and About Men

In Silent Sons, the author defines the silent son and examines the impact of parents, particularly fathers, on these men and shows how their dysfunctional upbringing affects their present relationships, especially with women. This book reveals how men raised in dysfunctional families can learn to cope with their pain, express their feelings, and achieve full potential in their relationships at work and at home.

Author: Ackerman, R.J.
Year: 1994
Format: Paperback book
Length: 240 pages
Target Audience: General public

Availability: Bookstore
Cost: $12

The Resilient Self: How Survivors of Troubled Families Rise Above Adversity

The Resilient Self is designed to help adult children of dysfunctional families free themselves from the past. The book explores characteristics that allow individuals to cope with trauma and forge a healthy life and explains how to develop these traits.

Authors: Wolin, S.J., and Wolin, S.
Year: 1993
Format: Hardcover book
Length: 238 pages
Target Audience: General public

Availability: Bookstore
Cost: $23

An Adult Child's Guide to What's "Normal"

An Adult Child's Guide to What's "Normal" is a practical guide for adult children of alcoholics to begin dealing with the pain and trauma of being raised in a dysfunctional family. This book will help the reader to learn how to respond to the challenges, problems, and traps that they are faced with daily.

Authors: Friel, J.C., and Friel, L.D.
Year: 1990
Format: Paperback book
Length: 245 pages
Target Audience: General public

Availability: Bookstore
Cost: $9.95

Children of Alcoholism: Struggle for Self and Intimacy in Adult Life

Children of Alcoholism examines the trauma experienced by children raised in an alcoholic home and the impact of this early trauma on their psychological development and adult adjustment. Because children of alcoholics often adopt the same self-destructive patterns of alcoholism as their parents, they tend to suffer from feelings of emptiness, futility, and hopelessness.

Author: Wood, B.
Year: 1989
Format: Paperback book
Length: 168 pages
Target Audience: General public and prevention professionals

Availability: Bookstore
Cost: $18.50

Children of Trauma: Rediscovering Your Discarded Self

Designed for adult children of alcoholics, this book focuses on healing, not only at the individual level but also at the family system and cultural levels. Chapters discuss developing emotional boundaries, panic attacks, self-hate, and recovering the discarded self.

Author: Middelton-Moz, J.
Year: 1989
Format: Paperback book
Length: 185 pages
Target Audience: General public

Availability: Bookstore
Cost: $9.95

Perfect Daughters: Adult Daughters of Alcoholics

In Perfect Daughters, women's lives are explored as they learn to live with the legacies of being raised in dysfunctional homes. The book discusses ways that daughters of alcoholics learn to recreate self-worth and find fulfillment in their adult lives.

Author: Ackerman, R.J.
Year: 1989
Format: Paperback book
Length: 197 pages
Target Audience: General public and prevention professionals

Availability: Bookstore
Cost: $8.95

It Will Never Happen to Me!

This "little green book" is meant to help the reader understand the roles children in alcoholic families adopt, the problems they face in adulthood as a result, and what they can do to break the pattern of destruction. It Will Never Happen to Me! shows how to understand roles, deal with problems, and break destructive patterns of behavior.

Author: Black, C.
Year: 1987
Format: Paperback book
Length: 224 pages

Target Audience: General public

Availability: MAC Publishing, 321 High School Road, #346, Bainbridge Island, WA 98110; 206-842-6303, 800-698-0148
Internet: http://www.claudiablack.com
Cost: $5.99

Booklets, Brochures, and Fact Sheets

For Concerned Adults

Children at Risk Because of Parental Substance Abuse

Children at Risk examines the relationship between substance-abusing parents and children with alcohol and drug problems, problems with delinquency and depression, and poor school performance.

Authors: Huang, L.X.; Cerbone, F.G.; and Gfroerer, J.C.
Year: 1998
Format: Booklet
Length: 11 pages
Target Audience: Prevention professionals

Availability: SAMHSA's National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 800-729-6686
Internet: http://ncadi.samhsa.gov
Cost: Free

Children of Alcoholics: An Overview

This fact sheet discusses the problems facing children of alcoholics. It presents the scope of the problem, the problems young children experience, the problems adolescents experience, and the health care costs associated with treating these children.

Year: 1995
Format: Fact sheet
Length: 1 page
Target Audience: General public and high-risk families

Availability: Connecticut Clearinghouse, 334 Farmington Avenue, Plainville, CT 06062; 800-232-4424
Internet: http://www.ctclearinghouse.org
Cost: Free

About Alcohol, Child Abuse and Child Neglect. Sobre El Alcohol, El Abuso de los Niños y El Descuido de los Niños

This booklet illustrates the often unfortunate consequences alcohol has on the children of alcohol abusers. Two theories about child abuse and alcohol are proposed: alcohol may cause abuse and neglect, and alcohol use may provide an excuse for abuse. The booklet provides an overview of the problem and suggests some intervention strategies and solutions.

Year: 1993
Format: Booklet
Length: 15 pages
Target Audience: Parents and general public
Language: English or Spanish

Availability: Channing L. Bete Co., Inc., 200 State Road, South Deerfield, MA 01373; 800-628-7733
Internet: http://www.channing-bete.com
Cost: $1.05 each for 1-99 booklets

Alcoholism is a Family Disease

Alcoholism is a Family Disease explains how alcoholism tends to run in families and warns that children of alcoholics are at greater risk for alcoholism and drug abuse than children of non-addicts. It also discusses alcoholism as it relates to a higher incidence of child abuse.

Year: 1993
Format: Fact sheet
Length: 1 page
Target Audience: General public and high-risk families

Availability: Connecticut Clearinghouse, 334 Farmington Avenue, Plainville, CT 06062; 800-232-4424
Internet: http://www.ctclearinghouse.org
Cost: Free

For Adolescents and Young Adults

What Kids Should Know About Parents and Drinking

This booklet explains the effects of parental alcoholism on young people in a family. It discusses how a parent's drinking problem affects the youngster's feelings and behaviors. It encourages children of alcoholic families to get help.

Year: 1998
Format: Booklet
Length: 15 pages
Target Audience: High-risk youth, elementary youth, jr. high youth, and sr. high youth

Availability: Channing L. Bete Company, 200 State Road, South Deerfield, MA 01373; 800-628-7733
Internet: http://www.channing-bete.com
Cost: $1.05

When Parents Are Addicted: Teens Talk About Their Parents' Problem

In this booklet, Neil discovers that, as a teenager with an alcoholic mother, he is not alone. His friend, Cheryl, suggests he come with her to a support group for children of alcoholics. Neil meets many teens just like himself at the meeting and he learns that he is not responsible for his mother's addiction.

Year: 1997
Format: Booklet
Length: 15 pages
Target Audience: High-risk youth, jr. high youth, sr. high youth, and general public

Availability: Channing L. Bete Co, Inc., 200 State Road, Deerfield, MA 01373; 800-628-7733
Internet: http://www.channing-bete.com
Cost: $1.05

The Fact Is…Alcoholism Tends To Run In Families

This fact sheet supports the idea that alcoholism tends to run in the family, and offers suggestions of what can be done to help children of alcoholics.

Organization: Center for Substance Abuse Prevention
Year: 1995
Format: Fact sheet
Length: 1 page
Target Audience: General public

Availability: SAMHSA's National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20852; 800-729-6686
Internet: http://ncadi.samhsa.gov
Cost: Free

Drugs 101: Children of Alcoholics

This brochure describes children of alcoholics (COA's), how children are affected by their parent's alcoholism, how COA's are more likely to develop emotional and behavioral problems, how they are prone to suffer stress-related diseases and develop low-self esteem, and how COA's can seek help.

Author: Brown, W.
Organization: William Gladden Foundation
Year: 1994
Format: Brochure
Length: 6 pages
Target Audience: General public and high-risk families

Availability: Continental Press, 520 East Bainbridge Street, Elizabethtown, PA 17022; 800-233-0759
Internet: http://www.continentalpress.com
Cost: $.44 each for 25-99 copies

For Teens Only, Living with an Alcoholic Parent/ Para Adolescentes Solamente, La Convivencia con Padres Alcoholicos

For Teens Only describes what alcoholism is, who can become alcoholic, and what the typical feelings of the children of alcoholics are. It lists steps to take if you know someone is alcoholic, explains how parental drinking affects children, and what to do if you are the child of an alcoholic.

Year: 1993
Format: Brochure
Length: 6 pages
Target Audience: Sr. high youth, jr. high youth, school, and community organizations
Languages: Spanish and English

Availability: The Bureau For At-Risk Youth, 135 Dupont Street, P.O. Box 760, Plainview, NY 11803-0760; 800-999-6884, 516-349-5520
Internet: http://www.at-risk.com
Cost: $.49 for 1-99 copies

Videos, Posters, and Other Items

For Concerned Adults

End Broken Promises, Mend Broken Hearts

Adults interested in helping children of alcoholics will find this video useful. End Broken Promises encourages the use of support groups to help children of alcoholics or addicted persons share their feelings and build self-esteem.

Year: 1998
Format: Videocassette
Length: 24 minutes
Target Audience: Educators, prevention professionals, general public, and community organizations

Availability: National Association for Children of Alcoholics, 11426 Rockville Pike, Suite 100, Rockville, MD 20852; 888-55-4COAS
Internet: http://www.nacoa.org
Cost: $79

Risk and Reality: Teaching Preschool Children Affected by Substance Abuse

In recent years, teachers have reported an increasing number of children who display troubling behaviors and learning problems that they suspect may be related to the effects of substance abuse-either prenatal exposure to alcohol and drugs or the consequences of living in families and communities where substance abuse is common. These materials (which include a 30-minute video, a teacher's guide, and a research review) draw upon research and service demonstration programs to identify specific techniques and interventions that can help teachers effectively work with these children. Specific techniques described include: creating a nurturing classroom, encouraging cooperative play, minimizing distractions and facilitating transitions, helping children to manage their behavior, conducting ongoing assessment, and building strong links with families.

Organization: Head Start
Year: 1994
Format: Videocassette
Length: 30 minutes
Target Audience: Educators

Availability: SAMHSA's National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 800-729--686
Internet: http://ncadi.samhsa.gov
Cost: $12.50

Poor Jennifer, She's Always Losing Her Hat

Growing up in a family in which a parent suffers from alcoholism can be difficult. This video explores the need to help children break the cycle of shame and silence. It is also about recovery and hope. The videotape is designed to educate adults about the issues faced by children of alcoholics and to encourage them to respond appropriately to their special needs. An extensive viewer's guide comes with this videocassette.

Organization: National Association for Children of Alcoholics
Year: 1991
Format: Videocassette
Length: 34 minutes
Target Audience: Community service groups, parents, teachers, and other concerned professionals

Availability: SAMHSA's National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 800-729-6686
Internet: http://ncadi.samhsa.gov
Cost: $12.50

For Children

You're Not Alone

Children talk about their own experiences as children of alcoholics in You're Not Alone. The video emphasizes that children of alcoholics don't cause and can't control their parent's alcoholism. Viewers are encouraged to get help from a safe adult and join a support group, where they can talk with other children with similar experiences.

Year: 1998
Format: Videocassette
Length: 9 minutes
Target Audience: Elementary youth, Jr. high youth, prevention professionals, educators, and community service groups

Availability: National Association for Children of Alcoholics, 11426 Rockville Pike, Suite 100, Rockville, MD 20852; 888-55-4COAS
Internet: http://www.nacoa.org/
Cost: $39

Studies, Articles, and Reports

Children of Substance Abusers: Overview of Research Findings
Johnson, J.L., and Leff, M.
Pediatrics 103(5): 1085-1099, 1999
A relationship between parental substance abuse and subsequent alcohol problems in their children has been documented extensively. Children of alcoholics (COA's) are considered to be at high risk because there is a greater likelihood that they will develop alcoholism compared with a randomly selected child from the same community. COA's and children of other drug-abusing parents are especially vulnerable to the risk for maladaptive behavior because they have combinations of many risk factors present in their lives. Parental substance-abusing behavior can place their children at biologic, psychologic, and environmental risk. Research on COA's can be classified into studies of fetal alcohol syndrome, the transmission of alcoholism, psychobiologic markers of vulnerability, and psychosocial characteristics. Relatively little is known about children of heroin addicts, cocaine abusers, or polydrug abusers.

Screening, Early Identification, and Office-Based Intervention with Children and Youth Living in Substance-Abusing Families
Werner, M.J.; Joffe, A.; and Graham, A.V.
Pediatrics 103(5): 1099-1112, 1999
All health care professionals with clinical responsibility for the care of children and adolescents must be able to recognize, as early as possible, associated health problems or concerns in children of substance-abusing parents, and to be able to assist these children and families in seeking treatment and promoting health. Health care providers can have a tremendous influence on families of substance-abusing parents because of their understanding of family dynamics and their close long-standing relationship with the family. Information about family alcohol and drug use should be obtained as part of routine history-taking and when there are indications of family dysfunction, child behavior or emotional problems, school difficulties, and recurring episodes of apparent accidental trauma, and in the setting of recurrent or multiple vague somatic complaints by the child or adolescent.

Prevention and Intervention Strategies With Children of Alcoholics
Emshoff, J.G., and Price, A.W.
Pediatrics 103(5): 1112-1121, 1999
This article was designed to give pediatricians a basic knowledge of the needs of children who live in families with alcoholism. It briefly presents issues involved in the identification and screening of such individuals and provides primary attention to a variety of preventive and treatment strategies that have been used with school children of alcoholics (COA's), along with evidence of their effectiveness.

The Social Ecology of Addiction: Race, Risk, and Resilience
Wallace, J.M.
Pediatrics 103(5): 1122-1127, 1999
The purposes of this article are to inform pediatricians and other health professionals of key contextual risk factors that elevate black and Hispanic Americans' likelihood to use substances and to discuss selected protective mechanisms that may shield members of these populations against substance use. The article selectively reviews the literature on the epidemiology, etiology, and consequences of alcohol and drug use among white, black, and Hispanic adults and youth.

Outcome Measures of Interventions in the Study of Children of Substance-Abusing Parents
Kumpfer, K.L.
Pediatrics 103(5): 1128-1144, 1999
Children of substance-abusing parents, including children of alcoholics (COA's), are one of the highest risk groups of youth for substance-abuse problems. For both genetic and family environmental reasons, COA's and children of drug abusers are very vulnerable to becoming alcohol and drug abusers. Prevention practitioners must work harder to identify and evaluate effective ways to prevent future substance abuse in these at-risk children. This article focuses on general and unique measurement methods and instrument problems in prevention interventions for children of substance-abusing parents.

Effective Family Strengthening Interventions
Kumpfer, K.L., and Alvarado, R.
Juvenile Justice Bulletin, November 1998
This report summarizes the effectiveness of family intervention programs, behavioral parent training, family therapy, and family skills training in the prevention of delinquency and violence among youth. Families are the primary means of support and guidance for children; effective programs must build on the strengths already in existence in most families and must concentrate on the family as a whole rather than just on the child. A list of the top family intervention programs found in a national search is presented in addition to a breakdown of the available types of interventions and future recommended research.

Breaking the Cycle of Addiction: Prevention and Intervention With Children of Alcoholics
Price, A.W., and Emshoff, J.G.
Alcohol Health and Research World 21(3): 241-246, 1997
Children of alcoholics (COA's) are at increased risk for behavioral and emotional problems, including alcoholism. Research has helped guide the design of prevention and intervention programs aimed at reducing this risk. Currently, most of these programs for COA's use a short-term, small-group format, often conducted within schools. Broad-based community programs are another promising option, but have not been sufficiently studied. Generally, interventions include alcoholism education, training in coping skills and social competence, social support, and healthy alternative activities. Increased interaction between basic research and intervention may lead to improved services for COA's.

Children of Alcoholics and Adolescence: Individuation, Development, and Family Systems
Crespi, T., and Sabatelli, R.
Adolescence 32(126): 407-417, 1997
Recent developmental studies have highlighted the traumatic experiences faced by youngsters from alcoholic families. So far, however, the concept of individuation has remained missing from the discussion. This article links the developmental-familial implications of parental alcoholism with the individuation process and suggests a developmental agenda for understanding adolescents coping with the influences of parental alcoholism.

Psychological Characteristics of Children of Alcoholics
Sher, K.J.
Alcohol Health and Research World 21(3): 247-254, 1997
More than 20 years ago, researchers first noted that children of alcoholics (COA's) appeared to be affected by a variety of problems over the course of their life span. Such problems include fetal alcohol syndrome, which is first manifested in infancy; emotional problems and hyperactivity in childhood; emotional problems and conduct problems in adolescence; and the development of alcoholism in adulthood. Although much has been learned over the ensuing two decades, a number of controversial research areas remain. In particular, debate stems from the fact that despite a common interest in COA's, clinically focused literature and research-focused literature have resulted in two distinct bodies of knowledge. This article reviews important research results, with emphasis on findings generated by the alcohol-research community. Attention also is given to examining the empirical validity of concepts that have been advanced by several influential clinicians from the COA field.

Strengthening Families Program for the Prevention of Delinquency and Drug Use
Kumpfer, K.L.; Molgaard, V.; and Spoth, R.
In: Preventing Childhood Disorders, Substance Abuse, and Delinquency, pp. 241-267. Thousand Oaks, CA: Sage Publications, Inc., 1997.
Research on family risk and protective factors that influence delinquency and drug abuse in youth is reviewed in this article. Principles of effective family intervention models and family-focused intervention models for use with special populations are identified. The report contains a description of the theoretical underpinnings, development, implementation process, and results of various forms of the Strengthening Families Program. The Strengthening Families Program is a family-focused, selective prevention intervention that has been tailored for special populations at high risk for substance abuse and delinquency, such as children of substance abusers, children being removed from the home because of child abuse and neglect, and low income rural and urban parents of different ethnic groups.

Substance Use Initiation Among Adolescent Children of Alcoholics: Testing Protective Factors
Hussong, A.M., and Chassin, L.
Journal of Studies on Alcohol 58(3): 272-279, 1997
Past research suggests that adolescent children of alcoholics (COA's) are at heightened risk for alcohol and drug use. However, not all COA's use substances during adolescence. This study investigated whether five factors (self-awareness, perceived control, family organization, behavioral coping, and cognitive coping) buffer COA risk for substance use initiation during adolescence. A community sample of 454 COA's and matched control families was recruited to participate in a 3-year longitudinal study involving annual computer-assisted interviews with adolescents and their parents. Main effects suggested that adolescents reporting high family organization and either very high or very low levels of behavioral coping were less likely to initiate substance use over the course of the study. These findings suggest that highly organized families and behavioral coping efforts may deter substance use initiation. Moreover, perceived control over one's environment and cognitive coping may buffer adolescents from the risk associated with parent alcoholism for substance use.

Transmission of Parent/Adult-Child Drinking Patterns: Testing a Gender-Specific Structural Model
Yu, J., and BudPerrine, M. W.
American Journal of Drug and Alcohol Abuse 23(1):143-165, 1997
A structural model on parent/adult-child alcohol use patterns was examined. Three analytical blocks were specified: adult-children's alcohol use onset by types of alcoholic beverage, their current use of these alcoholic beverages, and parents' drinking patterns. The model was examined with data collected from drunken driving offenders in California and Maryland treatment programs. The findings indicate that parent/child alcohol use transmission is more gender specific than race specific; fathers' drinking tends to affect sons' drinking and mothers' drinking tends to affect daughters' drinking.

Who Will Take Care of Me? My Mom is an Alcoholic
Tweed, S.
Journal of Addictions Nursing 9(2): 72-76, 1997
This article describes a secondary data analysis conducted to answer the following research questions: Are there differences in psychological adjustment outcomes in adulthood for daughters who grew up with an alcoholic mother compared to daughters who grew up with an alcoholic father compared to daughters who grew up with both parents alcoholics? Are there differences in daughters' descriptions of their "growing up" family climate, depending on whether the daughter grew up with an alcoholic mother, an alcoholic father, or both parents alcoholic? Are there differences in daughters' descriptions of their relationship with mother and relationship with father when growing up, depending on whether the daughter grew up with an alcoholic mother, an alcoholic father, or both parents alcoholic? Psychological adjustment outcomes for adult daughters of alcoholic parents were not affected by whether their mother was alcoholic, their father was alcoholic, or both parents were alcoholic.

College Student Suicidal Ideation and Suicidal Behaviors: Family Alcoholism, Hopelessness, and Reasons for Living
Sundberg, E. M.
Dissertation Abstracts International 56(7): 4038-B, 1996
Nonclinical undergraduates aged 17-49 were tested using a standard screening instrument for children of alcoholics and scales for suicidal ideation, behavior, hopelessness, and reasons for living. Scores indicated that 24.6 percent were adult children of alcoholics (ACA's), 9.9 percent were children of problem drinkers (CPD's), and 65.5 percent were children of nonalcoholic parents (CONA's). Increasing distress over parental alcoholism was positively associated with suicidal ideation, suicidal behaviors, and hopelessness and was negatively correlated with reasons for living. Even when hopelessness and reasons for living were controlled in multiple regressions, suicidal ideation and suicidal behaviors were still predicted by a family history of alcoholism. ACA's averaged more than twice the number of family members who had committed suicide than CONA's.

Coping Strategies, Stress, and Functioning in Children of Alcoholics
Leigh, E.
Dissertation Abstracts International 56(7): 4018-B, 1996
This study investigated the relationship between level of functioning, coping strategies, and stress among children of alcoholics (COA's). It was hypothesized that use of active coping strategies, self-calming, and distraction would be related to higher levels of functioning, and that passive strategies and ventilating feelings would be related to lower levels of functioning. Male and female COA's between 7 and 12 years old were assessed with a variety of instruments. Active coping strategies were significantly related to higher functioning. Passive coping strategies, ventilating feelings, and self-calming were unrelated to functioning. Higher stress was related to lower functioning. Use of a greater variety of coping strategies was unrelated to functioning. There was no significant interaction between passive coping strategies and stress. Hopelessness levels were unrelated to functioning. No age-related differences in coping were found, and the only gender difference was girls' more frequent use of social support. Teaching COA's coping strategies positively related to functioning may help them manage stress.

Development of a Cognitive Measure of Interpretive Style for Adult Children of Alcoholics
Tweed, S. H., and Ryff. C. D.
Journal of Addictions Nursing 8(3): 102-108, 1996
This study was used to develop and test the reliability and validity of an instrument to measure interpretive style of adult children of alcoholics related to the context of family experiences. An item pool was generated targeting six dimensions identified from the alcoholic family and cognitive theory literature: family secret, responsibility/blame, worry/threat, social/emotional support, challenge, and predictability. Content validity was established by a panel of experts and pilot tested. Reliability and concurrent validity were tested by administering the Interpretive Style Questionnaire (ISQ) to a sample of adult children of alcoholics, along with reliable and valid family, cognitive, and psychological adjustment measures. Internal consistency coefficients ranging from .75 to .90 and stability coefficients ranging from .82 to .90 for the six dimensions established adequate reliability. Correlations in the appropriate direction with family and cognitive measures demonstrated concurrent validity, while correlations in the appropriate direction with psychological adjustment measures for most subscales demonstrated discriminate validity.

Development of Alcoholic Subtypes: Risk Variation Among Alcoholic Families During the Early Childhood Years
Zucker, R.; Ellis, D.; Bingham, R.; Fitzgerald, H.
Alcohol Health and Research World 20(1): 46-54, 1996
Lifetime differences in antisocial behavior among alcoholic men historically have been useful in distinguishing alcoholic subtypes. However, the usefulness of this subtyping strategy for identifying differences in families that may put offspring at risk for developing later alcoholism has not been previously documented. Findings from a prospective study on the development of vulnerability for alcoholism among (initially) preschool-age children showed that children from families with antisocial alcoholism differ on a number of indicators of child risk, including measures of risky temperament, externalizing behavior problems, and hyperactivity. Risk differences among children from these family subtypes appear to be sustained into middle childhood. Differences between non-antisocial alcoholic families and nonalcoholic control families were less distinguishable in both early and middle childhood.

Do Codependent Traits Involve More Than Basic Dimensions of Personality and Psychopathology?
Gotham, H. J., and Sher, K. J.
Journal of Studies on Alcohol 57(l): 34-39, 1996
Despite widespread use of the term codependency, empirical evidence regarding its construct validity is generally lacking. This study analyzed the construct validity of codependency as measured by Potter-Efron and Potter-Efron's Codependency Assessment Questionnaire (CAQ). It attempted to determine the CAQ's factor structure and whether there are any unique relations between symptoms of codependency and parental alcoholism after controlling for basic dimensions of personality and psychopathology. The CAQ showed reliability and basically a one-dimensional structure, and CAQ scores were significantly related to family history. Although much of this relation between family history and codependency was accounted for by neuroticism and symptoms of general psychopathology, a small, but significant, association between family history and codependency remained even after statistically controlling for personality and psychopathology. It was concluded that although there may be unique aspects of the purported codependency syndrome that are related to a family history of alcoholism, most of the relation between codependency and family history appears to be "explained" by general negative affectivity.

Impact of Coping Styles and Family Communication on the Social Skills of Children of Alcoholics
Segrin, C., and Menees, M. M.
Journal of Studies on Alcohol 57(1): 29-33, 1996
This study examined the relationship between parents' alcoholism and their young adult children's social skills. Although parental alcoholism was hypothesized to be negatively related to children's social skills, this relationship was hypothesized to be moderated by family communication styles and young adults' coping styles. Prior to the actual study, potential subjects were screened on a measure of parental alcoholism. To compensate for the positively skewed distribution of this variable, a greater percentage of those in the upper extreme of the scale was invited to participate in the study. For the study, 143 students (77 female) completed self-report measures of parental alcoholism, social skills, family communication, and coping styles. Subjects also had a sibling complete measures of parental alcoholism and family communication. Results indicated no significant differences in adult children's social skills as a function of parental alcoholism. Furthermore, family communication and young adults' coping styles did not appear to moderate this relationship. This is one of a growing number of studies that show that children may exhibit undisturbed psychosocial functioning despite having an alcoholic parent.

Influences of Early Family Environment and Parental Alcoholism on Adult Psychological Status
Taliaferro, G.L. Dissertation Abstracts International 56(10): 5802B, 1996 This retrospective study investigated the effects of early family environment and parental alcoholism on adult social support, coping, depression, and anxiety. Adult children of alcoholics (ACA's) significantly differed from their non-ACA's counterparts on measures of disengaged coping, social supports, and depression. These differences disappeared when family environment was controlled. Further, parental alcoholism fell out of all regression analyses used to test a conceptual model linking the variables of interest in this study.

Longitudinal Study of Parenting as a Protective Factor for Children of Alcoholics
Curran, P. J., and Chassin, L.
Journal of Studies on Alcohol 57(3): 305-313, 1996
This study examined whether maternal parenting behaviors might serve to protect, or buffer, a child from the potentially negative effects associated with an alcoholic father. This hypothesis was tested with a community sample of adolescent children of alcoholics and a demographically matched comparison group of children with nonalcoholic parents. Three dimensions of parenting were considered: monitoring of child behavior, consistency of discipline, and social support. These dimensions were used in both cross-sectional and longitudinal regression analyses to predict child externalizing symptomatology, alcohol use, and drug use. Cross-sectional results supported independent effects of parenting on child outcomes, but produced limited support for the buffering hypothesis. Longitudinal analyses revealed no prospective effects of parenting and no support for the buffering hypothesis. The findings suggest that both parents influence child development outcomes, but that the influence of one parent does not depend on the influence of the other parent.

Predicting Alcoholism in Selected College-Age Women
Riddle, K.
Dissertation Abstracts International 56(9): 3462-A, 1996
This study determines the extent of relationships between characteristics of alcoholism in selected college-age women. The relationships between these characteristics and selected demographic attributes were also investigated. College-age men were used for comparison purposes. The accessible population was undergraduate students enrolled in a health education course. Of the respondents, approximately 50 percent were problem drinkers and alcoholics. The results of this study predicted with 70 percent accuracy the female college-age alcoholic woman enrolled in the health education course as white, from a non-intact family, never married, no children, not living with her family, 18-22 years old, a sorority member, annual family income greater than $50,000, claims religious affiliation, and with a family history of alcoholism. These predictors were further supported by the Gender Alcoholism Screening Test and its underlying constructs and the family factors model.

Relationships Between Early Parent-Child Variables and Later Psychological Adjustment Among Female Adult Children of Alcoholics and Controls Bakke-Jumper, B. Dissertation Abstracts International 56(7): 4005B-4006B, 1996 The qualities of early child-parent relationship as predictors of adult psychological adjustment for women raised in alcoholic and nonalcoholic homes were examined. Female undergraduate students responded to questionnaires on the degree of conflict and violence in the home, degree of parental alcohol consumption and related behaviors, and perceptions of their relationship with both parents between ages 5 and 10. Psychological adjustment was examined by assessing depression and anxiety proneness, current alcohol consumption and related behaviors, and self-concept. These variables contributed to the prediction of 23 percent of the variance in depression proneness, but they explained less than 10 percent in the regression models built to predict anxiety proneness, drinking tendencies, and self-concept. Lack of interaction between alcoholic status and relationship variables resulted in failure to confirm a hypothesis that parent-child relationship variables may mitigate the effects of parental drinking on adjustment in women.

Why Moderation Doesn't Work For Children of Alcoholics
Alcoholism and Drug Abuse Weekly
November 11, 1996, p. 5
Since alcoholism is a disease that unfolds progressively in many cases, the fact that a person is showing a relatively mild alcohol problem at a given point in time does not mean that the problem will remain mild. This is particularly true for children of alcoholics; their genetic profile makes most of these patients ill-suited for moderation management. A case study is presented of one such young woman who initially seemed to have minimal problems with alcohol, despite growing up in an alcoholic family and having occasional loss of control. It is contended that the selection of a treatment goal with such patients, even when they are just beginning to show mild alcohol-related problems, should always be influenced primarily by the fact that adult children of alcoholics comprise the single largest group of people at risk for developing alcoholism.

Wounds Become Gifts: The Process of Transilience in Adult Children of Alcoholic Parents
Cook, A.E.
Dissertation Abstracts International 56(8): 4237B, 1996
The purpose of this study was to explore and discover how adult children of alcoholics (ACA's) have achieved satisfactory life adjustments. A grounded theory study was conducted to answer these research questions: What is the social-psychological process by which adult children of alcoholic parents achieve self-perceived positive life outcomes? What are the experiences of adult children of alcoholic parents that contribute to their self-identified successful life adjustments? Subjects included 27 adults who identified themselves as ACA's and perceived that they have achieved positive life outcomes. The product of this study was a substantive theory describing the experiences of ACA's who perceive that they have attained positive life outcomes. The basic social-psychological process was transilience, defined as the process whereby these ACA's moved from a self-identified state in which their perceived life outcomes were positive and their overall life adjustments satisfactory. Major components of transilience included living in the alcoholic family, comprehending the old reality, relinquishing the old reality, and constructing the new reality. Encountering critical junctures facilitated either a more rapid progression to the next phase or a temporary retrogression to earlier phases until appropriated resolution occurred.

Parent-Child Interactions in Alcoholic and Nonalcoholic Families
Whipple, E.E.; Fitzgerald, H.E.; Zucker, R.A. American Journal of Orthopsychiatry 65(1): 153-159, 1995 A community-recruited sample of alcoholic and nonalcoholic families was videotaped in a standardized play task involving parents and their preschool-aged sons. Microanalyses revealed that alcoholic families had lower dyadic synchrony, that parents were viewed as less able to engage their children, and that the coders liked the control parents and children more.

The Relationship Between Parent and Offspring Comorbid Disorders
Johnson, V. Journal of Substance Abuse 7(3): 267-280, 1995 Data concerning alcohol and drug abuse and dependence, depression, and antisocial behaviors, among both subjects and their parents, were obtained from a community sample of 1,201 young adults. Although 35 percent of the sample exhibited alcohol abuse or dependence, 14 percent showed indications of marijuana or cocaine abuse or dependence, and 22 percent reported parental alcoholism, evidence of comorbidity with depression or antisocial personality was generally rare among both parents and subjects. Over one-third of the subjects were negative both for family history and any disorder of their own and 20 percent reported a problem in both themselves and in one or both parents. These findings lend only partial support for Winokur's depression spectrum disease hypothesis, in that diagnosed children of depressed-only families have a 30 percent chance of exhibiting substance abuse or dependence alone, whereas diagnosed children of alcoholic-only families have only a 7 percent chance of exhibiting depression alone.

Parenting Behavior of Adolescent Children of Alcoholics Bensley, L.S.; Spieker, S.J.; and McMahon, R.J. Addiction 89(10): 1265-1276, 1994 The parenting behavior of children of alcoholics (COA's) and non-COA's was compared within a sample of adolescent mothers. COA's and their children showed dyadic behaviors that were less problematic than those of their peers on mother-child teaching interactions at age 1, mother-child interactions during structured play at preschool age, and child attachment behavior at preschool age. COA's reported feeling relatively more rejection as compared to love from the alcoholic parent, but this was not related to their own parenting scores. Similar to other research, COA's reported more historical life stress, more family disruption, and more drug use compared to non-COA's, but these measures also were not related to parenting scores. These results suggest that, although adolescent mothers are at risk for parenting difficulties compared to adult mothers, adolescent COA's do not necessarily encounter more problems in parenting their own children compared to other adolescent mothers.

Why Some Children of Alcoholics Become Alcoholics: Emulation of the Drinker Ullman, A., and Orenstein, A. Adolescence 29(113): 1-11, 1994 From a review of recent literature, support was found for the hypothesis that the power of an alcoholic parent within a household is related to whether offspring become alcoholic. In considering reasons for this relationship, children and adolescents appear more likely to emulate and identify with a powerful alcoholic parent and, through these processes, learn that alcohol can make them feel powerful.

Differential Outcome as a Function of Risk and Protective Factors in Offspring of Alcoholics Bush, J.A.C. Dissertation Abstracts International 56(8): 4574, 1993 A model explaining differential outcome in children of alcoholics is presented, followed by a testing of the model. The model attributes differential outcome to risk factors and protective factors present in the lives of children of alcoholics. Risk factors, protective factors, and outcome were measured in 18- and 19-year-old children of alcoholics. Correlations between outcome, risk, and protective factors were computed to assess relationships between these variables. Analyses of variance were conducted comparing groups of subjects of recovering and non-recovering fathers, as well as groups of subjects of positive and negative outcome, risk, and protective factors. Outcome was significantly predicted by risk and protective factors through multiple regression, and moderating variables were revealed through moderated regression. Strengths and limitations of the study are presented, as well as directions for future research.

Ethnic Group Differences in Vulnerability to Parental Alcoholism and Life Stress: A Study of Hispanic and Non-Hispanic Caucasian Adolescents Barrera, M., Jr.; Li, S.A.; and Chassin, L. American Journal of Community Psychology 21(1):15-35, 1993 Ethnic differences in vulnerability to parental alcoholism and life stress were compared in Hispanic and non-Hispanic Caucasian adolescents. Respondents completed questionnaires relating to life stress, social support, and alcohol use. The parents reported on the adolescents' psychological symptoms and their own substance use. The study found that parental alcoholism and life stress were related to almost all indicators of adolescents' psychological distress and alcohol use. In addition, results showed some evidence that Caucasian adolescents were more vulnerable to the effects of life stress and parental alcoholism than Hispanics. Neither social support nor the higher substance use of Caucasian parents provided a good explanation for this differential vulnerability. Resilience factors associated with Hispanic culture may result in less psychological distress and alcohol use than is otherwise associated with life stress and parental alcoholism.

Cross-Cultural Perspectives and Codependence: The Case of Poor Hispanics Inclan, J., and Hernandez, M. American Journal of Orthopsychiatry 62(2): 245-255, 1992 Codependence treatment of poor Hispanics is discussed, with a focus on cross-cultural perspective and codependence. Headings within this review of the literature include: (1) concept of codependence; (2) Hispanic family values; (3) codependence versus family values; (4) therapeutic consequences of conflict; (5) socioculturally sensitive therapy; (6) culture-migration dialogue; (7) cultural reframing; and (8) behavioral focus. Interventions and service delivery systems should be sensitive to the cultural needs of people of different ethnocultural backgrounds. Many of the changes the client and the family are expected to achieve are in direct conflict with important Hispanic family values, particularly familism.

Organizations and Internet Sites

Adult Children of Alcoholics Resources Online Recovery Resources
http://www.recovery.org/acoa/acoa.html

Adult Children of Alcoholics World Service Organization, Inc.
P.O. Box 3216
Torrance, CA 90510
Tel: 310-534-1815
Email: info@adultchildren.org
http://www.adultchildren.org

Adult Children Anonymous
http://www.adultchildren.org

AL-ANON/Alateen Family Group Headquarters, Inc.
1600 Corporate Landing Parkway
Virginia Beach, VA 23454-5617
Tel: 757-563-1600
Fax: 757-563-1655
Email: WSO@al-anon.org
http://www.al-anon.alateen.org

Alcoholics Anonymous
World Service Office
475 Riverside Drive
11th Floor
New York, NY 10115
Tel: 212-870-3400
Fax: 212-870-3003
http://www.aa.org

Center for Substance Abuse Treatment
Drug Abuse Information and Treatment Referral Hotline
Tel: 800-662-HELP
Children of Alcoholics Foundation, Inc.
164 W. 74th Street
New York, NY 10023
HelpLine: 800-359-COAF
Tel: 212-595-5810 x7760
Fax: 212-496-6035
Email: coaf@phoenixhouse.org
http://www.coaf.org

Families Anonymous
P.O. Box 3475
Culver City, CA 90231-3475
Tel: 310-815-8010, 800-736-9805
Fax: 310-815-9682
Email: famanon@FamiliesAnonymous.org
www.familiesanonymous.org/

Hazelden Foundation
P.O. Box 176
15251 Pleasant Valley Road
Center City, MN 55012
Tel: 800-328-9000
Fax: 651-257-1331
Email: info@hazelden.org
http://www.hazelden.org

National Association for Children of Alcoholics (NACoA)
11426 Rockville Pike
Suite 100
Rockville, MD 20852
Tel: 301-468-0985, 888-55-4COAS
Fax: 301-468-0987
Email: nacoa@erols.com
http://www.nacoa.org/

National Association for Native American Children of Alcoholics
130 Andover Park East
Suite 230
Seattle, WA 98188
Tel: 206-248-3559
Fax: 206-248-3678
Email: nanacoa@nanacoa.org
http://www.whitebison.org/nanacoa/

National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard
Willco Building
Bethesda, MD 20892-7003
http://www.niaaa.nih.gov

SAMHSA's National Clearinghouse for Alcohol and Drug Information
P.O. Box 2345
Rockville, MD 20847-2345
Tel: 301-468-2600, 800-729-6686
Fax: 301-468-6433
Email: info@health.org
http://ncadi.samhsa.gov

National Council on Alcoholism and Drug Dependence, Inc.
12 West 21st Street
New York, NY 10010
Tel: 212-206-6770
Fax: 212-645-1690
Email: national@ncadd.org
http://www.ncadd.org

Women for Sobriety, Inc.
P.O. Box 618
Quakertown, PA 18951-0618
Tel: 215-536-8026, 800-333-1606
Fax: 215-536-8026 (same as telephone)
Email: NewLife@nni.com
http://www.womenforsobriety.org