High risk of severe child abuse and poly‐victimisation in families with parental substance misuse – results from a swedish school‐based survey

Child abuse is a widespread public health problem, potentially leading to long‐term consequences for the exposed individuals and society. By learning more about the major risk factors, child abuse can be prevented. The objective of this study was to examine the pattern and severity of maltreatment in adolescents reporting parental alcohol and/or other drug problems. Cross‐sectional data from a Swedish national school survey including 4,741 pupils (15‐ and 17‐year‐olds) conducted in 2016 were analysed using univariate tests (chi‐squared) and binomial logistic regression models. Results showed that parental alcohol or other drug misuse, reported by the adolescents, was significantly associated with all types of child maltreatment. There was a particularly increased risk of severe child abuse, including witnessing recurrent physical intimate partner violence (adjusted odds ratio (adj. OR) 11.01; confidence interval (CI) 6.61–18.35) and poly‐victimisation (adj. OR 7.82; CI 5.50–11.13), in families with parental alcohol and/or other drug problems compared to families without these problems. These results call for preventive measures, such as restrictive alcohol and drug policies, and early recognition of alcohol or other drug misuse among parents. In addition, professionals working with children and with substance‐using parents need to identify and support these children. Key Practitioner Messages Children and adolescents commonly grow up with parents misusing alcohol and/or other drugs. Parental alcohol and other drug misuse strongly increases the risk of severe child abuse, particularly witnessing recurrent physical intimate partner violence and poly‐victimisation. Early recognition and support for families with parental alcohol and other drug misuse is important to prevent child maltreatment.