Introduction: Seeing the Child Behind the Struggle

Today while I was running errands, I had the honor of speaking with a loving grandmother who was tasked with getting her grand-child into treatment for substance use disorder. As we spoke I could see the emotions on her face and hear them in her words. Hope and excitement, fear and uncertaintly, love mixed with confusion were evident.

In my years of working with people who live with a substance-use-disorder, I’ve sat across from faces that looked far older than their age. Behind their eyes was exhaustion, the kind that comes from carrying too much pain, too soon.

We rarely talk about childhood addiction. When we do, we tend to focus on the behavior: the sneaking out, the defiance, the substances. But beneath all that is a child who’s quietly reaching for something:

• Peace.
• Comfort
• Escape from pain they don’t know how to name.

Addiction in children isn’t a failure of character. It’s a response to distress.

These kids are not trying to be difficult. They’re trying to survive.

Addiction in childhood is never about moral weakness or lack of willpower. It is a child’s attempt to regulate unbearable emotions with the only tools they have. When we start to see it that way, our response changes from punishment to compassion, from blame to understanding, and from fear to hope.

The Environment That Shapes the Risk

No child wakes up and decides to become addicted. Most are reacting to environments that have failed to keep them emotionally safe.

I’ve worked with kids growing up amid domestic violence, neglect, and poverty. Some live in homes where substance use is part of daily life. Others feel unseen in otherwise functional households.

“When chaos becomes normal, peace feels foreign.”

Children raised in instability often reach for substances to find calm, even if that calm is only temporary.

If a child doesn’t have safe adults to help them regulate their emotions, they’ll find something else to do it for them.

The Science: When Addiction Runs in the Family

One of the hardest truths I share with families is that addiction doesn’t only come from environment. Science tells us there’s also a genetic component.

Research from the National Institute on Drug Abuse and other major studies shows that 40–60% of a person’s risk for developing addiction is genetic. Children whose parents have struggled with substance use are more likely to develop the same challenges.

That doesn’t mean it’s inevitable. It means these children may be biologically more sensitive, their brains reacting more strongly to the pleasurable effects of substances and more painfully to stress.

“Genes load the gun, but environment pulls the trigger.”

Love, safety, and stability can literally protect a child on a biological level.

The field of epigenetics has shown us that environment can turn certain genes “on” or “off.” In other words, nurturing relationships and emotional safety can override inherited risk.

Why Children Start Using

When we ask a child, “Why did you do this?” the answer is rarely what we expect.

Many tell me they wanted to stop feeling anxious, lonely, or unwanted. Some say they were just trying to fit in. Others don’t even know, they just knew the pain felt quieter when they used.

For some, substances offer a momentary sense of control in a world that feels unpredictable. For others, it’s curiosity that quickly spirals into dependency because of how their young brains respond to stimulation and reward.

“Children don’t use to rebel. They use to cope.”

The drug isn’t the problem. It’s the solution that’s hurting them.

The Weight of Fear and Shame

Almost every child I’ve met who struggles with addiction carries fear like a second skin. Fear of being found out. Fear of disappointing their parents. Fear of losing what little sense of control they have.

Then comes shame, the belief that they’re broken, that they’ve failed everyone. Shame doesn’t stop addiction; it fuels it. The more ashamed they feel, the more they need to use to escape that shame.

“We cannot shame a child into healing. We can only love them into it.”

We must stop seeing shame as a motivator and start seeing compassion as medicine.

Why Love with Boundaries Works

Families often ask me, “If we love them too much, won’t we enable them?” My answer is simple: real love has boundaries.

Love without accountability is chaos. But accountability without love is cruelty. The most effective healing environments are the ones where a child knows: You are responsible for your choices, but you are never alone in them.

“Love with boundaries teaches children that they are more than their behavior.”

It doesn’t erase consequences; it replaces fear with trust.

When we respond with understanding instead of judgment, we help them believe they are worth saving. And that belief is the first step toward recovery.

The Lost Child Searching for Coping Skills

Most of the children I’ve treated were never taught what to do with sadness, anger, or fear. They weren’t given the tools to process trauma or regulate emotions.

Many were never allowed to express or evento feel the emotions that they felt internally. In schema therapy,this is called “Emotional Deprevation”. This teaches that negative affects are wrong and not to be expressed or felt.

So they find their own tools, and unfortunately, those tools can destroy them.

“Addiction fills the space where healthy coping skills should be.”

When a child doesn’t know how to cope, the world feels unbearable. Healing starts when we teach them what no one else did: how to sit with pain, how to ask for help, and how to believe that feelings won’t last forever.

Phrases That Build Emotional Deprivation Schema

Schema Therapy reference chart with “Message heard” vs “Message learned.”

Clinical note: These examples are illustrative of patterns that can contribute to an Emotional Deprivation schema.

Category	Example phrases	Message heard (implicit)	Message learned (schema conclusion)
Dismissal of feelings	“You’re too sensitive.” “Stop crying, it’s not a big deal.” “That’s nothing to be upset about.”	“Your feelings are inconvenient / wrong.”	“My feelings don’t matter.” “I shouldn’t need comfort.”
Emotional unavailability	“I don’t have time for this.” “Go talk to your mother.” “I’m busy.” “We’ll deal with it later.” “Figure it out yourself.” “Pull yourself up by the bootstraps.”	“You’re on your own when you hurt.” “You shouldn’t need help.” “Your emotional struggle is a personal failure.”	“No one will show up for me emotionally.” “I have to handle things alone.” “My emotional needs are too much or illegitimate.” “I must handle distress alone.” “Needing support means I’m weak.”
Practical > emotional	“You have food and a roof, what else do you want?” “I work hard for this family.” “At least you’re not starving.” “That’s just life.”	“Emotional needs aren’t legitimate needs.”	“My emotional needs are too much / unreasonable.” “I don’t deserve emotional care.”
Shaming emotional needs	“Real men don’t cry.” “Stop acting like a baby.” “Grow up.”	“Needing comfort is weakness.”	“If I need support, I’m weak.” “I should shut down my feelings.”
Conditional attention	“I’m proud of you when you win.” “Don’t embarrass me.” “Why can’t you be more like your brother?” “You should know better than that.”	“You get attention when you perform.”	“Love is earned, not given.” “To be valued, I must achieve.”
Minimizing pain	“Other kids have it worse.” “That’s nothing compared to what I went through.” “You think that’s hard?” “You don’t know what real problems are.”	“Your pain isn’t valid.”	“My pain doesn’t count.” “I should stop talking about it.”
Punishment for emotion	“If you keep crying, I’ll give you something to cry about.” “Stop it—now.”	“Emotion leads to danger.”	“It isn’t safe to feel.” “Vulnerability gets me hurt.”
Silence / non-response	(No comfort, no checking in, no repair)	“You don’t matter enough to respond.”	“My needs won’t be met.” “I’m invisible.”

Core Emotional Deprivation schema belief (bottom line):
“My emotional needs will not be met.”

The Role of Families in Recovery

Addiction is never just one person’s disease. It’s a family condition that requires a family solution.

Parents often carry deep guilt, wondering where they went wrong. Siblings may feel overlooked or resentful. But guilt doesn’t heal; grace does.

Family therapy helps everyone process what’s happened and rebuild safety together. Recovery for a child is possible only when the entire family learns how to heal, not by blaming, but by growing together.

“Healing the child begins with healing the home.”

Breaking the Stigma

The stigma around addiction is one of the biggest barriers to healing. Too often, children are labeled as “bad” or “hopeless.” But these are the same kids who, with support, can become advocates, mentors, and leaders in recovery.

“Addiction is not a moral flaw. It’s an emotional emergency.”

When communities replace judgment with understanding, we create spaces where children and families can ask for help without fear. That single act of compassion saves lives.

Mental Health and Addiction: Two Sides of the Same Coin

Addiction doesn’t appear out of nowhere. It often walks hand in hand with depression, anxiety, trauma, or ADHD.

When we only treat the addiction, we miss the root cause. Children need care that addresses their mental health and their substance use at the same time. This dual-focus treatment helps them manage both the emotional and physical triggers that lead to relapse.

“Treating addiction without addressing mental health is like watering a tree but ignoring its roots.”

Barriers to Treatment and Hope for the Future

Finding effective care for a child is incredibly difficult. Cost, lack of local options, and long waitlists make it even harder. But there is hope.

When families advocate persistently and professionals collaborate with compassion, change happens. Early intervention, trauma-informed programs, and community education can transform outcomes for children who once felt lost.

A Message of Grace and Understanding

Every child caught in addiction is reaching for help, even when it doesn’t look that way. What they need most is our calm, our love, and our belief that they can recover.

“They are not their mistakes. They are children who have suffered and are trying to find their way out.”

When we show love, grace, and steady guidance, we become the bridge between despair and hope.

A Final Word and a Call to Action

If you or someone you love is struggling with substance use, help is available, and you do not have to figure it out alone. Reaching out can feel overwhelming, but it is the first and most courageous step toward real change.