Quality & Science

Editorial Comment 5/5/2020: Guest Editorial

by William Haning, MD, DFAPA, DFASAM | May 4, 2020

In response to our invitation for guest editorials, Dr. Timmen Cermak, past President of the California Society of Addiction Medicine, submitted the following essay on the symbolic and real confinements experienced by a child in an alcoholic family, employing parallels with the current pandemic public health confinements.  In reviewing his submission, I think it important to emphasize that this is not a condemnation of the epidemiologic strategy itself, but is an acknowledgement of the metaphor and of the unintended consequences. 

Dr. Cermak’s greatest pursuit over the years has been the impact of substance use disorders on the integrity and nurturance of the family.  There should thus be no great surprise that there is a very personal experience embodied in this brief essay.  That experience does not detract from the force of his message and may truly augment it.  Life is, after all, a projective test.

-W. Haning, MD, DFASM



Sheltering at Home Can Be Hell for Children with an Addicted Parent


Millions of children are isolated with a stressed alcoholic during the coronavirus pandemic.  Sheltering at home during the COVID-19 pandemic is supposed increase safety. It is supposed to protect families from the dangers surrounding them. But for many of America’s children, life has become more treacherous.


Domestic violence is distressingly common even in normal times. One of every seven children experiences abuse or neglect each year. One of three women and one of every four men has been the victim of violence from an intimate partner at some time in their life.  Calls to domestic abuse hotlines spike at times of stress - after mass shootings, during big sporting events and on major holidays, including New Year’s Eve, Thanksgiving, and Valentine’s Day. The stress of unemployment, financial insecurity, forced togetherness and fear of contagion created by COVID-19, especially when alcohol and drugs are added to the mix, increase the likelihood of combustion. It is no surprise that police in Jacksonville, Florida recorded a 20% increase in domestic violence calls during the first week of lockdown.


As people prepared to shelter, they went on a shopping spree for more than food and toilet paper. Nielsen reports alcohol sales rose 55%. While the 75% rise in liquor sales may have been, in part, to make hand sanitizer, there has also been a 66% rise in wine and nearly a 50% rise in beer sales. [ https://6abc.com/health/booze-buying-surges-5525-as-people-shelter-in-place-nielsen-report-says/6068661/ ]  People also stocked up on cannabis. Data are scarce, but cannabis sales around the country have risen, with strong delivery orders and an increase in new customers. A March 17 Orange County Register report is typical, that local dispensaries saw a 30% increase in sales in one week. [ https://squarmilner.com/covid-19-cannabis/ ]


The first 13 years of my life were marred by living with an alcoholic father, even without overt abuse or neglect. The arguments, disappointments and random disruptions of family life created enough tension to leave me with character traits and expectations that took years to untangle and drop away.  My mother was a stabilizing force, though her feigned compliance to soothe my father modeled destructive strategies for intimate relationships. I was lucky to find helpful guidance outside the home as well.  Friends counterbalanced my feeling unlikable. Teachers offered praise. Mrs. Kondas next door, a tenth of a mile up the road, always welcomed me as the child she never had. Baking bread together offered a respite from home whenever voices rose in anger and tears flowed.  Such resources have been stripped from the 11 million children of alcoholics under 18 years old isolated today in the time bomb of their home. No meeting with friends. No school. No acceptance by teachers or coaches. No activities outside the hot box where they live.


A history of domestic violence increases the likelihood of further incidents under times of stress. Imagine children in those homes hunkering down in anticipation of the next explosion, with nowhere to go, no one to talk to, no safe place.  Children living with active alcoholics or other drug addicts have been thrown into the lions’ den by public health regulations either obliging or advising them to stay indoors. Their parents have too much time on their hands, are bored and irritated by being locked up with the rest of the family and have stockpiles of intoxicants. Those already inclined to deal with stress by drinking and using substances are likely to indulge even more than usual.   More reason to hide under the bed at night, to play in your closet, or to numb out present reality. Sheltering at home can be hell.


Recommendation: There is help online. Information and even connection with other teens who have an addicted parent is available at Alateen - https://al-anon.org/newcomers/teen-corner-alateen/. No one understands the experience of living with an addicted parent better than someone the same age who is living through the same pain. Alateen offers real hope.  The National Association for Children of Addiction (NACoA, previously the National Association for Children of Alcoholics) is fighting to bring attention and support to children isolated in families suffering addiction. NACoA can be reached at nacoa@nacoa.org.  I encourage teachers, counselors, healthcare professionals, clergy and anyone interested in learning more to contact NACoA. The need is now acute, and will last for many years.


Everyone can help simply by passing this post on as widely as possible. It may eventually get into the hands of a child locked down, isolated and desperate.


Timmen L. Cermak, MD

Past President California Society of Addiction Medicine (CSAM)

Co-founder, National Association for Children of Alcoholics, 1984