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Hi Sober Lady,
My husband and I got married over the summer, and we’re talking about whether or not we want to start a family. When we were dating, we discussed whether we wanted kids, and neither of us came up with a firm yes or no, so we figured we’d wait and see how we felt after we got married.
Recently, he’s been talking about wanting kids, but I’m not sure. We both come from families with a history of addiction. I don’t drink, mostly because of my experience growing up. Both of my parents were active alcoholics; one until they died, the other until quite recently. (I don’t really think of myself as sober, a word I usually associate with someone who had to quit, but I guess I am.)
His family’s history of addiction involves some alcoholism, but in his more immediate family, opioids take center stage. He will sometimes drink more when he’s out with friends, but at home only has a beer or two, if that, and he’s never used opioids outside a surgical/medical context.
What I’m trying to say is that neither of us is actively addicted, but whatever gene makes someone susceptible to addiction is definitely present in us both. I keep googling odds for addiction if both parents have it in their families, but I get a huge range that’s not helpful. Do you know what the risk is? Is this an insane reason not to have a family?
Sincerely,
Anxious possible future parent
Hi APFP,
Thank you for the question. It’s an understandable concern, especially considering your experience growing up. You’re absolutely right that there’s a significant genetic component to addiction, but you’re also living proof that genes are only one part of the equation. In fact, growing up with two parents who were active alcoholics makes you, statistically speaking, far more likely to have a substance use disorder than your potential offspring.
The range you probably saw when researching this is that genes are estimated to affect 40–60% of a person’s risk of developing substance use disorders, but that doesn’t tell you the whole story. Equally important (literally equally, also 40-60%) is a child’s environment: that’s everything in a child’s life other than genetics.
A child’s risk of developing a substance use disorder increases if they experience trauma, parental substance misuse, parental neglect, abuse, poor or challenging socioeconomic factors, and a lack of emotional and social support. Also included in risk factors are a lack of coping skills, exposure to substances at an early age, mental health disorders—I could list risk factors until every person unsubscribes from this newsletter out of boredom.
Genetics and environment can heighten or lower a person’s vulnerability to developing a substance use disorder; they aren’t guarentees. By simply not misusing substances, you and your husband are giving any potential kids you have a good start.
Let’s simplify with something less charged than addiction. My maternal grandmother had osteoporosis; bone density is highly hereditary (about 50-80%, if an irresponsibly quick Google search is correct). If my mom also develops the disease, genetic factors put my sister and me at higher risk of developing it as well. But despite getting genes from the same set of parents, our risk isn’t the same. I have a similar build to my mom’s and my grandmother’s, which increases my risk compared to my sister’s. But even that’s not the end of the story.
If I did daily strength training, consumed a ton of calcium-rich foods, got lots of vitamin D, had great preventive healthcare, and didn’t smoke or drink (the only one of those things that’s true!), and she had the opposite environment and behaviors, her risk might be higher than mine. But that’s still just risk. Either, both, or (by some miracle) neither of us might end up with the disease. We are all a messy mix of genes, environment, habits, and dumb luck.
I know it seems like having a definitive risk percentage would help you decide, but I’m not sure it would. If you’re looking for them, you can find countless reasons not to have kids. So much of what’s happening in the world is heartbreaking, terrifying, and infuriating. The future has always been and will always be uncertain. For some people, that’s what they point to when they explain why they don’t want kids—and that’s valid.
Others might look at all the heartbreak and uncertainty and find that it makes their desire to have kids even stronger. The world’s chaos might stoke a desire to build a family unit—a core of stability in a world that feels upside down. Maybe it fuels a desire to build a better future through the next generation, or maybe it gives people a reason to focus on the beautiful, hopeful parts of life—that’s valid, too.
The thing about uncertainty is it’s often a kind of Rorschach test. We can talk about genetics and environment, but I’d rather ask you what you want. Take addiction off the table for a minute. If I could promise you right here and now that your potential kids wouldn’t ever touch an addictive substance, would you want children?
No one can tell you whether or not you and your husband should have kids, but before you make any decisions together, you have to get clearer about what you want.
If you decide you do want to have children, or are at least leaning in that direction, you and your husband should sit down and talk about your fears. Would you feel more comfortable raising a kid in a house without any alcohol? Would your husband give up his nightly beer for that goal?
Just as there are countless environmental factors that can heighten a child’s risk of substance misuse, there are just as many that have a protective effect. How will you ensure your child has emotional and social support? How can you make sure your child feels comfortable talking to you without feeling judgment or shame? What coping skills do you hope your kid develops, and how can you help facilitate that development? How will you talk about substance use and addiction with them, and when do you want to start having those conversations?
The parents out there might be laughing at me, I know, the best laid plans...don’t necessarily survive the real world challenges of child rearing. But it’s important that you a) figure out what you want and b) if you decide that’s kids, start having conversations with your husband about what you hope your kids’ environment looks like. You can’t control every environmental factor, but you can enter parenthood as a team, with a unified commitment to providing your child with the healthiest environment possible. It might be useful to have some of these conversations with a therapist who specializes in substance use disorders.
When you don’t know what you want, it’s easy to get lost in the pros and cons of each side. For whatever reason, I’ve always known that I didn’t want kids. That knowledge has allowed me to see the positives of that path—I didn’t have to worry about my biological clock ticking, feel pressured to settle down, or worry about genetics. Those positives aren’t why I don’t want kids; they’re the result of knowing what I want. I know downsides exist, but they’re harder for me to see or care about because I know I’m doing what’s right for me. Figure out what’s right for you
All kids deserve to be born to parents who want them. There’s no doubt in my mind that you’d be a loving, attentive mother if that’s what you end up wanting. Don’t let your family history make the decision for you—you deserve to make it yourself.
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Great post. Also… if one’s child becomes addicted to something, that is also not “wrong” nor the end of the story. As you say, it’s not a matter of genetics entirely, but even if it happens, there’s a whole slew of possible outcomes even in that experience.
So many people experience addiction, and it isn’t always a “now they’re lost in the abyss forever” case. Many incredible cases of recovery show that while addiction is horrific, it can also be an incredible initiation into an even fuller version of a person. I don’t say this to downplay the horrors, just to remind myself and others that kids experiencing addiction are also undergoing a potent process that may well prove transformative for them and others in a positive way. How parents trust in that possibility (or not) also plays into how a child navigates our addictive culture.
This sort of fear, in my view, also often includes a subconscious call-back to eugenics (meaning, the notion that there’s a genetically “good” version of a human that we must to strive to produce; usually, that’s been defined as an able-bodied, neurotypical, tall, athletic, white person). Of course, it’s completely reasonable to wish ease for one’s children as they/we navigate the world, and that’s hard when we/kids fall outside idealized categories. But and also… there’s beauty, meaning, community, and purpose to a disabled, neurodivergent, addicted, and otherwise challenging / stigmatized existence. Not to get too woo or something, but if Life is genuinely inspiring someone to have kids even if challenging genetic conditions may unfold from that choice, perhaps Life is communicating that those conditions are worth living out, too.
Again, not trying to downplay the really justifiable fear of this possible parent; simply trying to widen our collective understanding of what constitutes a life worth birthing.
Wonderfully coherent response!