November is National Adoption Month, a time when many families finalize adoptions and communities frequently hold events to raise awareness about the need for adoptive families. Adoption is a beautiful way for a family to expand and for a child to find permanency and stability. At Cottonwood, in Tucson, Arizona, we encourage parents to take a proactive approach to helping their children, including those who joined their family through adoption, to avoid substance misuse.

Types of Adoption

It is important to understand that there are several different types of adoption, and the experiences a person has before, during, and after their adoption can all have an impact on their risk of developing mental health and substance use disorders later in life. Some of the most common types of adoption include:

• Foster care adoption – a child who has been removed from their biological parents, usually for safety reasons, sometimes including abuse or neglect, is placed with a relative or non-relative caregiver. The goal for these children is often reunification with their birth parents, but if the parents are not able to regain custody within a specified period of time, a judge may remove their parental rights. At this time, the child may be adopted by the foster family or another family. While placed in foster care, the child may experience numerous moves, losing contact with extended birth family, classmates, teachers, and others they knew in the community. Frequent moves can be stressful and make it difficult for children to feel secure in future placements. Adoptions from foster care usually cost little to no money and may be subsidized by the government, but typically require licensure through the state or an adoption agency. 
• Domestic, private adoption – these adoptions generally involve infants whose birth parents have voluntarily given up their rights. Adoptees who joined their families through private adoption may not know their birth parents and may not realize they have been adopted unless their adoptive parents share this information with them. Private adoptions do not require licensure, but adoptive parents are often responsible for all legal fees and expenses the birth mother incurred during her pregnancy, so these adoptions are generally more expensive than foster care adoption.
• International adoption – children born outside the United States are adopted by American parents, who then bring them to America. Children may already be several years old by the time they meet their adoptive families and may not speak English prior to arrival in their new home. International adoptions can be expensive because they require not only the fees associated with the adoption but also travel expenses to meet the child and bring them home. There are also fees associated with helping the child to obtain U.S. citizenship.
• Stepparent adoption – when someone marries the mother or father of a child, they may become the legal parent of that child if the other parent relinquishes or loses their rights. 

Open Versus Closed Adoptions

Adoptions may be open or closed. An open adoption means that the birth parents are either able to have visits with the child or are provided updates in the form of photos, letters, or phone calls from the adoptive parents. A closed adoption means that there is no contact and there are no updates after the adoption occurs.

Genetics and Environment

If an adopted person’s birth parents struggled with mental illness or substance abuse, it can increase their chances of developing either type of disorder as well, as some of the mechanisms in the brain that are associated with addiction and mental illness can be passed down. 

Additionally, the environment can influence the likelihood of a person developing these problems. This includes exposure to alcohol and other substances while in utero and the external environment where the child lives after they are born.

Adoptees and Trauma

A trauma is a painful or terrifying event that occurs in a person’s life, which overwhelms their ability to cope. What is traumatic for one person might be only mildly upsetting for another. Trauma is linked to increased risk of both mental illness and substance use disorders. Some situations that frequently occur in the life of an adoptee that can be traumatic include:

• Grief and loss
  • Being separated from biological siblings
  • Wondering why birth parents did not keep them
  • Questioning if their adoptive parents love them
• Disrupted relationships
  • Not being able to live with biological parents
  • Not seeing extended family for years on end
  • Moving between foster homes and losing contact with foster parents and foster siblings
  • Changing schools and losing contact with friends and teachers
  • Feeling like everyone moved on without them
• Lack of information about one’s own identity
  • Not having photos from some periods of their lives
  • Being unable to complete school assignments, like family trees and biographies
  • Not knowing what countries their ancestors are from
  • Wondering how they got their name
• Lack of genetic information
  • Being unable to complete family medical and mental health history at doctor’s appointments
  • Wondering where they got their eye color, nose, or hair texture

Protecting Adoptees from Addiction 

It is important to understand that even if the factors above are not ideal, this does not mean that an adopted person will develop a mental illness or substance use disorder. Adoptive parents  have tools to influence the outcomes their children experience. These include:

• Providing healthy, stable attachments
• Giving the child permission to live authentically, where they do not feel they are required to pretend to be anyone but themselves
• Access to mental health resources
• Support for adoption within the extended family and the community
• Modeling healthy behaviors around substances

At Cottonwood, our staff are trained in trauma-informed practices, and we tailor our services to meet the needs of each patient we serve. We also welcome family involvement in treatment when appropriate.