DR QURATULAIN ZAIDI of MindNLife looks at the effects that a parent’s addiction can have on families, and the kind of support or therapy available for alcohol addiction as well as drug addiction in Hong Kong.
What are some of the more commonly seen addictions in Hong Kong?
Alcohol addiction is the clear front‑runner. It is socially sanctioned, professionally entwined and constantly present. The line between “normal” social drinking and problematic use blurs when long hours lead to late nights and networking is expected to be done with a glass in hand.
Recreational drug addiction is also part of the picture. Examples include cocaine, used in a high‑pressure environment where staying “on” is normalised, and cannabis for sleep or anxiety. There are quieter dependencies, too. These include nicotine and high‑nicotine vapes, prescribed sedatives and sleeping tablets used longer or more often than intended and often easy to obtain, and gambling at the races, in social settings, or online.
What can perpetuate this in family dynamics in Hong Kong, from what I have seen in my practice over the decades, is a high‑octane work culture, status dynamics, readily available nightlife, and isolation from extended family and usual support systems. Unaddressed underlying mental health challenges can then feed into the maintaining of unhealthy patterns.
Why do some people get stuck?
The psychology of addiction is complicated and multilayered. Repeated use of substances sensitises our reward and stress circuits. Over time, the brain’s reward centre is “rewired” to prioritise relief over pleasure, making the substance feel essential just to feel baseline OK.
Cues (places, people, time of day, certain work emails) become tightly linked to craving. Genetics, early adversity, untreated anxiety or depression, ADHD, chronic stress, sleep disruption, and loneliness increase vulnerability, and self‑medication can easily turn into addiction – especially if you add a sense of isolation, loneliness and dislocation from familiar supports, role and identity changes within couples, constant travel, and pressure to perform.
This is where willpower alone without support is not enough, and why relapse is not always a failure. It just reflects the chronic, relapsing nature of the disorder and the environments that cue it.
What does addiction in Hong Kong homes look like?
I meet many expat families in Hong Kong where one parent is struggling with alcohol or drugs, the other is trying to keep the environment steady, and the children are absorbing the uncertainty that follows. This family dynamic is energy‑consuming, complicated and multifaceted. Addiction is a mental health condition, not a moral failure, yet its ripple effects can be profound.
A place that was safe and had familiar patterns and routines doesn’t feel familiar when replaced by a constant sense of uncertainty and lack of predictability. It can lead to a child (or a non‑using parent) feeling like they’re walking on eggshells. They describe not knowing which version of the addicted parent will walk through the door, the familiar one or the unfamiliar, less patient and irritable or angry one. The cumulative impact of cancelled plans, missed school events, mood changes and lack of emotional availability sees children scanning the room to monitor the situation rather than feel safe in it.
For the other parent, this inconsistency creates a heavy emotional and cognitive burden. They constantly adjust on the go, covering up while maintaining some semblance of normality, and trying to protect the children while managing their own internal emotional storm.
Hong Kong is small and expat circles smaller. Lives of families here are interwoven, which can result in the need for secrecy to cover the shame. People tend to minimise, conceal or normalise behaviours longer than in their home base with their support network. Financial strain is added during separation or divorce and the sense of safety is questioned. All this can create a sense of chaos for the whole family system. Family courts usually prioritise a child’s safety and stability, and concerns about substance use may lead to supervised contact or conditions around access until stability is demonstrated.
How are children affected by addiction, and how can they be supported?
Children are highly attuned to the emotional climate at home. When addiction is present, worry can become a norm of daily life. This can present in younger children becoming clingier or more prone to tantrums. School-age children can show concentration problems or present physical signs of stress like headaches or stomach aches. Teenagers can swing between withdrawal and anger. They’ll sometimes experiment with substances themselves when access is easy and parental modelling is confusing.
There is hope. The strongest buffer is the presence of one consistently sober, emotionally available caregiver. Predictable routines, regular mealtimes and consistent bedtimes all create a sense of consistency and safety. Honest, age-appropriate conversations can help protect children. Use simple language about addiction as an illness, reassure the child that it’s not their fault, and give them permission to talk about their feelings.
As for wider support, child and adolescent psychologists, play therapists and family therapists all provide safe spaces to process feelings and learn coping skills. School-based counsellors are often invaluable. If the school knows there is a concern, they can quietly monitor the situation and offer support.
What help is there for a parent who is struggling with addiction?
In Hong Kong, English public options and in-person peer groups are limited. Many expats therefore rely on private clinicians, with intensive outpatient care locally and regional residential programmes if needed.
Having a strong support network is important. That includes a team around you of professionals and friends – an experienced, qualified psychologist; a school counsellor to support the children and family system; and two or three steady friends or family you can call.
Medication can help for some substance-use disorders. Good supportive holistic care assesses the whole person and system: substance use, mental health, sleep, stress, relationships and structure.
The most important step is the first one. This is to acknowledge the problem and engage a professional clinician to put a plan in place to help navigate this change, if and when you’re ready to make the change. Ensure safety measures are in place. So, no driving after drinking or using, and absolutely no using in the child’s presence. If legal proceedings are ongoing – for example, around divorce or custody – find a supportive collaborative lawyer and be transparent with them about treatment engagement and testing. Litigation can be toxic, so avoid it if possible. Accept your responsibility for substance use and get the help to manage it.
If you’re the non-using parent, know you don’t have to do this alone. Put your own oxygen mask on first, and put in measures for self-care so you can be present for your family and provide a consistent base with predictable structure and routine.
What’s a final word on the topic that might be helpful?
This is a transition, and there is an end to it. Families can and do come through this. I have seen parents move from shame and secrecy into recovery, and with time, trust grows back. I have seen children who were anxious and watchful find their footing with one steady adult, then flourish as things settle. We know well that any healing and repair is never linear and it takes time; however, it is possible. Addiction prefers silence; recovery begins in conversation.
Dr Zaidi is a British-registered clinical psychologist who works with individuals, couples and families in her private practice in Central. She also works as a mental health consultant for a number of NGOs and international corporations.
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info@mindnlife.com | mindnlife.com
This article on alcohol and drug addiction first appeared in the Autumn 2025 issue of Expat Living magazine. You can purchase the latest issue or subscribe so you never miss a copy!
