Following a review of the literature on the prevalence of substance misuse in families, more than 25 key points were noted, highlights of which include: 1) international household surveys and other population estimates suggest that approximately 10 percent of children live in households where there is parental alcohol or drug abuse; 2) international research indicates that parental substance misuse is a key feature of families identified by child and protective services; 3) treatment services need to help families with parental substance abuse to better manage the daily stresses associated with socioeconomic disadvantage in order to reduce the impact of this risk factor on child outcomes; 4) a significant protective factor in a child's life is the experience of a secure relationship with his/her parents through the provision of sensitive and responsive care and appropriate limits; 5) supply reduction strategies are critical to ensure the safety of women and children exposed to violence associated with substance abuse; and 6) provision of guidelines for drug and alcohol workers for the assessment of child protection issues is strongly recommended. On the basis of the key points and literature reviewed, a series of recommendations were derived for consideration and are grouped under recommendations for determining prevalence estimates of children living in families with parental substance misuse, recommendations regarding the content of treatment programs to meet the needs of children living in families with substance misuse, recommendations for Indigenous communities, and recommendations regarding policy and practice guidelines for government. Many children of substance-abusing parents face a preponderance of negative life circumstances that collectively heighten their risk for negative outcome. This report focuses on the impact of parental substance misuse specifically alcohol and illicit drug use in children aged between 2 and 12 years. Tables, references, and appendixes