Abstract: This conference originated from the findings of a literature review carried out by Dr. Justine Horgan, Senior Researcher National Advisory Committee on Drugs on the impact of parental substance misuse on children. The main finding of this review was that parental substance misuse can, and does, negatively impact on the health, development and welfare of children including both abuse and neglect. As children’s welfare and protection is a major governmental and societal priority, this conference was timely and the invitation by the NACD to the HSE and alcohol Action Ireland to become co-sponsors of the conference ensured the widest possible dissemination of the findings. The organisers welcomed the presence of two Ministers who were fully supportive of the aims of the conference. The presence of senior managers from the HSE Addiction and Children and Families Services was also key to the recognition of this as a conjoint managerial responsibility. This was the first national conference addressing the impact of parental substance misuse on children and the first combined gathering of staff working in addiction, child welfare and protection services from the community, statutory and voluntary sectors. Such a large gathering enabled the sharing of observations and experiences and an exchange of views on the challenges involved in early intervention and interagency work in the context of diminishing resources. The conference also highlighted the importance of public policy with local implementation supported by adequate resources. One such policy, the Hidden Harm strategy in Northern Ireland, highlights the need, as a main objective of policy and practice, to reduce the harm to children from parental substance misuse. This strategy also recognises that effective treatment of the parent can have major benefits for the child and that by working together, services can take many practical steps to protect and improve the health and well-being of affected children. Furthermore, recognition that problems affecting children will only decrease when the number of people with harmful drinking patterns and problem drug use diminishes is of critical importance as are the relevant strategies aimed at implementing such reductions. Points from the Hidden Harm strategy are re-iterated by the following key findings from our national conference as follows: 1. All services, including child, family and adult services need to view the welfare of the child as paramount. Agencies need to work together, taking a child-centred approach, supporting the whole family to meet their child’s needs. 2. Adult drug and alcohol services have a duty to consider and assess how the adult’s behaviour may be affecting the children in their care 3. Invest in prevention and early intervention services 4. Provide services and supports directly to children 5. Ensure organisations are clear about their responsibilities under Children First. Putting Children First on a legislative basis would ensure that organisations have a duty to work together in the interests of the child. 6. Policies that reduce substance misuse consumption levels can reduce the level of harm to children living with parental substance misuse problems. This conference provided a forum to respond to a literature review which clearly identifies that parental substance misuse is a most serious challenge to child welfare and child protection in modern Ireland. The challenge now is to recognise this issue as current, even though largely invisible and to take the necessary steps to implement the policies and measures required to safeguard and protect children now and for future generations.