This study explores social workers’ experiences of working with children living with parents who have substance abuse problems. Using a qualitative approach and semi-structured interviews, the study highlights how social workers identify risk and protective factors, as well as how they perceive their room for manoeuvre in practice. The findings show that children in these environments often experience inadequate care, insecurity, and take on adult responsibilities. Social workers emphasize that it is not solely the substance abuse itself that poses a risk, but above all its consequences, such as deficient parenting and an unstable everyday life. Protective factors such as stable schooling, trustworthy adults in the child’s network, and inter-agency collaboration are highlighted as crucial in strengthening the child’s situation. At the same time, the social workers describe that their scope for action is often constrained by organizational frameworks, lack of resources, legislation, and unclear guidelines. The study is theoretically grounded in the concepts of professional discretion, systems theory, and resilience, and it underscores the need for structural support and child-centred interventions. By making visible the perspectives of social workers, the study aims to contribute to more effective and legally secure social work focused on the needs of children.