"What is your emergency?" asked the 911 operator. The little boy replied, "My mom is making me blow air into her interlock."
The Albuquerque, N.M., youngster was asked to help his mother break the law and blow into her ignition interlock device to start the car. Police responded to the call this week and charged 30-year-old Genevieve Sullivan with violating her probation for drunken driving.
The 11-year-old walked a fine emotional line: He told operators he was afraid his mother would hear him and he'd get in trouble. But he was even more afraid of the consequences should his mother drive drunk.
Experts say children of alcoholics bear a heavy psychological burden for the sins of their parents. They are forced into adulthood early and spend much of their growing up years protecting themselves and their families.
"He knew at 11," said New York state psychologist Pat O'Gorman, who isn't involved with the New Mexico case. "He knew his mother was in trouble. He knew she needed help, and he knew he could provide that help."
According to the National Council on Alcoholism and Drug Dependence, nearly 14 million Americans are considered problem drinkers and 76 million are exposed to alcoholism in family settings.
Studies suggest about one in four children in the United States is exposed to alcohol abuse or dependence sometime before the age of 18, according to the Children of Alcoholics Foundation.
Life Is Chaotic, Unpredictable
"Many of the popular portrayals of children of alcoholics are clearly overgeneralizations and have the potential to be harmful," said Dr. Oscar Bukstein, a psychiatrist at Western Psychiatric Institute and Clinic in Pennsylvania. "However, many grow up too soon and attempt to act as parents while their parents' alcoholism renders them childlike."
Living with an alcoholic parent can be chaotic and unpredictable. Children can feel confused, insecure and blame themselves for a parent's drinking. Few realize they cannot "cure" their parent's problem.
"If a parent, no matter how loving or well-intentioned, is in a stuck behavior, they are distracted and preoccupied and often impatient and frequently totally insensitive to the needs of the child," said David Deitch, chief clinical officer for Phoenix House, which runs treatment programs for addiction.
Research shows parental substance abuse interrupts a child's normal development and cognition. They are also more likely to become alcoholics themselves.
These children deal with a range of unresolved emotions: guilt, anxiety, embarrassment, confusion and anger. Many later fail to develop intimate relationships and later experience depression, anxiety, eating disorders and suicide attempts.
Some children keep their rooms clean, get good grades and avoid fights with their siblings in the hopes that they won't cause their parents to drink. Others withdraw, hoping not to create any disturbance that encourages the drinking.
Such was the case in the home of a Utah mother of five, Lisa Berry, who started drinking to "go along with" her alcoholic and physically abusive husband.
Berry's son Jobee, now a 19-year-old honors student, barely escaped his home life alive. His drunken father once took him on a high-speed chase with police in hot pursuit and calmly called his mother.
'I Could Hear Cop Sirens'
"Tell your dad to pull over," Berry said she told him. "Tell your dad to let you out, he's always driving drunk."
Her oldest daughter became the substitute mother, protecting her four younger siblings. "I was scared and couldn't even leave the house to go to the store," she said. "Rosalee would take the kids to school and pick them up and cook for them."
Jobee was "like the man of the house and stood back and watched everything," she told ABCNews.com. "They tell me now that they never felt safe at home."
Like the 11-year-old who told 911 his mother had not been home the night before, because she was drinking, "Jobee would not let me leave the house for fear I wouldn't come back," said Berry.
The father eventually served jail time.
Today, sober for three years, she sees the cycle of abuse. Berry is raising Rosalee's two young children, as her daughter, a methamphetamine addict, serves prison time for attempted murder.
"There is so much guilt, but my daughter says not to blame myself, because the kids are older and doing good now," she said.
Still, Berry says the children have not gone unscathed.
"They tried to block a lot of stuff out," she said. "Jobee's very quiet and never shows anger ever, and when does, I'm afraid he will blow."
Her 18-year-old son is "very shy" and her 17-year-old daughter suffers from bipolar disorder.
Indeed, research shows that exposure to multiple trauma will increase the likelihood that a child will later have both mental and physical problems, according to Dr. Robert Anda, scientific adviser to the National Association for Children of Alcoholics.
Anda is one of the principal investigators of the federally funded Adverse Childhood Experiences study, which found that cumulative exposure to stress can affect neurodevelopment.
"It really affects the whole journey of human development when you stress a child," Anda told ABCNews.com. "Alcohol abuse in the home is part of a spectrum of interrelated experiences, and your chances of problems on the list goes up in tandem."
Stress Contributes to Disease
Growing up with alcoholic parents can increase the risk for all major chronic diseases -- heart, lung, liver -- as well as for suicide, injuries, HIV and other sexual diseases, according to the ACE study.
As for the 11-year-old who made headlines this week, "That is just one stressful moment in that child's life," Anda said. "But that boy has been stressed in many ways over a long period of time."
Children of alcoholics always deal with anxiety, according to Debra Borys, a clinical psychologist in Los Angeles, who treats adults who were raised in alcoholic homes.
"They have to anticipate what can go wrong in a situation, both the danger the alcoholic can cause to himself as well as abuse," she said.
"Most kids don't have to worry about the loss of the parent," she said of the boy who dialed 911. "But he does. And he himself could be in personal danger, and that life or death situation can be overwhelming for the whole child."
When children spend their developing years obsessing about protecting themselves and their family, "the energy that is normally going to development and educational growth is not happening."
Others become fixated on control, neatness or perfectionism in their schoolwork, or eventually become workaholics, she said. Many learn to calm themselves by turning to substance abuse and eating disorders.
Jeanne, a 53-year-old from Massachusetts who asked that her last name be withheld, once found her father lying facedown in a pool of blood with 20 bottles of vodka in the trash. Today, leading a successful career in the high-tech industry, she refuses to drink alcohol and shuns those who do.
Like many children of alcoholics, she led a life "hidden" from friends. "No one on the outside sees it," she told ABCNews.com. "People thought everything at home was happy and there were no problems. My mother did everything she could to hide it."
Her father never abused the family physically but waged a psychological war when he was drunk, especially at holiday time.
"My earliest memories were that every holiday was ruined," she said. "You could tell when he was starting -- it was humiliating and embarrassing, and he would slur his words and ignore you in favor of someone else."
'I Own You,' Father Shouted
Once, after her mother had the piano tuned and Jeanne was excited to sit down and play, her father shouted, "I don't want to hear you play. I want to hear the piano tuner play." He also dangled her promised college education as a "tool" to make sure she behaved. "I own you," he would tell her.
Since then, Jeanne has never enjoyed the holidays and she admits the experience probably has kept her from ever getting married and having the responsibility of children. But she gained personal strength.
"I have been fiercely independent ever since," said Jeanne. "I think there are permanent scars, but you can't let those dictate your life. It's there and you move on and you can't let it define you and get sucked down into that hole."
Jeanne is a living example of new research on children of alcoholics that finds that most children from "trauma-ridden" families make it," according to psychologist O'Gorman, who studies resiliency. "They gain something that makes them grow up faster and lose some of their childhood, but they gain maturity and wisdom, which is a good thing."
"There are incredible stories of heroism," she said. "You can change the end of your story."
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ABC News researcher Barbara Paulsen contributed to this report.