This article explores the processes through which dependence on opiates affects parenting capacity and family processes. The findings are based on in-depth interviews with 100 parents (50 drug-using [opiate dependent] and 50 non-drug using) living in Dublin. Qualitative analyses of semi-structured interviews suggest that opiate dependence has a specific impact on parenting processes and particularly on the physical and emotional availability of parents and on the capacity of parents to provide an emotionally consistent environment. Parenting behaviours were linked, based on parents’ perspectives, to elements of the culture surrounding illicit drugs and their supply and acquisition, to drug treatment regimes and to the physiological effects of drugs. The implications for children’s development and well-being, and for support of affected families, are considered.