Scotland is battling a substance problem among its youngest residents. More than 200 Scottish kids under the age of three have been referred to alcohol and drug treatment in the past year, the Daily Record reports. This means the children are vulnerable to drug or alcohol misuse, either using substances themselves or exposed through their family members.

The toddlers and infants were among more than 2,000 children needing some form of addiction treatment in the country. All were exposed to substances by a family member, including unborn babies whose mothers are addicted to drugs or alcohol.

About 613 of these cases involved a child’s own substance use in kids as young as five, and 1508 involved relatives. Overall, these recent numbers show a 14% rise in referrals among kids under 16.

“The vast majority of these referrals are to provide support and therapeutic services for children whose parents misuse substances,” said Mark Steven, Partnership & Policy Co-ordinator for the Fife Alcohol & Drug Partnership. “We want them to understand what’s happening around them, to build their self-esteem and help them make positive choices.”

Around 51,000 children in Scotland live with parents who have a problem with alcohol, according to Barbara O’Donnell of Alcohol Focus Scotland. “Children are especially vulnerable to alcohol harm and it is worrying these figures suggest increase in the numbers who are affected,” she said. “Children and young people’s brains are more vulnerable to the effects of alcohol because they are still developing.”

She said it is critical that children receive specialized support focused on helping young people and families. She also said kids today are growing up in a “pro-alcohol society” and called for changes in alcohol pricing, availability and marketing.

Many of the kids being referred are not addicts themselves, but could be on a path to become addicted later in life, said Scottish Labour justice spokesman Hugh Henry. “The tragedy is for those young people with a problem, they are often then in a spiral of addiction and crime,” he said. “This is a wakeup call to everyone with responsibility for Scotland’s young people.