Through close reading of medical and cultural texts, this article demonstrates how the narrativisation of relational harm underpinned the emerging categorisation of ‘addiction’ in the 19th century: excessive consumption was conceived through its detrimental impact upon others, and more specifically, upon the family. The problem was portrayed as physiological, psychological, and social: ‘addiction’ could not be located securely within a single individual, nor was it conceived simply as a social vice. While other societal themes emerge in the medical writing of the period, such as the relationship between drinking and criminality, and the visibility of drinking in the working-classes, these are not presented as proto-diagnostic criteria in the same way as relational harm. In theorising addiction, medicine relied upon rhetorical devices and narrative modes, and authors and artists took an active role in defining the terms of the debate around drinking, drug use, and gambling. Charles Dickens and George Cruikshank represent childhood through the adult's compulsive behaviour, which the child witnesses, while the adult's behaviour itself is conceived as harm directed towards child. The article demonstrates how 21st-century attitudes, particularly located in the fields of psychiatric diagnosis and child protection social work, echo debates established by 19th-century narratives, arguing that that the disease model of addiction was closely associated with the medico-legal production of childhood. Nineteenth-century narratives of addiction therefore anticipate late 20th- and 21st-century attitudes regarding the impact of parental substance use upon children.