In 2003, there were 22,500 families in Australia where grandparents were raising grandchildren. Many of these are due to substance abuse problems by the children's parents. This article explores the issues faced by these grandparents, which include health and ageing related issues, impacts on family relationships, legal and custody problems, social isolation, lifestyle upheaval, physical and emotional stress, and financial hardship and disadvantage. The children and their parents are also affected. In response, the article outlines the policy and service recommendations of the Canberra Mothercraft Society, which include early intervention and government financial assistance.