Substance abuse is associated with a host of harmful consequences to the substance user as well as other individuals and society as a whole. Although harm is an integral component of substance abuse, there is a dearth of research that investigates the relationship between harm and substance use problems. The goal of this study was to explore recovering substance users' retrospective perceptions of harm caused to self and others during periods of substance abuse and the resulting association with the development of problem awareness and treatment perspectives. The present study found that perceptions of harming children demonstrated a significant impact on adults' substance use problem awareness and treatment optimism. Perceived harm caused to a child during periods of substance abuse was associated with increased substance use problem awareness and treatment optimism. Findings suggest that harming children as a consequence of adult substance abuse may play an impactful role on adults' recovery process. Implications for future research are discussed.