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Impact on family members
(written by Sarah Zohhadi)
Family Members
Most people who use substances live in families; within a social context which may comprise partners, children, parents, siblings and others. An individual with problematic substance use usually affects others in the family. These pages will focus specifically on the impact on adult family members – for information about children, see the pages on ‘Parenting and Substance Use’ which contains a section on the ‘Impact on Children’.
The size of the problem
There are believed to be many millions of family members who are affected as a result of the problematic alcohol or drug use of a relative. However, it is difficult to calculate the exact number. Conservative estimates are often based on assumptions that every ‘problem alcohol or drug user’ will negatively affect two close family members. However, as Velleman and Templeton (2003) point out, the level of use that is considered to be ‘problematic’ is often set quite high, and in reality difficulties for families may arise from much lower consumption levels. It is important to note that someone does not have to have an identified alcohol or drug problem for their drug or alcohol use to have a negative impact on their family members.
The nature of the problem
Living with someone who has problems with their substance use can be difficult and disruptive. The behaviours that often are caused by, or associated with, substance use – mood swings, unpredictability, violence, stealing – are stressful to deal with, and can impinge on relationships and activities both within the family and wider community. Macdonald et al (2002) have devised a useful framework to understand the different ways in which problematic substance use negatively impacts on family members. They suggest the impact on families can be identified in four key areas:
Physical and psychological health
anxiety, guilt, fear, isolation, depression, stress
colds, headaches, ulcers, raised blood pressure |
Family relationships
breakdown in communication, lying, collusion, increased tension, arguments and conflict
fulfilling roles different to their position in the family, feeling neglected |
Finance and employment
theft of money/possessions by individual with the substance problem; repaying their debts/purchasing drugs
loss of job due to poor concentration, ill-health, caring responsibilities, decreased confidence, shame |
Social life
alienation by friends and family
caring responsibilities/ill health/embarrassment |
It is important to note that not all family members will experience negative effects to the same extent: there will be differences depending on the relationship with the person with the problem, the substances they use and how much they use, and the personality of the family member – some people have more support outside the family and are more resilient than others..
Refs: Macdonald, D., Russell, P., Bland, N., Morrison, A., and De la Cruz, C. (2002). Supporting families and carers of drug users: A review. Effective InterventionsUnit. Velleman R & Templeton L (2003) Alcohol, Drugs and the Family: Results from a Long-Running Research Programme within the UK. European Addiction Research, 9, 103-112.
Sarah Zohhadi is a Researcher in the Mental Health Research & Development Unit (University of Bath, Avon & Wiltshire Mental Health Partnership NHS Trust) and works on the Alcohol, Drugs and the Family Programme.
Working with the family | Support services | Websites
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