alcoholism affects family essay

The Effects of Substance Use on Families

Part 1: how substance use impacts the family system..

Posted March 25, 2022 | Reviewed by Davia Sills

• A family is a system, and what happens to one member happens to the whole.
• Each family copes and responds differently to a substance use disorder.
• However, there are common patterns in families' responses, including taking time to discover the problem, living with it, and separating from it.

On a family road trip, our adventurous driver wondered what would happen if he put the car into reverse while we were coasting downhill. Long story short, we ended up in Nowhere, Utah, stranded for several hours, waiting for a tow truck. Unsurprisingly, the vehicle—which is designed as an efficient, coordinated system—needed several repairs because once one part was thrown into chaos, other systems went awry as well.

Families, like vehicles, are similarly coordinated systems, with each person relying on others to make sure everything functions and everyone is taken care of. When an individual struggles with a substance use disorder (SUD), oftentimes, treatment is focused only on that one individual as if that person is the only one impacted.

But family members can feel great pain over a loved one’s SUD and are left to grapple with the consequences and the added stress all on their own. As a result, those with loved ones who struggle with a SUD often have to guess about how to manage their own emotions as well as added responsibilities and other practical consequences of the afflicted person’s impact on the family.

In this two-part series, we will elaborate on the potential impact that a SUD can have on a family, as well as tips for families struggling with a SUD.

Impact on the family system

Substance use leaves its mark on any family that encounters it, though each family’s experience with SUDs is unique. One research group termed their model of how SUDs affect families the Stress-Strain-Coping-Support Model, which is a broad-based model for describing how SUDs impact a family system. The group suggests that families suffering from SUDs tend to have the following experiences:

• Stress: Both individual family members and family life tend to suffer when there are struggles with a SUD. Stress levels in the family increase due to the negative impact of the SUD on them.
• Strain: Members of families with a SUD begin to show their strain through increased physical or mental health problems of their own.
• Coping: Family members are often forced into the dilemma of determining what course of action is best. This is usually a fraught process that can bring up conflicts among family members, even when those family members are not struggling with SUDs themselves.
• Support: Families attempt to understand what is happening and why; in this process, families typically seek out resources and information to develop an understanding of SUDs. At these times, families are often at the mercy of the resources available to them and how others in their circles react to the problems at hand.

While not every family struggling with a SUD will go through these experiences, the model demonstrates the general difficulty that SUDs pose for families. It is easy for family members to feel guilt , shame , stigma , or blame for the presence of a SUD, and these types of responses tend to compound an already stressful situation. It is important for family members to know that the process of “coping” or deciding what the best response is may be conflictual, confusing, and complicated. It is normal to have different responses at different times and to have different opinions than other family members. While it is hard to have patience, to tolerate “what if” fears, and to take others’ perspectives, ultimately, the stance of listening first is what will best support the family in the long run.

Common patterns in families with SUDs

Adapting to a family member’s substance use is a family’s way of trying to stay interconnected despite the disruptions caused by the presence of a SUD. Through close examination of families with one or more members with a substance use disorder, one researcher noted three common ways that families try to adapt to substance use in the family:

• Discovery: Because the SUD is often hidden, it takes time for families to recognize that another member is suffering from a SUD. Families may initially notice only small changes—physically, emotionally, or behaviorally. The fear of “what ifs” can sometimes cause panic . Because of shame or stigma, families may try to manage the SUD themselves without seeking professional or needed support.
• Living with the SUD: Oftentimes, family members find themselves in a long-term, increasingly stressful dynamic with a loved one whose SUD begins to damage family relationships. Even still, family members feel compelled to try to protect their loved ones from physical harm or death as much as possible. Sometimes this means family members can become involved in the struggling member’s life (or substance use) in uncomfortable and unwelcome ways in order to do damage control.
• Expulsion (separation): In circumstances when SUDs have had a significant negative impact on family members, families may come to a point at which they feel they must separate themselves from the loved one with a SUD or set strict guidelines for contact. Such a decision is often made knowing the member with a SUD will be placed at higher risk. Such an effort is typically made after many years of struggle when family members feel they have no other recourse. Similarly, this may be an effort for family members to preemptively protect themselves against the fear of their loved one’s death. Under the best circumstances, this type of decision would be made after efforts to get the family member who has the SUD (and the family) professional treatment and with the support of a mental health professional.

Every family’s experience is different, yet most families make efforts to remain connected—and to continue to be a functioning system—even when a SUD is brought into the family. Not all efforts are successful, but families undoubtedly experience increased stress, distress, and conflict as they attempt to adapt to a person with a SUD. It is imperative that at such times all family members seek care and support to maintain each person’s well-being as much as possible.

In our next blog post, we will discuss possible ways for family members to pursue their own well-being in the midst of the chaos that a SUD can create.

About the Authors

Elizabeth Laney, Ph.D., is a staff psychologist at The Menninger Clinic. She has a doctorate degree in clinical psychology from the Rosemead School of Psychology at Biola University. Dr. Laney’s clinical interests include training of psychologists, psychoanalytic treatment of trauma and attachment trauma, psychodynamic treatment of personality disorders , as well as motherhood and women’s issues.

Wendy Jamison, LPC, LCDC, earned a master’s degree in clinical psychology from the University of Houston-Clear Lake. She has experience working in psychiatric facilities, a corporate employee assistance program, and as a coordinator of a chronic pain recovery service. She has been working with people who struggle with substance use disorders since 2005.

Mind Matters is a collaborative blog written by Menninger staff and an occasional invited guest to increase awareness about mental health. Launched in 2019, Mind Matters is curated and edited by an expert clinical team, which is led by Robyn Dotson Martin, LPC-S. Martin serves as an Outpatient Assessment team leader and staff therapist.

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Alcoholism and Family Relationships: Effects and Consequences

Last Updated: August 7, 2019

Alcoholism affects everyone including those around the problem drinker. Families of alcoholics suffer from alcohol psychological effects sometimes even more than the addict himself. Living with an alcoholic mother, father or spouse can be destructive in many ways. The burden and solution to this problem need to be a holistic strategy.

Table of contents

• What is alcoholism in family statistics?
• Is alcohol abuse a genetically-induced problem?
• What are the negative effects of alcoholism on the family?
• What are the possible results of alcoholism on the family?
• Where to get help if you think your family member is an alcoholic?

What is the Statistical Data on Alcoholism in Families?

According to the SAMHSA 2012 study , every tenth American lived with at least one alcoholic family member. More than 50% of adult Americans have at least one close relative with alcohol use disorder. Alcohol social effects also affect all the family members of the person with drinking problems leading to financial complications and domestic violence.

According to the 2015 National Institute on Alcohol Abuse and Alcoholism report, more than 55% of Americans reported consuming alcohol in the month preceding the survey, 27% involved in binge drinking in the same period. In the same year, 88,000 died of direct causes related to alcohol abuse.

Is Alcoholism a Genetic Problem?

A key question that people are looking into treatment options consistently ask: can alcoholism run in the family? Current science points to the relationship between genes and social environments as being important factors. Alcoholics have a genetic disposition for higher metabolism rates, and this has an impact on how they will process it but also be aware of its impact. When it comes to the question of genetics and alcohol abuse, the current scientific paradigm is to look at alcoholism in family systems. The question asks: does alcoholism run in the family, can be answered by saying that there is not likely to be a single gene which will explain alcohol abuse. However, some people will experience higher amounts of stress worse, and because stress will lead to drinking, this is an example of how family members of alcoholics often have the same issues. Alcoholism has a social and genetic fact and one of the reasons that the primary treatment model with the best outcomes is holistic.

Negative Effects of Alcoholism on Family

The effects of alcoholism on the family are broad-ranging, and the challenges of this burden will impact people who do not even personally know the individual with the drinking issues, and alcoholism and relationships will also include the extended network of employers. There are many  side effects of alcohol abuse that affect families. There are some ways how alcoholism affects the wider support network negatively.

Neglect of duties

One of the key components which impacts all areas of recovery is the basic practice of self-care. Self-care means the necessities and basic functions an individual needs to achieve to meet their minimal financial and health requirements. One of the most significant areas of alcohol abuse and over drinking concerns the basic negligence or lack of self-care that the individual demonstrates. Sometimes it is important to look at how excessive drinking is a  symptom of health concerns. An individual and their support network need the right therapy tools to successfully move forward.

Legal problems

Alcohol abuse has many legal dilemmas associated with it. In general, depleted inhibitions caused by drinking, lead to poor decision making and emotional regulation, and this will finally lead to risky behavior. Risky behavior might include driving while drinking, getting into a fight, or even just having an open rather than a concealed drink in public. Risk behavior is one of the indirect the over drinking of alcohol for everyone involved.

Financial problems

Financial problems are part of the wider range of consequences of poor self-care. With financial concerns, core issues are often compounded. Financial concerns might lead to greater stressors for everyone involved, and it is a serious consequence of the alcoholism.

Alcoholism and children:

Children of alcoholics have a greater probability of becoming alcoholics themselves. How excessive drinking affects everyone will have a lasting impact on children and will likely prove to impact their children. Children suffer from neglect and sometimes abuse in homes where alcohol abuse or drinking is a complication, and this can lead to further concerns like underage drinking. These are mental health maladies which children will often self-medicate to cope with.

Possible Results of Alcoholism in Family

It is important to understand the impact of what impacts can alcoholism have on a family. There is a wide range of chronic and episodic problems which have been identified to be significant about alcohol abuse and domestic life. The consequences of alcohol abuse are significant and need to be understood.

Family Violence:

Under most circumstances, the problems caused by drinking will lead to further stressors, such as domestic violence and alcohol . Therefore, the consequences of alcohol have to sometimes take into consideration the very safety and even survival of everyone, and it is not just an issue for the alcoholic. Domestic violence is often a behavior which will likely repeat itself among subsequent or succeeding generations of an alcoholic.

Marriage Infidelity

The lack of executive function and cognitive control individuals have while intoxicated can lead them into situations that were unintended. Individuals who drink, lack inhibitions that would normally act as a buffer against poor and impulsive behaviors. Infidelity in a relationship can compound existing problems or bring about a whole new set of issues in a family of alcoholics.

Unplanned Pregnancies

Unexpected pregnancies are another notable result of alcohol abuse in the family. This issue will be further compounded by consuming alcohol during pregnancy . This can happen among the individuals who are abusing alcohol, but it can also be an unwanted outcome from the children in a challenged family. The offspring of alcoholics often repeat the cycles of impulsive and erratic judgment that they learned from their parents, and so unwanted pregnancy can result because of alcoholism within the wider family nexus.

Divorce rates are higher among individuals and families where alcohol is a problem. It cannot be overstated that alcoholism is a family disease. Sometimes the disease causes problems to the point where a relationship cannot be repaired or salvaged, and so separation and divorce become the results. The idea that it is a family disease means that the entire family must likewise recover and heal. The wounds left by alcoholism and the family can run deep and can remain open for a long time if they are not addressed in a therapeutic and clinically supportive setting.

Where to Get Help for an Alcoholic Relative

Your doctor is an important gateway toward receiving a proper assessment, diagnosis and then alcohol treatment programs . There are many community organizations and rehabs for alcohol addicts who also support individuals and families concerned about alcohol abuse, such as Alcoholics Anonymous. There are also many alcohol support groups online . The view in current addiction science research shows a mixed model of support is needed. The greater the professional support and recovery/treatment planning, the greater the short-term and long-term outcomes.

Marixie Ann Manarang-Obsioma

Content Writer

Marixie Ann Manarang-Obsioma is a licensed Medical Technologist (Medical Laboratory Science) and an undergraduate of Doctor of Medicine (MD). She took her Bachelor’s Degree in Medical Technology at Angeles University Foundation and graduated with flying colors. The combination of having a good medical background, being a mom, and wanting to help people, especially the elderly has cultivated her passion for working in remote areas with love and compassion. Marixie likes to travel, read, and watch movies.

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Essay about Alcohol and Family

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What are the effects of alcoholism on a marriage or family? The research provided in this paper will speak about alcoholism, the education for young adults regarding alcoholism, and all the ways that alcoholism can affect the family dynamic. Alcoholism can affect families financially, emotionally, physically, etc. This research paper will also give recommendations on educating young adults at an early age when temptation might arise to try alcohol or begin drinking. This topic is important because alcoholism is a growing problem in many countries such as the United States.

As a psychiatric nurse I see on a daily basis how alcoholism is affecting not only older adults and families, but how it is affecting young adults and their relationships with others.

This organizational website sets out to explain the prevalence of alcohol use and disorders in the United States. Alcohol use can occur in underage individuals, pregnant women, college students, and any other individuals that decide to partake in heavy alcohol use. This source also shows how alcohol use can lead to economic or global burden, family consequences, and alcohol related deaths. This source is useful for my research paper because it gives me statistics related to alcohol abuse, for all types of individuals at different stages in life. There are other sources that I feel will be useful for my research purposes as well. But this source stuck out to me as it is packed full of statistics and is formed by the National Institute on Alcohol Abuse and Alcoholism.

This scholarly article sets out to explain binge drinking; its intensity, prevalence, and frequency during 2011 in the United States. Results of this article showed that the Midwest was an area with the highest prevalence of binge drinking. Also, that binge drinking was most common among individuals between the ages of 18-34. This article discussed races in which the prevalence of binge drinking was greater and races in which the intensity of binge drinking was greater. This source is useful in my research paper as it gives exact results from a performed study regarding binge drinking. These results were based off race, household income, disability status, and educational attainment. This source can also be used to raise awareness to reduce the statistics of binge drinking in young adults.

This journal article sets out to explain the effects of alcoholism in 1988 on the family unit. This article discusses the findings on spouse, children, and blood relatives that are alcoholics, as well as discussing the costs related with alcoholism. This article gives specific examples of percentages of individuals, divorces, and separations that are affected by alcoholism. This source is useful in my research paper as it gives percentages of different areas of the family unit that are affected by alcoholism. This paper also discusses cost related to alcoholism and how the cost affects the family as a whole.

This scholarly article sets out to explain the effects of how alcoholism affects family interaction. This study was performed by videotaping the interactions between he family members, while the alcoholic father sat as the centre. This article found that in alcoholic families the interactions were friendlier and more dominant than those of families without an alcohol problem. This source is useful in my research paper as it gives specific examples of how interactions are rated between the alcoholic family member and the other members of their family. These results are given by rating areas of involvement, and how calm or anxious the alcoholic family members are versus that of nonalcoholic families.

This journal article sets out to explain binge drinking in young adults, the outcomes of heavy alcohol use, and screening or prevention in adolescents. This source discusses a recent study that showed in 13 to 20-year old’s, 44% of the binge drinking sessions involved hard liquor versus beer that was involved in less than a third of binge drinking sessions. This article also explains that half of the risk for alcoholism is environmental while the other half of the risk comes from genetic factors. The prevention strategies for pediatrician use in high school aged children is to ask two questions; the first is in past year how many days have you had more than a few sips of a beer. The second question is if your friends drink, how many drinks do they usually have. This source is useful in my research paper as it gives more statistics regarding alcohol use in adolescents as well as giving statistics regarding how binge drinking can lead to alcohol abuse. This source will give me prevention strategies and good examples on education adolescents against the effects of heavy alcohol use.

This journal article sets out to explain the epidemiology of substance use in the US. As well as the effects of fetal exposure and medical, behavioral, and psychiatric problems in kids due the parent’s substance use. This article states that in rural areas children have a greater risk for mental health problems if their parents have substance abuse disorders. This article also speaks of methods to engage a family that is affected by a substance use disorder. This source is useful in my research paper because it talks about different ways children or the family are affected by substance use disorders. This source also gives statistics regarding the medical affects of a substance use disorder on fetal development. This source will be beneficial to show several ways that alcohol abuse affects the family dynamic.

References:

• “Alcohol Facts and Statistics.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, Aug. 2018, www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics.
• Kanny, Dafna, et al. “Binge Drinking- United States, 2011.” Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, vol. 62, no. 3, 22 Nov. 2013, pp. 77–80., www.cdc.gov/mmwr/pdf/other/su6203.pdf?utm_source=H2RMinutes PCMH Nov. 26, 2013&utm_campaign=PCMH-AC Minutes 11/19/13 &utm_medium=archive#page=79
• Schoenborn, Charlotte A. “Exposure to Alcoholism in the Family: United States, 1988.” Centers for Disease Control, no. 205, 31 Sept. 1991, pp. 1–14., doi:10.1037/e608822007-001.
• Schweitzer, Robert, et al. “Alcoholism and Family Interaction.” Drug and Alcohol Review, vol. 11, no. 1, 1992, pp. 31–34., doi:10.1080/09595239200185051.

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How Alcohol Abuse Affects Family Relationships And Friendships

The effects of alcohol addiction are far-reaching, not only for the addicted person. It also extends to their spouse, children, parents, siblings, close friends, and other people in their inner circle. This is why knowledge of how alcohol abuse affects family relationships is important.

As the individual falls deeper and deeper into the pit of addiction, their behaviour can change in ways that loved ones find inexplicable and overwhelming. Chaos starts to take over and well-established bonds of trust are broken, causing relationships to fall by the wayside. 

This leaves friends and family members feeling betrayed and grief-stricken. Sometimes, they are in a position of having to rebuild practical elements of their lives, such as repairing damaged credit or finding a new place to live.

The Effect Of Alcoholism On Families

To understand how alcohol abuse affects relationships within families, we need to view families as the complex social structures they are. Each member functions both as an individual and as an essential part of the group. Everyone has their role, and the roles present vary from one family to the next. 

Examples of family roles include the caregiver, the problem-solver, the entertainer, and the breadwinner. Some family members are introverts, others are extroverts. Similarly, some are creative thinkers, others are logical thinkers.

All of these roles, when thrown together, make the family what it is. And so, if anything big changes, the family changes. For example, if any family member dies or becomes seriously ill, or if the family gains a new member, the roles of each person have to shift to make way for a new reality.

Alcohol addiction is a serious condition that changes the way the addicted person speaks, thinks, and behaves. And everyone else in the family has to make room for the reality of addiction. 

So how does alcohol abuse affect relationships in this context? Not only will it affect each person’s relationship with the addict, but it can also affect the family members’ relationships with each other.

Intimate Partner Relationships

There is a reason we colloquially refer to your spouse or partner as “your other half”. This is the person you are supposed to be able to trust more than anyone else. You share a life, finances, and a home with your partner; sometimes you have children with them. In a functional relationship, you are partners in every sense of the word: you support each other through individual goals, and you work together to achieve goals as a couple.

You also help each other in times of trouble. In most intimate partner relationships, this happens without either person really thinking about it. You and your partner are there for each other, no matter what, and you help each other instinctively. 

And so, when your partner is confronted with the reality of your alcohol abuse, they are not primarily thinking of the effects of alcohol addiction. Instead, they are thinking about how they can support you through this.

The problem, of course, is that you yourself may not understand that you have an addiction problem. You may become increasingly defensive about your alcohol use; eventually, the defensiveness may give way to outright secrecy.

Alcohol addicts are very good at hiding their addictions. In many cases, they patronize a number of liquor retail outlets in rotation, in order to avoid arousing the suspicion of any one retailer. They find creative ways of hiding both their alcohol and their alcohol use. What this means is that if you tell your partner that you have stopped drinking, they can be forgiven for believing you, even if it is not true.

But eventually, the addiction comes to light. This can happen in any number of ways. For one, you may get caught driving under the influence of alcohol and have to enter alcohol addiction treatment . Or you may become physically or mentally abusive. 

Sometimes the tipping point isn’t even something as extreme: your partner could find one of your hidden bottles of alcohol, or they could accidentally catch you drinking.

This can lead to an erosion of the relationship of trust that you and your partner have built up. At best, your partner will start to be wary around you. At worst, they will be afraid of you, and they will make the choice to put a physical or emotional distance between you.

Related article: Be in the Know: Canada’s Latest Alcohol Addiction and Recovery Facts

How Alcohol Abuse Affects Relationships With Children

When it comes to the effects of alcoholism on families, children tend to be the most severely affected. Young children do not even understand what addiction is. All they will see is that your behaviour is changing in ways that they cannot process. 

A lot of children internalize the struggles they see going on around them. In the absence of an explanation for a parent’s altered behaviour, they may regard these changes as a punishment. 

How alcohol abuse affects relationships with children is that it can have long-term implications for your relationship with your child. Also, it can add to the strain in your relationship with the child’s other parent as you clash over parenting issues.

In addition, children of addicted parents can suffer in the following ways:

• They are at high risk of becoming victims of child abuse, or of witnessing incidents of domestic abuse
• They may suffer from malnourishment and other forms of neglect as addicted parents put alcohol before their family responsibilities
• Emotional trauma can result in children and youths running away from home, dropping out of school, or engaging in delinquent behaviour
• Children of addicted parents are up to four times more likely than children of non-addicted parents to become addicts themselves

The Effects Of Alcoholism On Friendships

We’ve all heard the old saying: that “opposites attract”. Hence, is true that people who are reserved and introverted can have close friendships with those who are outgoing and adventurous. These differences in personality can create a balance, and bring out the best in both people. 

But regardless of how different two friends might seem, they do tend to share basic values. They are attracted to each other by the things they value in themselves. In light of this, the tension between friends is how alcohol abuse affects this kind of relationship. When one of then starts to behave in a way that contradicts those values, tensions between friends can arise.

Some long-standing friendships are able to weather the storm. When you have been friends with someone for a long time, you are more invested in the outcome of their addiction. You have a long shared history that you want to preserve. In a sense, you are more like family than friends.

But not all friendships have the benefit of history. So, if someone with an addiction starts to treat their friend in an abusive manner, that person may cut ties with the addict for the sake of their own self-preservation. 

If the addict commits to alcohol addiction treatment, some friendships can be rebuilt. But a lot of times, the crumbling of a friendship is a permanent loss that hurts both people.

How To Know If Alcohol Abuse is Affecting Your Relationships

One of the most challenging aspects of alcohol addiction is that you, the addict, may not realize that you have a problem. Being addicted to alcohol does not make you a bad person, but it can affect your judgment and make you behave in ways that are hurtful to the ones you love.

If you are wondering whether alcohol abuse may be driving a wedge between you and your friends and family members, ask yourself these questions:

• Have my loved ones stopped confiding in me about their problems?
• Do my loved ones frequently have to rescue me from tricky situations?
• Have I been hiding my drinking from my family and friends?
• Has my significant other cut off my access to a joint bank account because of my drinking?
• Have friends and family members asked me to stop drinking?
• Do I prefer to drink rather than spend time with loved ones?
• Do I get angry with my family members after I have been drinking?
• Do my loved ones feel sad when I’m around them?
• Have I ever asked a friend or family member to lie on my behalf, for example, when I miss a day of work due to drinking?

If you can answer “yes” to any of these questions, you may need to evaluate whether you have an alcohol abuse problem.

What Support Is Available For Loved Ones Of Alcohol Addicts?

At 1000 Islands Addiction Rehab & Treatment Centre , we provide comprehensive support not only to the person who is addicted to alcohol, but to family members and close friends as well. The supports available to loved ones include the following:

• Family counselling, where you and your loved ones are guided through the process of rebuilding any relationships that can be salvaged, and moving on in a positive way from the ones that are irreparable
• Opportunities for loved ones to visit inpatient alcohol addiction treatment clients, so they can see the progress that is being made
• Information about Al Anon groups, and other support organizations for friends and family members of people with alcohol addictions
• Education sessions and workshops that provide opportunities for loved ones to learn more about addiction and some positive ways in which they can support the addict

To start the process of healing from addiction, whether for yourself or for an addicted loved one, call us at 855-601-0555.

Related article: What Are The Signs Of Alcohol Abuse, Dependence And Addiction?

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My story: Growing up with an alcoholic parent

By Jody Lamb 71 Comments

Growing up with an alcoholic parent

I was one of billions of kids who grew up with an alcoholic parent.

Sometimes I’m hesitant to share my story because I know there are so many people who had it far, far worse than me. But I believe personal stories are powerful and should be shared.

So here’s mine:

My mother and father were extraordinarily kind-hearted, compassionate people. But my mother, who had a traumatic childhood, was an alcoholic before I was born. I love my mother deeply. She is a wonderful person. Every day, I wish I could do something to take away the hundreds of pounds of sadness she carries every day. But the effects of her alcoholism affected my sister and me terribly.

I was born in 1982 and grew up in Dearborn, Michigan. The first 10 years or so of my life, I don’t remember my father being home very much. He worked in the evenings, mostly, and this left me with my mom as the primary parent.

My mother drank at night and into the early morning hours several times a week.

Around that same age, I remember apple juice being my favorite drink. One day, I asked my mom why her apple juice always had foam on top of it. It took a few years after that to make the connection between my mom’s dramatic mood changes and her consuming the foamy apple juice. After a while, she drank directly from beer cans. She hid these cans and bottles all over the house.

By 8 or 9 years old, I regularly went looking through the closets and cabinets and poured out the beer and returned the empty cans and bottles to their spots. I also often organized the cabinets and closets because it made me feel there was kind of order to the house, even though my mom’s behavior made everything unpredictable, chaotic and messy.

I went to a small Catholic school about a 15-minute drive away from our house. We lived too far from the busing system limits so my mom had to drive me every morning. Sometimes – quite often, actually – she wouldn’t get out of bed. I got up myself, made my own breakfast, got ready and prayed she’d get out of bed. Sometimes, I’d have to plead and beg her to get out of bed for 20 minutes. By the time I made it to school, I’d be crying. I’d make it to the school as the last bell rang or minutes too late. I felt ashamed about my tardiness and hated the attention on me as I entered the classroom after my classmates were already seated. I’d be stressed, exhausted and nauseous before the day even began. The teachers at the school had zero clue. In fact, I was probably the last student they’d suspect to be dealing with an alcoholic parent at home. I was always super well behaved and got good grades. In the fifth grade, my teacher said, “Jody, you are so lucky to have a perfect mother.”

My mother was a good mother…when she wasn’t drinking.

I knew my mother’s behavior due to drinking wasn’t good. I knew her health was at risk and I knew the way she screamed at me and my dad and stumbled around wasn’t good. But like most kids of alcoholics, I was used to it and as a mini adult, I was really good at hiding any evidence of trouble at home. I saw my cousins often but besides that, we lived a very isolated life. When family and people at school saw us, everything seemed fine. My mother and father’s family knew she drank but I don’t think they really had any idea that it kept me up at night, that I was neglected in so many ways, that I went to school without enough sleep and that I was constantly – and I mean constantly – worried. I worried her cigarettes would burn the house down because she dropped burning cigarettes on the couch, the car, everywhere and she left stuff cooking on the stove and passed out and didn’t even wake up to the smoke detectors going off. Worse, I was perpetually confused by my mother’s behavior. One minute she was showering me with compliments, the next minute she was screaming, swearing and throwing things at me. I felt I couldn’t do anything right and that I was never good enough. Now, I knew my mother loved me but on some level, I felt I caused her drinking.

In every way, it was the family secret. To some degree, I don’t think my dad even knew in those early years, how much my mother’s drinking affected me but we had conversations about it. He called it a Jekyll and Hyde situation. If you met my mother, you’d only see an extremely sweet and kind person. This is the person she truly is. However, when she drinks, she becomes an entirely different person – completely unrecognizable. She transforms into a loud, angry, aggressive, violent, abusive and destructive person. My mother would scream at the top of her lungs about ridiculous things or things that had nothing to do with me or my dad. She’d throw things across the room. She’d hit my father. She’d take off for hours or a day. I’d fear she was dead. She’d drive drunk. I’d fear that she’d kill someone. And most memorable, she’d say the cruelest, hurtful things. As a young person, it was impossible to separate those mean words from the kind words she spoke when sober. The hurtful words were far more impactful. She doesn’t mean what she says when she’s drunk, my dad would explain. But that didn’t matter. The words echoed in my mind and scarred me.

Usually, my mom woke up the next day, all sweet acting, as if nothing happened. Sometimes it was easier to pretend the drunken behavior didn’t happen. Other times, I was so hurt and angry such as when she’d disappear for hours, I couldn’t even speak to her. Many times, she didn’t even remember what happened and definitely didn’t remember the things she said. Average days were nightmares. I also have horrible memories of ruined holidays and family weddings. I have zero good birthday memories.

But I was really, really good at covering up the messes – figuratively and literally. I tried to be a perfect kid. On some level, I think I thought my mom drank because of me and maybe if I could just be better, she wouldn’t have any reason to drink. Or, that if she really loved me, that would be enough to make her stop drinking. Through tears, I begged and pleaded that she stop drinking. She probably promised that she’d never drink again about 1,000 times throughout my childhood. I also wrote lengthy, heartfelt letters and slipped them under her bedroom door. She’d throw them away without a response.

I was sure that I could “fix” her if only I tried a little harder.

But she didn’t get better. She got worse. My late father, wonderful man he was, was totally trapped by codependency and paralyzed with fear that Mom would die if they divorced or some other action was taken. In fact, he told this to my sister and me on several occasions. He just always acted like it would get better on its own. He didn’t see clearly that my mother’s alcoholism was destroying all of our lives and that allowing life to go on the way it was actually enabling my mother’s alcoholism to go on and worsen. My dear father was a talented athlete and coach who had a positive impact on thousands of lives throughout his life. But he was made ill by alcoholism in our house. He simply tried to be the best dad and husband he knew how to be. But not a day goes by that I don’t wish he would have gone to Al-Anon meetings, gotten educated about what the hell was going on with his wife and taken action that would have pushed Mom to hit rock bottom and perhaps then, at the prospect of losing her life, finally get help. Maybe my father would be alive today if he had.

It was a lonely childhood. I always wanted brothers and sisters. My mom had a few miscarriages. Every time she lost a baby, I cried.  I wanted a sibling to experience life with; I may have hoped another child would give Mom purpose and happiness in the way I could not.

I was 14 when my sister, Brooke, was born.

Though I was a bit old to care about having a sibling at that point, I felt blessed to have her in my life. Complications during delivery almost killed Mom and Brooke.

I was the first person to hold Brooke, which I always think completely foreshadowed my role in her life.

Uh, hold the comments on 14-year-old me’s style…

My sister’s arrival did not snap Mom out of her drinking problem, though she drank less in my sister’s toddler years than she had before the pregnancy. Still, I could never have friends over to visit at the house. I have horrible memories from high school when friends dropped by unannounced and my mother’s drunken, aggressive and abusive behavior humiliated me. Another dominant memory is when I invited my first serious boyfriend over to the house and begged my mom not to drink and she promised that she wouldn’t. Of course, she got drunk and the evening ended with me humiliated and fighting back tears and a very uncomfortable boyfriend who departed early.

In those teen years, I was completely obsessed with my mom’s drinking.

Every day, I searched the house for her hidden bottles and cans and poured them out – which of course, only completely perpetuated the problem because she just then went out to the store and bought replacement supplies. I could determine, with spot-on accuracy, how many beers she’d consumed just by looking at her face or hearing her speak one or words. I could also predict if she planned on drinking that night or not. If she had supplies, she’d act happy, even giddy, that day. I’d get instantly sick to my stomach. If she couldn’t drink for some reason, she’d be terribly irritable – snapping at me over trivial matters, even becoming as evil tongued as she did while drunk.

During those teen years, I grew closer with my father. He was super supportive and encouraging about my cross-country and track running and involvement in school extracurricular activities. I began to understand him better. In the process, I began to resent my mother for what I perceived as a conscious decision not to get better. I believed she didn’t care enough about her family to get help. I was angry at her but I went off to college with a pit in my stomach. I worried about the well-being of my sister, though my dad assured me things would be OK and insisted that I would regret not focusing on myself for once.

After years of being the perfect, rule-following kid, I went a bit wild and did the common party thing in college. I liked the way alcohol erased my insecurities. By my second year, I recognized my relationship with alcohol was mirroring that of my mom and alcohol. I started feeling like I needed to drink in order to go to social events where I didn’t know many people. I felt I wasn’t drinking socially anymore; I was totally emotionally dependent on alcohol for a sense of confidence. I felt I was standing atop a very slippery slope. After that year, I stopped drinking heavily and focused my efforts on my education and building a foundation for a career.

That’s when I discovered that things were not good for my sister. My dad was working at night a lot again. My sister was being neglected by our mother and endangered. Mom would lock herself in her room for two days, leaving Brooke to care for herself. I spent my senior year of college basically commuting back and forth from class and work to home. My sister needed me. That year, I even sometimes brought Brooke to stay for the weekend at my college apartment. When a Big 10 college apartment is safer for a seven-year-old girl than her home, the home is an extreme problem. My father’s family urged my father to take action to get me and my sister out of the situation. He recognized the worsening problems but he was so trapped by a mix of denial, codependency and laidback, everything-will-work-out personality that prevented him from believing he had the ability to make things better. He really believed that Mom was a hopeless cause and that if he left her, she’d die.

At 26, I was exhausted and depressed – like I didn’t want to go on anymore yet I felt I had to. There were so many people depending on me. That’s when I finally got educated about alcoholism and addiction and its impact on kids and families. I better understood my mother and her disease. I let go of a lot of expectations. I learned about the effects of growing up as a child of an alcoholic. I discovered that many things I felt – extreme anxiety, low self-confidence, problems trusting people, lack of satisfaction with anything – were directly tied to the destruction my mom’s alcoholism caused. I began taking better care of myself. I went to Al-Anon meetings . I met other adult children of alcoholics. I began reading and writing more often, as I’d done as a child. This prompted me to write a middle-grade novel for tweens that was published in 2012.

Because I was focused on taking better care of me, this helped the whole family.

Then in 2014, Dad died from a heart attack.

My first thought was: My dad is gone. My second thought: Oh my God, now I am 100% responsible for Mom.

My sister was 17 and ending her junior year of high school.

So I did what most first-born children of alcoholics would do: I assumed my dad’s role. I moved out of my place and back into my parents’ home. I promptly forgot everything I’d learned about co-dependency and self-care.

My mother, overwhelmed with intense grief, plummeted. Every day, for months, I feared I’d come home and find her lifeless body. Once again, I became obsessed with her drinking. She binged for days on end. Again, I was determined to “fix” her. At one point, I convinced her to see a psychologist and I sure it the turning point – the road to recovery. It wasn’t.

After three months of sleepless nights, my sister said she couldn’t bear to stay there and watch Mom slowly kill herself so we moved out. I sobbed the day we moved. It felt like I was abandoning a sick child.

But then as the weeks passed, I get healthier. My sister got healthier. Our minds cleared as time passed being away from the chaos and the abuse. I detached, slowly.

My departure from the environment and my father’s death forced Mom to be more of an adult than she ever had in her life. While her alcoholism is still destructive, my sister and I are much better today.

Update – July 2022: 

• Mom is doing better than I ever could have imagined!
• Brooke is a happy, healthy person and we’re very close.
• Life is great for me! I’m engaged to an extraordinary guy who makes me laugh and laughs at all my jokes.

I believe sharing these personal stories is tremendously powerful. If you are an ACoA (adult child of an alcoholic) or grew up in a dysfunctional/abusive situation, I hope you’re well on your healing journey, too. Glad you’re here.

Take good care of yourself.

Reader Interactions

December 15, 2020 at 4:17 pm

I love you so much.

April 15, 2021 at 8:34 pm

As a heavy drinker (1.5 bottle a day on average, down from 3 bottles five years ago) here some piece of advise from “the other side”, mostly for alcoholics.

1. It is not necessarily hopeless. First thing, the alcoholic must recognize he has a problem. I did, everyone knows me as an alcoholic, but I hope to stop for good.

2. Don’t lie to your wife or kids. I never did. I drink in the main room in my home so everyone knows when I drink, and how much. No hidden bottles either. It used to be every day, now it is every other day on average. Yet recently my wife told me to drink “secretly”, with no one seeing me drinking. I am complying most of the time, and it is not increasing my consumption. I still want to stop.

3. My wife regrets the time I was drinking every day because it was more predictable for her. Now I can go four days with no drink, but it makes her sad because she sees more the good side of me being sober and has more home. But the moment I resume, her hopes vanishes. Before she did not have any hope. Nevertheless I know 10 bottles a week is better than 20, and I can not go back to the worse times.

4. Find a few restaurants where you use to drink, and go there and don’t drink. That way, when you are ready to stop for good, you can go to these places without having a trigger. Otherwise, you can’t go anymore to any restaurant once sober for good, which could make you angry when recovered. Prepare yourself little by little for the day you will stop for good. It’s about changing bad habits, one at a time.

5. I thought some days I needed a bottle to be OK to get rid of the shakes. I discovered it was not wine but food I needed. Sure wine would cure the shakes, but so did eating food. Try and see if this trick works for you.

Good luck! Relapses are expected and not a failure as long as you see the light at the end of the tunnel. Think about seeing your grandchildren when they will be born. Stop drinking to make that happen before it is too late.

April 19, 2021 at 9:07 pm

Thank you for sharing your perspective. Best wishes to you and your family. It sounds like you are determined to create a system to stop for good and are on your way to making that happen. Wishing you hope and great success.

May 2, 2021 at 4:56 am

Thank you for this. I’m 32 and had my son when I was 15. I grew up in a dysfunctional home where my mum was addicted to crack and alcohol. She is no longer in the crack but she is still drinking everyday (unless she hasn’t got any money). I can relate to so much of what you said, especially knowing how many drinks she’s had even over the phone. I really appreciate you sharing your testimony. Yesterday I had to block my mums calls again as she became abusive because I wouldn’t go and see her with my son. I can hardly stand to be around her when she’s drunk. But she’s blaming me for the fact she doesn’t see me or her grandchild. It feels so terrible and brings me back to being a child again.

May 6, 2021 at 3:20 pm

Thank you for publishing your journey, my own father has issues with alcoholism and a lot of what you have written is very recognisable to me. It’s nice to know I was not alone with my feelings.

We can’t fix everybody only try and look after ourselves.

May 6, 2021 at 3:52 pm

Telling your story is courageous! I am so proud of you . I, too am an adult child, although much older than you. Growing up with “alcoholism” leaves many scars, but with the help of people like yourself , ACOA groups, Alanon and written information about the effects of Alcoholism , many lives can be changed and even saved. Many blessings to you and your sister. Nathalie

July 5, 2021 at 9:25 am

I read all of your story and it resonated with me. I grew up with an alcoholic mother too. It was a terribly sad upbringing and it still affects me to this day (I am 42). My mum and dad split up when i was 14 and mum found a new boyfriend who was was an alcoholic also and used to beat her up. So many ruined birthdays and chirstmas’s throughout all of my childhood. Eventually she moved to Spain and tried to murder her boyfriend in a drunken arguement. I had to fly out there and go to a Spanish prison, negotiate the Spanish law system, get a lawyer etc. She got two years in the end. Eventually she died at aged 63. What a waste. My father was pretty useless as well and is very cold emotionally. Luckily i found a wonderful woman whom I have been married to for 16 years and have a wonderful son so I am out of that life now but it has left deep scars. My sister has become a cocaine addict as well and I dont contact her anymore as she lies and steals. The only advice I can give anyone is to get away from it as soon as you can. You cannot help an alcoholic and they will drag you down with them. I speak from experience.

November 7, 2021 at 11:55 am

Jody, thank you for sharing your story, something just like this is happening now, and I’d love to get your advice if willing. My Sister-in-law, displays many of the traits here – always has a full glass of wine at night, rarely leaves the house, wakes up at noon, regularly not getting the kids to appointments. My niece and nephew are 9yo (boy) and 10yo (girl), and live a very isolated life and don’t have many friends. My niece’s 10 year birthday was only family and no friends from school. My brother works all the time, but his life outside work is his children… so he does make up for a lot of misses of my sister-in-law (but demands on him are higher than i’ve ever seen in someone)

I’ve tried to help, for about a year going over there every night to help with kids, but I also noticed her drinking got worse… like i was there helping, so she could take less responsibilities and drink more… and for that year I was thinking – just keep blinders on, Robert, keep a good relationship with her so you can keep coming over… I kept telling myself these are the crucial development years for them and you’ve got to be like water and work with the constraints we have.

My sister in law is honestly one of the most fun people to be around – she’s so funny, and off the cuff with responses, and engaging in conversation. Which makes it easier for her to mask these things to our family or at any social events she goes to. She rarely goes to a day function. It’s always night functions, and she’ll spend the whole day relaxing stress free waking up at noon, getting her hair done, getting to looking immaculate, and then when she shows up at the social event, it even makes me questions whether i’m right in my assumptions of her – she looks beautiful, healthy, she’s engaging with everyone, she’s laughing, she’s not too dunk, she’s self depreciating, focusing on the children in those little ways, etc. But after a while, you start to see the routine.

And overtime i’ve built resentment towards her, and it’s not healthy and that’s my own issue I have to work through… But i have made a decision to address the issue with my brother (although i haven’t yet and i’m getting as educated as much as I can).

I know their is most definitely an element of codependency with my brother and sister-in-law… and his worry for her, but also likely his worry for doing anything that might rock the boat and make things even more unpredictable than they are currently.

So, my question to you is… if you’d had an uncle like me, when you were growing up, who saw and understood what was happening – what would your older wiser self encourage/plead him to do? Because eventually this will be the situation my niece and nephew will be in… 30 years from now…asking me, “if you knew, Robert, why didn’t you xyz?”

Should I be hammering my brother to go to A-A events and get more information? What sort of urgency should I be acting with? they are 9 and 10 years old. Are there other people in the family I should be including in my knowledge of all this? What if my brother says it will work itself out or it’s just the way she is and I’ve found ways around it (brushes it off like your father)? Should it be my responsibility to escalate, etc? For starters, I want the best shot of getting my brother’s buy in. Also, if you have someone in your network that you think I should reach out to… please advise, I’m happy to pay someone a consultation fee, etc. I’ll continue to get more information and seek out resources, but any thoughts you might share would be greatly appreciated.

November 7, 2021 at 12:01 pm

Jody, I noticed the books you recommended in one of your comments. I’m going to start with one of those. Thanks and please let me know if you do have some other specific thoughts on my previous comment.

February 8, 2022 at 3:14 am

Omg I thought I was reading my own life story. Everything you wrote I have gone threw . I have ywo younger siblings that I took care of because are mom was always drunk..I was 14 when my dad died . My sister was 10 and my grother was 7yr old. When he passed it made it worst on all of us.so every word you care saying I have lived it.

September 17, 2022 at 7:17 am

You’re story is my story except I was the youngest in the family so I was mostly neglected and forgotten. My mother was the alcoholic and dad the enabler just like in your family. Fighting was constant. As soon as I could get out of that house I did and right into a marriage with an addicted man. It took me 12 years to realize I had a problem as an enabler. Today I have a new husband and a different life but the scars of all those years past still are with me. I have tons of anxiety issues. I see a therapist. I am trying to find out who I am after a lifetime of being a shell of a person. Thank you for your story. It helped me realize my story could be anyones story.

September 20, 2022 at 12:38 pm

Best wishes to you on your journey, Nicole. Some people never attempt to find healing; you’re well on your way!

August 21, 2023 at 2:49 pm

Thank you for sharing your deeply personal and powerful journey of growing up with an alcoholic parent. Your story reflects resilience, strength, and the transformative power of healing. Your courage in sharing this can provide solace and encouragement to others who have faced similar challenges.

November 20, 2023 at 9:14 am

Thank you for sharing your story. I relate to almost everything you wrote although the roles were reversed. The alcoholic dad and the co-dependent mother. I am 63 and still reeling in the pain of it all. I have gone through one failed marriage and my second marriage is on the verge of breaking apart. I am learning now of the impact of being an adult child of an alcoholic. It’s never too late, right? I am in search of the hope, joy and peace that can be achieved by facing these childhood nightmares. I am so thankful that the Lord led me to your website. I am thankful to have found this community. Peace to you all.

November 26, 2023 at 1:04 pm

It is definitely always the right time to heal, no matter your age. Best wishes to you on your healing journey!

December 5, 2023 at 2:52 am

Thank you. I feel inspired.

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• Financial Cost
• Aggression and Violence
• Impact on the Family

Alcohol is the most commonly used drug among U.S. adults. Alcohol use is associated with a wide range of health risks and other problems for individuals. But the costs of alcohol don't just affect the person drinking. 

According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use costs the U.S. almost a quarter trillion dollars a year. Economic costs are one part of the toll, but there are also other societal issues that are tied to alcohol use.

At a Glance

The real-world impact of alcohol abuse reaches far beyond the financial costs. When a loved one has a problem with alcohol, it can affect their marriage and their extended family. There's also a larger impact on the community, schools, the workplace, the healthcare system, and society as a whole.

How Alcohol Affects Society

Alcohol use can affect society in terms of:

• Economic costs linked to increased healthcare expenses, lost productivity, and legal costs
• Health consequences caused by health problems caused by alcohol as well as accidents, injuries, and violence connected to alcohol use
• Legal consequences , including increased crime, drunk driving accidents, and other issues related to law enforcement and criminal justice
• Family effects , including child abuse, neglect, intimate partner violence, and substance use problems in children
• Educational costs associated with worse academic performance and achievement

Such costs are often linked to those who have alcohol use disorders. According to the 2021 National Survey on Drug Use and Health (NSDUH), 29.5 million people over the age of 12 (10.6% of the population) had an alcohol use disorder in the past year. Estimates suggest that approximately 13.9% of people in the United States will meet the criteria for severe alcohol use disorder in their lifetimes.

However, it's not necessarily people with alcohol addiction having the biggest impact on these figures. It's estimated that 77% of the cost of excessive alcohol consumption in the U.S. is due to binge drinking , and most binge drinkers are not alcohol dependent.

The National Institute on Alcohol Abuse and Alcoholism states that 140,000 people die each year due to alcohol-related causes. Alcohol is the fourth leading preventable cause of death in the U.S.

Financial Costs of Alcoholism

According to the Centers for Disease Control and Prevention (CDC), the cost of excessive alcohol use in the U.S. alone reaches $249 billion annually. Around 77% of that is attributed to binge drinking , defined as four or more alcoholic beverages per occasion for women or five or more drinks per occasion for men.

The CDC estimates that 40% of the cost of binge drinking is paid by federal, state, and local governments.

The CDC suggests that the most significant economic costs of alcohol use are due to the following:

• Lost workplace productivity (72% of the total cost)
• Healthcare expenses (11% of the total cost)
• Criminal justice expenses (10% of the total cost)
• Motor vehicle crash expenses (5% of the total cost)

The CDC estimates that these figures are all underestimated because alcohol's involvement in sickness, injury, and death is not always available or reported. These figures also do not include some medical and mental health conditions that are the result of alcohol abuse.

Also not included in these figures are the work days that family members miss due to the alcohol problems of a loved one.

Healthcare Expense of Alcohol Abuse

Alcohol consumption is a risk factor in numerous chronic diseases and conditions, and alcohol plays a significant role in certain cancers, psychiatric conditions, and numerous cardiovascular and digestive diseases. Additionally, alcohol consumption can increase the risk of diabetes, stroke, and heart disease.

An estimated $28 billion is spent each year on alcohol-related health care.

Alcohol-Related Aggression and Violence

Along with unintentional injury, alcohol plays a significant role in intentional injuries as a result of aggression and violence. Alcohol has been linked to physical violence by a variety of research studies.

On top of the healthcare cost of alcohol-related intentional violence in the United States, the estimated annual cost to the criminal justice system is another $25 billion.

Impact of Alcoholism on the Family

The social impact of alcohol abuse is a separate issue from the financial costs involved, and that impact begins in the home, extends into the community, and often affects society as a whole, much like the financial impact does.

Research on the effects of alcohol abuse on families shows that alcohol abuse and addiction play a role in intimate partner violence, cause families' financial problems, impair decision-making skills, and play a role in child neglect and abuse.

Long-term alcohol use leads to changes in the brain that affect decision-making, emotional processing, and self-control, making people who drink more susceptible to aggression and violence. According to the U.S. Department of Justice, alcohol makes intimate partner violence more frequent and severe.

As with the financial costs of alcohol abuse, studies have found occasional binge drinking can also affect families. Research suggests that the risk of intimate partner violence rises not only in the context of frequent drinking but also when a partner has consumed a large volume of drinks in one sitting.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database .

Alcohol Abuse and Children

Fetal alcohol spectrum disorders (FASDs) are one of the most common direct consequences of parental alcohol use in the United States, caused by alcohol consumption by the mother during pregnancy. Children with FAS display various symptoms, many of which are lifelong and permanent.

Children who grow up in a home with a loved one dealing with alcohol addiction may be affected as well; they are at significant risk of developing alcohol use disorders themselves.

Growing up in a home where at least one parent has a severe alcohol use disorder can increase a child's chances of developing psychological and emotional problems.

The Bottom Line

Alcohol's effects go beyond it's effects on individual health and well-being; it also has steep economic and societal costs. The excess use of alcohol leads to billions in lost productivity and healthcare costs. It also has a heavy strain on families, communities, and society as a whole. Increased violence, injuries, accidents, child abuse, and intimate partner violence are all linked to alcohol use.

Centers for Disease Control and Prevention. Excessive drinking is draining the U.S. economy .

National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder (AUD) in the United States: Age groups and demographic characteristics .

Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III . JAMA Psychiatry. 2015;72(8):757-766. doi:10.1001/jamapsychiatry.2015.0584

Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009-2011 . Prev Chronic Dis. 2014;11:E206. doi:10.5888/pcd11.140329

National Institute on Alcohol Abuse and Alcoholism. Alcohol-related emergencies and deaths in the United States .

Rehm J. The Risks Associated With Alcohol Use and Alcoholism . Alcohol Res Health . 2011;34(2):135-143.

Centers for Disease Control and Prevention. The cost of excessive alcohol use .

Wilson IM, Graham K, Taft A. Alcohol interventions, alcohol policy and intimate partner violence: a systematic review .  BMC Public Health. 2014;14:881. doi:10.1186/1471-2458-14-881

Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: From theory to practice . Soc Work Public Health . 2013;28(3-4):194-205. doi:10.1080/19371918.2013.759005

Sontate KV, Rahim Kamaluddin M, Naina Mohamed I, et al. Alcohol, aggression, and violence: From public health to neuroscience .  Front Psychol . 2021;12:699726. doi:10.3389/fpsyg.2021.699726

U.S. Department of Justice, Office of Justice Programs. Who facts on: Intimate partner violence and alcohol .

Centers for Disease Control and Prevention. Basics about FASDS .

Moss HB. The impact of alcohol on society: A brief overview . Soc Work Public Health. 2013;28(3-4):175-177. doi:10.1080/19371918.2013.758987

Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 National and State Costs of Excessive Alcohol Consumption . Am J Prev Med . 2015;49(5):e73-e79. doi:10.1016/j.amepre.2015.05.031

By Buddy T Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.

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How much is too much?

What are the symptoms of alcohol use disorder (aud).

Having even a couple of symptoms—which you might not see as trouble signs—can signal a drinking problem. It helps to know the signs so you can make a change early. Doctors diagnose AUD when a person has two or more of the symptoms listed below. AUD can be mild (the presence of two to three symptoms), moderate (the presence of four to five symptoms), or severe (the presence of six or more symptoms). See if you recognize any of these symptoms—or others, such as feeling low, dysphoria, or malaise—in yourself. And don’t worry—even if you have a symptom, you can take steps on your own or with help to reduce your risk of AUD and other alcohol-related consequences. (For more information about AUD, see What Are the Harms ?)

In the past year, have you:

• Had times when you ended up drinking more, or longer, than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn't?
• Spent a lot of time drinking, being sick from drinking, or getting over other aftereffects?
• Wanted a drink so badly you couldn't think of anything else?
• Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or engaging in unsafe sexual behavior)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had an alcohol-related memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? Or sensed things that were not there?

If you don’t have any symptoms, then staying within the limits provided in the 2020–2025 Dietary Guidelines for Americans could reduce your chances of having problems in the future. If you do have any symptoms, then alcohol may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health care professional can look at the number, pattern, and severity of symptoms to see whether AUD is present and help you decide the best course of action.

Thinking about a change? The next section may help .

Note: The questions listed above are based on symptoms of AUD in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders, Fifth Edition, Text Revision. The DSM is the most commonly used system in the United States for diagnosing mental health disorders.

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Download or order the free 20-page booklet, “Rethinking Drinking: Alcohol & Your Health” .

Disponible en Español Descargue o ordene copias gratis del folleto de 20 páginas ‘Piénselo Antes de Beber: El Alcohol y su Salud’ .

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Thousands Believe Covid Vaccines Harmed Them. Is Anyone Listening?

All vaccines have at least occasional side effects. But people who say they were injured by Covid vaccines believe their cases have been ignored.

Shaun Barcavage, 54, a nurse practitioner in New York City, said that ever since his first Covid shot, standing up has sent his heart racing. Credit... Hannah Yoon for The New York Times

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By Apoorva Mandavilli

Apoorva Mandavilli spent more than a year talking to dozens of experts in vaccine science, policymakers and people who said they had experienced serious side effects after receiving a Covid-19 vaccine.

• Published May 3, 2024 Updated May 4, 2024

Within minutes of getting the Johnson & Johnson Covid-19 vaccine, Michelle Zimmerman felt pain racing from her left arm up to her ear and down to her fingertips. Within days, she was unbearably sensitive to light and struggled to remember simple facts.

She was 37, with a Ph.D. in neuroscience, and until then could ride her bicycle 20 miles, teach a dance class and give a lecture on artificial intelligence, all in the same day. Now, more than three years later, she lives with her parents. Eventually diagnosed with brain damage, she cannot work, drive or even stand for long periods of time.

“When I let myself think about the devastation of what this has done to my life, and how much I’ve lost, sometimes it feels even too hard to comprehend,” said Dr. Zimmerman, who believes her injury is due to a contaminated vaccine batch .

The Covid vaccines, a triumph of science and public health, are estimated to have prevented millions of hospitalizations and deaths . Yet even the best vaccines produce rare but serious side effects . And the Covid vaccines have been given to more than 270 million people in the United States, in nearly 677 million doses .

Dr. Zimmerman’s account is among the more harrowing, but thousands of Americans believe they suffered serious side effects following Covid vaccination. As of April, just over 13,000 vaccine-injury compensation claims have been filed with the federal government — but to little avail. Only 19 percent have been reviewed. Only 47 of those were deemed eligible for compensation, and only 12 have been paid out, at an average of about $3,600 .

Some scientists fear that patients with real injuries are being denied help and believe that more needs to be done to clarify the possible risks.

“At least long Covid has been somewhat recognized,” said Akiko Iwasaki, an immunologist and vaccine expert at Yale University. But people who say they have post-vaccination injuries are “just completely ignored and dismissed and gaslighted,” she added.

In interviews and email exchanges conducted over several months, federal health officials insisted that serious side effects were extremely rare and that their surveillance efforts were more than sufficient to detect patterns of adverse events.

“Hundreds of millions of people in the United States have safely received Covid vaccines under the most intense safety monitoring in U.S. history,” Jeff Nesbit, a spokesman for the Department of Health and Human Services, said in an emailed statement.

But in a recent interview, Dr. Janet Woodcock, a longtime leader of the Food and Drug Administration, who retired in February, said she believed that some recipients had experienced uncommon but “serious” and “life-changing” reactions beyond those described by federal agencies.

“I feel bad for those people,” said Dr. Woodcock, who became the F.D.A.’s acting commissioner in January 2021 as the vaccines were rolling out. “I believe their suffering should be acknowledged, that they have real problems, and they should be taken seriously.”

“I’m disappointed in myself,” she added. “I did a lot of things I feel very good about, but this is one of the few things I feel I just didn’t bring it home.”

Federal officials and independent scientists face a number of challenges in identifying potential vaccine side effects.

The nation’s fragmented health care system complicates detection of very rare side effects, a process that depends on an analysis of huge amounts of data. That’s a difficult task when a patient may be tested for Covid at Walgreens, get vaccinated at CVS, go to a local clinic for minor ailments and seek care at a hospital for serious conditions. Each place may rely on different health record systems.

There is no central repository of vaccine recipients, nor of medical records, and no easy to way to pool these data. Reports to the largest federal database of so-called adverse events can be made by anyone, about anything. It’s not even clear what officials should be looking for.

“I mean, you’re not going to find ‘brain fog’ in the medical record or claims data, and so then you’re not going to find” a signal that it may be linked to vaccination, Dr. Woodcock said. If such a side effect is not acknowledged by federal officials, “it’s because it doesn’t have a good research definition,” she added. “It isn’t, like, malevolence on their part.”

The government’s understaffed compensation fund has paid so little because it officially recognizes few side effects for Covid vaccines. And vaccine supporters, including federal officials, worry that even a whisper of possible side effects feeds into misinformation spread by a vitriolic anti-vaccine movement.

‘I’m Not Real’

Patients who believe they experienced serious side effects say they have received little support or acknowledgment.

Shaun Barcavage, 54, a nurse practitioner in New York City who has worked on clinical trials for H.I.V. and Covid, said that ever since his first Covid shot, merely standing up sent his heart racing — a symptom suggestive of postural orthostatic tachycardia syndrome , a neurological disorder that some studies have linked to both Covid and, much less often, vaccination .

He also experienced stinging pain in his eyes, mouth and genitals, which has abated, and tinnitus, which has not.

“I can’t get the government to help me,” Mr. Barcavage said of his fruitless pleas to federal agencies and elected representatives. “I am told I’m not real. I’m told I’m rare. I’m told I’m coincidence.”

Renee France, 49, a physical therapist in Seattle, developed Bell’s palsy — a form of facial paralysis, usually temporary — and a dramatic rash that neatly bisected her face. Bell’s palsy is a known side effect of other vaccines, and it has been linked to Covid vaccination in some studies.

But Dr. France said doctors were dismissive of any connection to the Covid vaccines. The rash, a bout of shingles, debilitated her for three weeks, so Dr. France reported it to federal databases twice.

“I thought for sure someone would reach out, but no one ever did,” she said.

Similar sentiments were echoed in interviews, conducted over more than a year, with 30 people who said they had been harmed by Covid shots. They described a variety of symptoms following vaccination, some neurological, some autoimmune, some cardiovascular.

All said they had been turned away by physicians, told their symptoms were psychosomatic, or labeled anti-vaccine by family and friends — despite the fact that they supported vaccines.

Even leading experts in vaccine science have run up against disbelief and ambivalence.

Dr. Gregory Poland, 68, editor in chief of the journal Vaccine, said that a loud whooshing sound in his ears had accompanied every moment since his first shot, but that his entreaties to colleagues at the Centers for Disease Control and Prevention to explore the phenomenon, tinnitus, had led nowhere.

He received polite responses to his many emails, but “I just don’t get any sense of movement,” he said.

“If they have done studies, those studies should be published,” Dr. Poland added. In despair that he might “never hear silence again,” he has sought solace in meditation and his religious faith.

Dr. Buddy Creech, 50, who led several Covid vaccine trials at Vanderbilt University, said his tinnitus and racing heart lasted about a week after each shot. “It’s very similar to what I experienced during acute Covid, back in March of 2020,” Dr. Creech said.

Research may ultimately find that most reported side effects are unrelated to the vaccine, he acknowledged. Many can be caused by Covid itself.

“Regardless, when our patients experience a side effect that may or may not be related to the vaccine, we owe it to them to investigate that as completely as we can,” Dr. Creech said.

Federal health officials say they do not believe that the Covid vaccines caused the illnesses described by patients like Mr. Barcavage, Dr. Zimmerman and Dr. France. The vaccines may cause transient reactions, such as swelling, fatigue and fever, according to the C.D.C., but the agency has documented only four serious but rare side effects .

Two are associated with the Johnson & Johnson vaccine, which is no longer available in the United States: Guillain-Barré syndrome , a known side effect of other vaccines , including the flu shot; and a blood-clotting disorder.

The C.D.C. also links mRNA vaccines made by Pfizer-BioNTech and Moderna to heart inflammation, or myocarditis, especially in boys and young men. And the agency warns of anaphylaxis, or severe allergic reaction, which can occur after any vaccination.

Listening for Signals

Agency scientists are monitoring large databases containing medical information on millions of Americans for patterns that might suggest a hitherto unknown side effect of vaccination, said Dr. Demetre Daskalakis, director of the C.D.C.’s National Center for Immunization and Respiratory Diseases.

“We toe the line by reporting the signals that we think are real signals and reporting them as soon as we identify them as signals,” he said. The agency’s systems for monitoring vaccine safety are “pretty close” to ideal, he said.

Those national surveillance efforts include the Vaccine Adverse Event Reporting System (VAERS). It is the largest database, but also the least reliable: Reports of side effects can be submitted by anyone and are not vetted, so they may be subject to bias or manipulation.

The system contains roughly one million reports regarding Covid vaccination, the vast majority for mild events, according to the C.D.C.

Federal researchers also comb through databases that combine electronic health records and insurance claims on tens of millions of Americans. The scientists monitor the data for 23 conditions that may occur following Covid vaccination. Officials remain alert to others that may pop up, Dr. Daskalakis said.

But there are gaps, some experts noted. The Covid shots administered at mass vaccination sites were not recorded in insurance claims databases, for example, and medical records in the United States are not centralized.

“It’s harder to see signals when you have so many people, and things are happening in different parts of the country, and they’re not all collected in the same system,” said Rebecca Chandler, a vaccine safety expert at the Coalition for Epidemic Preparedness Innovations.

An expert panel convened by the National Academies concluded in April that for the vast majority of side effects, there was not enough data to accept or reject a link.

Asked at a recent congressional hearing whether the nation’s vaccine-safety surveillance was sufficient, Dr. Peter Marks, director of the F.D.A.’s Center for Biologics Evaluation and Research, said, “I do believe we could do better.”

In some countries with centralized health care systems, officials have actively sought out reports of serious side effects of Covid vaccines and reached conclusions that U.S. health authorities have not.

In Hong Kong, the government analyzed centralized medical records of patients after vaccination and paid people to come forward with problems. The strategy identified “a lot of mild cases that other countries would not otherwise pick up,” said Ian Wong, a researcher at the University of Hong Kong who led the nation’s vaccine safety efforts.

That included the finding that in rare instances — about seven per million doses — the Pfizer-BioNTech vaccine triggered a bout of shingles serious enough to require hospitalization.

The European Medicines Agency has linked the Pfizer and Moderna vaccines to facial paralysis, tingling sensations and numbness. The E.M.A. also counts tinnitus as a side effect of the Johnson & Johnson vaccine, although the American health agencies do not. There are more than 17,000 reports of tinnitus following Covid vaccination in VAERS.

Are the two linked? It’s not clear. As many as one in four adults has some form of tinnitus. Stress, anxiety, grief and aging can lead to the condition, as can infections like Covid itself and the flu.

There is no test or scan for tinnitus, and scientists cannot easily study it because the inner ear is tiny, delicate and encased in bone, said Dr. Konstantina Stankovic, an otolaryngologist at Stanford University.

Still, an analysis of health records from nearly 2.6 million people in the United States found that about 0.04 percent , or about 1,000, were diagnosed with tinnitus within three weeks of their first mRNA shot. In March, researchers in Australia published a study linking tinnitus and vertigo to the vaccines .

The F.D.A. is monitoring reports of tinnitus, but “at this time, the available evidence does not suggest a causal association with the Covid-19 vaccines,” the agency said in a statement.

Despite surveillance efforts, U.S. officials were not the first to identify a significant Covid vaccine side effect: myocarditis in young people receiving mRNA vaccines. It was Israeli authorities who first raised the alarm in April 2021. Officials in the United States said at the time that they had not seen a link.

On May 22, 2021, news broke that the C.D.C. was investigating a “relatively few” cases of myocarditis. By June 23, the number of myocarditis reports in VAERS had risen to more than 1,200 — a hint that it is important to tell doctors and patients what to look for.

Later analyses showed that the risk for myocarditis and pericarditis, a related condition, is highest after a second dose of an mRNA Covid vaccine in adolescent males aged 12 to 17 years.

In many people, vaccine-related myocarditis is transient. But some patients continue to experience pain, breathlessness and depression, and some show persistent changes on heart scans . The C.D.C. has said there were no confirmed deaths related to myocarditis, but in fact there have been several accounts of deaths reported post-vaccination .

Pervasive Misinformation

The rise of the anti-vaccine movement has made it difficult for scientists, in and out of government, to candidly address potential side effects, some experts said. Much of the narrative on the purported dangers of Covid vaccines is patently false, or at least exaggerated, cooked up by savvy anti-vaccine campaigns.

Questions about Covid vaccine safety are core to Robert F. Kennedy Jr.’s presidential campaign. Citing debunked theories about altered DNA, Florida’s surgeon general has called for a halt to Covid vaccination in the state.

“The sheer nature of misinformation, the scale of misinformation, is staggering, and anything will be twisted to make it seem like it’s not just a devastating side effect but proof of a massive cover-up,” said Dr. Joshua Sharfstein, a vice dean at Johns Hopkins University.

Among the hundreds of millions of Americans who were immunized for Covid, some number would have had heart attacks or strokes anyway. Some women would have miscarried. How to distinguish those caused by the vaccine from those that are coincidences? The only way to resolve the question is intense research .

But the National Institutes of Health is conducting virtually no studies on Covid vaccine safety, several experts noted. William Murphy, a cancer researcher who worked at the N.I.H. for 12 years, has been prodding federal health officials to initiate these studies since 2021.

The officials each responded with “that very tired mantra: ‘But the virus is worse,’” Dr. Murphy recalled. “Yes, the virus is worse, but that doesn’t obviate doing research to make sure that there may be other options.”

A deeper understanding of possible side effects, and who is at risk for them, could have implications for the design of future vaccines, or may indicate that for some young and healthy people, the benefit of Covid shots may no longer outweigh the risks — as some European countries have determined.

Thorough research might also speed assistance to thousands of Americans who say they were injured.

The federal government has long run the National Vaccine Injury Compensation Program , designed to compensate people who suffer injuries after vaccination. Established more than three decades ago, the program sets no limit on the amounts awarded to people found to have been harmed.

But Covid vaccines are not covered by that fund because Congress has not made them subject to the excise tax that pays for it. Some lawmakers have introduced bills to make the change.

Instead, claims regarding Covid vaccines go to the Countermeasures Injury Compensation Program . Intended for public health emergencies, this program has narrow criteria to pay out and sets a limit of $50,000, with stringent standards of proof.

It requires applicants to prove within a year of the injury that it was “the direct result” of getting the Covid vaccine, based on “compelling, reliable, valid, medical, and scientific evidence.”

The program had only four staff members at the beginning of the pandemic, and now has 35 people evaluating claims. Still, it has reviewed only a fraction of the 13,000 claims filed, and has paid out only a dozen.

Dr. Ilka Warshawsky, a 58-year-old pathologist, said she lost all hearing in her right ear after a Covid booster shot. But hearing loss is not a recognized side effect of Covid vaccination.

The compensation program for Covid vaccines sets a high bar for proof, she said, yet offers little information on how to meet it: “These adverse events can be debilitating and life-altering, and so it’s very upsetting that they’re not acknowledged or addressed.”

Dr. Zimmerman, the neuroscientist, submitted her application in October 2021 and provided dozens of supporting medical documents. She received a claim number only in January 2023.

In adjudicating her claim for workers’ compensation, Washington State officials accepted that Covid vaccination caused her injury, but she has yet to get a decision from the federal program.

One of her therapists recently told her she might never be able to live independently again.

“That felt like a devastating blow,” Dr. Zimmerman said. “But I’m trying not to lose hope there will someday be a treatment and a way to cover it.”

Apoorva Mandavilli is a reporter focused on science and global health. She was a part of the team that won the 2021 Pulitzer Prize for Public Service for coverage of the pandemic. More about Apoorva Mandavilli

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