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Effects of Alcoholism on the Family

How Alcohol Use Affects Our Loved Ones Too

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.

Aaron Johnson is a fact checker and expert on qualitative research design and methodology. 

alcoholism affects family essay

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Effects of Alcohol on the Brain

How alcohol affects families, how families can cope, support groups for family members, getting help.

People who have an addiction to alcohol continue to engage in compulsive behaviors despite negative consequences. Many of these negative consequences affect the individual's health and well-being, but family, friends, and other loved ones are also often affected as well.

If we are a friend or family member of a person with an alcohol use disorder (AUD), we might be searching for ways to better understand our loved one's behaviors. It can feel like a struggle not to internalize their hurtful actions, but the reality is that people with an alcohol problem may not fully understand the impact that their actions have on friends and family.

It can often be helpful for family members to learn more about alcohol use disorders and explore ways to improve their responses during interactions with someone who has a drinking problem. This may mean setting ground rules and joining a support group such as Al-Anon, designed specifically to meet the needs of families of people with alcohol use issues.

At a Glance

Alcohol misuse can have a serious detrimental impact on the health and well-being of individuals as well as their families. Getting treatment is essential and can help people begin to recover their normal functioning and improve relationships with their partners, children, and other loved ones. 

Support from family and friends is essential, but people who make up the individual's support system also need to be sure that they are caring for themselves. Reaching out to support groups, seeking educational resources, and talking to a mental health professional can all be beneficial if you have a loved one who has an alcohol use problem.

Loved ones of people with alcohol use disorder may feel less empathy for them and become more frustrated with them as time passes. We get how challenging this can be, but it may help to learn about how alcohol affects the brain.

Alcohol can impair an individual's motor and cognitive abilities . This occurs while a person is drinking. It can also create longer-term impairments that persist even after a person is no longer intoxicated.

Chronic, heavy alcohol consumption can cause reductions in both white and gray brain matter , leading to brain shrinkage. This can lead to problems with:

  • Impulsivity
  • Problem-solving
  • Processing speed
  • Spatial processing
  • Verbal fluency

Heavy alcohol consumption can also cause malnutrition and vitamin deficiencies which can further contribute to alcohol's detrimental effects on the brain. In some cases, people may develop alcohol-related dementia or a cognitive disorder known as Wernicke-Korsakoff syndrome.

Alcohol use can have a serious negative effect on close relationships. As the problem becomes more severe, people with the condition may withdraw from loved ones or lash out at those who try to help.

Increased Family Problems

The Centers for Disease Control and Prevention (CDC) reports that consuming alcohol increases the risk of family problems and violence. Some of the ways that alcohol may impact families include:

  • Defensiveness : People with an alcohol use disorder may come to see their partner or other family members as a threat. This can create a mindset where a person who is in denial about their alcohol issues may feel attacked or defensive by attempts to get help for the individual or the family unit.
  • Financial problems : It is not uncommon for people to experience financial hardships resulting from their alcohol use. This might be caused by poor choices, job loss, or spending excessive amounts of money on alcohol. Such problems affect the individual with the problem, but also create hardships for the entire family.
  • Legal troubles : Alcohol use may also play a role in legal difficulties relating to things like arguments, driving while under the influence , or domestic violence.
  • Negative emotions : Family members may often experience a variety of negative emotions in response to a loved one's drinking, including feelings of sadness, frustration, and fear.

Impact on Children

The Substance Abuse and Mental Health Services Administration notes that families that are affected by alcohol problems have high levels of confusion and stress. This can make children who grow up in such environments more susceptible to substance use and other mental health problems.  

Children who have a parent with an alcohol problem may also experience a wide range of negative effects and emotions. The American Academy of Child and Adolescent Psychiatry suggests that these feelings may include:

  • Embarrassment
  • Trouble forming close relationships

Kids may also exhibit behaviors such as social withdrawal, risk-taking, and academic problems.

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Encouraging our loved ones to get treatment is important, but there are also other steps that can help us protect our well-being.

  • Learn about alcohol use disorders : Educating ourselves about addictions can be helpful. In addition to learning more about how addiction affects the brain, knowing how treatment works can help give us the tools and resources to support our loved ones during their recovery.
  • Set boundaries : Being supportive is important, but it's also essential to clearly establish boundaries when it comes to our loved one's actions. For example, make it clear that you will not accept drinking in your home and then follow through on the consequences if those boundaries are crossed.
  • Take care of yourself : Caring for a loved one with an alcohol problem can sometimes cause us to neglect our own needs and well-being. Make sure that you are giving yourself the things that you need to feel well. That includes eating healthy meals, getting regular physical activity, interacting with friends, getting enough sleep, and pursuing hobbies that you enjoy.
  • Talk to a professional : Seeing a therapist can also help us make sense of our experiences. Our therapist can help us learn new ways of coping with our loved one's behaviors and practice new strategies to help cope with feelings of stress.

It is also important to manage your expectations. Recovery from alcohol addiction is a process that takes time and may involve setbacks.

When a loved one is receiving treatment for an alcohol use disorder, family members can also benefit from educational and support programs such as Alateen and Al-Anon . There are a number of important benefits of participating in support groups:

  • They may help reduce the risk of kids developing alcohol or substance use problems.
  • Such programs may help identify kids that are in need of additional treatment for problems such as anxiety and depression.
  • These educational and supportive resources can help kids and other family members understand that they are not responsible for their loved one's problems with alcohol.
  • They can help family members feel less isolated and understand that there are other people out there who have also been affected by alcohol misuse.

These support groups can serve as a source of stability, resources, and advice for people who have loved ones who are struggling with alcohol addiction. In addition to finding people who have had experiences similar to our own, we can learn more about how to care for our own health and well-being.

Helpful Resources

  • Alcoholics Anonymous
  • National Association for Children of Alcoholics

If you or someone you love has an alcohol use problem and are concerned about the impact it might be having on family and friends, talk to your healthcare provider. Effective treatments are available, and your provider can advise on next steps. Your provider can prescribe medications that can help people stop drinking and help with symptoms of alcohol withdrawal . They can also recommend treatment programs that may help with detox and recovery.

Unfortunately, many people are not aware that there are medications available to help treat alcohol use disorder. According to one 2019 survey, only around 1.6% of adults with an AUD reported using medications during treatment.

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 .

American Society of Addiction Medicine. Definition of addiction .

Stavro K, Pelletier J, Potvin S. Widespread and sustained cognitive deficits in alcoholism: a meta-analysis . Addict Biol . 2013;18(2):203-13. doi:10.1111/j.1369-1600.2011.00418.x

Rossi RE, Conte D, Massironi S.  Diagnosis and treatment of nutritional deficiencies in alcoholic liver disease: Overview of available evidence and open issues.   Dig Liver Dis . 2015;47(10):819-25. doi:10.1016/j.dld.2015.05.021

Centers for Disease Control and Prevention (CDC). Alcohol and substance use .

Substance Abuse and Mental Health Services Administration. What Is Substance Abuse Treatment? A Booklet for Families .

American Academy of Child & Adolescent Psychiatry. Alcohol use in families .

Han B, Jones CM, Einstein EB, Powell PA, Compton WM. Use of medications for alcohol use disorder in the US . JAMA Psychiatry . 2021;78(8). doi:10.1001/jamapsychiatry.2021.1271

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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The Role of the Family in Alcohol Use Disorder Recovery for Adults

Barbara s. mccrady.

1 Department of Psychology and Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico

Julianne C. Flanagan

2 Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, South Carolina

3 Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina

Alcohol use disorder (AUD) and family functioning are inextricably bound, and families are impacted negatively by AUD, but families show substantial improvements with AUD recovery. Family members can successfully motivate a person with AUD to initiate changes in drinking or to seek AUD treatment. During recovery, family members can provide active support for recovery. Several couple- or family-involved treatments for AUD have been developed and tested in rigorous efficacy trials. Efficacious treatments based in family systems theory or cognitive behavioral approaches focus on the concerned family member alone, or they engage the couple or family as a unit in the treatment. However, most treatments have been studied in fairly homogeneous, heterosexual, White, non-Hispanic populations, limiting the potential generalizability of these treatments. Substantial gaps remain in our understanding of family processes associated with the initiation and maintenance of AUD recovery among adults. This review outlines the existing literature and describes opportunities for future research to address knowledge gaps in understanding the mechanisms by which these treatments are efficacious, use of family-based treatments with diverse populations, integration of pharmacotherapies with family-involved treatment, role of families in recovery-oriented systems of care, and how to improve treatment development and dissemination.

It is almost axiomatic that alcohol use disorder (AUD) and the family are inextricably bound. AUD harms individual family members and the functioning of the family as a whole, and family members’ actions may exacerbate problematic drinking. Conversely, families play a key role in recovery from AUD, and recovery has a positive impact on family members and family functioning. Scientific research to understand the interrelationships between drinking and family functioning began in the early 1900s, and treatment models that address both drinking and family functioning have been developed and tested for close to 75 years. This article reviews the conceptual and empirical literature on the impact of AUD on families, the role of the family in recovery from AUD, the role of family-involved treatment in fostering recovery, and issues related to specific populations. The review concludes with suggested future directions for research. When discussing families, we are using the term broadly to refer to a broad range of kinship relationships. When discussing couples, we are referring to couples in intimate relationships regardless of marital or co-habiting status, and using the term “partner” to refer to either individual in the intimate relationship. However, where research findings apply to a more limited group (e.g., spouse versus partner) we use the correct term to delimit the population studied. Given the limitations of current research findings, we are referring to different-sex couples unless otherwise specified.


AUD affects the functioning of families: Family members take on additional household and childcare responsibilities, social events are disrupted, and families may experience significant financial difficulties. 1 Individual members of these families suffer as well. Spouses and children of adults with AUD or other substance use disorder (SUD). experience psychological distress as well as health and behavioral problems. For example, women with a male partner who has AUD and is actively drinking reported elevated levels of depression, anxiety and psychosomatic complaints, and disruptions to work and social/leisure activities, and they utilize more health care resources. 2 – 4 Similarly, children who have a parent with AUD experience a variety of psychological, behavioral, and school problems. 5 , 6

Research also has demonstrated a reciprocal relationship between drinking, AUD, and the quality of intimate relationships. For example, longitudinal studies of engaged different-sex couples have found that the husband’s drinking prior to marriage is a strong predictor of the wife’s drinking a year into marriage, 7 that the female partner’s drinking influences the male partner’s drinking in the next year, 8 and that relationship distress and AUD are strongly related. 9 A recent meta-analysis of 17 studies ( N = 10,553 couples) focused on different-sex couples found that partners influence one another’s drinking, although the magnitude of effects was modest. The extent to which women influenced men’s drinking (β = .19) was slightly greater than the extent to which men influenced women’s drinking (β = .12). 8 Results from clinical and nonclinical samples also reveal a close association between heavy drinking and the perpetration of intimate partner violence. 10 Couples with at least one partner with AUD have high rates of intimate partner violence, regardless of the sex of the partner with AUD, 11 and drinking is common during episodes of interpersonal violence. 12 Most typically, interpersonal violence is bidirectional in these couples.

Orford and his colleagues have proposed that the functioning of family members of those with AUD is best understood within a stress-strain-coping-support (SSCS) framework. 13 The SSCS model assumes that living with a family member with AUD is a stressful circumstance, putting family members at risk of a variety of psychological and physical health problems. Within this model, families are seen as engaging in a variety of behaviors to cope with this chronic stressor, some of which are more effective in helping families to cope with and to influence the drinker’s behavior, and others that are less effective. The SSCS framework has informed much of contemporary research on AUD and the family.


There are strong connections between family functioning and drinking outcomes. Family behaviors can contribute to changes in drinking, and, conversely, changes in drinking can contribute to more positive family functioning. For example, in early studies, Moos and colleagues examined the longitudinal course of functioning in families of men receiving treatment for AUD. At 2-year follow-up, they compared family functioning for men who were in recovery to men who had relapsed. Wives of men in recovery, compared to wives of men who relapsed, drank less, were less depressed and anxious, had fewer negative life events, and had higher family incomes. 14 Similarly, the children of the men in recovery showed fewer symptoms of emotional distress. 15 As a whole, families of men in recovery had greater family cohesion, greater expressiveness, a higher orientation toward recreational activities, and greater agreement in how they viewed the overall environment of their families, compared to families of men who had relapsed. 16 These studies highlight the positive impact of recovery on families.

Families may play a key role in fostering the initiation of recovery. Although popular literature and 12-step mutual help groups for families, such as Al-Anon ( https://al-anon.org/ ), emphasize detachment for family members and empirically supported interventions for families, such as Community Reinforcement and Family Training (CRAFT), 17 it has been found that family behavior can increase the probability that an individual will seek help for AUD. 18 Key family behaviors that support the initiation of change include ignoring behaviors associated with using alcohol or drugs, reinforcing positive or desirable behaviors related to sobriety or help-seeking, allowing the drinker to experience the naturally occurring negative consequences of drinking, and making specific and positive requests for changes in behavior related to drinking, such as reducing consumption or seeking help. 17

Families and other members of the social network of persons with AUD also play an important role in supporting successful changes in drinking. 19 Although the scientific literature is limited on specific family behaviors that facilitate and support successful recovery from AUD, there is evidence that active partner coping predicts positive outcomes. Specific types of active partner coping that support successful change include (a) decreasing negative or controlling behaviors that serve as antecedents to drinking; (b) increasing supportive and problem-solving communication; (c) reinforcing positive behavior change by the partner with an alcohol problem; (d) increasing shared positive activities; and (e) reducing family member drinking behavior to support changes in the drinking of the person with AUD. 20

Families also may make recovery more difficult. For example, individuals with AUD perceive relationship problems as significant relapse precipitants, 21 and believing that one’s partner also has AUD predicts poorer drinking outcomes compared to individuals who did not believe that their partners have AUD. 22 Specific family behaviors associated with relapse include negative attitudes, emotional responding, and low levels of distress tolerance. 19


Knowledge of the impact of AUD on families has led to the development of family-engaged treatments. Considerable research has focused on the development and testing of these family-engaged treatments to foster recovery from AUD. These treatments have focused on the role of the family in the initiation of help seeking, initiation of change, and maintenance of long-term change. The following sections describe and review treatments for affected family members in their own right, and as a way to help effect change in the identified individual with AUD. This is then followed by a review of the array of interventions influenced by cognitive behavioral therapy (CBT) and family systems models. Table 1 provides a summary of key elements in each of the treatments reviewed.

Family Interventions for AUD

Treatments for Affected Family Members

The 5-Step Method, a systematic intervention based on the SSCS model, is designed to help families cope more effectively with the AUD of a family member. The focus of the intervention is on the families in their own right, rather than on the relationship between family behaviors and outcomes for the person with AUD. The 5-Step Method helps families explore sources of stress and strain in their lives, provides psychoeducation about the SSCS model, helps them identify effective ways of coping with these sources of stress, assists them in identifying sources of social support for themselves, and assists with other needs that family members might have. The 5-Step Method has been tested with families in primary care as well as specialty care settings, with results supporting the effectiveness of the approach in reducing family-related harm in terms of both physical and psychological symptoms. 23

Two treatments focus on providing family members with skills to help a family member to seek AUD treatment. CRAFT helps concerned family members to change contingencies for drinking by decreasing behaviors that protect the drinker from naturally occurring consequences of drinking, increasing positive family responses to changes in drinking, learning self-care and protection from intimate partner violence, and learning how to communicate positive requests for change and/or help seeking. 17 Compared to Al-Anon, CRAFT results in significantly greater rates of help seeking, and comparable rates of improvement in family members’ depression and anxiety. The ARISE method (A Relational Intervention Sequence for Engagement) provides a series of steps that family members may use to encourage their loved one to seek treatment; ARISE also is effective in encouraging persons with AUD to seek treatment. 24 In addition to treatments for the affected family member alone, there are several treatment models and approaches that involve both the affected family members and the individual with AUD. Treatments with strong empirical support have drawn largely from cognitive behavioral and family systems concepts; the following sections review these approaches.

Cognitive Behavioral Approaches

Cognitive behavioral therapy (CBT) approaches view alcohol use as a learned behavior, cued by environmental stimuli and maintained by the positive consequences of alcohol use. Family-engaged CBT approaches view family behaviors as potential cues for drinking, as providing positive consequences of drinking, and as having the potential to provide positive consequences for changes in drinking behavior.

Adding partner-assisted components to individual treatment might involve partners assisting the person with AUD with accurate self-monitoring of alcohol intake and contributing to functional analysis of drinking patterns to help identify high-risk situations in which craving and alcohol consumption are likely to present a challenge. Psychoeducation is also common to help the partner more clearly understand the treatment needs and program of recovery for the person with AUD. Partner involvement might provide additional benefits such as helping the partner without AUD to develop new skills to reinforce changes in drinking and minimize behaviors that might contribute to maladaptive couple and family interactions. One recent study exemplifying this approach found support for integrating romantic partners into individual motivational interviewing interventions to improve individual AUD outcomes. 25 , 26

Several manual-guided conjoint couple therapies incorporate cognitive behavioral techniques that have proven useful in individual treatments along with couple-focused interventions. One such modality with strong empirical support for both men and women with AUD is Alcohol Behavioral Couple Therapy (ABCT). 20 ABCT is a 12-week, cognitive behavioral treatment that has demonstrated efficacy in reducing alcohol consumption, enhancing relationship functioning, and improving partners’ skills to facilitate reductions in drinking. 27 Core components of ABCT include (a) CBT interventions to help the person with AUD change his or her drinking, (b) psychoeducation for the intimate partner to learn how to support changes in the behavior of their partner with AUD and to decrease behaviors that might serve as triggers for drinking, (c) interventions to teach the couple how to deal more effectively with drinking situations and drinking urges, (d) behavioral couple therapy interventions to increase positive interactions and improve communication skills, and (e) couple-focused relapse prevention. Figure 1 summarizes the hypothesized mechanisms by which ABCT impacts drinking outcomes. Recent ABCT literature indicates a strong association between partner participation in treatment and AUD outcomes. Reductions in drinking have been associated with increases in partner coping, conflict resolution skills, relationship satisfaction, and support behaviors. 28 Greater relationship quality before treatment predicted abstinence and alcohol consumption posttreatment. 29 Greater relationship satisfaction also is associated with fewer drinking urges and greater reduction in drinking urges during ABCT. 30 One notable strength of ABCT is that it results in positive outcomes for couples presenting with poor relationship functioning and high levels of psychiatric comorbidity, and it is equipped to treat couples in which one or both partners have AUD. 27

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Hypothesized mechanisms of change in Alcohol Behavioral Couple Therapy. Note: AUD, alcohol use disorder; CBT, cognitive behavioral therapy.

A second well-researched approach to couple-involved therapy is behavioral couples therapy (BCT) for AUD and other SUD. 31 BCT is a 12- to 20-session intervention that lasts 3 to 6 months. The core components of BCT include (a) a daily “recovery contract” to encourage abstinence from substance use, (b) interventions to increase positive couple behaviors, and (c) training in behavioral communication skills. Participants with SUD also complete weekly urine drug screens, and progress is monitored in a calendar-assisted approach (similar to the Timeline Follow-Back procedure). 32

Like ABCT, BCT is suitable to implement alongside 12-step groups such as Alcoholics Anonymous ( https://aa.org/ ) and individual AUD treatments. Data from randomized controlled trials suggest that BCT has excellent feasibility, participant acceptability, and efficacy. 33 , 34 , 35 BCT also has the ability to reduce maladaptive couple conflict behaviors such as intimate partner violence 36 and has been tested for use among military veterans with positive outcomes 37 and with couples in which both partners have AUD. 38 However, findings from one recent trial indicate that a group adaptation to BCT to treat multiple couples simultaneously did not perform as well as when couples were treated separately. 39

Brief family-involved treatment (B-FIT) is a three-session intervention that aims to improve family functioning, increase family-related incentives associated with reduced alcohol consumption, and implement proven techniques for family treatment of AUD to achieve and maintain long-term abstinence. 40 Specifically, B-FIT incorporates adaptations such as (a) involving any concerned family member rather than romantic partners only, (b) implementation within a patient’s multifaceted program of recovery, (c) targeting the key components of ABCT in an accelerated manner, and (d) leveraging behavioral contracting techniques to increase treatment efficiency. 41 B-FIT was recently examined in a pilot randomized controlled trial ( N = 35 couples) with promising outcomes. 42

Family Systems Approaches

Treatment models based in family systems theory assume that the actions of individual family members affect all other members of the family, and that families have typical and repetitive ways of interacting that maintain dysfunctional behavior patterns of the family as a whole and of individuals within the family. Thus, these models focus on change in the structure and functioning of the family to effect change in dysfunctional behaviors, such as alcohol or drug use, in individual family members. Three major approaches in family systems therapy have evidence supporting their efficacy and should be noted, although most of the controlled trials of these treatments have been conducted primarily with adolescents with AUD or other SUD.

Brief strategic family therapy (BSFT) combines interventions from structural and strategic family therapies and assumes that substance use as well as other behavioral problems are symptoms of family dysfunction. Thus, the treatment focuses on influencing maladaptive patterns of family interaction, alliances, boundaries, and scapegoating of individual family members. Data reported from multiple studies support that BSFT is efficacious in decreasing adolescent substance use a year after treatment, that changes in family functioning mediate the relationship between BSFT and outcomes, and that parents receiving BSFT also decreased their drinking after treatment. 43

Multidimensional family therapy (MDFT) views adolescent problems as multidimensional and addresses factors on multiple levels (i.e., individual, family, environment) that may be contributing to the adolescent’s problem behaviors. The treatment involves establishing multiple relationships between the therapist and the adolescent, family, and other systems, and it uses a range of interventions to restructure family and individual functioning. Data suggest that MDFT is more effective than comparison treatments, 43 although it is more costly to deliver. However, when the associated costs of delinquency are considered, the cost-effectiveness of MDFT is comparable to cognitive behavioral interventions. 44

Multisystemic therapy (MST), developed as a family intervention for youth involved with the juvenile justice system, intervenes in multiple systems, including the individual, family, school, peer, and community. The primary focus of MST has been on antisocial behaviors, but data also suggest that, compared to community treatment as usual, MST leads to positive substance use outcomes. 43 Combined with interventions to strengthen families with parental AUD and child maltreatment, MST has been found to decrease child negative symptoms, parental substance abuse, and instances of child maltreatment. 45

Summary of Family-Involved Treatments

Efficacious treatments drawn from cognitive behavioral and family systems theories have been developed both for family members alone and for family members together with the individual with AUD. Most controlled trials of these treatments have compared either the family-involved treatment to treatment without the family member, or variations on the specific treatment (e.g., ABCT with or without involvement in Alcoholics Anonymous). Thus, the research literature to date does not provide guidance to clinicians about selecting a treatment from among those with empirical support.


A great deal has been learned to date regarding efficacious family and couple treatment models. However, the empirical literature is also clear that AUD is a condition characterized by a great deal of heterogeneity in etiology, course, and factors influencing treatment outcomes. The following section describes treatment considerations for populations that might require tailored treatment considerations and adaptations to optimize outcomes.

Military and Veteran Families

Rates of hazardous and harmful alcohol use and AUD are high among active duty military and veteran populations. Compared to age- and sex-matched civilian samples, both women and men in active duty and veteran populations consume alcohol more frequently and heavily as well as incur a nearly fivefold greater risk for experiencing harmful alcohol-related health outcomes and developing AUD. Toward the goal of improving the health of the U.S. armed forces, their partners, and their families, emerging research has examined existing or adapted behavioral treatment approaches to determine their appropriateness in military and veteran populations, including couple therapy and treatment for families of veterans with AUD. For example, one recent open-label trial examined an adaptation of ABCT for returning military veterans ( N = 44 couples). 46 This study utilized a 15-session format and incorporated relevant topics for combat veterans, including intimate partner violence, depression, post-traumatic stress disorder (PTSD), and traumatic brain injury, which are all known to co-occur at high rates with heavy drinking and to affect military populations disproportionately. Similarly, BCT has demonstrated efficacy among veterans with AUD and co-occurring PTSD. More recently, a novel integrated approach that combines BCT with Cognitive Behavioral Couples Therapy for PTSD (Couple Treatment for AUD and PTSD) has shown promise in a preliminary open-label pilot study ( N = 13 couples). 37 Given that military culture places heavy emphasis on marriage and family, this population is ripe with opportunities to advance dyadic alcohol research to better understand how veteran and active duty families cope with and encourage recovery from AUD, and how the family as a whole changes as the person with AUD recovers. In addition, more attention is needed to address the unique challenges to implementing dyadic treatment in active duty and veteran treatment settings (e.g., frequent relocations, extended deployments).

Women with AUD experience different challenges than men with AUD in general and particularly in terms of intimate relationships. Data from longitudinal research suggest that husbands’ drinking patterns prior to marriage strongly predict women’s drinking in the first year of marriage, and male partners of women with AUD are more likely than wives of men with AUD to have AUD as well. 47 Women with AUD see relationship problems and the male partner’s drinking as important antecedents to relapse, and they use alcohol to cope with relationship problems. Male partners of women with AUD tend to avoid confrontation as a way to cope with the woman’s drinking. 48

The efficacy of ABCT and BCT has been tested with women with AUD and their male partners. 47 , 49 , 50 In all three studies, ABCT or BCT led to better alcohol use outcomes for the women compared to the control condition. McCrady and colleagues also found that women who entered treatment with higher levels of relationship distress and women who presented with another clinical and personality disorders had greater improvements in drinking with BCT than individual therapy. 47 However, if given the choice, women with AUD prefer individual rather than conjoint therapy, citing as reasons their desire to work on individual problems, their perception of a lack of support from their partner, and logistical challenges to attending treatment together. 51

Racial and Ethnic Minority Populations

Race and ethnicity play a significant role in family and couple relationship structure and functioning for many persons with AUD, thereby influencing the complex role of the family in AUD treatment seeking and recovery trajectories. To develop the knowledge base regarding the mechanisms by which race and ethnicity influence AUD recovery in families, dyadic AUD research must improve diversity within samples and must focus on treatment development adaptations for specific diverse populations. The existing literature demonstrates that substantial differences exist in alcohol consumption patterns, etiology, and risk factors associated with developing AUD as well as treatment engagement and outcomes in different racial and ethnic groups. 52 Racially and ethnically diverse minority populations are persistently underrepresented as participants in randomized controlled trials focused on alcohol use. AUD research on families and couples faces a similar constraint that currently limits the generalizability of current findings.

Cultural constructs and institutional marginalization are likely to impact AUD recovery among racial and ethnic minority groups in varying ways. Furthermore, the complex intersectionality of various cultural and institutional factors is likely to influence drinking and recovery. Among other factors, gender roles, socioeconomic status, health care access, employment status, immigration status, involvement with the criminal justice system, religion, and language barriers are likely to manifest in separate but overlapping ways among families who belong to racial and ethnic minority groups. 53 , 54 Some research suggests that acculturation and “traditional” family structures more often identified in non-White, non-Hispanic families might prevent the onset of AUD and facilitate effective treatment seeking and change in racial and ethnic minority groups. 52 , 55 Conversely, stigma and cultural beliefs related to AUD and help seeking, as well as couple and family therapy specifically, might negatively influence AUD recovery processes for some members of racial and ethnic minority groups. However, these mechanisms have not been well tested in the context of couple or family treatment for AUD.

Socioeconomic Status

Socioeconomic status (SES) is defined by many variables, including educational access and level, occupational status, housing access, neighborhood factors, and income. 56 Although AUD occurs among individuals and families from all socioeconomic backgrounds, the direct association between socioeconomic status, AUD, and alcohol-related harms is complex. 57 However, research indicates that families with lower SES (based on factors such as income and educational level) might incur increased negative physical and mental health sequelae of AUD, encounter barriers to accessing treatment, and confront more barriers to successful treatment outcomes, compared to families with higher SES. 53 , 54 , 57 , 58 Minimal research has been conducted regarding socioeconomic barriers to accessing couple therapy for AUD specifically; thus, research is necessary to identify potential socioeconomic disparities and pathways to mitigating them. One study of access to general couple therapy was conducted among couples living in neighborhoods with at least 30% of households below the poverty threshold. Results showed that when couples in this sample obtained access to treatment, they utilized couple therapy services and derived positive gains. 59 Thus, research is needed to better understand AUD recovery among families with different socioeconomic advantages or disadvantages. Studies investigating effective methods to increase access to low-cost treatment options—including those with technological adaptations to increase treatment availability—are warranted. Leveraging existing study data and using qualitative data collection techniques to identify barriers and methods to overcoming barriers are also needed.

Sexual and Gender Minority Populations

Individuals identifying as sexual and gender minorities are more likely to consume alcohol and have higher rates of AUD than individuals identifying as heterosexual. 60 Some accruing research suggests connections between alcohol use, AUD, and relationship functioning in this population. For example, in same-sex male couples, poorer relationship functioning appears related to higher rates of alcohol problems; 60 in same-sex female couples, higher levels of verbal aggression and physical violence are associated with higher levels of alcohol use; 61 and differences in alcohol use in same-sex female couples are associated with poorer relationship functioning (e.g., poor conflict resolution, poor satisfaction). 62 However, research on intimate or family relationships and recovery in sexual minority groups is very limited. One qualitative study of gay men in recovery examined familial and other social network influences on recovery. 63 Family and other social network factors cited as important to their recovery included acceptance of their sexual orientation and a sense of social connectedness. Conversely, although the men indicated that they continued to look to their families for support, many continued to experience family rejection of their sexual orientation and perceived this as a stressor that made recovery more difficult.

Engaging Communities in AUD Treatment

A crucial shift emerging in the AUD treatment community is the recognition that treatment approaches need to be adapted to accommodate families from diverse backgrounds, rather than expecting individuals and families to adapt to current treatment methods. To achieve this goal, research is needed on how to modify current approaches to reduce pervasive barriers to identification of AUD, how to develop evidence-supported approaches to treatment access and engagement relevant to diverse populations, and how to include diverse communities in the scientific process (as both participants and investigators). Increasing partnerships between research and AUD provider teams with health systems and community representatives serving racial and ethnic minority families, families with limited economic resources, and sexual minority populations might reveal pathways to achieve this goal. Community-based participatory research is an approach that provides one framework for developing research through true community partnerships. 64


During the past several decades, the empirical literature has expanded significantly to develop a critical foundation of knowledge and advance the implementation of family and couples-based approaches to AUD treatment. This section reviews promising areas for future research to further advance the state of the science in this area and to inform clinical best practices to optimize the AUD recovery process by incorporating family members.

Understanding Couple and Family Support in Recovery

Data are limited on the role of couple and family support in AUD recovery processes outside of treatment; most of our knowledge to date has come from clinical trials of specific couple- or family-involved treatments or from studies using patients in treatment programs. A related question that warrants attention in the literature is learning about the circumstances under which partners and family members are well suited versus possibly inappropriate for conjoint therapies. Clinical guidelines for couple therapy for AUD suggest that conjoint therapy should not be attempted for couples with intimate partner violence that has resulted in physical harm or fear of retaliation or for couples in which one partner is planning to leave the relationship. 20 Gaining a clearer understanding of the specific couple and family behaviors that support or are detrimental in AUD recovery, as well as the mechanisms by which these behaviors influence AUD recovery, is crucial to improve alcohol prevention and treatment efforts. For example, studies examining family-specific interactive behaviors that increase or mitigate known precipitants to drinking and relapse risk, such as heightened craving, are warranted. Similarly, this literature can be improved by examining thoughts, behaviors, and emotions that acutely predict both positive and negative AUD treatment outcomes, including those that occur within and between treatment sessions.

Exploring Partner and Family Integration in Recovery-Oriented Systems of Care

Although the majority of the current review has focused on manual-guided and single-episode treatment approaches, it is widely recognized that more integrated and sustainable resources often are warranted to initiate and maintain AUD recovery across populations. During the last two decades, research focused on recovery-oriented systems of care (ROSC) has demonstrated positive findings. 65 – 69 ROSC is defined as “networks of organizations, agencies, and community members that coordinate a wide spectrum of services to prevent, intervene in, and treat substance use problems and disorder.” 65 Identifying pathways to integrate partners and family members, where appropriate, into ROSC models holds promise, but has not been investigated thoroughly. Future research directed at examining facilitators and barriers—at the patient, provider, and system levels—to inviting family members into AUD treatment under this model is necessary. For example, some individuals engaged in ROSC might be facing obstacles such as homelessness or incarceration that might make it more challenging to identify and engage a supportive peer, partner, or family member. Under these circumstances, an adjunctive approach to developing or strengthening nonfamilial social support relationships could be explored. It also is possible that improved training in existing couple and family theory and treatment modalities could facilitate greater accessibility and treatment outcomes.

Role of Partners and Family in AUD Resilience

The existing literature can be improved by developing a better understanding of couple- and family-level factors promoting AUD resilience, with a particular focus on individuals, couples, and families who choose to change their drinking behaviors without engaging formal treatment resources. Recent literature has begun to expand the knowledge base regarding individual-level behavioral and neurobiological factors associated with greater likelihood of sustained recovery. However, less research has focused on the specific roles of partner and family members in changing drinking behaviors, neurobiological functioning associated with recovery-related cognitions and behaviors, and recovery when formal treatments are not engaged. 70 – 72 Extending this area of the literature might be particularly useful for diverse populations with disproportionate risk for developing AUD or disparities and barriers to accessing formal or traditional AUD treatment resources. 73 , 74

Specific Populations

Couples and families from diverse backgrounds differ in their values, the structure and functioning of the families, gender roles within these relationships, how family members influence and support each other, and the role of alcohol use and AUD in the family. Although awareness of diversity in family functioning among different racial and ethnic groups, socioeconomically challenged populations, sexual and gender minorities, and veteran populations is increasing, the specific associations between alcohol use, AUD, family functioning, and AUD recovery have not been studied. Future research needs to focus on developing a more nuanced understanding of family structure and function around AUD in diverse populations to develop effective family-engaged treatments and dissemination of knowledge of effective practices to support recovery for these populations.

Expanding Couple and Family Treatment for AUD

One new direction for dyadic AUD treatment is the integration of existing and emerging modalities with electronic and technologically based adaptations (e.g., smartphone/online access, e-health [electronic health], m-health [mobile health]). Such adaptations hold promise to facilitate treatment access and engagement, enable accuracy in assessment, reduce participant burden, and streamline delivery of treatment content.

Among individual participants, technology-assisted and fully technology-based interventions are rapidly proliferating in the alcohol field. Technology-based approaches have proven utility to inform novel treatment development efforts, and they focus existing interventions on key components that are most likely to yield significant impacts on alcohol-related cognitions and behavior. Studies conducted among individuals consistently find that technology-assisted modalities are highly feasible and acceptable among participants. They show promise to increase participant access, engagement, and outcomes; to improve reach and cost-effectiveness; and ultimately to provide a viable AUD treatment option for individuals in a variety of populations. 75 , 76 An emerging body of literature is examining technology-based, e-health, or mobile interventions for couples with AUD. Findings from the limited emerging literature on technology-based couple interventions are encouraging. For example, one recent study tested a mobile support system to facilitate family communication among families affected by AUD ( N = 9). 77 Another study examined the feasibility and acceptability of a novel, four-session, web-based AUD intervention for military and veteran couples ( N = 12) with promising outcomes. 78 As remote telehealth (e.g., using telephone and/or videoconferencing) approaches are evolving in the AUD treatment field, an emerging literature suggests that telehealth implementation of couple and family therapy is also feasible and acceptable. 79 Recent research on a brief, in-person, home-based couple intervention found positive results for enhancing accessibility and efficacy. 80 Creating a home-based family telehealth intervention model of recovery has the potential to improve treatment access for individuals in AUD recovery and their partners and families.

A recently completed Small Business Innovation Research Phase 1 development project created a novel e-health intervention for families to reduce driving while intoxicated (DWI) and DWI recidivism. 81 The intervention, B-SMART, was designed to help reduce risk for DWI reoffending by leveraging environmental support (e.g., family support) known to reinforce and thus increase the likelihood of alcohol abstinence and simultaneously reduce harmful drinking outcomes. Participants ( N = 32) were family members of individuals with a recent DWI arrest and an interlocking ignition device installed on their vehicle, who rated the useability of the smartphone app. A Small Business Technology Transfer Phase 2 grant is underway to develop additional intervention modules and to conduct a randomized trial of the efficacy of the intervention. 82 Overall, a great deal more research is needed to adapt existing dyadic AUD treatment modalities to incorporate technology such as mobile or online assessment monitoring, telehealth sessions, or self-guided online interventions.

Pharmacological treatment of AUD for couples and families

Combining pharmacological interventions with evidence-based behavioral treatments has the potential to optimize and sustain AUD treatment outcomes. 83 – 85 However, few studies have examined the role of pharmacological interventions in trials of conjoint or family treatments for AUD. Research aimed at examining the role of medication utilization and compliance in dyadic and family modalities is needed. More specifically, medication-enhanced psychotherapy for AUD, in which medications and behavioral interventions are designed to work synergistically within or between sessions, is a promising new direction for couples. As new medications for AUD are being developed specifically with the goal of targeting brain stress and social reward systems (e.g., intervening in the withdrawal/negative affect and preoccupation/anticipation stages of AUD), medications to simultaneously maximize AUD outcomes and enhance relationship functioning could optimize AUD and relationship functioning outcomes among couples. 86 – 91 One such medication, intranasal oxytocin, is currently being examined among couples with AUD for that purpose. 92 Phase II trials of 3,4-methylenedioxymethamphetamine (MDMA) also are being conducted for a variety of psychiatric conditions, including among couples, and could hold promise to augment dyadic intervention for AUD. 93

Neurobiological underpinnings of AUD

Current AUD research has a heavy emphasis on understanding the neurobiological and behavioral underpinnings of AUD and interactions between them. Such approaches have proven utility in novel treatment development efforts. However, advanced neurobiological measures and techniques, which have proven useful in treatment development efforts with individuals, have not yet been applied to couples. For example, clinically relevant AUD biomarkers are rarely examined in epidemiological or treatment research with couples. Similarly, although functional magnetic resonance neuroimaging is widely used in laboratory and treatment research in the alcohol field, there is a scarcity of literature examining resting state or task-related neural functioning in romantic couples. Some novel directions include hyperscanning, in which two participants are scanned simultaneously in response to shared stimuli, and adapting imaging paradigms to address relational behaviors relevant to AUD. 94 , 95 Preliminary evidence from a small sample of couples with relationship distress and substance misuse suggests that intimate partner violence in the relationship might exacerbate neural stress responses associated with couple conflict cues. 96 When applied to either mechanistic or treatment development efforts, this emerging line of literature might help to develop neural prognostic and diagnostic indicators of positive AUD treatment outcomes, risk for AUD relapse, and short- and long-term correlates of AUD relapse risk.

Another area of potential for future research is applying the existing literature on dyadic physiological and neuroendocrine co-regulation to the alcohol field, an effort that has begun but needs to be extended. Data collected from samples of couples experiencing relationship distress and who enrolled in treatment trials for problems other than AUD indicate that discordant dyadic autonomic dysregulation is associated with acute and more severe couple conflict, 97 whereas synchrony in autonomic functioning is indicative of constructive couple therapy processes such as working alliance and improved health outcomes. 98 As biofeedback intervention approaches continue to evolve in the AUD field, these emerging data can help to inform the development and refinement of remote and in-person dyadic biofeedback to support recovery efforts among families affected by AUD.

Involvement of partners and family members in AUD therapies in the context of co-occurring mental health conditions

Identifying pathways to successfully treat AUD and co-occurring conditions among individual participants remains an area of intense scientific inquiry. However, far less attention has been dedicated to understanding how partners and family members might contribute to adjunct or conjoint therapies. One preliminary pilot study found promising feasibility and acceptability outcomes when examining a novel integrated approach that combines BCT with Cognitive Behavioral Couples Therapy 99 for PTSD ( N = 13 couples). 37 Research also suggests that ABCT is more efficacious than individual CBT for women with AUD and co-occurring clinical and personality disorders. 47 A great deal more research is needed to identify dyadic pathways to treating AUD and commonly co-occurring conditions such as PTSD and depression.

Dissemination and implementation

Despite the abundance of rigorously conducted studies and findings supporting the efficacy of dyadic AUD treatment, evidence-based couple and family therapies are rarely applied in frontline treatment settings. Literature identifying barriers to provider uptake and patient utilization is also limited. The scant data available suggest that a lack of familiarity with modalities such as BCT among treatment providers and administrators of treatment clinics are among the most commonly cited challenges. 100 Additional challenges include (a) logistical and time-related barriers to scheduling sessions with both members of a couple; (b) a lack of clarity regarding insurance reimbursements available for couple therapies (and whether reimbursements are greater than for individual sessions); (c) lack of formal training in couples therapies for AUD; and (d) perceived increase in the difficulty of implementing dyadic treatment compared to treating individuals with AUD. 100 As a result, dissemination and implementation efforts are needed to identify more clearly provider and administrative barriers to uptake across various treatment settings (e.g., community clinics, Veterans Affairs clinics, academically affiliated clinics), to develop accessible provider education models, and ultimately to develop a more robust and diverse pipeline of capable and confident providers.

The majority of individuals with AUD who change successfully do so on their own, without any formal treatment. 101 As knowledge accrues about the most effective ways for families to motivate persons with AUD to change and to support change efforts, models to disseminate this knowledge in provider training programs and outside of treatment settings are needed. Community-based studies of these dissemination efforts also are needed to advance provider education and training efforts and to promote utilization of the full scope of couple and family treatments for AUD that are both available and efficacious.

Mechanisms of Treatment Response

Although efficacious couple and family treatments for AUD have been developed and tested, knowledge regarding behavioral mechanisms of action underlying treatment response largely remains untested. It is possible that both individual and relational mechanisms specific to family and couple interactions might facilitate improved treatment outcomes, maintenance of recovery programs and sobriety, and long-term health. Thus, studies examining the mechanisms of action underlying effective couple and family treatments for AUD—as well as secondary analyses of extant data sets and studies combining data sets from multiple randomized controlled trials—are warranted. One avenue to addressing this gap in the literature is the use of observational coding schemes to examine within-session behaviors indicative of treatment response. A recent study examined the association between pronoun utilization (i.e., “I” versus “we”) within ABCT sessions and found that greater “we” language utilization was associated with greater alcohol abstinence at end of treatment and follow-up. 102 Recent analyses based on coding of within-session language in ABCT sessions have found that contemptuousness by individuals with AUD toward their partners predicts poorer drinking outcomes 103 and that within an ABCT treatment session there is a complex interaction among client and partner change language and positive and negative relationship behaviors. 104 This line of research can be expanded to further improve our understanding of within-session behaviors relevant to AUD recovery among couples and families, given that several reliable and valid observational coding systems (i.e., the Rapid Marital Interaction Coding System [RMICS]; System for Coding Couple Interaction in Therapy–Alcohol [SCCIT-A]) have been developed and are widely used among couples in laboratory settings.

One specific mechanistic aspect of this literature that has not been thoroughly explored is the role of specific conflict behaviors and dyadic processes (both adaptive and maladaptive) in influencing alcohol craving as well as risk for lapse and relapse in AUD. The daily process and micro-longitudinal research designs and methods that have proven essential to understand some individual and dyadic mechanisms linking alcohol with couple conflict behaviors, such as intimate partner violence, have not been extended to nonviolent dyadic processes and recovery-related cognitions and behaviors. This literature could be advanced through innovative intersections of multi-method approaches that link laboratory, neurobiological, and naturalistic data, such as incorporating traditional clinical trial designs with micro-longitudinal and remote assessment methods. Such data might be used to inform novel and accessible adjunct interventions and tailored treatment modifications to insulate people with AUD and their families from high-risk situations.

Leveraging Representative Samples

Future large-scale and multisite studies examining nationally representative samples (such as the National Epidemiologic Survey on Alcohol and Related Conditions [NESARC] data set, 105 etiological processes (such as the Adolescent Brain Cognitive Development study [ABCD]), 106 and treatment development (such as the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence [COMBINE study]) 107 have the ability to leverage rich infrastructures and diverse resources, often in a longitudinal fashion, to measure dyadic and family functioning using reliable and valid measures. To date, measurement of partner- and family-related variables has been limited in existing efforts. Increased collaboration between investigators and treatment providers with dyadic and family expertise pertaining to AUD is warranted in future integrated and large-scale efforts. As brief and empirically sound measurement approaches become more widely available, such collaborative efforts have the potential to reduce existing silos between fields of expertise within the AUD research community and ultimately to provide critical new information to drive the AUD field forward.


The existing literature suggests that families play a key role in motivating persons with AUD to recognize the need to change, providing support for change, and supporting long-term recovery and that AUD recovery is good for families. Most of our current knowledge, however, has come from studies of relatively small clinical samples or from treatment studies. The lack of community-based research, multisite randomized controlled trials, research on integration of partners and family members in recovery-oriented systems of care, conduct of AUD treatment-specific meta-analyses, and the exclusion of couple- and family-level variables in large-scale longitudinal studies of the onset and course of AUD remain important areas for future research. Similarly, the lack of research on the role of the family in AUD recovery in diverse populations is a major gap in the current literature.

The existing literature from treatment studies suggests that integrating partners and family members into AUD treatment is a highly effective way to maximize positive treatment outcomes and to facilitate long-term AUD recovery and health of individuals with AUD and their families. Several manual-guided approaches have proven efficacy, but efforts to improve provider education and increase uptake of evidence-supported couple- and family-based AUD treatment modalities are needed to improve access and maximize the reach of available interventions. Challenges also might emerge if social relationships are persistently strained, if it is not safe or appropriate to include partners and family members in these modalities, or if individuals with an alcohol problem are navigating additional challenges such as incarceration or homelessness that are likely to influence day-to-day social contact and implementation of currently available modalities. There is an abundance of new opportunities to integrate emerging novel scientific methods—such as multimodal, multidisciplinary assessment and intervention approaches—into research focused on couples and families with a family member with AUD. The literature also is clear that improved access to AUD treatments among diverse populations is needed. It is crucial to improve synergy between existing alcohol research and the treatment community as well as the vast population of individuals in need of AUD treatment and their partners and families. Progress toward meeting these goals can be facilitated through increased collaboration with community partners to develop culturally informed modifications to research inclusion, AUD assessment, and intervention. Increased collaboration between investigators, administrators, and clinical providers to maximize existing federal funding investments in couple and family AUD treatment and recovery processes also holds potential to reduce treatment barriers and improve long-term outcomes for couples and families.


This manuscript is the result of work supported, in part, by the National Institute on Alcohol Abuse and Alcoholism (K23AA023845).

Publisher’s Note

Opinions expressed in contributed articles do not necessarily reflect the views of the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. The U.S. government does not endorse or favor any specific commercial product or commodity. Any trade or proprietary names appearing in Alcohol Research: Current Reviews are used only because they are considered essential in the context of the studies reported herein.


Dr. McCrady is the author of a therapist manual and a client workbook on Alcohol Behavioral Couple Therapy, a treatment that is discussed briefly in this paper. She receives royalties from the sale of these publications and also receives payments for workshops to train practitioners in the use of Alcohol Behavioral Couple Therapy. Dr. McCrady’s research on Alcohol Behavioral Couple Therapy and the B-FIT treatment discussed in this paper has been supported by grants from NIAAA. Dr. Flanagan is Principal Investigator of an NIAAA-sponsored grant using the Alcohol Behavioral Couple Therapy treatment manual. There are no other competing financial interests or other conflicts of interest to declare.


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.

alcoholism affects family essay

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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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

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

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

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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  • Essay on Alcoholism

Effects Of Alcoholism On Life And Family Essay Samples

Type of paper: Essay

Topic: Alcoholism , Alcohol , Alcohol Abuse , Family , Social Issues , Health , Drinking , Violence

Words: 2000

Published: 02/20/2023


Alcoholism is a medical condition in which an individual drinks large quantities of alcohol over a long period. Primarily, most of the alcoholics have problems in controlling the consumption of alcohol even if they are conscious of the inherent effects of excessive use of alcohol.Roger notes that overconsumption of alcohol over a long period leads to addiction. Besides, alcoholism has immense effects on both the lives of alcoholic and the members of the family. A study by Carlson reiterates that people who abuse alcohol are at risk of many health issues some which are characterized enhanced tolerance to drinking. Prolonged use of alcohol has adverse effects on an individual’s mental and physical health a fact that can expose one to risks of suicidal feelings, depression or psychiatric disorders. Also, alcohol usage results in risky conditions like alcohol tolerance and withdrawal when an alcoholic stops drinking abruptly. Alcoholics are also ashamed of their condition a fact that can cause stress. Teenagers are always at risk of alcohol dependence. Primarily, an individual starts with taking small quantities of alcohol. The individual then starts taking large volumes of alcohol occasionally. With time, the drinking pattern of the alcoholic changes thus causing addiction. According to Poprawa alcohol consumption impairs the effectiveness of the motor skills. Also, the increase in blood alcohol concentration due to consumption of alcohol led to an overall improvement in the mood of the alcoholic and enhanced self-confidence (5). Large concentrations of the BAC can lead to ineffective coordination of the fine muscles are impaired judgment. This condition can cause fatal accidents especially when one is driving or operating a machine. Khaltourina and Andrey contend that overdrinking is the third leading cause of deaths globally. Also, Alcohol poisoning and respiratory depressions are life-threatening conditions that are related to overconsumption of alcohol (601). Alcoholism has been blamed the spreading of sexually transmitted infections among the teenagers. Research by Lewis et al. (10) Indicates that most of the youths who indulge in unhealthy sex behaviors while drunk are less likely to use protection during sexual intercourse. Overindulgence in alcohol is another cause of premature pregnancies among the teenagers and the spread of HIV/Aids. Also, an individual who is drunk is more likely to involve himself in deviant behavior like sexual harassment which can lead to spreading of the venereal diseases. Women who are alcoholics are susceptible to more health complications that their male counterparts. Lewis et al. note that the mortality rate among the women who overindulge in alcohol tends to exceed that of men (15).Also; alcoholism has a significant effect on the reproductive health of a woman. Reproduction dysfunction issues like an irregular menstrual cycle and early menopauses are some of the effects of overindulgence of alcohol among women. Excess consumption of alcohol can cause some life-threatening diseases. For instance, those individuals who drink excessively are at a high risk of getting a heart attack. Hematological disorders like anemia are also common among the addicts. This is because most of the alcoholics are poor eaters since overdependence on alcohol makes them lose appetite a condition that can lead to nutrition deficiency diseases. Chronic heavy consumption of alcohol impairs the development of an individual’s brain. Also, some health conditions like dementia, alcoholic polyneuropathy and the shrinking of the brain are among the long-term effects of drinking on the alcoholic’s nervous system. The distortion of the brain chemistry and cognitive disorders due to drinking can cause the disruption of an individual’s memory and learning-related issues. As noted by Roger there is a positive correlation between alcoholism and stroke. Alcohol increases the probability of one to contract stroke by about 50%.Alcoholism causes the impairment of the prospective memory. The impairment of an individual’s cognitive ability enhances the failure of an individual to carry out an intended task thus leading to the postponement to a later date. Carlson highlights that overdrinking reduces the efficiency of an individual at the workplace. Addiction has made many people lose their jobs due to poor performance in the workplace. Depressive disorders are common among people who abuse alcohol and heavy drinkers. Alcoholics are always ashamed of their inability to control the consumption of alcohol a condition that causes stress. The addict is likely to turn to self-medication if he doesn’t get adequate social support. Self-medication may increase the drinking habit since the alcohol which acts as a depressant is used to produce a calming effect to the user. A study by Carlson on people who were hospitalized for suicidal attempts found out that 50% of the victims were alcoholics. In general, people who abuse alcohol are at a higher risk of committing suicide compared to non-drinkers. According to Carlson, chronic drinking impairs the social skills of an individual. This is because excess alcohol causes neurotic effects on the brain. An alcoholic with impaired social skills always has problems with perceiving the facial emotions and humor a fact that a fact that makes alcoholics poor communicators. The alcoholic liver disorder is a critical public health issue. For instance, the US has over two million individuals with alcohol-related diseases. Treatment to some of the diseases like the alcohol hepatitis and liver cirrhosis are limited. In the event of a servers liver disorder, the only viable treatment option is the liver transplant which is too expensive. Excessive drinking of alcohol during pregnancy has immense effects on the development of the fetus. Fetal alcohol syndrome is a common birth defect among children whose mothers abuse alcohol. A study by Carlson reveals that alcohol has small molecules that make it easy to cross the placental barrier. The exposure of alcohol to the fetus leads to damages the brain structure of the unborn baby a fact that may lead to mental retardation in children. Also, mothers who abuse alcohol tends to give birth to underweight children. Alcoholism has a great effect on the children. Johnson and Stone opined that parents who abuse alcohol in any way were likely to cause frightening conditions for their children. This is because most of the children find it hard to understand a shift in personality that is brought by consumption of alcohol (10).Also; parents whose parents drink excessively are more likely to suffer from residual neglect. Children who are brought up in families where parents are chronic drinkers are likely to engage in drinking habits at a younger age. Continued exposure to alcohol can cause addiction. Many teenagers have become victims of sexual abuse since they are lured by unsuspecting adults who takes advantage of their condition. Crime and violence are highly associated with alcoholism in the family. Besides; battering and incest are some of the common phenomena in the families where parents’ abuse alcohol. John argues that almost 35% of the father-daughter incest incidents and about 70% of domestic violence cases are perpetrated by family members who abuses alcohol. Victims of battering and incest usually feel ashamed of themselves (65). This condition can make the victims turn to drinking as a way of escaping the pain. It is imperative to provide a strong psychosocial support to children of the alcoholics. If proper social care is not provided, the children are likely to carry their issues into later life (Belleair 20). Family members of the alcoholic often become codependent.Fernández-Solà define codependency as an unconscious addiction to an abnormal behavior of a loved one. Alcoholics usually have periods when they stop drinking for a short time a fact that makes codependent members of the family believe that the drinking issue can be solved.Besides.The alcoholic codependent family members often strive to hide the drinking problem from strangers so as to preserve the family dignity. The children and the spouse avoid making friends or bringing friends at home. The codependent individuals also tend to forget their personal desires and needs since they devote a considerable amount of time taking care of the alcoholic (Fernández-Solà ). Alcoholism also has a significant effect on the spouse. This is because many spouses sexually develop feelings of self-pity and hatred and avoidance of social contact. Also, excessive drinking shifts the responsibilities of the family from two parents to one of the parents. The non-alcoholic parent is likely to neglect the children since he is overburdened by the family responsibilities. Families whose one of the parents is an alcoholic are often faced with financial issues. Family members are occasionally forced to give up on particular privileges since a substantial amount of money is used for alcohol by one of the parents. Exposure to alcoholism in the family has been attributed to the rise in divorce cases among couples. Alcoholism can cause domestic violence due to misunderstanding among the couples. Children of parents who are alcoholics may develop health issues like depression and impulsive behavior. A study by Laaksonen highlights that these children are likely to abuse drugs so as to hide from their problems. Children of the alcoholics always experience difficulty in establishing strong, healthy relationships with their colleagues. Also, the children are also embarrassed by the condition of the parent a fact that dents their self-image (687). Alcoholism affects all family members from the spouse to the unborn child. The problem of alcoholism has far reaching consequences on not only the physical health of the alcoholic but also on the psychological well-being of the family members. Even if the alcoholic reforms, the family members who were affected by the drinking condition takes a long time to recover since they are always afraid that the alcoholic can go back to his old drinking habit. Despite the fact that alcoholism treatment programs like Alcoholics Anonymous are critical in helping the alcoholic to reduce the dependency, it is imperative to provide psychosocial support to families of the alcoholics so as to enhance their well-being. Also, the government has a responsibility of enacting legislations that ensure that teenagers are not exposed to alcohol until they reach a particular age.

Works Cited

Bellenir, Karen. Alcohol Information for Teens: Health Tips About Alcohol Use, Abuse, and Dependence Including Facts About Alcohol's Effects on Mental and Physical Health, the Consequences of Underage Drinking, and Understanding Alcoholic Family Members. N.p., 2014. Print. Carlson, Corissa. Stress and substance abuse in homeless and matched housed adolescents: A longitudinal model. www.digitalcommons.wayne.edu/ n.d. web. March 8, 2016. Fernández-Solà, J. "SY23-2 alcohol and cardiovascular risk. Harmful effects." Alcohol and Alcoholism 50.suppl 1 (2015): i26.2-i26. Print. John, Bowes. "American Indian Removal beyond the Removal Act." Wicazo Sa Review 1.1 (2014): 65. Print. Johnson, Patrick, and Stone, Rachel. "Parental Alcoholism and Family Functioning: Effects on Differentiation Levels of Young Adults." Alcoholism Treatment Quarterly 27.1 (2009): 3-18. Print. Khaltourina, Daria, and Andrey Korotayev. "Effects of Specific Alcohol Control Policy Measures on Alcohol-Related Mortality in Russia from 1998 to 2013." Alcohol and Alcoholism 50.5 (2015): 588-601. Print. Laaksonen, E., S. Vuoristo-Myllys, A. Koski-Jannes, and H. Alho. "Combining Medical Treatment and CBT in Treating Alcohol-Dependent Patients: Effects on Life Quality and General Well-Being." Alcohol and Alcoholism 48.6 (2013): 687-693. Print. Lewis, Judith A, Robert Q. Dana, and Gregory A. Blevins. Substance Abuse Counseling. Australia: Brooks/Cole Cengage Learning, 2011. Print. Poprawa, Ryszard. "A subjective assessment of the short-term effects of alcohol consumption. Preliminary studies on the Polish language adaptation of “The Biphasic Alcohol Effects Scale”." Alcoholism and Drug Addiction (2015): Print. Roger, Gregoire. The effect on the family. www.alcoholanswers.org/ n.d. web: March 8, 2016.


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How Does Alcohol Affect Family Relationships?

  • Chad Johnson
  • March 15, 2023

Alcohol is one of the most commonly consumed substances around the world, but it’s more than just a beverage . Its effect on people is not limited to their physical and mental health, but also extends to their relationships— particularly with family members. 

Whether it’s an occasional drink or a full-blown addiction, alcohol consumption can have a significant impact on family dynamics. In this week’s blog post, we will explore how alcohol affects family relationships and offer insights into how you can deal with its impact in your own life. 

The Different Types Of Family Relationships

There are many different types of family relationships, and each one can be affected by alcohol in different ways. For example, parents who drink heavily may have a difficult time maintaining a healthy relationship with their children. They may also be more likely to get divorced or have other problems within the family.

Siblings who drink heavily may also have a difficult time getting along. They may fight more often and have a hard time resolving disagreements. Additionally, heavy drinking siblings may put a strain on the relationship between their parents.

spouses who drink heavily may also have difficulty maintaining a healthy romantic relationship. They may argue more often, have communication problems, and be less physically and emotionally intimate with each other. Additionally, heavy drinking spouses are more likely to get divorced .

Finally, grandparents who drink heavily may have difficulty maintaining a healthy relationship with their grandchildren. They may not be able to spend as much time with them, they may not be as involved in their lives, and they may not be able to provide the same level of support and love that they would if they were sober.

The Effects Of Alcohol On Family Relationships

Loving couple has problem in relationship - tranquilshores.org

Most people are aware of the potential negative effects that alcohol can have on individuals, but less is known about how it affects families. Research has shown that drinking can cause problems within families and lead to relationship problems.

Alcohol can cause financial problems for families. It is estimated that alcohol costs the average family $500 per year in increased expenses.

This includes things like medical bills, car repairs, and lost work productivity. Additionally, drinking can lead to domestic violence. In fact, studies have shown that alcohol is a factor in about 50% of all domestic violence incidents.

Children are also affected by their parents’ drinking. They may suffer from anxiety and depression as well as behavioral problems.

They may also be more likely to abuse alcohol themselves when they become adults. They may also have difficulty developing trusting and close relationships with others, and this trauma can last well into adulthood.

If you suspect that your drinking is affecting your family, there are resources available to help you stop. You don’t have to struggle with this problem alone.

Does Alcohol Cause Abuse In Family Relationships

As mentioned before, alcohol abuse can cause all sorts of problems in family relationships. One of the most common problems is domestic violence, another way to say abuse in this context. 

Alcoholics are more likely to become abusive towards their family members, and this can cause a lot of pain and suffering for everyone involved. In some cases, it can even lead to death.

Another way that alcohol affects family relationships is through neglect, another type of abuse. When someone is an alcoholic, they may start to neglect their responsibilities at home.

This can include not taking care of the children or not doing the housework. As a result, the other members of the family may have to pick up the slack, which can lead to a lot of resentment and tension.

How to Deal with Alcoholism In A Family Relationship

If you have a loved one who is struggling with alcoholism, it can be difficult to know how to best support them. You may feel helpless, frustrated, and even angry. It is important to remember that you are not alone and that there are resources available to help you both cope with this disease.

Here are a few tips on how to deal with alcoholism in a family relationship:

Educate yourself about the disease.

The more you understand about alcoholism, the better equipped you will be to deal with it. There are many helpful books and websites that can provide information about the causes, symptoms, and effects of alcoholism.

This knowledge can help you better understand your loved one’s condition and why they may behave in certain ways. It can also give you insight into how best to communicate and support them.

Seek professional help.

If you feel like you are struggling to cope, don’t hesitate to seek professional help. A therapist or counselor can provide guidance on how to best deal with the situation.

They can also offer support and understanding if you are feeling overwhelmed or hopeless. Individual or family therapy may be particularly helpful if there is conflict within the family related to alcoholism.

Attend an Al-Anon meeting.

Al-Anon is a 12-step program for friends and family members of alcoholics. At meetings, attendees share their experiences and offer support to one another. This can help family members cope with the effects on their family, as well as find help for struggling family members. 

Get your family members into treatment. 

This may be the best thing you can do for your loved one: get them into treatment. We offer a wonderful facility right here at Tranquil Shores. 

Find Treatment For A Family Member With Alcoholism 

Alcohol can have a significant negative impact on family relationships, but it doesn’t have to be this way. By understanding how alcohol affects us and our families, we can make better decisions and work towards healthier relationships. 

Talking openly about the issue of alcohol is an important step that can help all members of the family understand their roles in creating healthy relationships with minimal or no use of alcohol.

Ultimately, reducing reliance on alcohol as a coping mechanism or source of entertainment will benefit everyone in the family by strengthening ties and promoting positive communication between members.

And if you believe your family member might be addicted, please give us a call. We can help to get them into effective an alcoholism treatment program as soon as possible. Call us at 727-513-6799 before any more damage is done. 

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Home — Essay Samples — Nursing & Health — Alcohol Abuse — The Impact of Alcohol Abuse: Causes, Effects, and Solutions


The Impact of Alcohol Abuse: Causes, Effects, and Solutions

  • Categories: Alcohol Abuse Health Care Policy Social Justice

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Published: Mar 16, 2024

Words: 483 | Page: 1 | 3 min read

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alcoholism affects family essay

How Does Addiction Affect Families Essay

The proposed paper will revolve around the problem of addiction and its impact on families, their functioning, relations between members, and children. At the same time, the importance of emotional support and empathy in families in treating individuals with this problem and reducing the number of relapses is also outlined. In this regard, the following thesis will be offered:

Addiction has multiple adverse effects on families and all members preconditioning deterioration of relations and high risk of the development of abuse among children, while emotional support and empathy can help to decrease the number of relapses and help to treat patients.

To prove the given statement and provide credible evidence, peer-reviewed articles will be used as the central source of information. It will guarantee the relevance of findings and their practical utility. The presented work will offer a detailed analysis of the problem, along with its discussion.


Family is a basic institution of society as it guarantees its functioning and evolution. For this reason, there is much attention devoted to the peculiarities of this unit and factors that have both negative and positive effects on it. The sober fact is that the health of all members of the family is a key aspect of the improvement of relations between all individuals belonging to it and the evolution of this institution. At the same time, some stressors or undesired behaviors might have a pernicious impact on families and all their members. For this reason, it is essential to assess all possible factors related to the functioning of households with the pivotal aim to determine their effects and offer ways to avoid undesired consequences, and establish a paradigm that will foster the evolution of this unit. Addiction can be related to the factors mentioned above, as its negative effects are apparent today. In this regard, the paper will delve into the problem of substance abuse and its influence on families.

The problem of addiction remains one of the major concerns for the modern healthcare sector. The threatening statistics demonstrate the growing number of adults and children who engage in these undesired behaviors and acquire different kinds of issues related to the adverse effects of substances on mental and physical health (Atadokht, Hajloo, Karimi, & Narimani, 2015). Regarding the selected topic, multiple researchers admit the existence of various threats for families where parents or children have addictive behaviors.

They include deterioration of relations, the appearance of health concerns, acquisition of new addictive behaviors. At the same time, there is a solid body of evidence showing the emotional support provided by individuals within a household can have a significant impact on the reduction in the number of relapses and better recovery processes. With this in mind, it is the following research paper will encompass knowledge related to the issue and outline the most critical assumptions and findings related to the effect of substance addiction on families.

Importance of Family Support

Addiction might have multiple effects on the emotional state of families and trigger different responses among their members. Moreover, in a high number of cases, abuse can be promoted by responses from close people. The results of studies show that there is a significant positive correlation between the frequency of relapse and tolerance, negative attitude, emotional response, and expressed emotion (Atadokht et al., 2015).

It means that individuals with addiction introduce specific changes in the structure of existing relations and precondition the emergence of various alterations in their reactions. At the same time, this factor remains an important component of the given problem as the decrease of perceived social support from family, or close people is linked to the increase of relapse probability (Atadokht et al., 2015). In this regard, addiction affects families by triggering various types of responses, and their character, either positive or negative, influences the frequency of new cases, which is vital for treatment and recovery.

Negative Attitudes

Today, addiction is recognized as a disease presupposing a significant impact of biological, social, and psychological factors on the health and behavior of an individual. It means that the given state should be considered an illness and treated appropriately, which presupposes specific changes in attitudes and mentalities. Unfortunately, addiction might also affect family members in undesired ways by triggering the appearance of negative emotions related to a person who has this problem. The given alteration in relations might precondition the increase in the number of new cases and severer reactions.

Moreover, the success of treatment depends on the support provided by close people, and negative moods and attitudes will reduce the change for complete recovery (Atadokht et al., 2015). It is one of the problems that can be seen in households with a person who has this health issue. The frequency of this sort of reaction remains high, which means that substance abuse can be considered a facilitator of negative emotions in families.

Adolescent Addiction

Speaking about addiction among adolescents, its effects on family might also be severe. There is still limited research related to the effects of substance dependence among teens on parenting and family function, which introduces the need for additional investigation (Choate, 2015). However, the existing evidence shows the critical deterioration of relations between a young person and parents preconditioned by the appearance of the problem and its development.

The adverse effects might include the lack of understanding between family members, increased frequency of conflicts, absence of trust, and detachment between parents and their children. Studies also show that children have fewer chances to adapt their behaviors and engage in cooperation (Choate, 2015). Under these conditions, the opposition of young and adult family members should be resolved with the help of emotional support and tolerant attitudes vital for adolescents in such period of his/her life.

Negative Impact of Parents’ Addiction on Children

There are also multiple studies demonstrating the appearance of numerous harmful effects of addicted parents on their children. First of all, in many families with an adult who has abusive behaviors, cases of violence are reported (Hernandez, Rodriguez, & Spirito, 2016). Being unable to control their actions, parents might beat their children and injure them. Additionally, because of the decreased attention to their problems and the lack of time, the overall functioning of children, their socialization, communication with peers, and schooling also suffer (Hernandez et al., 2016).

In many cases, young members of the family can be ashamed of their adults because of the existence of mainly negative attitudes to addicted people in societies (Sakiyama et al., 2015). Under these conditions, the lack of emotional support, emerging problems in communication aggravated by the lack of money, and constant conflicts create the basis for the appearance of a high risk of undesired behaviors among children and difficulties with their socialization.

Predisposition Among Children

Among the effects addiction might have on families, the emergence of predisposition to substance abuse among children should be considered one of the most undesired ones. In the traditional approach, a nuclear family (with mother and father) is viewed as a barrier to the appearance and development of addictions as they provide the needed emotional support and tolerance to their children (Ewing et al., 2015). However, the alteration in this pattern and the emergence of an addictive parent increases the change of the development of substance abuse among children significantly (Smith & Wilson, 2016).

The lack of resilience and empathy causes substance abuse among children, and their intention to use drugs (Velleman & Templeton, 2016). This negative impact becomes one of the most problematic aspects of the problem of addiction in families, and it contributes to the appearance of risk groups with similar characteristics and chances to become addicted.

Addiction and School Performance

A significant deterioration of children’s academic successes and their inability to reach the usual school performance level are other possible effects of addiction on the functioning of families and their members. Parental substance use negatively affects adolescent’s learning activities and their ability to succeed in educational establishments (Gifford, Sloan, Eldred, & Evans, 2015). Because of the lack of attention and interest among adults, children become less motivated to do their best and accomplish various tasks. Moreover, conflicts in families, financial issues, and violent behaviors might also limit their opportunities to succeed (Gifford et al., 2015).

At the same time, research shows that positive emotions, support, empathy, and treatment provided to a family member who has this sort of problem might help to improve the academic performance of a child and guarantee his/her ability to learn (Gifford et al., 2015). For this reason, this negative effect should be considered when cogitating about the topic.

Mothers’ Addiction Impact on Families

Analyzing the problem, the negative impact of the mother’s addiction on families and children should be discussed. Being critically important for a child, especially during the first years of his/her life, a woman plays a vital role in the formation of appropriate behavioral patterns, responses, and actions. For this reason, researchers admit the existence of a strong correlation between maternal addiction and the functioning of children, their development stages, and the ability to succeed in various activities (Schuman et al., 2017).

At the same time, women with abusive behaviors are expected to have problems with their husbands or partners because of the appearance of misunderstandings and conflicts preconditioned by this factor (Schuman et al., 2017). Only in rare cases, the emotional support and appropriate attitudes contribute to the better resolution of the problem and recovery. For this reason, this issue should be investigated to propose practical solutions that can be used to manage the pernicious impact of addiction among mothers.

Maternal Behavior

The existing research also shows the appearance of serious alterations in maternal behavioral patterns among addicted mothers. In healthy women, the views of their babies’ faces trigger a strong reaction that is considered a part of their motherly instinct; however, mothers with addictions demonstrate a pattern of decreased activation in dopamine and oxytocin-innervated brain regions, which means that the strength of their responses is weaker (Kim et al., 2017).

It is a threatening sign proving the appearance of physiological changes in the functioning of women’s bodies under the impact of addiction and deterioration of their maternal function, which might have a pernicious effect on the life of families. At the same time, the quality of responses to older children also alters, and mothers become less emotional and emphatic (Kim et al., 2017). In the long-term perspective, it might trigger undesired behaviors among adolescents and their inability to succeed.

Parental Involvement

Finally, the existing evidence shows that addiction might harm parental involvement. Under statistics, adults who use drugs or alcohol have a decreased level of interest for their children and the situation in the family (Hernandez et al., 2016). It comes from the appearance of the psychological and physiological dependence on substances and the need for their constant use (Hernandez et al., 2016). However, from the perspective of the family, it causes a destructive impact on relations and the ability to evolve. A partner and children will suffer from the lack of participation and deteriorated behavioral patterns, which might destroy this institution.

Altogether, the problem of substance addiction and its impact on families remain topical as multiple effects should be discussed. The paper offers the most significant aspects that should be analyzed because of their critical significance for households. Parents and children might suffer from the deterioration of relations between them, the lack of trust, or interest. At the same time, positive emotions, support, and assistance are critical elements of successful recovery and rehabilitation. For this reason, it is recommended to continue the investigation of this topic to find additional data related to it.

Atadokht, A., Hajloo, N., Karimi, M., & Narimani, M. (2015). The role of family expressed emotion and perceived social support in predicting addiction relapse. International Journal of High Risk Behaviors & Addiction , 4 (1), 1-5.

Choate, P. W. (2015). Adolescent alcoholism and drug addiction: The experience of parents. Behavioral Sciences , 5 (4), 461-476.

Ewing, B. A., Osilla, K. C., Pedersen, E. R., Hunter, S. B., Miles, J. N., & D’Amico, E. J. (2015). Longitudinal family effects on substance use among an at-risk adolescent sample. Addictive Behaviors , 41 , 185-191.

Gifford, E., Sloan, F., Eldred, L., & Evans, K. (2015). Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children’s school performance. American Journal of Orthopsychiatry, 85 (5), 452-468. Web.

Hernandez, L., Rodriguez, A., & Spirito, A. (2016). Brief family based intervention for substance abusing adolescents. Child and Adolescent Psychiatric Clinics of North America, 24 (3), 585-599. Web.

Kim, S., Iyenhar, U., Mayes, L., Potenza, M., Rutherford, H., & Starhearn, L. (2017). Mothers with substance addictions show reduced reward responses when viewing their own infant’s face. Human Brain Mapping, 38 (11), 4521-5439. Web.

Sakiyama, H. M., Padin, M. D. F. R., Canfield, M., Laranjeira, R., & Mitsuhiro, S. S. (2015). Family members affected by a relative’s substance misuse looking for social support: Who are they? Drug and Alcohol Dependence , 147 , 276-279.

Schuman, N., DeCoste, C., McMahon, T., Dalton, R., Mayes, L., & Borelly, J. (2017). Mothering from the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment. Development and Psychopathology, 29 (2), 617-636. Web.

Smith, V. C., & Wilson, C. R. (2016). Families affected by parental substance use. Paediatrics , 138 (2), 1-13.

Velleman, R., & Templeton, L. J. (2016). Impact of parents’ substance misuse on children: An update. Psych Advances , 22 (2), 108-117.

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