Addiction in the family

Introduction

Through scientific advances, drug use has been conceptualized through different theoretical lenses. One theory deals with systems-level functioning and the role of family. Drug addiction is commonly defined as a compulsive need for and use of a habit-forming substance with the essential features of tolerance and physiological symptoms upon withdrawal. The consequences of drug addiction in the family are well documented. Not only are the substance-abusing individual's physical health, emotional well-being, and social functioning affected, but family members often also experience stress-related physical and psychological effects such as family disruption, marital discord, interpersonal conflict, financial problems, domestic violence, and child maltreatment. In this entry, the causes and correlates, assessment, and treatment of drug addiction in the family are addressed. Given the magnitude and complexity of this topic, it is important for future clinicians to have an understanding of how family environments contribute to drug addiction and treatment.

What Causes Addiction?

Research reveals multiple, interacting factors contributing to the development and maintenance of drug addiction. Just as the risk and protective framework has revolutionized prevention and treatment in medical specialties such as heart disease and AIDS, this framework has also greatly influenced the drug addiction field.

Among the various risk and protective factors researchers have identified, familial factors affect drug use in a number of ways: distant and inconsistent parenting; negative parent-child communication; unclear family rules/expectations regarding a teen's alcohol or drug use; poor parental monitoring; or a chaotic family environment. Other intrapersonal and contextual risk factors include genetic predispositions, antisocial behavior, early first use of drugs, anxiety or depression, associating with deviant peers, and low socioeconomic status. Risk factors are offset by the presence of protective factors: The more protective factors there are, the less likely is the chance of addiction.

There are numerous familial protective factors, including a caring and involved family demonstrating positive parent-child relationships, and appropriate and consistent discipline methods and supervision. Intrapersonal and contextual protective factors include healthy self-esteem, intelligence, a positive school attitude, and academic success. Advances in understanding risk and protective factors have served to further develop effective treatment strategies, which has led to a greater importance being placed on family.

The role that families play in the development, maintenance, and recovery from drug addiction cannot be underestimated. Family factors influence the onset of drug use and can exacerbate it. However, family factors are not to blame for all problems, as youth from all sorts of families can develop serious drug addiction problems.

Regardless of the parents' role in the development of their teen's drug problem, with a skillful clinician's help, parents are key to the solution. Family factors, including parental influence and a positive parent-child relationship and family environment, are among the strongest protective influences against drug taking. These findings have led to the increasing number of policy recommendations and practices involving family in the treatment for drug addiction.

Alcoholism

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