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February 14, 2019

Alcoholic Effects on the Family

Alcoholism has a notoriously destructive impact on the family unit.  According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately 10 percent of US children currently live with an alcoholic parent. The institute further reports that of the approximately 15 million US adults struggling with alcohol use disorder (AUD), less than eight percent receive professional treatment.

Alcoholic households are characterized by volatility and dysfunction, and relatives and children suffer greatly as a result. Children who are exposed to alcoholism experience a heightened risk of developing mental health disorders and psychological instability, and the negative impact of the disease is frequently multigenerational and deeply scarring.  Alcoholism destroys families, ruins reputations, prevents successful parenting, and produces lasting social, medical, professional, and legal consequences.

CAUSES OF ALCOHOLISM

The causes of alcoholism are multifactorial. For many people, a strong family history of multigenerational alcoholism—or substance abuse—is the primary cause. In others, trauma, emotional distress, personal and professional obligations, or pre-existing mental health disorders create a climate ripe for escapism and indulgence. And frequently, all of these factors converge to form a greater susceptibility. But regardless of the underlying cause, one thing remains certain—people who drink excessively do so in order to anesthetize negative emotions. Unfortunately, this is never the end result.

MARITAL DISCORD

Alcohol can—and does—literally destroy marriages in a myriad of ways. For example, drinking erodes trust, incites conflicts, and imperils physical and mental health. It can also cause infidelity, unplanned pregnancy, hostile separation, and ultimately divorce. According to the National Council on Alcoholism and Drug Dependence (NCADD), approximately 60 to 70 percent of all physical altercations between married couples are alcohol-fueled. 

In many alcoholics, neglecting personal and professional responsibilities becomes inevitable as a result of impaired cognition. Legal issues such as DUI’s, DWI’s, disorderly conduct, and assault charges are common hallmarks associated with alcoholism, yet many alcoholics continue to drink irresponsibly even after becoming the recipients of such life-altering consequences. Undoubtedly, alcoholism inspires a litany of maladaptive coping mechanisms, turning partners into caregivers and grown adults into children. This toxic co-dependency is mutually damaging and eventually topples the foundation of trust in any relationship.

FINANCIAL ISSUES

Alcohol is notoriously expensive despite its relative cheapness compared to many illicit drugs. Yet a full-blown alcoholic can easily incur financial debt due to immoderation or squander critical savings. Even in the best of cases—when high-functioning alcoholics somehow manage to hold onto savings—they cause simmering resentment with family members and partners as a result of their costly, destructive, and selfish habit. Loss of inhibition can result in unnecessary purchases and job productivity suffers greatly as a result of chronic abuse due to absenteeism.

Health problems associated with alcoholism such as cirrhosis, pneumonia, cardiovascular disease, hepatitis, pancreatitis, and various forms of cancer are as lethal as they are financially devastating, and become a long-term financial burden. In some cases, they may even cause bankruptcy, divorce, or interminable debt.

EFFECT ON CHILDREN

Family members of alcoholics frequently feel—or express—a desire to help but are rendered helpless by the deeply entrenched patterns of denial, minimization, and avoidance exhibited by their loved one. Children, in particular, may be emotionally devastated by their parent’s alcoholism yet unable to help them stop drinking. According to the American Academy of Child and Adolescent Psychiatry (AACAPP), approximately 20 percent of all adults lived with an alcoholic, creating a greater likelihood of emotional problems compared to those who were raised in sober environments. It also exponentially increases their future chances of alcohol abuse—creating a vicious and difficult-to-heal cycle. 

FACING THE PROBLEM

When confronting a family member’s alcoholism—never do so when they are drinking or appear intoxicated. Evidence shows that such an approach is unlikely to help, and may meet with a hostile reaction. Free will is another factor that must be considered, as we can never force someone to stop drinking against their own will.  Some suggestions for effectively talking to an alcoholic family member include:

  • Plan a time to talk to your family member when you know that there will be no distractions, interruptions, or additional stressors.
  • Never argue with them. Heated discussions can easily lead to physical altercations and/or verbal abuse
  • Speak in a gentle, concerned, and sympathetic manner.
  • Have information available about alcoholism, treatment programs, and possible support systems.
  • Never remain stuck in an abusive situation. If you are experiencing physical, emotional, or sexual violence fueled by a family member’s alcoholism, seek professional help or leave the home after making plans to stay with friends or relatives.
  • Try using “I” statements when expressing how you feel about their drinking rather than “you” statements which automatically puts them on the defensive.
  • If they aren’t receptive to treatment, never force the issue. You have initiated the discussion, which is the most difficult part, and can readdress it at a later date once they have had time to consider was said.
  • Never enable or make excuses for your family member. Learn to set firm, yet reasonable, boundaries with them.
  • Never resort to alcohol or drugs as a coping mechanism when dealing with the situation—especially since having an alcoholic parent is a known trigger for later life substance abuse. Instead, reach out to friends, extended family members, or other forms of support in order to help process your feelings.

INTERVENTONISTS

Alcoholism is a chronic, relapsing disease characterized by toxic emotions and maladaptive behaviors. Although an alcoholic family member may occasionally be receptive to hearing the expressed concerns of a loved one, they will more likely display resentment at any mention of their “problem.” In some cases, the help of a professional interventionist may be required in order to successfully penetrate a loved one’s defense mechanisms. Unlike concerned family members and friends, professional interventionists are not emotionally invested in the relationship to the same extent and have a far greater degree of objectivity—a fact that gives them a significant advantage when dealing with even the most stubborn cases of denial. Additionally, their polished verbal and clinical skills may prove to be the deciding factor between success and failure in a critical situation.

PROFESSIONAL TREATMENT OPTIONS

For those family members who succeed in helping their loved one seek professional treatment, a methodical approach much be taken. Regardless of the stage of alcoholism, optimal treatment begins with admission into a medically managed detox program. Detox is considered a critical, short-term process (less than a week in most cases) designed to safely remove the harmful effects of alcohol from the system, and forms the foundation of successful future treatment. Detox also helps prevent unnecessary–and potentially deadly—complications as clients regain mental, physical, and psychological stability.

Upon successful completion of detox, evidence-based practice shows that clients benefit most from inpatient—or residential—treatment. Residential treatment programs usually last between 30 and 90 days, during which time clients live at a designated facility.  As part of their treatment protocol, clients receive round-the-clock clinical supervision and intensive medical care.

Medication-assisted treatment (MAT) is considered the cornerstone of residential treatment and describes the use of pharmacological interventions in tandem with psychotherapy. Individual client needs dictate the therapeutic modalities chosen for the course of treatment, as well as the physician-prescribed medications used to treat alcoholism. Additional medications may also be prescribed as needed to treat co-occurring mental health disorders such as Generalized Anxiety Disorder (GAD) or major depressive disorder (MDD)—both of which are regularly observed in those suffering from alcoholism.

Although many families are thrilled to see their loved one successfully discharged from a residential treatment program, further treatment is needed to ensure optimal outcomes and prevent future relapse. For some clients, outpatient treatment, or intensive outpatient treatment, is the next logical step. These treatment options are less intensive and allow a greater degree of flexibility for clients with demanding personal and professional schedules. They are also ideal for purposes of transitional care and longer-term maintenance therapy. Beyond these continuing care options, clients suffering from alcoholism will also need to commit to the following:    

  • Involvement in Alcoholics Anonymous (AA)
  • Continuing medication management
  • A working relationship with a sponsor
  • Life and jobs skills coaching—if necessary
  • Sober peer support and community involvement
  • Healthy diet, physical activity, and responsible lifestyle decisions
  • One-on-one, group therapy, and family therapy
  • Avoidance of social and environmental triggers

If your parent or family member is suffering from alcoholism or displaying warning signs, call a substance abuse professional today. Alcoholism is an extremely serious, life-threatening disease that requires professional medical treatment and behavioral management. Early intervention is critical to successful long-term outcomes. Never resort to self-guided treatment or at-home detox, as both can lead to serious complications and potentially fatal consequences.

And remember, alcoholism knows no personal, social, political, religious or economic boundaries. Anyone, at any time, can progress from recreational alcohol consumption into full- blown addiction and find themselves in need of professional help.

For more about alcoholism and recovery, check out these related articles:

Sources:

Foundation for Alcohol Research and Education. The hidden harm: Alcohol’s impact on children and families. Feb, 2015.

Health Affairs. The Economics of Alcohol Abuse and Alcohol Control Policies. March, 2002.

US National Library of Medicine National Health Institutes. The impact of family environment on the development of alcohol dependence.  Sept, 2013.

Journal of Hepatology. Managing excessive alcohol consumption at a population level: The earlier the better. March, 2018.

Journal of the American Medical Association (JAMA). Alcohol Abuse and Alcoholism. May, 2006.

The Journal of Neuroscience. Behavioral Neurobiology of Alcohol Addiction: Recent Advances and Challenges. May, 2002.

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