Alcohol and Families

Following our article last month on alcoholism, our good reader Lynn pointed out that we had missed an important dimension of that issue, family relationships and alcohol.  This is, in fact, a multi-dimensional dimension and well worth our attention.

Basic, Readable Information on Alcohol

Before we move into that, we do want to give you a couple of helpful links to general information about drinking and alcohol problems.

We buried a reference in our previous piece to a treatment guide from the National Institute on Alcohol Abuse and Alcoholism.  It is clearly written and meant give basic information about recognizing the extent of a drinking problem and the various ways to seek help.  It's called "Treatment for Alcohol Problems: Finding and Getting Help".  Find the guide here:  http://pubs.niaaa.nih.gov/publications/Treatment/treatment.htm .  You can read it online or download a print "pdf" version.

Also we came across another NIAAA brochure on drinking itself, "Rethinking Drinking: Alcohol and Your Health".  Very basic stuff on quantities, calorie counts, even an "alcohol budget", that is, the amount of weekly spending.  And resources if you decide you have a problem you need help with.  Find this guide here:  http://rethinkingdrinking.niaaa.nih.gov/ .

Now to our topic at hand on families.  You may have noticed in our previous article that the symptoms of an alcohol use disorder ("AUD") are not necessarily physical.  They also include mental or emotional conditions, such as depression, trouble with concentration on work, school or other activities, a need to drink more to achieve the same pleasurable feeling, forgoing other pleasurable activities in order to have time to drink more, and so on.

With issues like these resulting from excessive alcohol consumption, it would come as no surprise that family relationships and friendships face extra complications when drinking is involved.  Two kinds of reactions take place among other people in a home or with close relatives who have AUDs.  First, those people have greater probability of incurring an AUD themselves, and second, they also have emotional challenges getting along with family members and with associates outside the family.

Alcoholism Increases Children's Likelihood of Drinking

To begin, here are some numbers.  In the 2001-2002 NIAAA survey we cited last time, a surprising number, 52%, of the total adult population had some family history of alcohol use disorders.  This includes the immediate family as well as grandparents and aunts and uncles.  The chances an individual in a particular family will develop an AUD themselves depend on how extensive the alcoholism already is in the family.   When there is no family history of alcoholism, someone's chances of having had a drinking problem in the last year are just 9%.  But if any close relatives experience alcoholism, the chances go to 16%, that is, nearly twice as high.  Further, if a parent is an alcoholic, chances a child will be one are 19%.  We do caution that various surveys give various results on these numbers; we chose this one because the number of people surveyed was so very large; 43,093 people actually participated.  And the question here pertains only to the last year before the survey; the results would be higher if a total lifetime were considered.  The point is that the frequency of alcoholism is remarkably affected by alcoholic situations already in the family.

One specific chain of causation we explored is the age at which the young people in a household begin to drink.  If there's no family history of AUD, the median age at which someone begins to drink is around 19 years.  But if there's any family history, this drops by at least a year or perhaps two to 17 or a bit younger.  The public data we found aren't precise enough to be more specific.  But what is clear is that the younger someone begins to drink, the greater are the prospects that they will themselves have AUD and/or various psychological conditions.  If someone started drinking at ages 18 to 20, chances they have an AUD are just under 11%.  But if they started drinking in the 15 to 17-year age range, this doubles to 22%.  So drinking problems in a family reduce the age at which the children begin to drink and that increases the chances that they will at some point develop their own alcohol issues.

Psychological Problems from Alcoholism in Your Family

Reader Lynn comments that a family history of alcoholism is really difficult for a child, and professional research backs this up.  Besides the drinking tendency itself, Lynn points out that many children of alcoholics are subject to any number of emotional and psychological conditions.  They never learn good coping skills for facing ordinary life situations because they don't face life in an ordinary way.

As Lynn's comments and a handy summary from a professional association explain, a number of detrimental factors come into play:  daily routines are shuffled constantly, children feel guilt, anxiety, embarrassment, confusion, anger and depression.  They don't know how to build close relationships with other people, much less raise children of their own in a constructive way.  They might fail in school, commit various delinquent acts and take huge risks, because they simply don't know basic ways to live positively.  And, of course, as we have already alluded, the coping mechanism they do learn is drinking or drug abuse, which they tend to fall back on much more than the population as a whole.  See "Facts for Families: No. 17 Children of Alcoholics" from the American Academy of Child & Adolescent Psychiatry; go here:  http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-Of-Alcoholics-017.aspx.

Support Groups for Families 

This is all tough stuff.  It's important for people to know they're not alone in dealing with these situations; the support of others who grapple with these issues is helpful, as well as professional care.  Alcoholics themselves can, of course, go to Alcoholics Anonymous.  For family members, whom we emphasize here, there are two groups we know of and call to your attention: Al-Anon and ACoA.  Al-Anon – and its partner, Alateen – is specifically intended for "families and friends of problem drinkers", to quote the website, http://www.al-anon.org/.  Meetings, sponsor relationships and literature all work to ease the tension family members and good friends feel when constantly surrounded by the alcohol issue.

"ACoA" stands for Adult Children of Alcoholics, found at www.adultchildren.org.   This organization is also based on the "12 Steps" and includes, literally, adult children:  people who are now adults out in the world and who grew up in families where there were alcohol problems, or similar issues that cause dysfunction.  While we had heard of ACoA, it is another resource offered to us by Reader Lynn.  She highlights again that these people have grown up without developing constructive approaches to problem solving; ACoA gives them a chance to talk to others who must now also feel their way forward against the same background.  These groups are a huge help.  Both websites help you locate meetings in your own vicinity.

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That big survey of alcohol use is the National Epidemiologic Survey on Alcohol and Related Conditions ("NESARC").  Find an introduction on the website of the National Institute on Alcohol Abuse and Alcoholism:  http://pubs.niaaa.nih.gov/publications/arh29-2/74-78.htm .  Extensive data tables are available and much scholarly work has examined many facets of the survey.  Many of the same people were re-interviewed three years later, giving some notions of changes in their habits.  And then a whole new survey was done in 2012-13, which those results just now beginning to be published.

The federal government is hardly the only party to conduct surveys about this issue.  Reader Lynn recommends a piece with the striking title, "This surprising factor can make people 4,600 percent more prone to addiction".  It's from the "Raw Story" website, found here:  http://www.rawstory.com/2015/05/this-surprising-factor-can-make-people-4600-percent-more-prone-to-addiction/, and talks – logically enough these days – about Whitney Houston and her daughter Bobbi Kristina Brown.  The survey work described there, known as Adverse Childhood Experiences ("ACE"), is by Kaiser Permanente in California; they initially talked to 17,000 people just in the San Diego area alone.  ACE work is now done in many state government surveys of drug problems, as well as alcohol.