What are some of the ways alcohol abuse impacts families and family members? And in turn, are there ways families/family members impact alcohol abuse?
Alcohol abuse can impact family functioning in a number of different ways.
Routines
A likely consequence of problem drinking is that the drinker’s behavior becomes unpredictable, and naturally this makes it very difficult for the family as a whole to plan anything in advance or to stick to familiar routines. Will they be okay to pick up the kids from school? What time will they come home, and in what state? This sort of constant uncertainty can be highly disruptive, and it helps to explain a commonly found paradox in the families of problem drinkers: that while the problem drinker may be withdrawing from the family by no longer playing the role within it that they did previously, they nonetheless appear to dominate it.
Roles
Alcohol misuse tends to change the roles played by family members in relation to one another, and to the outside world. Most families operate some form of division of labor – one person managing the family’s finances, the other doing more work in supervising the children, one doing the gardening, the other doing more of the cooking, and so on. But as one member of the family develops more of a drinking problem, the other members are likely to find themselves having to take over parts or all of that person’s role themselves. Eventually, one member may be performing all the roles – finances, disciplining, shopping, cleaning, household management, and so on.
Communication
Another area of family functioning which is often affected by alcohol and alcohol misuse relates to the kind of communications that takes place between family members. It may be that the partner with the problem refuses to talk about it, even though it is clearly beginning to dominate his or her, and the family’s, life. Or again, alcohol can itself become the main topic of conversation – has they been drinking again, if so how much and with what effect, who is going to help the individual or the family manage the consequences of the family member’s drinking?
Social Isolation
Many people who have a parent or partner with a drinking problem find talking about it to others to be extraordinarily difficult. The problem is often simply seen as being too shameful to admit. As a result of their reluctance to discuss or expose their situation to the outside world, the family tends to withdraw into itself. The degree of social embarrassment and unpredictability associated with drinking problems constrains family members from extending invitations to others to visit the family home, accepting invitations to visit someone else’s home or other social gatherings. The family thus tends to become increasingly socially isolated.
Are there ways members of a family are impacted by alcohol abuse differently? How are siblings impacted by alcohol abuse? Parents? Children? Spouses?
Evidence indicates that children in families where at least one parent misuses alcohol are more likely to experience the following:
Friendship difficulties (social isolation)
As they cannot predict how things will be at home, the presence, mood and behavior of their parents, children from these families will avoid inviting friends over to their home. In turn this makes it hard to accept invitations to friends’ houses and the child may avoid developing and or deepening friendships for these types of reasons.
Division between home and peers (avoidance)
As a child grows older they may deal with the problem by keeping their home and their social life very separate. This strategy may allow a child to have a social life and develop a life away from the family, but carries its own difficulties and stresses and is likely to mean that parents will know even less about the child’s non-home life. Other ways to think about how addiction impacts family members differently is to consider the differences between how functional families operate versus families impacted by addiction. Some basic characteristics or rules of a healthy family system:
- Self worth is high.
- Communication is direct, clear, specific and honest and feelings are expressed.
- Rules and boundaries are flexible, clear and consistent.
- It is natural to be connected and open to community beyond the family.
- Each person has goals and plans for themselves that are understood and supported by the family.
Characteristics or Rules in a dependent or addicted family:
- Family member’s use of substance(s) is the most important thing in a family life.
- Family members engage in blaming others, avoiding mention of substance use, covering up, creating alibis. Loyalty to the family is demonstrated by keeping the secret of addiction and its impact. This means the family enables the addict.
- No one may discuss the problem outside the family.
- No one says what they feel or think.
- Different family members can take on different roles in order to help the family manage and organize around the addict/addiction. Examples include; the Hero, the Scapegoat, the Mascot, the Lost Child, the Enabler, the Addict.
What are a few of the main things people should understand about alcohol use and/or abuse? Are there any myths and/or misunderstandings?
I think one of the main myths that is being appropriately challenged these days is the idea that alcoholism or substance misuse/addiction is a moral failing or lack of willpower on the part of the drinker or user. It is clear that addiction is a disease; chronic and treatable. Substance use disorders change the way the brain works, resulting in compulsive behavior focused on drug seeking and use, despite sometimes devastating consequences—the essence of addiction. We are starting to look at addiction treatment the way we would look at treatment for other chronic diseases such as heart disease or cancer. When folks get diagnosed with these diseases, we do not shame them or withhold treatment until they “prove” they are ready the way we have done with individuals who seek treatment for substance use disorders. When cancer returns, we don’t punish the person for “relapsing,” we offer them continued treatment.
Substance use disorder can be looked as a kind of coping mechanism; an unsustainable, maladaptive coping mechanism, but not something that people engage in because they are weak, ignorant or selfish. I don’t know a single client who sought help in changing their relationship with drugs or alcohol who wasn’t trying to manage pain, mitigate shame or lack self-esteem with their substance use.
Another myth I think we could dispel further is the concept of an addict needing to hit “rock bottom” before they are receptive to any form of treatment. Assuming someone isn’t ready for treatment because they have yet hit their rock bottom assumes we know what their rock bottom looks like. This myth also assumes that we just need to wait until that rock bottom event happens before we step in to help. I think there are ways to intervene much earlier in the progression of addiction where a better outcome is possible than if we watch and wait for the “rock bottom.” Another way to think about this “raising the bottom.”
How can families, couples, and/or individuals better manage their relationship to alcohol? Are there ways to drink healthily? Are there warning signs to look for? Behaviors/patterns to change before they turn into a larger problem or issue?
For Couples: The number one tip I would offer is to notice your own relationship to alcohol. Think about it and talk about it with your partner. Talk to one another about any specific concerns you have with your own or with your partner’s drinking. It starts with conversation. Say: “I’ve noticed changes in your behavior lately that concern me. I want to understand what’s going on.” Hang in there with patience. Take a break if you notice yourself becoming upset or overwhelmed. Prompt with gentle questions and comments. Think “I am being curious, not critical.”
For Parents of Teenagers: During your conversations, listen with an open mind to what they say. Be curious about their ideas. Say “Tell me more” before you offer a rebuttal to something you hear that you don’t like. You want to get them talking, sharing their thoughts on this challenging topic; you need to know what’s in their minds if you’re going to be able to respond meaningfully.
If your child says that weekend drinking in high school is normal and that everyone does it, you can say: “I know that it seems like everyone at school is drinking on the weekends and that you might feel left out. Or that you need to drink to be accepted. Nevertheless, my expectation is that you will not drink. You will be surprised at how accepting your peers will be if you demonstrate an ability to think and act for yourself.”
Make clear, many times and over many conversations, that your expectation is that they will not drink. Walk the talk by not leaving them and their friends alone in the house with access to alcohol. Don’t offer them a drink at your family dinner table. Resist the temptation to extend them wiggle room around this, i.e. “okay, one drink only”. Remember that you are not your kids’ friend, trying to earn likeability points. Let them be angry with you if they must. The firmer your stand, the less comfortable they might feel about giving alcohol a try, and that might slow them down (or prevent them from drinking in the first place).
Be clear about consequences if they do drink, consequences tailored to what you know they value. For example, if driving is important to your teen, determine what amount of driving would be curtailed for each infraction. Cell phones can be temporarily shut down; curfews can be imposed. Discuss consequences as a family now, before a first infraction.
Finally, discuss laws about underage drinking (illegal for anyone under the age of 21) and arm yourself with specific knowledge about the consequences their school levies when students are caught drinking on campus or at school activities (football games, dances, etc.)
Don’t soft-peddle the message. The stakes are too high.
Most 6-year-olds know that alcohol is for adults only. But once they hit the tween years (9 to 12) and beyond, many are willing to give it a try. That’s why it’s never too early to talk with youngsters about the dangers of underage drinking. (Studies show that teens say they rely on adults in their lives to help them make tough decisions. That’s our cue to step in.)
Find multiple opportunities, woven into casual conversations, to let your kids know that early alcohol use can:
- Harm the brain’s development, and the ability to think clearly.
- Cause lasting damage to the liver and heart.
- Increase the likelihood of anxiety and depression.*
- Increase the likelihood of being involved in physical violence or auto accidents.**
- Increase the risk of developing alcoholism as an adult, and experimenting with drugs as a youngster.
There are ways to drink healthily. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that “low-risk drinking” for men is no more than four drinks on any given day AND no more than fourteen drinks in a given week. For women to be considered low-risk drinker, she doesn’t drink more than three drinks on any given day AND not more than seven drinks in any week.
Low-risk drinking does not mean “no-risk.”
A few mild symptoms — which you might not see as trouble signs — can signal the start of a drinking problem. It helps to know the signs so you can make a change early. If heavy drinking continues, then over time, the number and severity of symptoms can grow and add up to an “alcohol use disorder.” Doctors diagnose an alcohol use disorder, generally known as alcohol abuse or alcoholism, when a patient’s drinking causes distress or harm. See if you recognize any of these symptoms in yourself. And don’t worry — even if you have symptoms, you can take steps to reduce your risks.
In the past year, have you:
- had times when you ended up drinking more, or longer, than you intended?
- more than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- more than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- spent a lot of time drinking? Or being sick or getting over other aftereffects?
- continued to drink even though it was causing trouble with your family or friends?
- found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?>more than once gotten arrested, been held at a police station, or had other legal problems because of your drinking?
The symptoms at the top of the list tend to indicate early signs of potential concern. The ones nearer the bottom are indicators of a more severe issue.
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*http://aacap.org/page.ww?name=Teens:+Alcohol+and+Other+Drugs§ion=Facts+for+Families&utm_source=REFERENCES_R7&LS-2659 **http://pubs.niaaa.nih.gov/publications/MakeADiff_HTML/makediff.htm#Talkingwith
How do we know whether our youngsters have become involved in the abuse of substances? Here are some signs to look for:
- an unexpected drop in academic grades or school attendance
- a change in friendships, especially new friends they’re reluctant for you to meet
- isolating themselves in their rooms
- a loss of interest in previous activities
- uncharacteristic outbursts of temper or mood changes
- memory lapses or poor concentration
- stealing cash or possessions
- uncharacteristic secretiveness or deception
These signs don’t only point to substance use; some of them are symptoms of depression or other conditions. How can parents determine “what’s going on?” It starts with conversation. Say: “I’ve noticed changes in your behavior lately that concern me. I want to understand what’s going on.” Hang in patiently, without anger, if your son or daughter begins with little or nothing to say. Prompt with gentle questions and comments. “I know a lot of young people experiment with alcohol and drugs. Some of your friends might be doing some drinking. What have you noticed?” Or, “If you’re like a lot of kids, you’re probably curious about drinking or drug use. Maybe you’ve even tried something already. Let’s talk about your experiences up to now.” Or, “I remember what it was like when I started thinking about drinking or drug use. It was complicated for me, and I’d like to tell you about it. Can we talk?”
If you hit a solid wall and your child shuts you out, offer a rain check and then collect on the rain check in a day or two. In the meantime, do your best to show a patient and relaxed approach to the topic. The more your child identifies that you’re angry or upset, the less likely he or she will be to disclose what’s going on — to participate in honest conversation. TimeToTalk.org is a helpful resource with many concrete suggestions for ways to engage children — at all ages — in conversations about alcohol and drug use.
When signs of substance use persist for more than a week or two, consider consulting with a counselor experienced in this area. You’ll be glad you addressed the situation sooner rather than later.