Mitigating the impact of substance use disorders on family members

In the United States, the estimated number of overdose deaths between May 2020 and April 2021 surpassed 100,000, even worse than a record 93,000 last year. As 20.4 million people age 12 years or older were diagnosed with a substance use disorder (SUD) in 2019, the number of the impacted family members is likely 50 million or more. Numerous studies have examined the negative health impacts on individuals with SUD, but studies about the effects of addiction on family members are limited. SUD can negatively affect family members’ health, especially mental health, along with their quality of life, work, and finances. Barriers such as stigma, limited support services, hopelessness, and feeling undervalued deter affected family members from seeking help. Sacrificing their time and money for loved ones who are suffering from SUD can lead family members to neglect their own chronic medical conditions.

For instance, I cared for a woman in her early 50s whose husband struggles with alcohol use disorder, which caused him to lose his job. She developed new heart failure with reduced ejection fraction secondary to uncontrolled hypertension, likely from stopping all of her antihypertensive medications due to financial burden and self-neglect. She disclosed that she does not have enough time and energy to take care of herself. She had not asked for help or received medical care because of stigma and isolation until she could not tolerate her symptoms any more.

As the number of patients with SUD has been increasing, family physicians play a central role in taking care of these patients and their family members. Additionally, the COVID-19 pandemic has worsened mental conditions and potentially exacerbated the negative consequences for family members. When uncontrolled chronic conditions or mental illnesses are identified in the outpatient setting, screening for family members with SUD can be considered as a means to better understand the full situation and provide support and helpful resources as needed.

The following resources are available for family members and loved ones of individuals with substance use disorders: Adult Children of Alcoholics World Service Organization (a 12-step, 12-tradition program of people who grew up in dysfunctional homes due to substance use disorder), Al-Anon (a mutual support program for people whose lives have been affected by someone else’s drinking), Alateen (a part of the Al-Anon Family Groups for young people), Family Anonymous (a 12-step fellowship for the family and friends of those individuals with substance-related issues), Nar-Anon (a 12-step program for family and friends with SUD), and National Association for Children of Addiction (the only national membership organization focusing on the children of parents struggling with SUD).

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Dr. Sonoda is an Addiction Medicine Fellow at the University of Pittsburgh Medical Center and the 2021 AFP Resident Representative.