The whole family suffers from a family member’s substance use problem

Alcohol, Drugs

The article is written by researchers, on request of popNAD. Corresponding author: Jóna Ólafsdóttir
Published 5 Jun 2018

This study was designed to explore the extent to which the use of alcohol or drugs by a family member affects the psychosocial state of their family members. It asks: Are family members of substance abusers more likely to report increased depression, anxiety and stress than the general population? The study was conducted in Iceland.

The three subscales of the DASS — depression, anxiety, and stress — served for examining the status of family members of people diagnosed with Substance Use Disorders (SUD). 36 per cent or more of the respondents reported that in all three subscales they experiences average, serious, or very serious depression, anxiety, and/or stress. This is a significantly higher level than in DASS studies of the general population in Iceland. A second main result of the study was that it seemed to make little difference to the family’s well-being which family member was affected by SUD.

Limitations and further research

The applicability of the research is limited due to its relatively small sample size. This also limits the ability to extrapolate that anyone who lives with a family member affected by SUD will be found to suffer from depression, anxiety, and/or stress. Yet the sample is sufficiently large and well-defined, and the comparisons of participants’ DASS responses statistically sensitive enough to support the conclusion that the risk of being affected negatively in the three continuums of DASS is significantly greater in families that have firsthand experience SUD.

Considering the discrepancy found in this study and in other studies further research is especially needed regarding the influence of growing up with a parent who has SUD in Iceland. This could sharpen our understanding of the Icelandic experience and whether an upbringing associated with SUD can lead to depression in younger years and to consumption of alcohol and/or other drugs in later life phases. Research into such aspects could be especially valuable when it comes to measuring and managing national health and developing preventive measures.

To conclude

The results show that all family members suffer when one family member has SUD. It is therefore imperative for clinicians to treat the family as a whole and to do so as early as possible. This is not only a good practice in view of the family member who suffers from SUD, but it can be seen as a preventative measure for the next generation.

A recommendation is for the DASS survey to be administered to participants in the family group therapy treatment process both at the beginning and at the end of treatment to more accurately measure that program’s effectiveness. Doing so would help determine the degree to which the treatment can reduce depression, anxiety, and stress. Such a systematic evaluation of the current treatment programme could be a significant step towards improved health and increased life quality for many.


Jóna Ólafsdóttir
University of Iceland, Reykjavik, Iceland

Steinunn Hrafnsdóttir
University of Iceland, Reykjavik, Iceland

Tarja Orjasniemi
University of Lapland, Rovaniemi, Finland