Substance abuse occurs in many forms, ranging from alcohol addiction and dependence to the use of street drugs or even prescription drugs. Substance abuse has a catastrophic effect on families, society and individuals. When looking at substance abuse, it is necessary to address the important issue of family history.
Definition of Substance Abuse
According to the DSM IV (Diagnostic and Statistical Manual of Mental Disorders), the diagnosis of substance abuse can be made if there is the presence of one of the following criteria:
Failure to fulfill major obligations.
Use when physically hazardous.
Recurrent legal problems.
Recurrent social or occupational problems.
Substance Dependence
In addition, three of the following additional criteria must be met for substance dependence:
Tolerance
Withdrawal
Large amounts over a long period
Unsuccessful efforts to cut down
Time spent in obtaining the substance replaces social, occupational or recreational activities
Continued use despite adverse consequences
The terms "addiction," "dependence" and "alcoholism" are often used interchangeably.
Family History Factors
What do we know about the family histories of individuals with substance abuse problems? Most of the research on substance abuse and family history provides us with data that is seen as having a correlation rather than being causal. In other words, we cannot say that a family history of abuse caused a substance abuse problem. We can say that there is a correlation between child abuse and later substance abuse.
The following factors are correlated with substance abuse: child physical and sexual abuse; family of origin use of substances and attitude toward substance abuse; family structure (whether a child was raised with both parents); family conflict such as arguing, fighting and domestic violence in the home; and other predisposing factors such as mental illness, mental illness in the family, genetics, trauma history for the substance abusing person, and adverse childhood events.
Teen Substance Abuse
Teens are at higher risk for substance abuse if their parents are substance abusers and if they have a history of child abuse or neglect. In addition, a parent's mental illness or the existence of mood and anxiety disorders may predispose teens to substance abusing. Although it is true that teens may succumb to peer pressure to "use" substances, other factors tend to influence arriving at a diagnosis of abuse or dependence.
Final Thoughts
Substance abuse and dependence are widespread problems in the United States. Many children, teens and adults suffer from substance abuse and dependence. The families of these individuals suffer as well. It takes more than tough love to help someone with substance-abusing problems. Many substances that are abused are legal, such as alcohol and cigarettes. Society sends mixed messages to youths about substances and then expects them to know how to modulate the use of these substances. Most individuals with substance abusing histories also have a coexisting mental health issue, such as depression or anxiety.
References
- "Childhood Trauma and Health Outcomes in Adults With Comorbid Substance Abuse and Mental Health Disorders"; Wu, Shairer, Dellor, Grella; 2010
- "Diagnostic and Statistical Manual of Mental Disorders IV"; American Psychiatric Association; 1994
