WebMD Substance Use Disorders and Addiction Guide: Alcohol Use Disorder

Only if clients feel a positive therapeutic rapport and trust the social worker will they disclose substance use. Understanding the family’s specific developmental stage can help with assessing the interventional needs of a family. Carter and McGoldrick (1989) identify eight stages of the family life cycle and corresponding developmental tasks.

What Does It Mean To Have a Substance Abuse Problem?

Up to 30% of people with alcohol use disorder do manage to abstain from alcohol or control their drinking without formal treatment. People with severe or moderate alcohol use disorder who suddenly stop drinking could develop delirium tremens (DT). It can be life-threatening, causing serious medical issues like seizures and hallucinations that require immediate medical care. Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder. Behavioral treatments—also known as alcohol counseling, or talk therapy, and provided by licensed therapists—are aimed at changing drinking behavior.

Your brain and body want to continue this good feeling, even if it’s unhealthy. It can significantly impact your emotional well-being, relationships, education and career. Almost always, people feel nervous or defensive about their drinking, which is one reason this very common problem so often goes undetected or unaddressed. Therefore, primary care physicians often make a point of use time during a visit to provide education about drinking and its dangers. Even though alcohol related disorders are very common, relatively few individuals recognize the problem and get help.

Studies indicate that between one third and two thirds of child maltreatment cases involve some degree of substance use (U.S. Department of Health and Human Services USDHHS, 1996). An even more severe impact can begin in utero with maternal substance abuse that causes damage to the growing fetus resulting in birth defects, fetal alcohol syndrome, and/or fetal alcohol effects. These difficulties may cause disabilities that require early intervention and often ongoing and social and mental health services. Social workers can help by encouraging their clients who abuse substances to use precautions to prevent pregnancy and providing education about the risks of maternal drug use on the developing fetus.

Management and Treatment

If a social worker is working with a pregnant client with an SUD, referral to a Perinatal Addiction Clinic and/or high-risk pregnancy OB/GYN clinic is indicated. Although active substance abuse can impair attachment and healthy modeling for affect regulation, sometimes the consequences of severe and ongoing substance abuse on the part of a parent can result in parent and child separation. In extreme substance use disorder cases, the separation may be due to the substance-related death of the parent from overdose, motor vehicle accident, or medical complications due to substance abuse. The significant increase in out-of-home child placements in the 1980s and 1990s closely paralleled the pandemic drug addiction in the United States during those decades (Jaudes & Edwo, 1997). Any long-term separation will have a negative impact on the child’s ability to attach, regulate affect, and can lead to a trauma response of numbing or hyperarousal (inability to discriminate and respond appropriately to stimulus).

Detox, Withdrawal & Treatment

Depending on the amount and duration of drinking and any symptoms, detoxification (often simply called “detox”) from alcohol can be done as an outpatient, or as an inpatient in a hospital or drug treatment facility. During the withdrawal process, the doctor may prescribe a class of antianxiety drugs called benzodiazepines for a short period in order to reduce withdrawal symptoms. Treatment used to be limited to self-help groups such as Alcoholics Anonymous (established in 1935). Now there are a variety of evidence-based treatments, including psychotherapy and medication, to treat alcohol use disorders. Many people with AUD do recover, but setbacks are common among people in treatment. Behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking.

• If you drink more alcohol than that, consider cutting back or quitting.
• They may also evaluate prescription drug monitoring program reports (a database of distributed controlled substances).
• Modifications have been made to Column 2 to identify concepts relevant to the family with a SUD, and Columns 3 and 4 are contributions of the authors of this article.
• Understanding the family’s specific developmental stage can help with assessing the interventional needs of a family.

Do I need detox before starting treatment?

These are 12-Step programs for family members that will help them disengage with love, so that they stop enabling and begin to care for themselves. Often parents blame themselves for their children’s substance use and feel responsible for fixing the problem. In Al-Anon and Nar-Anon they receive support from other family members and learn they did not cause the SUD, nor can they control it or cure it. The risk of substance use increases during times of stress and change. For an adult, a divorce, loss of a job or death of a loved one may increase the risk of substance use.

Alcohol use disorder (alcoholism)

• Therefore, screening is very important, whether primary care physicians or friends and family do it.
• Several types of treatment settings, including inpatient and outpatient settings, as well as short-term care and long-term therapeutic communities, are available.
• While it may be one of the most difficult things to do, it’s OK to ask for help when you need it.
• They release dopamine, a chemical in your brain that makes you feel good — until the substance wears off.
• Semaglutide, the active ingredient in blockbuster drugs Ozempic and Wegovy, may help people drink less alcohol.

The effects of a substance use disorder (SUD) are felt by the whole family. The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder. Family systems theory and attachment theory are theoretical models that provide a framework for understanding how SUDs affect the family. In addition, understanding the current developmental stage a family is in helps inform assessment of impairment and determination of appropriate interventions. SUDs negatively affect emotional and behavioral patterns from the inception of the family, resulting in poor outcomes for the children and adults with SUDs. Social workers can help address SUDs in multiple ways, which are summarized in this article.

What are the symptoms of alcohol use disorder?

Given that the family in which one is raised influences both of these, it is important to explore the impact of SUDs on the family. Studies looking at the relative weight of these influences show that both add contribution and impact (Haber et al., 2010). The impact will vary depending on the role and gender that the individual with the SUD has in the family. For example, if an adolescent child is identified as having a SUD, this will affect the family differently than if a parent has an SUD. The attitudes and beliefs that family members have about SUDs are also of importance as these will influence the individuals as they try to get sober and will influence the efficacy of treatment interventions. For example, if a parent sees a SUD as a moral failing and thinks his or her adolescent child should just use “will power” to quit, this will be important to know if the treating therapist is working from a disease model of addiction.

National Institutes of Health

Talk to your healthcare provider if you’re under stress and think you may be at risk for relapse. SUDs affect families and children in every area of their development. Social workers have opportunities to intervene and change the trajectory of these potential problems at many junctions.