Families as a cause of alcohol problems

Home and family are the child's first and primary source of concepts of what is normal or acceptable drinking. It is hardly surprising, therefore, that children normally follow their parents example. Light drinking parents tend to produce light drinking children, heavy drinking parents heavy drinking children. This is not, of course, invariably the case. Different generations can have their formative years in quite different drinking cultures and environments. Equally, some children of heavy drinking parents may reject their parents' example, perhaps precisely because of the problems associated with it, and, as adults, drink little or nothing.

While most of this report is concerned with problems caused to children by parental alcohol consumption, it is, of course, also the case that children's own consumption of alcohol can cause problems to themselves and to their parents.

Among 15-16 year olds in Europe, around 6 - 22 per cent of boys and girls report problems arising from their own drinking such as reduced performance at school and accidents or injury, and 17 per cent of girls and 20 per cent of boys report problems in their relationships with their parents due to their own drinking. The highest rates of such problems appear to be found in the UK and the Scandinavian countries, countries in which teenagers also report high frequencies of drinking to intoxication. (1)

Family breakup and the youth culture

A major international study (2) of the large post World War 2 increase in crime, alcohol and drug problems and other psychosocial disorders in young people, attributed this increase at least partly to the breakdown of family structures and values and the rise of youth culture. As well as the psychological stresses and strains experienced by young people as a result of family discord and breakup, their increased freedom and independence has tended to insulate young people from the influence of adults, in particular their parents, and to increase the influence of the peer group with its cultural values of 'sex, drugs and rock and roll'.

Other commentators have referred to the impact of youth culture in promoting the values of hedonistic self-centredness. This has been in the context of conformity to the peer group, thus fostering 'other-directed personalities' and undermining the psychological and moral achievements of individual autonomy. A particular aspect is that many people now remain in the youth culture for a prolonged period, with, these commentators suggest, debilitating consequences both for themselves and for society as a whole. These debilitating consequences include "juvenile delinquency, and (increasingly) serious crime, drugs and alcoholism, suicide, a frenetic preoccupation with sexuality, mental disorders, and the appeal of fanatical cults." (3)

Family structures

A number of studies have found that children from 'non-intact' or 'non-standard' families (i.e. those in which the children are not living with both natural parents) have a raised risk of substance misuse as well as other problems. A Finnish study (4) found that children from non-standard families, particularly where parents had divorced or one had died, were more likely to consume alcohol and showed an increased risk of drunkenness and experimentation with other intoxicants, suggesting the possibility of a raised risk of substance abuse problems in later life.

A large American study (5) also found evidence of the protective effect of intact families in regard to children's substance abuse. Adolescents living with both natural parents were significantly less likely to use alcohol, cigarettes and illicit drugs or to report problems associated with their use. For most substances, the highest risks of adolescent substance use, dependence and the need for illicit drug abuse treatment were found in 1) families with a father and stepmother and 2) families in which the adolescent was married and living with his or her spouse. High risks were also found in families where the adolescent lived with a father and no mother figure or lived with a mother and a non-relative.
A Canadian study (6) found that adolescents living in single parent or mixed marriage families had an elevated risk of problem or dangerous behaviour, although the highest risk was found in adolescents living with neither natural parent. Compared with children living with both natural parents, these children were seven times more likely to smoke cigarettes, five times more likely to use cannabis and eight times more likely to use other drugs, four times more likely to exhibit delinquent behaviour and three times more likely to drink heavily.

The Canadian study took family functioning into account as well as family structures. The measures included communication between parents and children, the amount of time parents spent with their children and whether the parents kept track of where their children were and what they were doing. When these factors were taken into account, the higher risks of substance abuse in children in single parent or mixed marriage families were reduced.

Studies in other countries have found similar results. For example, a UK study found that 15-16 year olds living with both parents were significantly less likely than those living with one parent to drink alcohol to intoxication, smoke cigarettes or use illicit drugs. However, the differences between two parent and one parent families were reduced when factors such as psychological symptoms and social support were taken into account. (7)

These findings are of considerable significance. In the first place, it suggests that measures can be taken, in this case by parents, to protect children from a potentially adverse situation. This is a theme which will be discussed further in relation to the children of problem drinking parents.

Secondly, the finding is consistent with the conclusions of other studies of adolescent drinking behaviour and the influence on it of family relationships. (8) Adolescent drinking, including heavy drinking, has been found to be associated with low parental and family support and control. Support comprises behaviour which fosters in adolescents feelings of comfort, belonging and acceptance; control is a dimension of strictness as against permissiveness in the upbringing of adolescents. However, very high levels of control are also associated with heavy drinking by adolescents, drinking perhaps being chosen as a means of rebellion against parental or adult authority.

Children from single parent families may be at higher risk of substance and alcohol abuse, because, as well as any psychological repercussions from the divorce or separation itself, it is more difficult for one adult than two to provide adequate support and control.

Family breakup and adult drinking

Some commentators have referred to the protective effect of marriage and families in relation to alcohol problems among the adult partners as well as the children. Of course, where this protective effect fails to operate the consequent problems within families can be very severe indeed, and it is with these that this report is mainly concerned.

However, the evidence is clear (in some countries at least) that for the majority of people, forming stable relationships, marriage, and producing children are literally sobering experiences. Adults, especially men, who are married and/or living in stable partnerships tend to drink less than those who are single, separated, divorced or widowed. The pattern is more complex in women. It is also unclear whether the pattern in men is consistent throughout Europe.

There are numerous reasons why single and newly separated people are more likely than others to be relatively heavy drinkers. Most obviously, they tend to be freer of other commitments and responsibilities; to have more disposable income and leisure time; and they may seek company in bars and other places where drinking is one of the main activities.

Single people who acquire new families or stable relationships tend to decrease their alcohol consumption again. Of course, in some cases, heavy or problematic drinking is the cause of the divorce or separation. However, in the UK, researchers have suggested that high rates of separation and divorce (the highest in Europe) may be an underlying cause of a current rise in alcohol related deaths and disease at a time when consumption levels appear to have been generally stable. (9)

The prevalence of alcohol dependence tends to follow the prevalence of heavy drinking in relation to family status. In the UK the lowest risk of alcohol dependence is found in couples with children. The highest risks are found in single people, adults living with one parent and, especially significantly for this report, single parents with children. It is worth noting that in a UK study, unmarried and post-marital groups also had high rates of neurotic disorders in general, as did single parents and people living on their own. (10)

There is evidence that divorcees of all ages and both sexes are at greater risk of premature death than married people. This has been shown for every country with accurate health statistics. (11) For men between the ages of 35 and 45 the risk is doubled. (12) Psychiatric consequences of marital breakdown include affective and anxiety disorders, para- suicide and misuse of alcohol. Divorcees, especially men, have higher mortality from cardiovascular and cerebrovascular disease, cancer, suicide and accidental death.

The strong association between marital breakdown and subsequent ill health both mental and physical has led some to argue that divorce as such should be a key target in strategies for improving public health. (13) (See below for the effects of divorce on children.)

Parental separation in childhood and problem drinking in adulthood

A UK study found that higher levels of alcohol consumption, heavy drinking and problem drinking were found for those who had experienced parental divorce in childhood. The increased risk became apparent between the ages of 23 and 33. The same effects were not found for later parental divorce or parental death. (14)

Marriage and divorce in the EU

The potential significance of these findings is clear, given that if present trends continue, almost one in three marriages in the European Union will end in divorce. There are also fewer marriages.

In the EU, divorce has risen from 11 per cent of marriages in 1970 to 30 per cent in 1995; marriages have fallen from eight per 1,000 inhabitants in the 1970s to 5.1 per 1,000 in 1995. Belgium and Sweden are the most divorce-prone countries, with more than half of marriages likely to end in divorce. Finland, England and Wales and Denmark have rates of 49 per cent, 45 per cent and 41 per cent respectively. The divorce rate is lower in the Mediterranean countries, and lowest in Italy, where fewer than one in 10 of marriages ends in divorce. (15)

The causes of increased rates of marital breakdown and the growth of single parent families are, of course, both complex and controversial. A number of factors have been identified including cultural changes, such as the growth of feminism and the decline of religion; social factors such as the welfare state; economic factors such as the growing participation of women in the labour force and, in consequence, increased financial independence, and technological factors such as improved methods of birth control.

Another factor is divorce law reform which, presumably, has been both cause and consequence of changing attitudes to marriage and increasing rates of divorce. Since 1970, divorce has been legalised in Italy, Lichtenstein, Spain, Portugal and Ireland. Almost all EU countries have made divorce easier by reducing the number of years of prior separation and simplifying the procedures, and virtually everywhere in the Union divorce is now obtainable 'by mutual consent'.

Across the Union, therefore, hundreds of thousands of children now experience parental divorce. In the UK, it is estimated that around 40 per cent of the present generation of children will experience parental divorce or separation before they are 18.(16)

References:

1. European School Survey Project on Alcohol and Other Drugs. The Swedish Council for Information on Alcohol and Other Drugs & The Pompidou Group at the Council of Europe 1995.
2. M. Rutter and D.J. Smith. Psycho-social Disorders in Young People. John Wiley & Sons 1995.
3. B & P Berger: The War Over the Family. Penguin Books 1983.
4. M. Isohanni et al: Teenage Alcohol Drinking and Non-Standard Family Background. Social Science & Medicine 1994 Vol 38 Number 11.
5. R. A. Johnson et al: The Relationship Between Family Structure and Adolescent Substance Use. US Dept. of Health & Human Services 1996.
6. Addiction Research Foundation. Ontario Drug Use Survey.
7. P. Miller: Family Structure, personality, drinking, smoking and illicit drug use: a study of UK teenagers. Drug & Alcohol Dependence 45. 1997. 121-129.
8. D. Foxcroft & G. Lowe: Adolescent Drinking Behaviour and Family Socialisation Factors: A Meta-Analysis Journal of Adolescence 1991. 14. 255-273.
9. J. Chick: Evidence Suggesting Increasing Health Damage in Scotland Related to Alcohol. Health Bulletin 1997.
10. Health Psychology: 1996 March 15 (2) 94-101.
11. R. H. Coombs: Marital Status & Personal Well-being: A Literature Review. Family Relations 1991:49:97
12. O.P.C.S. Mortality Statistics. HMSO 1989.
13. J. Dominian et al. Marital Breakdown & the Health of the Nation. London. One Plus One 1991.
14. S. Hope et al. The relationship between parental separation in childhood and problem drinking in adulthood, Addiction Vol 93 Number 4 April 1998
15. Eurostat. See appendix 7.16. A Giddens. Sociology. Blackwell 1989.