Does Substance Use by Family Members Predict Alcohol & Drug Use Among Older Adults?

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A great deal of research has focused on problems associated with growing up with a parent who misuses alcohol or drugs. This MIDUS study instead looked at middle aged and older adults and whether they had family members (parents, partners, or children) with substance use problems, and if so, whether it affected their own likelihood of using alcohol or drugs. Substance use by other family members can be a chronic source of stress, even for adults, due to worries about how it will affect the family member’s health, job, and finances. Additionally, any negativity associated with the substance use may endure for a long time, because it can be challenging to end a relationship with a family member. One maladaptive response may be to increase one’s own substance use.

In addition, there may be life stage differences that affect exposure to family member’s substance use. Older adults are less likely to have living parents with possible substance use, but they also tend to have fewer relationships outside their families, so might be more affected if substance use is present. Middle-aged adults, in contrast, may be living with both parents and children, thereby increasing the likelihood of multiple family members with substance use, which could take an even bigger toll.

To look at these issues, researchers assessed the following:

Problems with alcohol use were evaluated by asking participants if they had used alcohol during the past 12-months, and if so, whether they:

    • were ever under the effects of alcohol in a situation that increased their chances of getting hurt
    • had any psychological or emotional problems from using alcohol
    • ever had such a strong urge to drink that they could not resist
    • ever had a period of a month or more when they spent a great deal of time drinking
    • found that they had to drink more to get the same effects

and also how many times they:

    • used much larger amounts of alcohol than intended
    • had been under the effects of alcohol while at work or school.

Problematic drug use in the past 12-months was assessed with questions similar to the above regarding:

    • use of any of five illegal substances (inhalants, marijuana, cocaine, hallucinogens, and heroin)
    • misuse of any of five prescription drugs (sedatives, tranquilizers, stimulants, painkillers, and depressive medications).

Family member substance use was assessed by asking participants whether their parents, spouse/partner, or children had had alcohol or other substance use problems in the last 12 months.


Results regarding alcohol use showed that:

    • Having a parent or partner, but not a child, with problematic substance use predicted greater risk of participants also having problems with alcohol.
    • Having multiple family members with substance use increased risk of participants having alcohol problems by 57% for each family member that had problems.
    • Differences by life stage:
      • Among middle-aged adults (40s to mid-60s), substance use by parents and partners predicted greater risk of alcohol-related problems, but child substance use did not.
      • Among older adults, none of the variables were related to problems with alcohol, but this may be because few older adults reported having a partner with substance use issues.

Results regarding drug use showed that:

    • Substance use by partners, but not parents or children, was associated with participants’ having problems with drugs.
    • Having more family members with substance use did not predict drug use among participants.

There were no significant differences in results by gender. Results also did not differ between those who lived in the same household and those who lived separately.

Although this study did not determine whose substance use problems came first, the results suggest that this may not be the most important issue. Rather, it seems that substance abuse should be treated as a problem within the family context, instead of as an individual issue. Screening middle-aged and older adults for substance use among family members may be one way to identify older adults who might benefit from early substance use treatment. So doing may help prevent the diseases of alcoholism and drug addiction from being transmitted within families from one generation to the next.

Source: Miller, S. E., Maggs, J. L., Eiden, R. D., & Almeida, D. M. (2023). Familial predictors of alcohol and drug use-related problems among middle-aged and older adults. Journal of Family Issues, 44(7), 1838-1858.×211064877


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