Alcohol Problems in the Family

At least 4.5 million children in the European Union are living in families suffering from the effects of alcohol. The actual figure is almost certainly much higher, possibly as great as 7.7 million.

These deeply worrying conclusions are drawn by the new report Alcohol Problems in the Family, the result of a joint project of Eurocare and Coface (Confederation of Family Associations in the European Union).

The report was launched at a press conference in Brussels in December, 1998, by Padraig Flynn, EU Commissioner. Commissioner Flynn said that he was very pleased with the contents of the report. "It sets out in a very clear and comprehensive manner the serious consequences for the family which result from alcohol abuse. This is a factor which is all too often overlooked in reports on problems associated with alcohol abuse.

"We are all aware of the statistics on road accidents and deaths associated with alcohol abuse. Similarly, we know of the problems associated with violence and crime. But, all too often, we overlook the important consequences for the family resulting from alcohol problems. And this report makes very disturbing reading in this respect."

A cautious estimate for the entire European Union shows that 14 per cent of men and 4 per cent of women report lifetime experience of alcohol abuse or dependence. This gives a figure of 42 million Europeans having experienced alcohol problems for some period of their lives. Even if each of these drinkers adversely affected only one other person, that means that there are 84 million people in Europe either suffering from alcohol problems or afflicted by another's drinking. "In terms of sheer numbers this problem dwarfs the problems arising from illegal drugs," says the report.

The working party consisted of representatives of all Member States of the EU with the addition with Norway. The intention was to assess the scale of the problem and to find out what is being done, or not done, in member countries. Andrew McNeill, of the Institute of Alcohol Studies, said, "It quickly became clear that this was a very difficult job, largely because of the shortage of hard information. It is known that alcohol is involved in a range of social and family problems such as domestic violence, divorce and family break-up, and behavioural problems in children, but the contribution of alcohol to these problems is not normally ascertained or recorded in official statistics."

The report states that more than "one third of problem drinkers receiving treatment cite marital conflict as one of the main problems caused by drinking. In the UK, the divorce rate is twice as high in marriages complicated by alcohol problems as in those without alcohol problems. Marital conflict may take a violent form, and there is much evidence to show that domestic violence and alcohol are often associated. While problem drinking is neither a necessary nor a sufficient cause of domestic violence, high proportions of perpetrators of domestic violence are either problem drinkers or under the influence of alcohol at the time of the assault. Equally, high proportions of victims of violence are also under the influence of alcohol at the time of the assault.

"There also appears to be an association between problematic drinking and child abuse, including incest. The connection between child abuse and alcohol abuse 'may take the form of alcohol abuse in parents or alcohol intoxication at the time of the abuse incident."
In the section on Families as a Cause of Alcohol Problems, the report says: "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...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... 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."

The bulk of the report is concerned with family problems caused by alcohol. It makes the vital point that problematic drinkers can bring suffering not only to themselves but also to everyone around them: spouses, children, parents, and other family members.

In general terms, social life if often severely disrupted: "Activities, particularly recreational activities within the family are likely to be restricted as the drinker becomes unwilling or unable to participate, or the other family members themselves choose to avoid activities out of fear of the behaviour of the drinker.

"The unpredictable, disruptive and often drunken behaviour of the drinker is likely to be regarded by family members as acutely embarrassing and shameful. The tendency is to keep the problem a secret from the outside world. Divulging the nature of the problem to others may be regarded as an act of betrayal or disloyalty. This makes it difficult or impossible to invite others into the family home, or, given the norms of hospitality, to accept invitations from others. The family tends to become increasingly socially isolated. Activities and relationships outside the home may come to be severely restricted. Where family members do still engage in activities and relationships outside the home, these are likely to be kept rigidly segregated from life at home.

"In either case, family members may be unable to explain to others the real reasons for what is happening. A particular feature of this inability is that family members, often the spouse, are put in the position of having to tell lies in order to prevent the truth becoming apparent. For example, it may be the spouse who has to make the excuses for her partner's repeated absences from work. In this way the spouse may unwittingly protect her partner from the consequences of his own behaviour. Many commentators have referred to this tendency to collusion and cover-up and the way in which it may serve to perpetuate the drinking."

The family is put under further stress because "money spent on alcohol is not available for other purposes. An alcohol problem may impair or destroy the drinker's capacity to earn a livelihood. Reduced earnings or unemployment are not infrequent consequences of drinking problems and these, naturally, affect the other members of the family and can have all sorts of repercussions. Holidays may have to be forgotten; it may become impossible for children to be sent on school trips; the rent may not be paid."

More specifically the report goes on to look at individual family members: "The spouse has to cope with the bewildering unpredictability and frequent unpleasantness of life with a problem drinker. The more serious an alcohol problem, the less able a person is likely to be to perform competently, or at all, the various roles and responsibilities of a spouse and parent.

"More than one third of problem drinkers receiving treatment cite marital conflict as one of the main problems caused by drinking. In the UK, the divorce rate is twice as high in marriages complicated by alcohol problems as in those without alcohol problems. Marital conflict may take a violent form, and there is much evidence to show that domestic violence and alcohol are often associated. While problem drinking is neither a necessary nor a sufficient cause of domestic violence, high proportions of perpetrators of domestic violence are either problem drinkers or under the influence of alcohol at the time of the assault."

The reports states that "how badly a child is affected by parental problems is likely to depend, amongst other factors, on the child's age at the time they develop. The child under five is particularly vulnerable to diminished physical care whereas the older child may be more vulnerable to psycho-logical damage. This is not to say, of course, that the younger child does not suffer psychological damage, merely that its situation does not allow it to detach from the abusive parent in the way an older child can do by simply leaving the family home.

"As has been described, in the worst cases the world of the child of a problem drinking parent is likely to be bewildering, unpredictable and threatening.

"The possible adverse effects of a problem drinking parent may be seen in relation to... the importance of trust for the development of a healthy personality: the child must be able to trust the love of the adults who care for him, and he must also be able to trust in the fact that they will continue to be around in the future.

"The child may experience various forms of neglect and feel abandoned by both parents; it may fear that the drinking parent may die, or that the non-drinking parent may leave; it may have a restricted capacity to make or sustain friendships; to be the victim of verbal or physical aggression; to be a witness to conflicts, perhaps violent conflicts, between his or her parents, and may experience the break-up of the family...

"Children may be forced to take on adult roles and responsibilities and in this very real sense be deprived of their childhood. A particular feature that can arise is that the child, like the spouse, comes to believe that he or she may be to blame for the problems the family is experiencing."

The report discusses the psycho-logical, emotional, and behavioural problems faced by children and whether these persist into adult life. In an important section, it looks at what is being done and examples of good practice. Prevention and treatment, as they are approached in the different member countries, is covered.

"It is clear that the problematic consumption of alcohol affects millions of families, and thus millions of children and adults across the European Union, causing harm and misery on a scale which dwarfs the problems associated with illegal drugs. Despite this, national governments often devote more resources to campaigns against illegal drugs. Likewise, combating illegal drugs is written into the Treaty of Rome but there is no special EU campaign against the far larger problem of alcohol misuse.

"It is worth noting at this point that Eastern European countries, including those seeking membership of the European Union have high levels of alcohol consumption and harm. In most of these countries the situation appears to be worsening. The entry of Eastern European countries into the European Union will thus result in additional millions of EU citizens affected by alcohol problems.

"For a substantial minority of the affected children, the problems continue into their adult lives and, indeed, some children of problem drinking parents themselves become transmitters of the problems to the next generation.

"The difficulties experienced by family members go beyond indiv-idual unhappiness to health and social problems that affect, and are an economic burden upon the whole society. Unknown but necessarily large amounts of public money are expended in all member states each year on health and social services in dealing with the consequences of alcohol problems in families.

"And yet, in no Member State do family alcohol problems appear to be accorded the importance that they actually deserve. All Member States promote often very high profile public awareness programmes on the dangers of drunken driving: none promotes any remotely similar awareness programme about the dangers of drunken parenting.

"Across the Union there are some treatment and helping services for family members but provision is patchy and, undoubtedly, there are many people, particularly children, who currently have no real access to help or support.

"A particular problem identified is that alcohol treatment services may not be prepared or equipped to deal with the family aspects of the problem, while family treatment services may not be prepared or equipped to deal with alcohol problems.

"However, while more and better helping services are a priority, crisis intervention alone is of limited value to society however much it may benefit individuals. The main task is to prevent problems reaching crisis point or, preferably, from occurring at all. There is also the question of how and by whom helping services should be funded.

"Partly because of lack of information, it has not been possible to explore in this report the question of the economic costs of family alcohol problems to society. The issue of funding treatment services should be seen in this context and, as suggested above large sums of public money are already being expended on dealing with the consequences of family alcohol problems. It makes sense therefore to allocate some resources to addressing and treating the problems that produce the consequences. New money is likely to be required. An obvious source is revenue from alcohol sales. In member states where alcohol taxes are low it is unlikely that they are sufficient to cover the economic costs of alcohol problems including family problems. As well as raising excise duties a special levy could be placed on alcohol sales to fund treatment and prevention services.

"In some Member States family alcohol problems are at least on the public policy agenda, although occupying only a relatively minor place. In most Member States, however, we have been unable to find any explicit reference to the family aspects of the problem in national policy or any authoritative statement by government ministers recognising the existence of the problems and the need to do something about them.

"It is not surprising, therefore, that there is much that is not known. As has been made clear in this report, lack of information makes difficult even a rudimentary estimate of the size of the problem. In a number of Member States there appears to be a lack of statistical information about the involvement of alcohol in cases of child abuse and related social problems. Earlier in this report, this lack of knowledge was described in terms of the `ostrich response' and it does not require an excess of cynicism to believe that a lack of information can on occasion be extremely useful and convenient: so long as the true scale of a problem remains unknown it has no real existence in relation to public policy, and Governments and others are spared the unwelcome necessity of having to do something about it.

"Children and the non-drinking parent may here be paying the price of the clear difference in public attitudes towards problems associated with alcohol and those associated with the illegal drugs. When problems occur with illegal drugs, the tendency is to blame the drugs; when problems occur with alcohol, the tendency is to blame the drinker. As one of the quotations at the beginning of this report illustrates, the drinkers family are likely to experience the problem of guilt by association. Blaming the individual drinker diverts attention from the social and economic factors that encourage the problematic consumption of alcohol.

"In reality, alcohol problems in families are affected by the same factors as affect alcohol problems in general: at both the individual and the population level, the likelihood of experiencing such problems increases with the amount of alcohol consumed and with the frequency of intoxication. Policies that increase alcohol consumption are thus likely to increase family alcohol problems, problems that can impair and destroy families.

"Equally, family conflict and family break-up can increase the likelihood of alcohol and other substance abuse problems in both adults and children. For these reasons, policies that reduce alcohol problems are likely to strengthen and support families, and policies that strengthen and support families are likely to reduce alcohol problems.

In regard to substance abuse by children and teenagers, it is becoming increasingly clear that, in the words of a recent report, 'If society intends to provide young people with an environment which helps them not to take illicit drugs (or abuse volatile substances), or to reduce the harms which they do, the climate of awareness and belief on alcohol and tobacco must be seen as part of that context.'"

The report forcefully brings out, not only the problems alcohol can cause to the family, but also the vastness of its scale to the attention of the European Union and makes recommendations to national governments, the European Commission, and to non-governmental organisations. Among these are that governments should encourage research and monitoring to obtain more complete and reliable information about the contribution of alcohol to divorce, family break-up, child neglect and abuse; that national policies should make explicit reference to family alcohol problems; require local health and social service authorities to draw up plans for tackling alcohol problems and, in particular, for meeting the needs of family members including children; and that national alcohol education programmes should provide information not just about alcohol and health but also about alcohol as a potential social problem.

The report recommends that the Commission should encourage Member States to improve the collection of information in regard to family alcohol problems and coordinate these investigations; that it should use the existing Health Promotion Programme to disseminate information about alcohol in general and family alcohol problems in particular; cont-inue to promote workplace alcohol policies and anti-drink driving campaigns, the latter paying particular attention to the management of the 'high risk offender'; ensure that the Union's other policies, particularly those on taxation and the single market do not undermine efforts to reduce alcohol problems; and, in view of the fact that for many young people, alcohol, tobacco and illicit drugs are all part of the same domain, extend drug awareness campaigns to include alcohol and tobacco.

In the case of non-governmental organisations, the report suggests that specialist alcohol agencies should designate a member of staff to be responsible for family and children's services; that the agencies should also ensure that adequate training is provided to staff in relation to child development and the family aspects of alcohol problems; COFACE and EUROCARE should cooperate in the field of alcohol problems in the family by setting up a joint working party at European level which would meet on a regular basis to take stock of developments and decide on and carry out joint initiatives; and that the same organisations should encourage their members at national, regional and local community level to seek cooperation with each other to develop a network of appropriate information, support and counselling services for families suffering from alcohol problems.