Alcoholism and consequences for the family

Co-dependency, aggression, neglect - alcohol addiction brings these with it and impairs family life and relations. Social worker Anna Becker reports.

Alcohol dependence as a family disease

Co-dependency, aggression, neglect - alcohol addiction brings all these problems with it and thus impairs family life and partnerships. Social worker Anna Becker from the Median Clinics in Koblenz, Germany reports on the issue.

Translated from the original German version.

Alcohol makes people more sociable, it has a disinhibiting, calming and euphoric effect and is therefore readily consumed, especially at parties. In Germany, around 131 litres of alcohol are drunk per capita and year. Unfortunately, the positive effect can quickly turn into the opposite, because alcohol also reduces reaction time and the ability to concentrate, but increases the willingness to take risks and aggression. Alcohol dependence or alcohol consumption in Germany causes 40 billion euros in medical costs per year, 13,343 traffic accidents and 74,000 deaths.

In a 2018 survey by the foundation Stiftung Gesundheitswissen on consumption behaviour in Germany with 9,267 people aged 18 to 64, 3.1% of respondents were alcohol dependent. Two-thirds of them were male. Extrapolated to the total population, this was 1.6 million people. However, it is not only the addicts themselves who are affected by addiction, but also their families.

How to recognise addiction

The more alcohol, the more severe the negative effects on body and soul. For this purpose, the effect of alcohol is divided into six per mille ranges:

0.2 per mille: The following abilities decrease: sight and hearing, ability to concentrate, attention, self-assessment, ability to judge and criticise
0.5 per mille: a disinhibiting effect sets in, the affected person overestimates him/herself, feelings such as anger, joy and sadness are felt more intensely, the ability to react and see is restricted and balance problems set in
0.8 per mille: the field of vision narrows, which manifests itself in the so-called tunnel vision, the reaction time is prolonged by 35%, the brain processes the information only inadequately, psychomotor abilities are impaired and an increasing disinhibition is the consequence of alcoholism from 0.8 per mille onwards
1-2 per mille (intoxication stage): orientation and balance disorders, difficulty walking and standing, first speech disorders, disinhibition, loss of self-control and confusion
2-3 per mille (stupefaction stage): confusion increases, memory and consciousness disorders, first signs of breathing difficulties, vomiting, alcohol poisoning, unconsciousness and coma are possible, muscle slackening
3-5 per mille (paralysis stage): unconsciousness, loss of memory, weak breathing, hypothermia, uncontrolled excretion, deep paralysis of the nervous system, fatal respiratory arrest

The ICD 10 criteria help to identify alcohol dependence:

Is there a strong, compulsive desire to consume alcohol?
Is there a decrease in control over the onset and quantity of alcohol consumption?
Is there a physical withdrawal syndrome, is the consumption done to relieve withdrawal symptoms?
Has the amount of drinking increased?
Are previous interests neglected?
Is consumption continuing despite harmful consequences?

If three of these have occurred in the last 12 months, then the person is dependent.

How partners react

Every person reacts differently to stress. However, research has analysed five behaviours that partners of dependent people often develop.

Heart-saviours: They try to cover their own pain by helping their partner and trying to be perfect. They try to maintain the facade of the ideal world and take responsibility for everything.
Persecutors: In this behavioural boredom, the relatives get annoyed with the addict's behaviour. They try to subjugate the addict to rules and can get so caught up in their anger that they may not even notice positive behaviour.
Rebels: The partners unconsciously divert attention from the dependent family member through their own unseemly behaviour. For example, the children are neglected and through this problem the dependency is not perceived by the outside world.
Naïve: They ignore the actual conditions. They try to rationally explain the behaviour of the dependent partner, for example by elevating personal consumption to the general level.
Passive: These people completely refuse to take note of the partner's addiction. They take refuge in fantasies and show no outward feelings.

Reactions of children to the alcohol dependence of a parent

A parent's addiction has a great influence on children. Even babies have a fine sense for their parents' sensitivities and depend on reliable and understandable reactions from their parents in order to develop in an age-appropriate way. Similarly, the development of children and adolescents can also be disturbed if the dependency of a parent develops in the course of growing up. The parent's mood swings lead to arguments and the lack of interest often triggers a strong inner tension in children, which they try to compensate for through certain behaviours.

There are also different roles for children:

Hero: The children try to compensate for the parent's behaviour through high-achieving and faultless behaviour. These children write good grades in school or help around the house. They believe they can change their parent’s problems through their behaviour.
Scapegoat: These children divert the attention of their environment from the addicted person to themselves and thus try to restore the intra-family balance. According to studies, these children often become addicted themselves.
Invisible: These children only show feelings that are accepted at home. They do not develop their own needs or desires, are shy and silent and want to win their parent’s affection by not being a burden.
Mascots: They try to entertain the family with their jokes and in this way, compensate for resigned and depressed moods.

5 forms of addiction

There are 5 forms of psychological and physical alcohol dependence.

The stress drinker needs alcohol to relieve inner tensions and conflicts.
The occasional drinker consumes a lot of alcohol during social occasions.
The binge drinker alternates phases of high consumption with periods of abstinence.
The mirror drinker regularly consumes a certain amount of alcohol to maintain the state of intoxication and remains socially inconspicuous.
The interval drinker can be recognised by his heavy consumption of alcohol in intervals interrupted by periods of abstinence.

There may be a link between these types of consumption and family problems.

Alcohol abusers have less time for their children and/or partners due to their visits to the pub and their increased need for sleep. In addition, quarrels arise because of consumption. In addition, alcohol addicts have a significantly lower life expectancy. Their children are at higher risk for accidents.

Children learn through the behaviour of adults that high alcohol consumption is part of everyday family life. This develops a higher risk of becoming addicted themselves later on. The propensity to violence also increases. Children of alcohol addicts lack the support of their parents. For example, if the parents cannot take them to hobbies or friends or help them with their homework. Parents may also use money that was meant for toys or a healthier diet to buy alcohol. In addition, drinking parents are impaired in their ability to make decisions, which also creates stressful conflicts for the children.

Possible measures

If alcohol dependence is suspected, it is recommended to talk to the affected persons themselves and motivate them to visit a counselling centre. Above all, signs of a possible endangerment of the child's well-being should be looked for. Do the children have bruises or look unkempt? Do they show conspicuous social behaviour, such as frequent absences from school or day care?

Because alcohol addiction has many forms and faces, Becker advises those treating the child to offer help in case of suspicion. This also applies to relatives, but especially to children and adolescents. There is a wide range of help available: Counselling centres, self-help groups for those affected and their relatives, youth welfare offices, municipalities with various offers and projects for families with addiction problems, as well as welfare organisations with independent sponsors.