Mental and physical health in family members of substance users: A scoping review

• Published in: Drug and alcohol dependence 2021-02, Vol.219, p.108439, Article 108439
• Main Authors: Di Sarno, Marco, De Candia, Valentina, Rancati, Fabio, Madeddu, Fabio, Calati, Raffaella, Di Pierro, Rossella
• Format: Article
• Language: English
• Subjects: Adjustment; Adult; Affected family member; Aggression; Blame; Burden; Drug abuse; Drug Users; Families & family life; Family - psychology; Female; Health; Health problems; Health risks; Health status; High pressure; Humans; Male; Medical conditions; Mental health; Mental Health - statistics & numerical data; Qualitative Research; Quality of Life; Relatives; Selfblame; Social interactions; Social Isolation; Social Stigma; Socioeconomic factors; Stigma; Strain; Stress; Substance abuse; Substance use; Substance-Related Disorders - psychology; Systematic review; Women
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2020.108439

•We systematically review health in Affected Family Members of substance users.•Stress, burden, and impaired mental health are common.•Impaired physical health, risk for aggression, and low quality of life also emerge.•Stigma and social isolation are often reported in qualitative accounts.•Family members should be regarded as targets for treatment. Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.