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Long-Term Effects of Alcoholism on Family and Children
Studies show that children raised in alcoholic families have the potential to suffer emotional distress as they transition to their own committed relationships, including a higher risk for divorce and separation, “increased marital conflict, decreased marital satisfaction, and decreased family cohesion.”1 Depression and antisocial behavior are also associated with alcoholism, with the potential to lead to marital conflict and partner violence, especially when the male is an alcoholic.2, 5 Other negative behavioral outcomes, such as “substance abuse, antisocial behavior, mood disorders characterized by depression and anxiety, low self-esteem, and relational difficulties” may also be present in the relationship.1

Children of alcoholics may suffer long-term effects of poor parenting practices suffered as children, which surface as COAs become husbands and wives, and have children of their own. Behaviors experienced as children, such as alternating love and rejection by an alcoholic parent, cause trust and bonding issues (insecure attachment) with intimate partners and offspring. In addition, parental emotional unavailability may contribute to a lack of conflict resolution skills.1 Evidence also indicates that alcoholic fathers may display harsh and ineffective parenting practices2 leading to “an increased risk of alcohol dependence in adolescence and into adulthood.”4

Children of alcoholics are often unable to trust other adults because they “experience persistent fears of abandonment.”1 Further, because children learn their bonding behaviors from watching their parents’ interactions as children, daughters of alcoholic fathers may be unable to interact appropriately with men when they reach adulthood.1 “When the opposite gender parent is an alcoholic it is likely that the child lacks an adequate model for learning how to engage in these opposite gender interactions.”1

Boys of alcoholics are at risk for poor self-regulation that may be demonstrated in the preschool years, which leads to blaming others for behavioral problems, impulsive behavior, and poor decision-making. This may lead to early alcohol use, especially in boys.2, 3, 5. Boys may also demonstrate “novelty seeking and harm avoidance, and react more intensely to novel stimuli, more actively seek stimulation, and be more impulsive, excitable, and have a lower level of frustration tolerance.”3,4, 5

References

1 Kearens-Bodkin J, Leonard K. Relationship Functioning Among Adult Children of Alcoholics. Journal of Studies on Alcohol and Drugs. 2008;November 69(6):941-950.

2 Finger B, Kachadourian L, Molnar D, Eiden R, Edwards E. Alcoholism, Associated Risk Factors, and Harsh Parenting Among Fathers: Examining the Role of Marital Aggression. Addictive Behavior. 2010;June 35(6).

3. Sher K, Walitzer K, Wood P, Brent E. Characteristics of Children of Alcoholics: Putative Risk Factors, Substance Use and Abuse, and Psychopathology. Journal of Abnormal Psychology. 1991;100(4):427-448.

4 Gerhant A, Olajossy M. Personality Traits in Alcohol-Dependent Individuals in the Context of Childhood Abuse. Psychiatry. 2016;2016 50(5):973-987.

5. Adkinson S, Grohman J, Colder C, Leonard K, Orrange-Torchia T, Peterson E, Eiden R. Impact of Fathers’ Alcohol Problems on the Development of Effortful Control in Early Adolescence. Journal of Studies on Alcohol and Drugs. 2013; September 74(5): 674-683.

Health risks and alcohol consumption
As per centers for disease control and prevention (CDC) thousands of death have been reported between the years of 2006 to 2010 due to excessive alcohol consumption in the United States. (1)

CDC defines a drink as 0.6 ounces of pure alcohol and excessive drinking as 8 or more drinks per week for women and 15 or more drinks per week for men. (1)

Health risks associated with alcohol consumption:

-      Sexually transmitted disease due to unprotected sexual intercourse and intercourse with multiple partners and unintended pregnancy (2)

-      Utero exposure to alcohol can lead to birth defects, neurological disorders and miscarriage (in case of regular alcohol consumption during pregnancy)(3)

-      Excessive drinking can lead to high blood pressure, ulcers, liver disease, kidney disease cardiomyopathy, and cancer. (4)

-      Altered cognitive ability resulting in violent, abusive behavior and can result in automobile accidents. (5)

-      Long-term use can result in memory loss, reduced intellectual ability, reduced brain size, Wernicke-Korsakoff syndrome and may result in unemployment, criminal activities like theft and injury to others.(5)

-      Long –term use is also known to induce depression; impulsive decision making that can impact family life and social interactions. It may result in self harm and suicidal inclinations. (6)

References:

1.     https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

2.     https://www.ncbi.nlm.nih.gov/pubmed/12728126?dopt=Abstract

3.     http://pediatrics.aappublications.org/content/early/2015/10/13/peds.2015-3113

4.     http://www.webmd.com/heart-disease/guide/heart-disease-alcohol-your-heart

5.     http://americanaddictioncenters.org/alcoholism-treatment/mental-effects/

6.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872355/

Economic Impact from Long-Term Consumption of Alcohol
There is currently no consistent approach in measuring the economic impact of alcohol consumption. The economic burden such as direct, indirect, and intangible cost of diseases can be estimated through cost-of-illness studies. Direct costs are estimated through prevalence and incidence studies, while indirect costs are estimated through the human capital method, the demographic method, and the friction cost method. It is difficult to accurately measure the economic impact due to differences in methodologies, cost items related to alcohol consumption, and measurement techniques.

Alcohol dependence has far reaching impact on health outcomes. In one study conducted in Germany in 2016, researchers found the economic burden for those dependent on alcohol is 50% higher than those who are not. Over half of the economic burden was due to lost productivity, and only 6% was due to alcohol treatment program. The economic burden was mostly borne by individuals between 30 - 49 years old. In another study conducted with data from eight European countries, 77% of Alcohol dependent patients suffered from psychiatric and somatic comoborbidities, which in turn increase systematic healthcare and economic cost. Alcohol consumption also has a detrimental impact on infectious diseases such as tuberculosis, HIV, and pneumonia, when the immune system is adversely affected by alcohol consumption.

In-direct costs due to alcohol dependence are significant. The biggest indirect cost comes from lost productivity, followed by premature mortality. Men with alcohol dependence in the U.S. have lower labor force participiration (2.5%), lower earnings (5.0%), and higher absenteeism of 0.5 - 1.2 days. Female binge drinkers have higher absenteeism of 0.4 - 0.9 days. Premature mortality is another large contributor to in-direct cost of alcohol dependence. In 2004, 3.8% of global deaths are attributable to alcohol, 6.3% for men and 1.1 for women. Those under 60 years old have much higher prevalence, with 5.3% of deaths attributable to alcohol.

In general, in-direct cost such as premature mortality due to alcohol dependence, loss of productivity due to absenteeism and presenteeism, and cost of property damage and enforcement, far exceed the direct health care and law enforcement costs. Aggregating the economic burden from all sources, the impact can range from 0.45% - 5.44% of a country's gross domestic product (GDP). The wide range is due to inconsistency in measurement of economic burden, as researchers in some studies attributed possible positive effect from long term alcohol consumption, such as lower risk of cardiovascular illness.