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NETWORK A national newsletter on substance misuse management in primary care network NETWORK 30 SEPTEMBER 2010

Families affected by substance use: an overview

The effects of an individual’s drug and alcohol problem on their family can be catastrophic, and is a large but often a hidden problem; as many as 17% of the population are likely to have been affected by a loved one’s substance use, and between 8-12% of children are affected by parental drug and alcohol use1 2

. The

range of issues faced by families includes dealing with guilt, isolation, bereavement, harassment, domestic violence, extreme social stigma, and financial difficulties. This can result in chronic stress in one or more members of the family leading to mental and physical health problems.

The anger, shame and embarrassment family members can experience often means that help is not sought and the problem remains hidden from those able to offer a way forward 3

. This hidden problem

can be compounded by practitioners’ lack of confidence, knowledge, training and guidance in this area of work, and as a

1 Velleman R and Templeton L (2005) Alcohol Use and Misuse. In Ewles L (ed) Key Topics in Public Health. Oxford: Elsevier

2 Velleman R and Templeton L (2005) Drug Use and Misuse. In Ewles L (ed) Key Topics in Public Health. Oxford: Elsevier

3 Copello A, Velleman R and Templeton L (2005). Fam- ily Interventions in the Treatment of Alcohol and Drug Problems.

Drug and Alcohol Review 24:369–385 In this issue

Gloria P tells her powerful story of how Al- Anon, a 12 step organisation which supports the families of people with alcohol problems, helped her. Page 3

Mary Hepburn argues that drug services may be failing to support women to plan for healthy pregnancies. Page 4

Patricia Boydell describes the important work of Harbour, a family support group. Page 5

Vicky Brooks highlights the impact caring for grandchildren can have on grandparents and the family as a whole. Page 6

John Westhead takes us through some basic therapeutic approaches practitioners can adopt to improve the service we provide to families. Page 7

Samantha Perry and Carole Hunter describe how the families, friends and carers of drug users can play a crucial role in preventing drug related deaths by being involved in a programme that includes administering naloxone. Page 8

Joss Smith outlines Adfam’s five key challenges to delivering support to families of problem drug and alcohol users. Page 9

Elizabeth Burton-Phillips highlights the difficulties faced by families bereaved by addiction, and how to support them. Page 10

Is it possible for public sector organisations to have a family centred approach? Phil Merrick, Debbie Lloyd, Barbara Jones, outline how Telford and Wrekin’s Family Intervention Project are meeting this challenge, and Sophie Kershaw describes how a Family Drug and Alcohol Court pilot in London is pioneering a new family centred way of working with offenders. Page 11

Jo-Anne Welsh highlights the effects of parental substance use on children, and approaches to working with children to build their resilience and improve their outcomes. Page 12

Elsa Browne outlines the National Treatment Agency’s approach to families in their business plan. Page 13

Chris Ford is Dr Fixit to a GP who is supporting the mother of someone who is using crack. Page 14

See our top tips for working with families. Page 15

Carole Sharma and Oliver Standing describe the latest developments in family services workforce development. Page 16

See the latest courses and events Page 16 We hope you enjoy this edition. Editor


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result family members’ needs can fail to be addressed. This special edition of network, which is a joint collaboration with Adfam and the Federation of Drug and Alcohol Professionals (FDAP), will highlight the key issues for working with and supporting the families of people who use drugs and alcohol problematically.

Primary care can play a unique role in supporting the families of substance users. As family members are often registered at the same practice, practitioners can offer support and health care interventions both to family members and the drug and alcohol user. But often the family member will not present directly with the issues affecting their health by saying ‘I am stressed because of my son/daughter’. Instead they will present with vague symptoms, for example low mood, aches and pains, and trouble sleeping.

embarrassment family members can experience often means that help is not sought and the problem remains hidden from those able to offer a way forward

“ The anger, shame and

Evidence suggests that family and carer involvement helps substance users at all

stages of the treatment journey and is associated with positive outcomes, both drug-related and social4

. However family

members have distinct needs, separate and different from the family member who is using drugs and/ or alcohol. There is evidence that support to family members improves their own outcomes, resulting in reduced physical and mental health symptoms, better coping mechanisms, and improved quality of life, leading to better outcomes for children in the family 2,3


Families need support in their own right, and at times it may not be appropriate for them to support the family member with a problem, and two articles in this edition powerfully describe this issue. Vicky Brooks describes the specific needs of grandparents on page 6 and Elizabeth Burton-Phillips champions the needs of families bereaved by addiction on page 10. We must not see family members simply as a means to improving the outcomes of drug and alcohol users, but as individuals with their own needs.

4 Copello A, Velleman R and Templeton L (2005). Family Interventions in the Treatment of Alcohol and Drug Prob- lems. Drug and Alcohol Review 24:369–385

…continued overleaf


Special Edition on families

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