ABSTRACT
Of the major public health concerns of the 21st century, alcoholism and drug addictions are among the most pervasive, with devastating social, legal, and economic consequences for individuals and families, not only in the United States, but across the globe. The World Health Organization estimates that 76.3 million individuals have an alcohol-use disorder and 5.3 million individuals have drug use disorders (World Health Organization, 2010). The National Survey on Drug Use and Health reports more than half of the U.S. population, aged 12 and older, uses alcohol. Of these, 23.3% engage in binge drinking (i.e., drinking five or more drinks on the same occasion at least once in the past month), and nearly 7% are heavy drinkers (Office of Applied Studies, 2009). Along these lines, 10.5% of children live with a parent who has experienced an alcohol-use disorder in the previous year (Substance Abuse and Mental Health Services Administration, 2012). Although the prevalence rates of other drug use disorders are much lower than for alcohol, they are sizable by nearly any standard. For illicit psychoactive substances, the lifetime prevalence of substance-use disorders is roughly 6% in the United States, with lifetime cannabis abuse (i.e., 4.6%) being the most common after alcohol (e.g., Haynes, 2002). Substance use in the United States claims 600,000 lives annually, including 440,000 attributable to nicotine use, 125,000 from alcohol use, and 10,000 from heroin and cocaine use (exclusive of deaths from HIV; McCrady & Epstein, 1999). Alcoholism is the third major cause of death in the United States (behind coronary heart disease and cancer), with the life span of individuals with alcoholism being about 12 years shorter than their nonalcoholic counterparts (Mokdad, Marks, Stroup, & Gerberding, 2004). In addition to the serious problems individuals
with alcohol or drug problems create for themselves, victims of family violence, accidents, and violent crime add to the numbers of those adversely affected. On days when alcohol is used, intimate partner violence increases (e.g., Mignone, Klostermann, & Chen, 2009). Parental substance use is associated with a host of emotional, behavioral, and social problems for children (e.g., Boris, 2009; Osborne & Berger, 2009), which may evolve into problems with alcohol and drugs as these children progress through adolescence and into adulthood. Thus, the effects of alcoholism and substance-use disorders can be accurately described as being part of an intractable, multigenerational vicious cycle.
