ABSTRACT
This chapter focuses on the family unit as a context for understanding the development, maintenance, and intergenerational transmission of substance abuse, with the goal of informing treatment for these families. It addresses some of the broad factors that place individuals at risk from an individual and a contextual level in order to provide a comprehensive picture of the dynamic and complex array of variables at play in families affected by substance abuse. Substance use often is associated with regulation of distress and negative emotion. Social epidemiology, in particular, is concerned with documenting how the distribution of substance-related behaviors within the population is shaped by social factors. Considerable evidence has amassed over the past 20 years documenting the co-occurrence of substance abuse and mental health disorders. Rates of concurrent disorders appear to be elevated among individuals using illicit drugs as compared to alcohol, with rates doubling for those using both alcohol and illicit substances.
