Alcoholism, Effects on Relationships

Definitions and Extent of Problem

An individual with alcoholism meets the criteria for alcohol dependence; that is, there is craving, loss of control over drinking, tolerance (needing to drink more to experience the effects), and physical dependence (experiencing withdrawal when not drinking). Alcoholism is accompanied by profound impairments of relationships, at school, work, and family. Someone who abuses alcohol (drinks too much, too often, but has not experienced tolerance or withdrawal) may not technically meet the definition of an alcoholic, yet there are often serious problems in their important relationships. Among college students, heavy drinking, such as frequent binge drinking (the consumption of four, if female, or five, if male, drinks on one occasion) is associated with romantic relationship quality. For example, the more frequent the binge drinking, the greater the communication problems and the less the relationship quality with romantic dating partners. Thus, relationship problems and heavy drinking co-occur even in the absence of a clinically recognized diagnosis of alcoholism.

According to the U.S. National Survey on Drug Use and Health, during the years 2002 through 2004, there were 18.2 million people ages 12 and older who were alcohol dependent or alcohol abusers. Almost 20 percent of young adults, 18 to 25, met the criteria for alcohol dependence or alcohol abuse. These percentages declined steadily with age. Of considerable concern are the 1.5 million youth, 12 to 17, who needed alcohol treatment—only 111,000 received it. Also of concern are the more than 6 percent of those alcoholics 18 and older who lived with at least one child under 18, accounting for approximately 5 million households.

In terms of demographic characteristics, for every 33 women who meet the criteria for alcohol dependence and abuse, there are 66 men. Of those who actually receive treatment, about 70 percent are men compared to 30 percent who are women. Factors that hinder women from seeking treatment include concerns for the care of children in the home, fears of having children removed, or if pregnant, being arrested for endangering a fetus. Ethnic groups in the United States vary, with the highest rates of alcoholism among Native Americans and the lowest among Asian Americans. Marriage is less likely for alcoholic adults, and divorce, more likely. Across these variations by age, gender, ethnicity, and marital status, almost 8 percent of the U.S. population from adolescence through old age abuses alcohol. Moreover, each alcoholic is part of a social network whose members are affected by the alcoholic's behavior.

Relationships Affected by Alcoholism

A life-span approach to alcoholism suggests that it is important to consider the effects of alcoholism on relationships at different stages of the life course. This life-span approach begins with infants. In any given year, some 40,000 children are born with Fetal Alcohol Spectrum Disorder (FASD); a range of effects occur in children whose mothers drank alcohol during pregnancy. A number of these children are born alcohol dependent and suffer withdrawal at birth. Such infants are fussy, with difficult temperaments and poor bonding with caregivers. FASD is associated with lifelong difficulties in cognitive, physical, and social development.

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