The relationship between family variables and adolescent substance abuse: a literature review.

Substance abuse is a major problem confronting adolescents today. One out of every six teenagers suffers from chemical dependency (Thorne & DeBlassie, 1985). Adolescent drug addiction crosses a broad range of backgrounds (Thorne & DeBlassie, 1985) and affects physical, psychological, and social development (Green, 1979). Researchers have attempted to understand the etiology and perpetuation of drug abuse among adolescents but have found no specific causal factors. Rather, studies reveal that abuse is influenced by a "complex, interacting network of sociological, psychological and biological variables" (Barnes, 1977; Campbell, 1983). One area of focus has been the family. Researchers have found a relationship between teenage substance abuse and certain characteristics of the family. A review of the current literature reveals two broad categories of characteristics: family drug usage patterns and family atmosphere.

Family Drug Usage Patterns

Family drug usage is one category that may influence adolescent substance abuse. Table 1 shows that the use of mind-altering chemicals by family member(s) significantly increases the chance that other family members will use drugs (Adler & Lotecka, 1973; Beardslee, Son, & Valliant, 1986; Blum, 1972; Craig & Brown, 1975; Needle, McCubbin, Wilson, Reineck, Lazar, & Mederer, 1986; Tec, 1974; Tolone & Dermott (1975). The overall influence of family members can be seen in the results of a study by Craig and Brown (1975) who found that a high percentage of adolescent substance users reported drug use in the immediate family.

Table 1

Studies of Family Drug Usage Patterns

Investigator   S(*)   NS(**)            Finding

Tec             x              positive association between
(1974)                         parent's and children's
                               consumption of drugs

                x              more parental drug use among
                               adolescents who use marijuana
                               regularly than nonusers

                x              less parental drug use among
                               adolescents who are abstainers
                               than regular marijuana users

Tolone &        x              positive relationship between
Dermont                        parental smoking and drinking
(1975)                         habits and adolescent's use of
                               marijuana

                        x      no relationship between parental
                               smoking and drinking habits and
                               adolescent's use of hallucinogens

                x              perceived seriousness of parental
                               drinking relates positively to
                               adolescent use of marijuana

                        x      perceived seriousness of parental
                               smoking does not relate to
                               adolescent's use of drugs

                x              parental use of sleeping pills and
                               tranquilizers relates positively to
                               adolescent's use of marijuana and
                               somewhat relates to adolescent's
                               use of hallucinogens

Craig &         x              adolescent drug users report more
Brown                          drug users among family
(1975)                         members than nonusing
                               adolescents

Needle,                 x      mothers' and fathers' use of
McCubbin,                      drugs does not relate to
Wilson,                        adolescent use
Reineck,
Lazar, &        x              older sibling substance use relates
Mederer                        positively to adolescent's use
(1986)

Adler &         x              adolescent drug users report a
Lotecka                        higher percentage of parental
(1973)                         drug usage than adolescent
                               nonusers

Beardslee,      x              positive relationship between
Son, &                         parental and child alcoholism
Vaillant
(1986)

Blum            x              parents of "high-risk" adolescents
(1972)                         tend to be regular drinkers

                x              "high-risk" adolescents report
                               more maternal alcohol problems
                               than "low-risk" adolescents

                x              fathers of "high risk" adolescents
                               report using alcohol for
                               "escapist" purposes

                x              siblings of drug users tend to be
                               users themselves

Cannon          x              offspring of drug-abusing families
(1976)                         are allowed or encouraged to find
                               escape rather than to cope with
                               problems

                x              offspring of drug-abusing families
                               tend to show a pattern of feeling
                               unprepared to cope adequately

Jurich,         x              adolescent drug abusers report
Polson,                        more parental use of drugs and
Jurich, &                      denial as crutches than adolescent
Bates                          users
(1985)
                x              high frequency of parental
                               hypocritical morality among
                               adolescent drug abusers

* S = Significant as reported by researcher
** NS = Not significant as reported by researcher

Parents' habits and attitudes toward mind-altering chemicals are significantly related to those of their children (Adler & Lotecka, 1973; Cannon, 1976; Tec, 1974; Tolone & Dermott, 1975). This influence varies according to the type of drug used by the parent. For example, it has been found that parental alcoholism increases the probability of problem drinking and even chemical dependency in children (Beardslee et al., 1986; Needle et al., 1986; Tec, 1974; Tolone & Dermott, 1975), but that parental use of marijuana seems to have no relationship with children's use (Needle et al., 1986).

Family members who abuse drugs seem to be using them as a "psychological crutch" to cope with their problems. For example, adolescent substance users report that their parents use drugs and denial to cope with stress (Jurich, Polson, Jurich, & Bates, 1985). Similarly, fathers of drug-abusing adolescents report using alcohol for "escapist" purposes. Cannon (1976) found that children are "allowed or encouraged" to use these same coping strategies. As a result, the adolescent of a drug-using family tends to become chemically dependent as well.

Jurich et al. (1985), on the other hand, suggest that a "hypocritical morality" exists in many drug-using families. Parents tell their teenagers to avoid using drugs, yet continue to use drugs themselves. Their actions tend to play a more significant role than do their verbal messages (Cannon, 1976; Tec, 1974). Thus, regardless of whether parents encourage or discourage use of drugs, their children are more likely to be substance abusers than are children of parents who do not use drugs or alcohol.

Sibling drug usage is also significantly related to adolescent drug usage patterns (Craig & Brown, 1975; Needle et al., 1986). A high percentage of chemically dependent adolescents report having siblings who are regular users as well (Craig & Brown, 1975). It is assumed that availability and modeling increase the likelihood that a younger sibling will also use drugs. For example, Needle et al. (1986) report that adolescents with older drug-abusing siblings start using drugs at an earlier age and that adolescents with siblings who do not use drugs are less likely to be users.

FAMILY ATMOSPHERE

Family atmosphere is a second bread category that may influence adolescent substance abuse. Adolescents who abuse drugs frequently report poor family environments (Adler & Lotecka, 1973) and often suggest that weak family relationships have contributed to their drug problems (Svobodny, 1982). Family atmosphere includes family composition, family interaction, and discrepancies in family perceptions of each other.

Composition of Family. The composition of the family has been found to have a significant relationship to adolescent substance abuse. Parental absence due to break-ups, death, or divorce increase the chances that children will abuse drugs (Blum, 1972; Cannon, 1976; Craig & Brown, 1975; Johnston, 1973; Jurich, Polson, Jurich, & Bates, 1985; Tec, 1974; Tolone & Dermott, 1975).

Research indicates that a significant number of teenage drug users are raised in single-parent homes (Cannon, 1976; Craig & Brown, 1975) or in families where parents are absent due to break-ups (Johnston, 1973). This relationship between family composition and adolescent substance abuse may be modified by the type of drug used by the adolescent. For example, Tolone and Dermott (1975) found that adolescents who used marijuana tended to be from less intact homes, whereas this was not the case for adolescents who used hallucinogens. Generally, however, parental absence is typically found to relate to adolescent substance abuse. This is particularly disconcerting, since the number of single-parent families has increased in recent years. The implication is that a large number of children from separated families can be considered at high risk and in need of proactive services to help them adjust to the problems associated with single-parent homes. Thus, educators, counselors, and administrators must identify resources to meet this need.

Family Interaction. Family interaction is another variable that seems to influence adolescent chemical dependency. Aspects of family interaction are involvement with family, communication, and discipline. Findings pertaining to these relationships are presented in Table 3.

According to Reardon and Griffing (1983), positive child-parent association is vital to the development of a strong self-concept and to the prevention of drug abuse. This finding has been supported by Tec (1974) who found that a high percentage of adolescents who abuse drugs often mention low satisfaction with their families. For example, although there seem to be no major differences between families of teenage drug abusers and nonabusers in decision-making abilities (Gantman, 1978) and in time needed to make decisions, adolescent substance abusers and their parents have shown significant dissatisfaction in the decisions made (Meade & Campbell, 1972).

Table 2

Studies of Family Atmosphere: Composition

Investigator   S(*)   NS(**)            Finding

Tolone &       x               adolescents who use a greater
Dermott                        amount of marijuana tend to
(1975)                         come from less intact families

                      x        adolescents who used
                               hallucinogens do not tend to
                               come from less intact families

Craig &        x               adolescent drug users tend to be
Brown                          from single-parent homes
(1975)

Tec            x               a higher proportion of regular
(1974)                         marijuana users tend to come
                               from broken homes than do
                               nonusers

Blum           x               adolescents who abuse drugs tend
(1972)                         to come from families with
                               separated or divorced parents

Johnston       x               adolescents who abuse drugs tend
(1973)                         to come from homes broken due
                               to divorce or death

* S = Significant as reported by researcher
** NS = Not significant as reported by researcher
Table 3

Studies of Family Atmosphere: Interaction

Investigator   S(*)   NS(**)            Finding

Tec            x               higher percentage of regular
(1974)                         marijuana users reports low
                               family satisfaction than nonusers

               x               higher percentage of regular
                               marijuana users reports more
                               parental deprivation than nonusers

               x               higher percentage of regular
                               marijuana users considers family
                               to be less salient than do nonusers

               x               higher percentage of marijuana
                               users reports parental pressure
                               especially in education than do
                               nonusers

               x               a high percentage of regular
                               marijuana users reports parental
                               reaction to be "non-caring" with
                               no anger or punishment for the
                               substance use

Gantman        x               more scapegoating by family
(1978)                         members of the drug-abusing
                               adolescent than by nondrug-
                               abusing families

                      x        no significant difference among
                               drug abusing and nondrug-
                               abusing families on decision-
                               making abilities

               x               nondrug-abusing families engage
                               in more positive communication
                               than drug-abusing families

                      x        nondrug-abusing families give
                               same amount of suggestions or
                               opinions as drug-abusing families

               x               more freedom of expression
                               among nondrug-abusing families
                               than drug-abusing families

               x               more cooperation among
                               nondrug-abusing families than
                               drug-abusing families

               x               more equal participation and
                               more clarity in communication in
                               discussions among the nondrug-
                               abusing families than by drug-
                               abusing families

Mead &         x               more agreement among nondrug-
Campbell                       abusing families than drug-
(1972)                         abusing families

                      x        no difference in time needed to
                               make a decision between drug-
                               abusing and nondrug-abusing
                               families

               x               drug-abusing families show less
                               choice fulfillment than nondrug-
                               abusing families

Pandina &      x               adolescent drug abusers perceive
Schuele                        their parents more negatively than
(1983)                         nondrug abusers

                        x      both adolescent drug abusers and
                               abstainers describe their family
                               environment as controlling and
                               hostile

               x               adolescents who abuse drugs
                               heavily report mere parental
                               control than do moderate users

               x               adolescents with higher level of
                               drug usage report a lack of
                               parental love and a hostile family
                               environment

Streit,        x               most adolescent drug users,
Halsted, &                     excluding those who use
Pascale                        amphetamines, perceive hostility
(1974)                         from both parents and view their
                               parental environment as "hostile
                               with autonomy"

               x               adolescent nonusers give
                               more love from both parents than
                               adolescent users

Hamburg,       x               adolescent drug abusers tend to
Kraemer, &                     report that mothers "seldom,
Jahnke                         never" understand them
(1975)

               x               adolescent drug abusers
                               frequently report that parents do
                               not know their friends

Rees &         x               drug-abusing teenagers tend to
Wilborn                        describe their parents on one
(1983)                         hand as neglectful, selfish, and
                               nonaffectionate while on the other
                               hand as intrusive, possessive, and
                               controlling by guilt

               x               parents of drug-abusing
                               adolescents indicate more of a
                               lack of open relevant
                               communication than nondrug users

               x               drug-abusing adolescents report
                               more of a lack of parental direction

               x               parents of drug-abusing teenagers
                               report more child-rearing
                               problems and view parenting as a
                               job requiring suffering and
                               sacrifice than nondrug users

               x               parents of drug-abusing teenagers
                               tend to believe that changing their
                               children's behavior is impossible

Blum           x               regular teenage drug users report
(1972)                         less family cohesiveness than
                               nonusers

                      x        no difference in the amount of
                               affection shown between families
                               with users and nonusers

               x               parents of teenagers who use
                               drugs regularly put less emphasis
                               on child-rearing and adapt a
                               permissive attitude regarding
                               freedom of choice than parents of
                               nondrug users

               x               parents of drug-abusing
                               adolescents describe themselves
                               as less confident in child-rearing
                               and uncertain as to how to raise a
                               child compared to parents of
                               nondrug-abusing adolescents

Adler &        x               high percentage of habitual drug
Lotecka                        users report lack of or negative
(1973)                         contact within home

               x               habitual drug users report parents
                               having less influence in
                               determining drug usage than do
                               nonusers

Wechsler &     x               teenage drug users are less likely
Thum                           to report feeling close to family
(1973)                         than nonusers

               x               adolescent drug users frequently
                               feel less able to talk about drugs
                               with parents than nonusers

Tolone &              x        no relationship between use of
Dermott                        marijuana and perceived
(1975)                         closeness to family

               x               negative relationship between
                               teenage use of
                               hallucinogens/speed and
                               perceived family closeness

               x               negative relationship between
                               adolescent drug usage and
                               consulting with parents

               x               students who use drugs show a
                               lower quality parent-child
                               relationship than students who do not

Jurich,               x        no significant difference between
Polson,                        abusers and occasional users
Jurich, &                      regarding who they saw as
Bates                          closest family member
(1985)

               x               high frequency of scapegoating
                               among families with drug-abusing
                               teenagers

               x               adolescent drug abusers report
                               more of a communication gap
                               between themselves and their
                               parents than nonusers

               x               parents of drug-abusing
                               adolescents are more likely to
                               report a laissez-fair or
                               authoritarian discipline than
                               parents of nonusers

Steier,        x               families with drug-abusing
Stanton, &                     adolescents display greater
Todd                           rigidity in decision making and
(1982)                         conflict resolution than
                               nonabusing adolescents

               x               families with drug-abusing
                               adolescents show more rigid
                               communication patterns regarding
                               who follows whom and who
                               allies whom than families of
                               nonabusing adolescents

* S = Significant as reported by researcher
** NS = Not Significant as reported by researcher

Although dissatisfaction varies according to the type of drug used by the adolescent, the family environment is generally described by the teenager as hostile (Pandina & Schuele, 1983; Streit, Halsted, & Pascale, 1974), void of understanding (Hamburg, Kraemer, & Jahnke, 1975; Rees & Wilborn, 1983), lacking love (Pandina & Schuel, 1983; Streit et al., 1974), lacking cohesiveness (Adler & Lotecka, 1973; Wechsler & Thum, 1973), and lacking cooperation (Gantman, 1978). Only one study (Tolone & Dermott, 1975) found that the amount of quarreling between mothers and fathers is not significantly related to adolescent drug abuse.

There is a sense of alienation (Tolone & Dermott, 1975; Adler & Lotecka, 1973; Wechsler & Thum, 1973) and a feeling that parents are self-centered and nonsupportive (Rees & Wilborn, 1983). Although Jurich et al. (1985) found that teenage substance abusers and nonabusers were similar in their ability to identify their closest family member, Adler and Lotecka (1973) reported a high frequency of negative or no contact.

A second aspect of family interaction is communication. Jurich et al. (1985) suggest that there is a communication gap between family members of adolescents who are chemically dependent. This is supported by findings that teenagers who abuse drugs typically describe their communication with parents as closed and unclear (Rees & Wilborn, 1983; Cannon, 1976; Gantman, 1978), and by observations of rigid patterns of communication (Steier, Stanton, & Todd, 1982). A study by Cannon (1976) revealed that a low percentage of drug-abusing adolescents and their families considered the others to be honest about their thoughts and feelings. Parents have also reported communication problems. A significant number of these parents indicate that they are inadequate in communicating trust, acceptance, and understanding (Rees & Wilborn, 1973).

A third aspect of family interaction is discipline. Researchers have found that parents with drug-abusing adolescents view parenting as a job requiring suffering and sacrifice, and frequently report a lack of confidence in raising a child (Rees & Wilborn, 1983; Blum et al., 1976). They perceive changing their child's behavior as impossible (Rees & Wilborn, 1983). These feelings may relate to the type of discipline they use.

Findings have been inconsistent regarding discipline in the home. Some studies have found that parents assume a permissive attitude, while others have found them to practice excessive control. Jurich et al. (1985) suggest that there is a tendency for parents of drug-abusing teenagers to use either a laissez-faire or authoritative discipline. Some parents are unable to set rules and limits (Rees & Wilborn, 1983) and typically adopt a permissive attitude or handle problems by taking away privileges (Blum, 1972). For example, adolescents who use drugs regularly have reported a lack of parental direction (Rees & Wilborn, 1983) and believe that their parents do not care about their actions (Tec, 1974). A low percentage see their parents as reacting to their drug usage with anger and punishment (Tec, 1974).

Conversely, adolescents who abuse drugs frequently have been found to consider their parents to be controlling (Pandina & Schuele, 1983; Rees & Wilborn, 1983). One form of control is parental pressure. Tec (1974), for example, found that drug-using adolescents typically come from homes where there is much parental pressure, especially in the area of education. In general, adolescent substance abusers who come from controlling families tend to see themselves as lacking autonomy and independence (Pandina & Schuele, 1983). They view their parents as "intrusive, possessive, overprotective, and controlling by guilt" (Rees & Wilborn, 1983). So, although most studies find significant relationships between discipline and adolescent substance abuse, the findings are contradictory. Because of these varying findings, the relationship between discipline and adolescent substance abuse is not yet clear.

Overall, certain types of family interaction seem to encourage adolescents to reject the family unit and turn to other resources to meet their needs. It has been found that a high percentage of drug users considered the family to be less significant in comparison to school friends and themselves (Tec, 1974) and that parental disapproval tends to have no significant influence on chemically dependent adolescents (Needle et al., 1986; Adler & Lotecka, 1975).

The implications of the relationship between family interaction and adolescent substance abuse are that proactive parent/child counseling and education may be needed to help families interact in more healthful ways. Knowledge of the significant relationships between adolescent drug use and dissatisfaction, poor communication, and discipline can offer the counselor/educator direction for developing programs for all members of the family.

Discrepancies in family perceptions. Discrepancies in family members' perceptions of each other have been found to relate to adolescent substance abuse. Much of the hostility and misunderstanding described earlier may be the result of inaccurate perceptions of family members. Parents' perceptions of their chemically dependent children seem to be less accurate than the perceptions of those who do not have chemically dependent children (Gantman, 1978). Despite agreement between drug-abusing children and their parents regarding "the ideal child" and the extent to which the child meets this ideal, there is a discrepancy in how parents and children describe the "real child" (Alexander & Dibb, 1977). Concurrently, a significant proportion of adolescent drug abusers describe their parents as lacking trust and understanding even though parents feel they have these qualities (Rees & Wilborn, 1983). These findings imply that practitioners may need to help families communicate more openly in order to understand each other.

Table 4

Studies of Family Atmosphere: Discrepancies in Perception

Investigator   S(*)   NS(**)           Finding

Gantman        x               families with nonabusing
(1978)                         teenagers seem to be more
                               accurate in their perceptions than
                               families of drag abusers

Alexander &    x               parents and their drug-abusing
Dibb                           teenagers tend to see the teenager
(1977)                         as discrepant from the ideal child

               x               parents of drug-abusing teenagers
                               do not agree with child when
                               describing the real child

Rees &         x               more disagreement among
Wilborn                        drug-using adolescents and their
(1983)                         parents on perceived parental
                               behavior than nonusing
                               adolescents and their parents

* S = Significant as reported by researcher
** NS = Not significant as reported by researcher

CONCLUSION

Many adolescents live in a drug-oriented society and sometimes in drug-oriented families. Studies have demonstrated that there is a relationship between adolescent drug abuse and particular familial characteristics, namely, family drug usage patterns and family atmosphere. Professionals must closely examine this relationship in order to incorporate a family perspective in plans for intervention, treatment, and prevention. For example, schools and communities can educate both children and parents about the facts of drug abuse. Programs within the school and/or community (i.e., mental health clinics and treatment centers) can be devised to aid children "at risk" of chemical dependency. Finally, the community can create "drug-free" centers and activities that draw families together to enjoy being a part of the community. Recognizing these family influences and developing programs from a family perspective is an important step in managing the dilemma of adolescent substance abuse.

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