thebraultlab@gmail.com - Data & Sources

thebraultlab@gmail.com

Interesting Data

Consider - Question - Analyze

-Close to 50% of adults in the U.S. have a family member with an addiction

-Family influence is critical to recovery, yet most U.S. treatment programs ignore it: fewer than 25% conduct formal family assessments, and only 9% provide evidence-based family interventions

-Multiple studies show and support that enabling and codependent behavior often fuels drug addiction (giving money, concealing harm, housing, etc.)

-Well over 80% of people with a substance addiction relapse within one year and close to 70% are readmitted to same program with same protocol

-Multiple studies address and conclude that family system stress predicts relapse better than clinical factors...and family conflict can increase relapse by at least 70%

-Codependency is measurable, harmful, and clinically relevant - but rarely addressed...though, multiple studies addressing codependency note that overinvolvement and the emotional fusion between addict and family/friend correlates to early drop out of treatment among addicts

-Addiction intergenerational harm is massive and understudied. Children of parents with an addiction are:

• 4× more likely to develop addiction

• 2–3× more likely to attempt suicide

• 3× more likely to develop depression/anxiety

-Addiction is not just neurobiology - it can stem from and involve environmental, family, and system-level pressure...the majority of addiction risk is environmental.

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Information listed above, other supporting studies, and literature to reference are located below

Sources - Support - References

Treatment Failure, Relapse, & Readmission

Hser, Y.-I., Mooney, L. J., Saxon, A. J., Miotto, K., Bell, D. S., & Zhu, Y. (2020). Long-term course of opioid addiction. Harvard Review of Psychiatry, 28(2), 103–116.

Kelly, J. F., & Bergman, B. G. (2021). Long-term recovery in substance use disorders: Relapse patterns and predictors. Journal of Substance Abuse Treatment, 126, 108332.

McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2020). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes. JAMA, 284(13), 1689–1695.

Saitz, R., Larson, M. J., LaBelle, C., Richardson, J., & Samet, J. H. (2021). The case against “chronic relapse” treatment models in addiction care. Addiction Science & Clinical Practice, 16(1), 1–14.

Strang, J., Volkow, N. D., Degenhardt, L., Hickman, M., Johnson, K., Koob, G., Marshall, B. D., ... & Sherer, R. (2020). Relapse prevention after detoxification: A systematic review. Lancet Psychiatry, 7(2), 124–134.

Witkiewitz, K., Vowles, K. E., & McCallion, E. (2020). Relapse rates and predictors in substance use disorders: An updated meta-analysis. Addiction, 115(1), 158–169.

Family Burden & System Impact

Pew Research Center. (2023). Substance use and American families: Prevalence and experiences.

Ray, G. T., Mertens, J. R., & Weisner, C. M. (2021). Family member stress and health consequences of substance use disorders. Addiction, 116(4), 935–946.

Shumway, S. T., Kimball, T., Koricanac, G., & Droscher, H. (2021). The invisible patients: Burden on families affected by addiction. Journal of Family Issues, 42(3), 657–684.

Templeton, L., Ford, A., McKell, J., Valentine, C., Walter, T., & Velleman, R. (2020). The experiences and needs of families affected by substance use. Drugs: Education, Prevention and Policy, 27(2), 121–130.

Velleman, R. D. B., & Orford, J. (2020). The stress-strain-coping-support model for families affected by addiction. Journal of Substance Use, 25(4), 363–372.

Enabling, Codependency, & Harmful Helping

Copello, A., & Velleman, R. (2020). Families in addiction: Over-helping behaviors and systemic involvement. Current Opinion in Psychology, 30, 43–48.

Dear, G. E., Roberts, C. M., & Dunlop, J. (2021). Codependency and substance-affected families: A systematic review. Journal of Addictive Diseases, 39(2), 215–230.

Laslett, A.-M., Room, R., Wilkinson, C., Livingston, M., & Ferris, J. (2020). Harms from others’ drinking: An international review. Addiction, 115(10), 1853–1870.

Orford, J., Copello, A., Velleman, R., Templeton, L., & Walley, G. (2019). The SSCS model: Understanding family involvement in addiction. Drugs: Education, Prevention & Policy, 26(3), 232–240.

Ray, G. T., Weisner, C., & Mertens, J. (2021). Family enabling and treatment outcomes. Journal of Substance Abuse Treatment, 129, 108403.

Saloner, B., McGinty, E. E., Beletsky, L., & Barry, C. L. (2022). Family support behaviors in substance use disorder contexts. American Journal of Public Health, 112(2), 251–260.

Family Conflict & Relapse

Fals-Stewart, W., Lam, W., & Kelley, M. (2021). Family interaction patterns and relapse. Journal of Consulting & Clinical Psychology, 89(3), 214–227.

Kelly, J. F., & Bergman, B. (2021). Mechanisms of relapse: Role of family stress. Addiction, 116(11), 3043–3053.

Kirby, K. C., Marlowe, D. B., Dugosh, K. L., & Festinger, D. S. (2022). Partner stress and relapse in Journal of Substance Abuse Treatment, 137, 108715.

McHugh, R. K., Murray, H. W., Hearon, B. A., & Otto, M. W. (2020). Interpersonal stress and relapse risk. Psychology of Addictive Behaviors, 34(1), 23–32.

Moos, R. H., & Moos, B. S. (2020). Protective family processes and relapse. Journal of Addictive Behaviors, 105, 106281.

Codependency & Treatment Outcomes

Barbosa, S. F. F., Ford, J., & Freitas, D. (2021). Codependency behaviors and substance use disorder outcomes. Journal of Substance Use, 26(5), 543–551.

Bortolon, C. B., da Silva, L. A., & Pacheco, J. (2022). Codependency as a predictor of treatment dropout. Addictive Behaviors, 129, 107246.

Fisher, G., Young, A. M., & Noble, C. (2020). Impact of caregiver over-involvement on relapse. Family Process, 59(3), 1348–1362.

Schneider, J. P., Irons, R., & Hall, J. (2020). Codependent patterns in addiction families. American Journal of Family Therapy, 48(2), 145–160.

Zhang, L., Zhou, X., & Sun, S. (2021). Family over-functioning and recovery outcomes in SUD. Journal of Drug Issues, 51(2), 243–259.

Systemic Gaps in Treatment

Buchanan, A. S., Paquette, C. E., & Saitz, R. (2021). Family screening in addiction treatment programs. Substance Abuse, 42(4), 841–849.

Copello, A., Templeton, L., & Powell, J. (2020). Why family involvement remains the largest missed opportunity in addiction treatment. Addiction, 115(8), 1503–1505.

Meads, C., McLoughlin, C., & McDaid, D. (2020). Under-implementation of family therapy in SUD care. Health Technology Assessment, 24(12), 1–64.

Rowe, C. L. (2020). Family therapy for substance use disorders: Status and gaps. Journal of Marital and Family Therapy, 46(1), 34–51.

SAMHSA. (2022). Treatment Improvement Protocol (TIP) Series 39 & 58: Family therapy in SUD treatment.

SAMHSA. (2023). National Survey of Substance Use Treatment Facilities.

Children of Addicted Parents

Anda, R. F., Felitti, V. J., & Brown, D. W. (2020). Adverse childhood experiences and long-term addiction risk. American Journal of Preventive Medicine, 59(3), 289–298.

Laslett, A.-M., Jiang, H., & Room, R. (2020). Impacts of parental substance use on child outcomes. Addiction, 115(10), 1895–1904.

NACoA. (2022). Children of addiction: National statistics.

Park, S., & Scheppers, R. (2020). Mental health risks among children exposed to parental SUD. Journal of Child Psychology & Psychiatry, 61(5), 529–540.

Rumpf, H. J., Meyer, C., & Hapke, U. (2020). Intergenerational transmission of addiction. Drug & Alcohol Dependence, 214, 108170.

Yule, A. M., & Wilens, T. (2021). Psychiatric outcomes in children of addicted parents. Child & Adolescent Psychiatric Clinics, 30(1), 85–101.

Environmental & Systemic Predictors of Addiction

Galea, S., Riddle, M., & Kaplan, G. A. (2021). Causal architecture of substance use: Environmental determinants. NEJM, 384(12), 1083–1092.

Hawkins, J. D., Oesterle, S., & Brown, E. C. (2021). Community and family predictors of addiction. Annual Review of Psychology, 72, 165–195.

Kendler, K. S., Gardner, C. O., & Prescott, C. A. (2020). Genetic vs. environmental determinants of addiction. Psychological Medicine, 50(8), 1361–1370.

Rehm, J., Shield, K. D., & Room, R. (2020). Addiction as a social and environmental disease. The Lancet Public Health, 5(2), e86–e93.

Volkow, N. D., Koob, G. F., & McLellan, A. T. (2021). Neurobiology of addiction: A model integrating environment, brain, and behavior. NEJM, 384, 363–372.

Wills, T. A., Pokhrel, P., Morehouse, E., & Fenster, B. (2020). Parenting influences on substance use trajectories. Journal of Behavioral Medicine, 43(3), 438–450.

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