By: Mathew Kunnath John MSW, MPhil.
Addiction is often viewed as an individual’s battle, but the reality is far more complex. The family unit, the very foundation of our social learning, plays a profound and often unseen role in the initiation, continuation, and recovery from addictive disorders. This intricate relationship, woven from a combination of genetics, learned behaviors, and the quality of relationships, underscores the necessity of a family-focused approach to understanding and treating addiction.
The Seeds of Addiction: How Family Life Can Play a Part
The journey into addiction can begin within the family environment in several ways:
- Genetic Predisposition:
- A family history of substance use is a significant risk factor. Studies on alcohol addiction, for instance, show a threefold increased risk for individuals with a first-degree relative who has an addiction. This suggests a genetic vulnerability that can be passed down through generations.
- Learned Behavior:
- Children are keen observers. When they witness substance use as a coping mechanism for stress, a part of celebrations, or a routine activity, they may internalize these behaviors. Phrases like, “I had a tough day, I need a drink,” can normalize substance use as a way to manage life’s challenges.
- Parenting Styles:
- Both overly rigid and excessively permissive parenting can increase the risk of substance use. A lack of consistent monitoring and the failure to address negative behaviors can be seen as a breakdown of the family’s ability to guide its members.
- Relationship Dynamics:
- The quality of relationships within a family is crucial. A lack of cohesion, warmth, and open communication can lead individuals to seek solace in substances as a way to manage negative emotions or build social networks.
- Socio-Cultural and Economic Factors:
- In some cultures, substances like alcohol and cannabis are used in religious ceremonies or are socially accepted at gatherings, which can provide early exposure. Additionally, families with a lower socioeconomic status may experience increased stress and have less access to alternative coping mechanisms, while working-class parents may have less time to spend with their children, leading to isolation and potential substance use.
The Family's Role in Maintaining a Cycle of Addiction
The intricate web of family life can become a crucible for the continuation of addiction, often unintentionally. Beyond the initial triggers, the very dynamics of a family unit can create a fertile ground for substance dependency to flourish. From well-intentioned but misguided support to ingrained communication breakdowns, the family’s role in sustaining addiction is a complex and often heartbreaking phenomenon
Enabling Behavior: The Velvet Glove on an Iron Fist
At the heart of addiction’s continuation within a family often lies the insidious pattern of enabling. This is not overt encouragement of substance use, but rather a series of actions, driven by love, fear, or a desperate desire for peace, that shield the individual from the natural consequences of their addiction. This “help” paradoxically becomes the biggest hindrance to recovery.
Common forms of enabling include:
Making Excuses and Covering Up:
A spouse might call their partner’s boss with a fabricated illness to hide a hangover, or a parent might lie to other family members about their child’s erratic behavior. These actions prevent the individual from facing the social, professional, or legal repercussions of their choices.
Taking Over Responsibilities:
Family members may increasingly shoulder the responsibilities that the person with an addiction neglects. This can range from paying their bills and managing their finances to taking care of their children and household chores. This buffers the individual from the reality of their deteriorating ability to function.
Financial Bailouts: Providing money for rent, bills, or legal troubles, knowing it will likely be used to fund the addiction, is a direct infusion into the cycle. This removes the financial pressure that might otherwise force a person to confront their problem.
Minimizing the Problem:
Phrases like “It’s not that bad,” or “They’re just going through a tough time,” downplay the severity of the addiction. This denial prevents the family from uniting in a clear and firm stance against the substance use.
The psychological roots of enabling are deep and varied. They can stem from a fear of conflict, a sense of guilt or misplaced loyalty, low self-esteem in the enabler who feels needed in the “caretaker” role, or a desperate hope that the problem will simply resolve itself.
The Triggering Environment: When Celebrations Become Cues
For many, family life is punctuated by rituals and celebrations. However, when these events are consistently intertwined with substance use, they transform from joyous occasions into powerful triggers for an individual struggling with addiction.
Family gatherings, holidays, and even regular weekend get-togethers can become so strongly associated with alcohol or other substances that abstinence feels alien or even disruptive to the family tradition. The cultural and social norms within the family can create an environment where sobriety is the exception, not the rule. The pressure to partake, whether spoken or unspoken, can be immense, making it incredibly difficult for an individual to maintain their resolve. The very act of celebrating becomes a conditioned cue for substance use, reinforcing the addictive pattern with each festive occasion.
The Breakdown of Words: How Poor Communication Fuels the Fire
The way a family communicates—or fails to—can be a significant factor in the perpetuation of addiction. Dysfunctional communication patterns create a chaotic and emotionally charged environment where substance use can feel like a necessary escape.
Key communication issues that sustain addiction include:
Inconsistent Messages:
Family members may present a united front one day, expressing concern and setting boundaries, only to backtrack the next out of fear or pity. This inconsistency sends a confusing message to the individual with an addiction, undermining any motivation to change.
Poorly Communicated Expectations:
Vague or unrealistic expectations for recovery can set an individual up for failure. If the family’s hopes are not clearly articulated and grounded in the reality of the recovery process, which often involves setbacks, the individual may feel overwhelmed and relapse.
Frequent Conflicts and Blame:
A home environment characterized by constant arguments, blame, and criticism can be a significant source of stress. An individual may turn to substances to cope with the emotional turmoil, creating a vicious cycle where the substance use exacerbates the conflict, and the conflict fuels the substance use.
Emotional Unavailability:
- In some families, there is a reluctance or inability to express emotions openly and honestly. This emotional distance can leave an individual feeling isolated and misunderstood, making it harder for them to seek genuine connection and support, and easier to find solace in their addiction.
Dysfunctional Roles:
In an attempt to cope, family members may unconsciously adopt specific roles: the “hero” who tries to fix everything, the “scapegoat” who gets blamed for the family’s problems, the “lost child” who withdraws, or the “mascot” who uses humor to deflect tension. These roles, while a survival mechanism, prevent open and direct communication about the core issue of addiction.
A Force for Healing: The Power of Family in Recovery
While the dynamics of a family can sometimes contribute to the complexities of addiction, they are also an unparalleled source of strength and a catalyst for profound healing and lasting recovery. The intricate web of relationships within a family holds the power to create a resilient support system, foster therapeutic breakthroughs, and instill a sense of shared purpose on the path to wellness.
Strong Support Systems: A Bulwark Against Relapse
A family that is united in its support provides a powerful defense against the persistent threat of relapse. Strong familial bonds and a nurturing environment are not just comforting; they are clinically significant tools in the recovery process. Research consistently shows that individuals with engaged and supportive families have a greater chance of achieving and maintaining sobriety.
At the heart of this supportive framework is open and honest communication. When family members feel safe to express their fears, frustrations, and hopes without judgment, it creates an atmosphere of trust and mutual respect. This foundation allows for the collaborative tackling of problems as they arise, preventing the buildup of resentment and misunderstanding that can so often derail recovery. Simple acts, such as regular family check-ins, active listening, and expressing encouragement, can significantly bolster a person’s resolve. This supportive environment also extends to celebrating small victories and offering understanding during setbacks, reinforcing the message that the individual is not alone on their journey.
Therapeutic Interventions: Healing the Family Unit
The journey of recovery is rarely a solo endeavor. Family-based therapies have proven to be highly effective in treating addiction by addressing the family system as a whole. These interventions recognize that addiction is a “family disease,” impacting each member and the dynamics between them.
Therapeutic approaches such as Functional Family Therapy (FFT), Behavioral Couples Therapy (BCT), and Multi-Dimensional Family Therapy (MDFT) are designed to:
Enhance Communication: Therapists guide families in developing healthier communication patterns, moving away from blame and criticism towards understanding and empathy.
Rebuild Trust: Addiction often erodes trust. Therapy provides a structured and safe environment to address past hurts and begin the process of rebuilding this crucial foundation.
Educate on Addiction: A vital component of family therapy is educating members about the neurobiology of addiction. This understanding helps to shift perspectives from viewing addiction as a moral failing to recognizing it as a chronic disease, fostering patience and informed support.
Differentiate Enabling from Supporting: A key distinction that families learn is the difference between genuinely helping and enabling. Enabling behaviors, such as making excuses for the individual or shielding them from the consequences of their actions, can inadvertently perpetuate the addiction. In contrast, supportive behaviors empower the individual to take responsibility for their recovery while still feeling loved and cared for. This can include setting healthy boundaries, encouraging treatment adherence, and refusing to provide financial support for substance use.
Collective Responsibility: A Shared Path to a Healthy Environment
The concept of collective responsibility is pivotal in transforming the home into a sanctuary for recovery. This shared commitment involves every family member actively participating in creating an environment that is conducive to healing and free from temptation.
This responsibility manifests in several practical ways:
Removing Triggers: This can be as straightforward as removing all alcohol, drugs, and associated paraphernalia from the home. It can also involve being mindful of social situations that may be triggering for the person in recovery.
Promoting a Healthy Lifestyle: Families can collectively adopt healthier habits, such as preparing nutritious meals together, engaging in regular physical activity, and prioritizing adequate sleep. This not only benefits the individual in recovery but also improves the overall well-being of the entire family.
Establishing New Rituals and Traditions: Creating new, positive family rituals that do not revolve around substance use can help to replace old, unhealthy patterns. This could include game nights, outdoor adventures, or shared hobbies.
Special Considerations Across Different Groups
The influence of family on addiction can vary across different populations:
Adolescents: A Battleground of Parental Influence and Peer Pressure
For teenagers, the family environment is a primary determinant in their journey toward or away from addiction. The actions and attitudes of parents are powerful predictors. Parental substance use stands out as a significant risk factor, normalizing addictive behaviors and increasing access to substances. A home where drugs or alcohol are misused can create a blueprint for unhealthy coping mechanisms.
However, the family can also be the strongest line of defense. Positive and supportive relationships with parents are a potent buffer against the siren call of peer pressure. Open communication, consistent and fair discipline, and a sense of being understood and valued can equip adolescents with the resilience to navigate social challenges. This supportive framework is not only crucial in preventing substance abuse but also in mitigating other modern-day addictions. For instance, internet addiction in teenagers has been strongly linked to family environments characterized by a lack of warmth, poor organization, and dysfunctional communication patterns. Families that prioritize connection and healthy activities provide a real-world alternative to the virtual escapism that can lead to compulsive online behavior.
The Elderly: Late-Onset Addiction in the Shadow of Loss and Loneliness
In the geriatric population, the specter of addiction often emerges in the wake of profound life changes, a phenomenon known as late-onset substance use. For many older adults, the loss of a spouse is a cataclysmic event that can shatter their social and emotional foundation. This grief, compounded by a lack of robust social support from remaining family and friends, creates a fertile ground for addiction to take root.
Retirement, while often anticipated, can also usher in an era of social isolation. The structured social network of the workplace dissolves, and if not replaced by meaningful connections, can lead to profound loneliness and boredom. In the absence of engaged family support to help navigate these transitions, older adults may turn to alcohol or prescription medications to self-medicate their emotional pain and fill the void. The family’s role in this stage of life is to remain connected, to offer companionship, and to help their elderly loved ones find new purpose and community, thereby mitigating the risk of them succumbing to addiction as a means of coping.
Women: A Triad of Genetic Predisposition, Relational Stress, and Stigmatization
For women, the path to addiction is often paved with a unique combination of biological vulnerability, interpersonal turmoil, and societal judgment. A family history of substance use is a particularly strong predictor for women, suggesting a genetic predisposition that can be activated by environmental stressors.
Relationship problems with a spouse or partner and a general lack of social support are common triggers that can push women toward substance use as an escape from emotional distress. However, the challenges for women do not end with the onset of addiction; in many ways, they are amplified by the reactions of those closest to them.
Unfortunately, women with addictions frequently face more profound stigma and negative attitudes from their families compared to their male counterparts. These judgments are often rooted in societal expectations of women as caregivers and moral compasses. This familial disapproval can manifest as blame, shame, and a withdrawal of support, creating significant barriers that prevent women from seeking or receiving the help they desperately need. The fear of being ostracized by their own family, or of losing their children, can trap them in a cycle of silence and continued substance misuse, making the family’s understanding and support an even more critical component of their potential recovery.
Conclusion
In conclusion, the family’s role in the landscape of addiction is undeniably and profoundly multifaceted, weaving a complex web of genetic predispositions, learned behaviors, and ingrained communication patterns that can either fuel the cycle of substance use or become a powerful force for healing. To truly address addiction, we must evolve beyond an outdated and ineffective model of individual blame, which so often isolates the person struggling and ignores the systemic dynamics at play. A more compassionate and effective approach acknowledges that while family systems can inadvertently contribute to the problem through enabling, codependency, or unresolved trauma, they are also uniquely positioned to be the cornerstone of lasting recovery. By actively engaging families in the healing process through therapy, education, and open dialogue, we can transform a source of pain and dysfunction into an environment of profound support, understanding, and shared responsibility, ultimately paving the way not just for the individual’s sobriety, but for the collective restoration of the entire family unit.
It is crucial to recognize and act upon the signs of addiction, whether in yourself or a loved one, as early intervention can significantly improve outcomes. For established dependencies on substances like alcohol or other drugs, a structured inpatient admission is often recommended to ensure proper medical monitoring and safely manage the physiological aspects of withdrawal. However, if you identify that you or someone you care about is exhibiting behaviors that could lead to addiction, proactive measures such as counseling and psychotherapy can be incredibly effective. Modern therapeutic approaches, including convenient and accessible virtual sessions, can provide the necessary tools and support to address underlying issues and prevent the progression of addictive behaviors. We encourage you to reach out for a confidential consultation to explore these options further and find the right support for your unique situation.
Connect with us for more details by emailing manancalicut@gmail.com or by sending a message on WhatsApp to +919709288932.
About the author:
- Mathew Kunnath John is a highly experienced Psychiatric Social Worker and Mental Health Professional with over 13 years in the field. He established mananmentalhealth.com, offering secure online therapy to a diverse global clientele.
- Since November 2018, Mathew has completed five international missions with Doctors Without Borders (MSF), serving in Jordan, Sierra Leone, Ethiopia, Libya, and South Sudan, addressing critical mental health needs in conflict and crisis zones. He is also a prolific researcher, covering topics such as the impact of COVID-19, explanatory models of mental illness, social connectedness, gender discrimination, and psychological distress.
Important references
- Abel, E. L. (1980). The first twelve thousand years. McGraw Hill.
- Andrews, J. A., Hops, H., Ary, D., Tildesley, E., & Harris, J. (1993). Parental influence on early adolescent substance use: Specific and nonspecific effects. The Journal of Early Adolescence, 13(3), 285–310.
- Andrews, J. A., Hops, H., & Duncan, S. C. (1997). Adolescent modeling of parent substance use: The moderating effect of the relationship with the parent. Journal of Family Psychology, 11(3), 259–270.
- Arria, A. M., Mericle, A. A., Rallo, D., Moe, J., White, W. L., Winters, K. C., & O’Connor, G. (2013). Integration of parenting skills education and interventions in addiction treatment. Journal of Addiction Medicine, 7(1), 1–7. https://doi.org/10.1097/ADM.0b013e318270f7b0
- Bahr, S. J., Marcos, A. C., & Maughan, S. L. (1995). Family, educational and peer influences on the alcohol use of female and male adolescents. Journal of Studies on Alcohol, 56(4), 457–469.
- Barr, H. L. (1985). What happens as the alcoholic and the drug addict get older? The combined problems of alcoholism, drug addiction and aging. Charles C. Thomas.
- Baumrind, D. (1985). Familial antecedents of adolescent drug use: A developmental perspective. NIDA Research Monograph Series, 56, 13–44.
- Baumrind, D. (1989). Rearing competent children. In W. Damon (Ed.), Child development today and tomorrow. Jossey Bass.
- Bobo, J. K., & Husten, C. (2000). Sociocultural influences on smoking and drinking. Alcohol Research and Health, 24(4), 225–232.
- Botvin, G. J., & Griffin, K. W. (2010). Evidence-based interventions for preventing substance use disorders in adolescents. Child and Adolescent Psychiatric Clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005
- Boyd, M. R., & Mackey, M. C. (2000). Alienation from self and others: The psychosocial problem of rural alcoholic women. Archives of Psychiatric Nursing, 15(3), 134–141.
- Brook, J. S., Brook, D. W., Gordon, A. S., Whiteman, M., & Cohen, P. (1990). The psychosocial etiology of adolescent drug use: A family interactional approach. Genetic, Social, and General Psychology Monographs, 116(2), 111–267.
- Brook, J. S., Whiteman, M., Gordon, A. S., & Cohen, P. (1986). Some models and mechanisms for explaining the impact of maternal and adolescent characteristics on adolescent stage of drug use. Developmental Psychology, 22(4), 460–467.
- Cattarello, A. M., Clayton, R. R., & Leukefeld, C. G. (1995). Adolescent alcohol and drug abuse. Review of Psychiatry, 14, 151–168.
- Cermak, T. L. (1986). Diagnostic criteria for codependency. Journal of Psychoactive Drugs, 18(1), 15–20.
- Choi, J. K. (2003). An exploratory study on the assessment factors of female problem drinker [Unpublished master’s thesis]. Seoul Women’s University.
- Choi, K. D. (2005). The determination of problem drinking for women [Unpublished master’s thesis]. Chonbuk National University.
- Chopra, I. C., & Chopra, R. N. (1957). The use of cannabis drugs in India. Bulletin on Narcotics, 9(1), 4–29.
- Chopra, R. N., & Chopra, I. C. (1990). Drug addiction with special reference to India. Council of Scientific and Industrial Research.
- Christiansen, B., & Teahan, J. (1987). Cross cultural comparison of Irish and American adolescent drinking practices and beliefs. Journal of Studies on Alcohol, 48(6), 558–562.
- Coie, J. D., Watt, N. F., West, S. G., Hawkins, J. D., Asarnow, J. R., Markman, H. J., Ramey, S. L., Shure, M. B., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 48(10), 1013–1022.
- Coombs, R. H., & Paulson, M. J. (1988). Contrasting family patterns of adolescent drug users and nonusers. Journal of Chemical Dependency Treatment, 1(2), 59–72.
- Dobkin, P. L., Civita, M. D., Paraherakis, A., & Gill, K. (2002). The role of functional social support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97(3), 347–356.
- Dodgen, C. E., & Shea, W. M. (2000). Substance use disorders: Assessment and treatment. Academic Press.
- Dorabjee, J., & Samson, L. (2000). A multi-centre rapid assessment of injecting drug use in India. International Journal of Drug Policy, 11(1–2), 99–112.
- Ducci, F., & Goldman, D. (2012). The genetic basis of addictive disorders. Psychiatric Clinics of North America, 35(2), 495–519. https://doi.org/10.1016/j.psc.2012.03.010
- Duncan, T. E., Tildesley, E., Duncan, S. C., & Hops, H. (1995). The consistency of family and peer influences on the development of substance use in adolescence. Addiction, 90(12), 1647–1660.
- Eckersley, R. M. (2005). ‘Cultural fraud’: The role of culture in drug abuse. Drug and Alcohol Review, 24(2), 157–163.
- Flora, K., & Stalikas, A. (2013). Factors affecting substance abuse treatment across different treatment phases. International Journal of Psychosocial Rehabilitation, 18(1), 27–42.
- Forney, M. A., Forney, P. D., & Ripley, W. K. (1989). Predictor variables of adolescent drinking. Advances in Alcohol & Substance Abuse, 8(2), 97–117.
- Fraser, S., & Moore, D. (Eds.). (2002). The drug effect: Health, crime and society. Cambridge University Press.
- Frazier, P. A., Tix, A. P., Klein, C. D., & Arikian, N. J. (2000). Testing theoretical models of the relations between social support, coping, and adjustment to stressful life events. Journal of Social and Clinical Psychology, 19(3), 314–335.
- Ganguly, K. K., Sharma, H. K., & Krishnamachari, K. A. V. R. (1995). An ethnographic account of opium consumers of Rajasthan (India): Socio-medical perspective. Addiction, 90(1), 9–12.
- Garmendia, M. L., Alvarado, M. E., Montenegro, M., & Pino, P. (2008). Social support as protective factor of recurrence after drug addiction treatment. Revista Medica de Chile, 136(2), 169–178.
- Ghasemi, V., & Malek Ahmadi, H. (2010). Determining internet addiction among café net users in Shahinshahr. Journal of Communicational Researches, 17, 51–77.
- Habibi, A., Danesh, P., & Mazandarani, M. J. Z. (2015). The relationship of family function with internet addiction among girl high school students in Malard. Mediterranean Journal of Social Sciences, 6(4), 215.
- Hanson, M. D., & Chen, E. (2007). Socioeconomic status and substance use behaviors in adolescents: The role of family resources versus family social status. Journal of Health Psychology, 12(1), 32–35.
- Huckle, T., You, R. Q., & Casswell, S. (2010). Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction, 105(7), 1192–1202. https://doi.org/10.1111/j.1360-0443.2010.02931.x
- Indian Council of Medical Research. (2008). Pattern and process of drug and alcohol use in India. ICMR Bulletin, 38(1-3). http://icmr.nic.in/bulletin/english/2008/bulljan-mar08.pdf
- Jacob, T., & Leonard, K. (1994). Family and peer influences in the development of adolescent alcohol abuse. In The development of alcohol problems: Exploring the biopsychosocial matrix of risk (Vol. 26, pp. 123–155). Department of Health and Human Services.
- Jeong, S. Y. (2003). The relationship of sex-role identity, self-esteem, social support and satisfaction of life of the alcoholic women and general women [Unpublished master’s thesis]. Dongshin University.
- Johnstone, B. M. (1994). Sociodemographic, environmental, and cultural influences on adolescent drinking behavior. In R. A. Zucker, G. M. Boyd, & J. Howard (Eds.), The Development of Alcohol Problems: Exploring the Biopsychosocial Matrix of Risk (National Institute on Alcohol Abuse and Alcoholism Research Monograph No. 26, NIH Pub. No. 94–3495, pp. 123–156). National Institute on Alcohol Abuse and Alcoholism.
- Kandel, D. (1974). Inter- and intragenerational influences on adolescent marijuana use. Journal of Social Issues, 30(2), 107–135.
- Kandel, D. B., & Andrews, K. (1987). Processes of adolescent socialization by parents and peers. The International Journal of the Addictions, 22(4), 319–342.
- Kim, S. (2006). Drinking experiences of women alcoholics: A feministic approach. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 15(4), 362–374.
- Kim, W., & Kim, S. (2008). Women’s alcohol use and alcoholism in Korea. Substance Use & Misuse, 43(8–9), 1078–1087.
- Kosterman, R., Hawkins, J. D., Spoth, R., Haggerty, K. P., & Zhu, K. (1995). Preparing for the drug free years: Effects on videotaped family interactions [Unpublished manuscript]. Social Development Research Group, University of Washington.
- Kraut, R., Kiesler, S., Boneva, B., Cummings, J., Helgeson, V., & Crawford, A. (2002). Internet paradox revisited. Journal of Social Issues, 58(1), 49–74.
- Lamb, R. J., Schindler, C. W., & Pinkston, J. W. (2016). Conditioned stimuli’s role in relapse: Preclinical research on Pavlovian-Instrumental-Transfer. Psychopharmacology, 233(10), 1933–1944. https://doi.org/10.1007/s00213-016-4216-y
- Lamborn, S. D., Mounts, N. S., Steinberg, L., & Dornbusch, S. M. (1991). Patterns of competence and adjustment among adolescents from authoritative, authoritarian, indulgent, and neglectful families. Child Development, 62(5), 1049–1065.
- Lee, C. S., & Kim, S. J. (2000). The drinking experience of women alcoholics. Journal of Korean Academy of Psychiatric and Mental Health Nursing, 9(2), 409–427.
- Li, T., & Zhang, L. (2004). How college students’ internet addiction are related to parental rearing patterns. Psychological Science (China), 27(3), 662–663.
- Li, W., Garland, E. L., & Howard, M. O. (204). Family factors in Internet addiction among Chinese youth: A review of English- and Chinese-language studies. Computers in Human Behavior, 31, 393–411.
- Lim, S. Y. (2002). A case study of female alcoholics’ addictive process [Unpublished master’s thesis]. Catholic University.
- Lin, C., Wu, Z., & Detels, R. (2011). Family support, quality of life and concurrent substance use among methadone maintenance therapy clients in China. Public Health, 125(5), 269–274.
- Lochman, J. E., & van den Steenhoven, A. (2002). Family-based approaches to substance abuse prevention. Journal of Primary Prevention, 23(1), 49–114.
- Lonczak, H. S., Fernandez, A., Austin, L., Marlatt, G. A., & Donovan, D. M. (2007). Family structure and substance use among American Indian youth: A preliminary study. Families, Systems, & Health, 25(1), 10–21.
- Lorente, S. (2002). Youth and mobile telephones: More than a fashion. Revista de Estudios de Juventud, 57(2), 9–24.
- Luthar, S. S., & Goldstein, A. S. (2008). Substance use and related behaviors among suburban late adolescents: The importance of perceived parent containment. Development and Psychopathology, 20(2), 591–614. https://doi.org/10.1017/S095457940800029X
- Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press.
- McIntyre, E., Wiener, K. K., & Saliba, A. J. (2015). Compulsive Internet use and relations between social connectedness, and introversion. Computers in Human Behavior, 48, 569–574.
- Meyers, A. (1985). The epidemiology of late-life problem drinking: What a survey says. In H. L. Barr (Ed.), The combined problems of alcoholism, drug addiction and aging (pp. 228–239). Charles C. Thomas Publishers.
- Meyers, R. J., Apodaca, T. R., Flicker, S. M., & Slesnick, N. (2002). Evidence-based approaches for the treatment of substance abusers by involving family members. The Family Journal, 10(3), 281–288.
- Morgan, M., & Brosi, W. A. (2007). Prescription drug abuse among older adults: A family ecological case study. Journal of Applied Gerontology, 26(5), 419–433.
- Nattala, P., Leung, K. S., Nagarajaiah, & Murthy, P. (2010). Family member involvement in relapse prevention improves alcohol dependence outcomes: A prospective study at an addiction treatment facility in India. Journal of Studies on Alcohol and Drugs, 71(4), 581–587.
- Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2–21.
- Perring, C. (2011). Bridging the gap between philosophers of mind and brain researchers: The example of addiction. Mens Sana Monographs, 9(1), 193–201. https://doi.org/10.4103/0973-1229.77435
- Piercy, F. P., Volk, R. J., Trepper, T., & Sprenkle, D. H. (1991). The relationship of family factors to patterns of adolescent substance abuse. Family Dynamics of Addiction Quarterly, 1(2), 41–54.
- Reilly, M. T., Noronha, A., Goldman, D., & Koob, G. F. (2017). Genetic studies of alcohol dependence in the context of the addiction cycle. Neuropharmacology, 122, 3–21. https://doi.org/10.1016/j.neuropharm.2017.01.017
- Schonfeld, L., & Dupree, L. W. (1991). Antecedents of drinking for early-and late-onset elderly alcohol abusers. Journal of Studies on Alcohol, 52(6), 587–592.
- Şenormancı, O., Şenormancı, G., Guclu, O., & Konkan, R. (2014). Attachment and family functioning in patients with internet addiction. General Hospital Psychiatry, 36(2), 203–207.
- Shukla, B. R. (1979). Drinks and drugs in a North Indian village: An anthropological study. Ethnographic and Folk Culture Society.
- Steinberg, L., Fletcher, A., & Darling, N. (1994). Parental monitoring and peer influences on adolescent substance use. Pediatrics, 93(6, Pt. 2), 1060–1064.
- Stelle, C. D., & Scott, J. P. (2007). Alcohol abuse by older family members: A family systems analysis of assessment and intervention. In Familial responses to alcohol problems (pp. 43–63).
- Tandon, T. (2015). Drug policy in India. International Drug Policy Consortium. http://idhdp.com/media/400258/idpc-briefing-paper_drug-policy-in-india.pdf
- Turner, R. A., Irwin, C. E., Tschann, J. M., & Millstein, S. G. (1993). Autonomy, relatedness, and the initiation of health risk behaviors in early adolescence. Health Psychology, 12(3), 200–208.
- United Nations Office on Drugs and Crime. (2007). Cannabis in Africa: An overview. https://www.unodc.org/documents/data-and-analysis/Can_Afr_EN_09_11_07.pdf
- Van der Westhuizen, M., & de Jager, M. (2007). Relapsing after treatment: Exploring the experiences of chemically addicted adolescents. University of South Africa.
- Velleman, R. D. B., Templeton, L. J., & Copello, A. G. (2005). The role of the family in preventing and intervening with substance use and misuse: A comprehensive review of family interventions, with a focus on young people. Drug and Alcohol Review, 24(2), 93–109.
- Walters, G. D. (1994). Escaping the journey to nowhere: The psychology of alcohol and other drug abuse. Taylor & Francis.
- West, R., & Hardy, A. (2005). Theory of addiction. Blackwell Publishing Ltd.
- Wilson, H. (1980). Parental supervision: A neglected aspect of delinquency. The British Journal of Criminology, 20(3), 203–235.
- Yoshikawa, H. (1994). Prevention as cumulative protection: Effects of early family support and education on chronic delinquency and its risks. Psychological Bulletin, 115(1), 28–54.
