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  • Home > Prev-Stat > County Profiles Data > Introduction

    Family Risk Factors


    Parents have the greatest potential to positively influence their children with regard to use of alcohol, tobacco and other drugs.   Their strongest tool for influence is role modeling.    Children of parents who abstain from cigarettes and illegal drugs, and who do not drink or drink responsibility, are less likely to use and abuse alcohol, tobacco, or other drugs.

    Adverse Childhood Experiences have been found to be associated with later-life health and well-being.  A study by this name is being conducted by the Centers for Disease Control and Prevention and the Kaiser Permanente’s Health Appraisal Clinic in San Diego.  The study findings suggest “that certain experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the United States.”  (CDC, Adverse Childhood Experiences Study, 2012, accessed 1-15, 2012 at http://www.cdc.gov/ace/index.htm).   SAMHSA’s fact sheet on Adverse Childhood Experiences [http://bhis.smdi.com/Resources/NPN2012/ACEs_Handout_NPN.pdf] lists the following as examples of adverse childhood experiences:
    • Verbal abuse during childhood
    • Trauma: child physical abuse, sexual abuse, neglect
    • Incarceration of a parent or family member
    • Family history of mental illness
    • Family history of substance use disorders
    • Family history of co-occurring disorders
    • Witnessing domestic violence
    • Parental divorce/separation (during childhood)
    Although children of divorced parents have higher rates of substance abuse (CASA, Family Matters, 2005), family conflict rather than divorce appears to be the predictive factor.   Examples of family conflict and violence within the family are domestic abuse and child abuse.

    In recent years more children live in single parent households, and the vast majority with single mothers.  Single mothers are more likely to live below the poverty line, presenting further struggles for these families.  Also, the consequences of substance use for the economically disadvantaged tend to be more extreme than for affluent substance users.   (CASA, Family Matters, 2005) 

    Children of parents who abuse substances are at particularly high risk and in a variety of ways.  There are increased risks for economic problems, health problems, accidents, and problems at work.  Impact on the academic performance and opportunities of these children can negatively affect their lifetime prospects for professional and economic achievement.   (CASA, Family Matters, 2005)

    See in GIS in Prevention, County Profiles, sections on poverty and single parent households.   For an extensive discussion on this topic see the following publications and also see related topics in the IPRC HOME library,

    Andrea L. Stone, Linda G. Becker, Alice M. Huber, Richard F. Catalano, “Review of risk and protective factors of substance use and problem use in emerging adulthood, Addictive Behaviors 37/7 (2012):747–775  Accessed 1-9-2012 at http://www.sciencedirect.com/science/article/pii/S0306460312000810

    Also, these publications from The National Center on Addiction and Substance Abuse at Columbia University (CASA):

    Family Matters:  Substance Abuse and The American Family (2005) [http://www.casacolumbia.org/articlefiles/380-Family%20Matters.pdf]  

    National Survey of American Attitudes on Substance Abuse XVI: Teens and Parents  (2011) http://www.casacolumbia.org/upload/2011/20110824teensurveyreport.pdf

    The Importance of Family Dinners VII (2011)  http://www.casacolumbia.org/templates/PressReleases.aspx?articleid=653&zoneid=87

    The following is an excerpt from SAMHSA’s 2012 online publication:

    The Relationship of ACEs to Substance Use and Related Behavioral Health Problems  (http://captus.samhsa.gov/prevention-practice/targeted-prevention/adverse-childhood-experiences/2)

    Adverse childhood experiences (ACEs) are stressful or traumatic experiences, including abuse, neglect and a range of household dysfunction such as witnessing domestic violence, or growing up with substance abuse, mental illness, parental discord, or crime in the home. ACEs are strongly related to development and prevalence of a wide range of health problems, including substance abuse, throughout the lifespan.

    When children are exposed to chronic stressful events, neurodevelopment can be disrupted. Disruption in early development of the nervous system may impede a child’s ability to cope with negative or disruptive emotions and contribute to emotional and cognitive impairment. Over time, and often during adolescence, the child adopts coping mechanisms, such as substance use. Eventually, this contributes to disease, disability and social problems, as well as premature mortality. Figure 1. depicts the lifespan impact of ACEs.

    Research has demonstrated a strong graded (i.e., dose-response) relationship between ACEs and a variety of substance use-related behaviors, including:
    • Early initiation of alcohol use. For states, tribes, and jurisdictions focusing on underage drinking, these results suggest the importance of addressing ACEs as one component of preventing underage drinking, as responses to underage drinking may not be effective unless they help youth recognize and cope with stressors of abuse, domestic violence and other adverse experiences (Dube et al, 2006)
    • Problem drinking behavior into adulthood (Dube et al, 2002)
    • Increased likelihood of early smoking initiation (Anda et al, 1999)
    • Continued smoking, heavy smoking during adulthood (Ford et al, 2011)
    • Prescription drug use (Anda et al, 2008)
    • Lifetime illicit drug use, ever having a drug problem, and self-reported addiction (Dube et al, 2003)
    Research has also demonstrated a strong graded relationship between ACEs and related behavioral problems, such as the following:
    • Increased risk of suicide attempts, including attempts by men and women, as well as attempts during adolescence and adulthood (Dube et al, 2004).
    • Lifetime depressive episodes (Chapman et al, 2004).
    • Sleep disturbances in adults (Chapman et al, 2011)
    • Sexual risk behaviors (Hillis et al, 2001)
    • Teen pregnancy (Hillis et al, 2004)