Treatment of the family disease of addiction would greatly benefit if treatment for both sides – the family AND the addict | alcoholic – were FULLY covered under health care insurance. Why? Because one often contributes to the other and both contribute to the continuance of the cycle, passing it from one generation to the next.

There are 23 million Americans living with the disease of addiction of which only 10 percent are receiving the treatment they need. There are more than 100 million American family members affected by those 23 million. Yet most of the focus is on the treatment and long-term recovery of the addict | alcoholic. I am ABSOLUTELY in support of the treatment and long-term recovery of the addict | alcoholic as key and of utmost importance, to be sure. But, if we don’t fully treat the other 100 million – the ones whose brain circuitry has been impacted by repeated exposure to secondhand driving | drugging – we impact not only these family members’ quality of life, but we influence the success of a loved one’s addiction treatment and long-term recovery, and we perpetuate the cycle of the disease. [Note: to better understand this cycle, please consider reading, “Secondhand Drinking Prevention,” which equally applies to secondhand drugging prevention.]

My Thoughts on Expanding Health Care to Treat Both Sides of the Family Disease of Addiction

Heads or Tails – either side – it’s still a quarter. Treating both sides of the family disease of addiction can break the cycle, support quality of life health for the family member and support long-term recovery for the addict | alcoholic.

Secretary Kathleen Sebelius’ announcement of new regulations that will mean most Americans with health insurance under the Affordable Care Act (ACA) will now be fully covered for the treatment of addiction to the same extent they are covered for physical diseases, was hugely exciting for anyone touched by this brain disease.

I believe part of the solution for improving addiction treatment is to include Affordable Care Act coverage and protocols for screening and prevention efforts that address BOTH sides of this family disease. Four of the five key risk factors for developing the disease – childhood trauma, social environment, mental illness and genetics – are often in play before a person even has their first drink or drug use experience. All four are often present in families with untreated, unhealthily discussed substance misuse by a loved one. Using screening and prevention efforts that incorporate 21st century brain and addiction-related research findings can help with addressing and/or understanding the entry points to the disease long before it develops into the disease. (As previously shared, this post expands on this idea, “Secondhand Drinking Prevention.”)

Let’s start with the family side of this disease. When patients present with anxiety, depression, stomach ailments, migraines, sleep problems, obesity… medical professionals trained to assess for underlying secondhand drinking | drugging (aka codependency) impacts will often find the root cause to be the chronic activation of the fight-or-flight stress response system associated with secondhand drinking | drugging (SHD), which is a term referring to the impacts of dealing with the someone’s drinking / drugging behaviors. (Check out “The Health Consequences of Secondhand Drinking | Drugging” and “Coping with Secondhand Drinking | Drugging Can Cause a Young Person to Wire Unhealthy Coping Skills.”)

Instead of just treating the presenting symptom(s), it is important to get to the underlying secondhand drinking | drugging issues in order to truly help that patient. Helping them at that initial point of physician contact to understand SHD, understand the physical and emotional impacts it causes, understand its root causes – namely a loved one’s alcohol (or drug) misuse – and how/where to find effective treatment for their issues does two things. One, it help that patient find the tools they need to live a healthier, happier life, and 2) it can help that patient help their loved one get help because in their treatment process, they will learn the importance of setting boundaries around the drinking/drugging behaviors and how to set them. (This post expands on this concept, “Alcohol Abuse Going On in the Family? – If Only My Doctor Had Asked.”)

In the case of screening for substance misuse – the addict | alcoholic side of this family disease – let’s start with alcohol misuse. NIAAA has developed a single Q screen to help medical professionals root out problematic drinking. The single Q is: “Have you had 4 or more standard drinks on any one day in the past year (for women); 5 or more (for men)?” An answer of yes (even if only once) sets up the prevention screening / intervention process because that drinking pattern is considered “at-risk” drinking. Insuring the ACA includes time and money and training for medical professionals to effectively use this kind of screening method and then refer accordingly can be critical to interrupting the progression. (Addiction is a developmental disease – people are not born addicts | alcoholics – and it always starts with substance abuse. In the case of alcoholism,  “at-risk” drinking is a sign of alcohol abuse; alcohol abuse can progress to alcoholism. There are similar screens that can be used to address “at-risk” drug use, drug abuse.)

Both of these screening examples – one for secondhand drinking and one for “at-risk” drinking – allow medical professionals, who really know and understand 21st century brain and addiction related research, to help their patients get the prevention | intervention help they need long before it crosses the line to addiction (or even if it has already crossed the line) or crosses the line to more serious health complications, as in the case of SHD. Helping both sides of this family disease early can prevent the cycle from repeating itself – from children being raised in the chaos and confusion that exists in families with untreated, unhealthily discussed substance misuse behaviors, which in turn contributes to their risk factors for developing a substance abuse problem | addiction, themselves.

Continuing in this line of thinking, using the ACA to incorporate SHD and “at-risk” substance use prevention education as part of Employee Wellness Programs can extend this 21st century brain, stress and addiction-related research into the workplace for a wider reach and thereby improve employee health and wellness and workplace safety and productivity. Just as employers receive premium reductions for smoking cessation, nutrition, exercise and other EAP programs, so too can the ACA extend the reach of this new research through premium reductions for similar SHD and off-hours “at-risk” substance us prevention, education, intervention programs.

Similar reaches can be made in schools, community efforts, family law practices, prison reform around how we handle drug-related crime and probation…the list is endless.

There are so many things we can do better at the front-end – before addiction treatment is necessary, before family members and friends exposed to repeated SHD suffer health consequences – when we address the health consequences to both sides of this family disease equally.

For more on healing the family disease of addiction, check out my latest book, released November 2019, 10th Anniversary Edition If You Loved Me, You’d Stop! What you really need to know when your loved one drinks too much. [I’ve added the link to this post in April 2020.]

© 2013 Lisa Frederiksen

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

Latest posts by Lisa Frederiksen (see all)

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