Prevalence, functioning and treatment needs of family members affected by addiction in Germany: Findings from the BEPAS study

Introduction:

Family members affected by addiction (FMA) have been found to report elevated levels of stress and strain. Due to the high prevalence of FMAs, this experience significantly contributes to the global burden of disease. The present study gives an overview on the prevalence of FMAs, their functioning and perceived treatment needs in Germany using a mixed-methods approach.

Methods:

In the German Health Update survey GEDA, being an FMA was assessed in a representative sample of 24,824 residents aged 15 years or more. In addition, health-related variables were assessed using standardized instruments. Functioning and treatment needs were assessed in a sample of 100 FMAs recruited from self-help groups, addiction services and by proactive screening in the general health system using standardized instruments and qualitative interviews. Qualitative data were analyzed following Grounded Theory.

Results:

In the general population, 9.5% of respondents reported being an FMA. Compared to non-FMAs, they reported significantly higher levels of depression and ill-health. Qualitative data showed that origins of stress varied by type of addiction, gender and relationship status towards the addicted individual. Being a parent was associated with the highest level of strain. Stigmatization, lack of availability and information on treatment offers were reported as being barriers for help seeking. Treatment needs most often endorsed were receiving behavioural guidelines for coping with the problem behavior of the addicted individual.

Conclusions:

FMAs are a substantial group in the general population that is characterised by ill-health and has not been adequately addressed by the addiction treatment system. Treatment offers and policy measures should focus on barriers towards help seeking and provide evidence-based interventions addressing the needs of FMAs.