Clinical Addiction Research and Education Unit, General Internal Medicine (ASV, SMB); and Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA (SMB).
J Addict Med. 2017 Sep/Oct;11(5):339-341. doi: 10.1097/ADM.0000000000000331.
: Approximately 21 million people in the United States have a substance use disorder (SUD); the number of family members impacted by a loved one's SUD is exponentially greater. Affected family members of individuals with SUDs are at high risk for developing chronic medical and psychiatric health conditions, are high utilizers of the health care system, and have high health care expenditures. Family members play a central role in the lives of many individuals with SUDs; information given to family members can have a significant impact on persons with addiction and therefore the SUD treatment that an individual might receive. Evidence-based interventions targeting affected family members have been shown to: improve health outcomes for all family members, result in better addiction treatment outcomes, and prevent adolescent substance use. Despite mounting evidence, the health care system has been hesitant to engage families in a meaningful way. Health care providers should consider how implicit and explicit assumptions about the role of family members in SUD development, treatment, and recovery may contribute to this underlying reluctance. Antiquated policies and procedures that alienate family members should be modified (e.g., limiting phone access). Family members have a right to receive professional treatment and to be educated about the difference between mutual/peer support and evidence-based treatment options. Despite the potential for family members to move the needle on the country's current addiction crisis they remain an underutilized resource. A paradigm shift will be required to get the current SUD care continuum to adopt a family-centric model.
: 美国约有 2100 万人患有物质使用障碍（SUD）；受亲人 SUD 影响的家庭成员数量呈指数级增长。患有 SUD 的个体的受影响家庭成员患慢性医疗和精神健康状况的风险很高，是医疗保健系统的高使用者，并且医疗保健支出也很高。家庭成员在许多患有 SUD 的个体的生活中起着核心作用；提供给家庭成员的信息会对成瘾者产生重大影响，从而影响个体可能接受的 SUD 治疗。针对受影响家庭成员的循证干预措施已被证明：改善所有家庭成员的健康结果，导致更好的成瘾治疗结果，并预防青少年物质使用。尽管证据越来越多，但医疗保健系统一直犹豫不决，无法以有意义的方式让家庭成员参与其中。医疗保健提供者应考虑关于家庭成员在 SUD 发展、治疗和康复中的作用的隐含和明确假设如何促成这种潜在的不情愿。应修改疏远家庭成员的过时政策和程序（例如，限制电话访问）。家庭成员有权接受专业治疗，并了解互助/同伴支持和循证治疗选择之间的区别。尽管家庭成员有可能推动该国当前的成瘾危机取得进展，但他们仍然是未充分利用的资源。需要进行范式转变，使当前的 SUD 护理连续体采用以家庭为中心的模式。
