When we think about the impact of substance use, we often focus on the person using alcohol or drugs. However, a new study sheds light on the substantial burden carried by family members, partners, and others affected by someone else’s substance use.
In this context, “burden” refers to the ongoing emotional, practical, and psychological strain experienced by people coping with someone else’s problematic substance use. This might include feeling constantly drained, dealing with family conflicts, experiencing social stigma, or having to alter your own life plans to manage the situation.
Researchers surveyed more than 8,000 American adults to understand the challenges faced by those experiencing secondhand harms from alcohol, cannabis, or other drugs. The study developed a seven-item scale to measure different types of burden. Participants rated how much they experienced each type of burden (not at all, a little, some, or a lot), and researchers combined these responses into a “burden score”—essentially a numerical summary showing the overall level of strain someone is experiencing.
The findings paint a clear picture of the toll these situations take. Nearly four in ten people affected by someone else’s substance use reported feeling emotionally drained or exhausted, while a similar number experienced family friction and arguments. About one-third found the stigma associated with their loved one’s substance use upsetting. Other burdens included feeling trapped in caregiving roles, experiencing problems with people outside the family, and having to neglect other family members’ needs or change personal plans.
The study examined how different types of harm related to burden levels. People who experienced family or marital problems due to someone else’s drinking showed particularly high burden scores. Feeling emotionally hurt or neglected because of another person’s alcohol or drug use also strongly correlated with increased burden. Being threatened or feeling afraid due to someone’s substance use was significantly associated with burden as well.
Interestingly, the research found demographic differences in burden experiences. Younger individuals and cisgender men reported relatively higher burden levels compared to cisgender women and older adults, when accounting for the types of harms experienced. African American respondents reported higher burden levels compared to White respondents, while those with more education and people who had never married tended to report lower burden scores.
This research represents an important step in recognizing that substance use problems extend far beyond the individual user. The study adapted measurement tools previously used to assess caregiver burden in mental health contexts, demonstrating that similar frameworks can help us understand the ripple effects of substance use on families and communities.
The implications are clear: addressing substance use requires more than just treating the person with the problem. Family support interventions and policy approaches are needed to reduce the burden on those living with or caring for someone whose substance use causes harm to others.
Greenfield, T. K., Li, L., Karriker-Jaffe, K. J., Munroe, C., Patterson, D., Rosen, E., Zhu, Y., & Kerr, W. C. (2025). Family burden among US adults experiencing secondhand harms from alcohol, cannabis or other drugs. International Journal of Alcohol and Drug Research, 13(2), 71-79.
