Children of alcoholics (COA) and adult children of alcoholics (ACA) are identified as a group with recognizable characteristics resulting from their childhood situation. The major conclusions in the literature regarding the psychosocial consequences of being a COA are reviewed. Two lists, one for children and one for adults, are provided which summarize these consequences. Variables which influence these effects are discussed, as well as the development of adult psychopathology from child psychopathology. Treatment strategies designed to prevent this development are reviewed briefly and a resource table for COAs is presented.

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Substantial recent progress has been made in the study of family systems and in the field of family therapy. The gradual application of these new technologies to the field of substance abuse is discussed. A shift has occurred toward quantitative assessment of the three generational systems of the substance abuser as well as inclusion of that entire system in the family therapy. Family therapy treatment methods have been developed to motivate substance abusers, detoxify them, and work with the family when the identified patient is not involved in treatment and to restructure the entire family. The field of family therapy evaluation is in its infancy but plans are underway for elaborate scientific investigation of efficacy.

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Seventy-five families of former narcotic addicts were studied in New York City and Los Angeles. All patients were in residential treatment at the time of the study and they and their families participated in a multiple family group which was the major source of data. The most common familial pattern seen was that of a mother enmeshed with her addicted son. The father feels excluded by this dyad and reacts with disengagement, brutality, or increased consumption of alcohol. However, in certain ethnic groups the entire family including the father is quite enmeshed with each other and their addict sons. Siblings were either fellow addicts whose drug abuse is fused with that of the identified patient or, to the contrary, "good' children who were parental figures and quite successful. Addict spouse pairs tend to duplicate patterns which they have developed in their family of origin. Male addicts frequently dominate their addicted or drug-free spouse to assure themselves of being cared for. The female addict population in this study was too small (N = 16) for generalization but observed patterns are discussed.