The Perpetuating Cycle of Substance Use Disorder

The idiom, “the apple doesn’t fall far from the tree,” refers to the characteristics you share with your parents. It may be your mother’s laugh, your grandfather’s sporting prowess, or your father’s eyes.

Unfortunately, there are also negative characteristics that can be passed down from one generation to the next. For many families, Substance Use Disorder (SUD) is a cycle that is passed intergenerationally and can be extremely difficult to break. Even if only one person in the family has a substance use disorder, it can risk the health and well-being of future generations.

SUDs are typified by the recurring use of alcohol or substances that results in considerable physiological or psychological impairment.  Common problems which arise from SUDs include: failing to meet responsibilities at home or at work, accruing debt, spending an increased amount of time obtaining, using, or recovering from substances, being unable to control use, suffering from poor physical health, and experiencing mental health conditions such as depression, anxiety or psychosis, medical complications, and early mortality.

It is estimated that around one in eight children in the United States lives in a household with at least one parent who has an SUD.[1]

Studies have demonstrated that children of parents with an SUD are frequently more din SUD.  These children tend to have more difficulties in academic, social, and family functioning and have higher rates of mental and behavioral disorders.[2]  Furthermore, children who share a household with or who are exposed to a parent with an SUD are more likely to develop an SUD themselves.[3]

According to the 2018 Substance Abuse and Mental Health Administration, 1.3 million American adolescents are suffering from a substance abuse disorder–that is five percent of all teenagers.  Nearly two percent of these young people are also struggling with co-occurring mental health conditions.[4]

The Role of Genetics

Numerous diseases and health conditions can be genetic.  A vulnerability to a particular disease, such as breast cancer, sickle cell disease, Huntington’s Disease, cystic fibrosis, and many others can be passed down through lineage.

Mental health disorders can also be hereditary. Epigenetic mental health issues can include ADHD, schizophrenia, major depression, bipolar disorder, and borderline personality disorder.

Numerous studies have also evidenced that around 40 to 60 percent of an individual’s propensity for developing an SUD is due to hereditary factors.[5] The remaining percentage is considered to be due to environment, a lack of positive coping mechanisms, and behavior or attitude.

Having a direct blood relative with an SUD significantly increases a person’s susceptibility to developing a substance use issue.  However, as with the above conditions, it is not certain, and many people whose parents have an SUD do not go on to develop one.

Additional Risk Factors

Studies have also found that children of those with SUDs are eight times more likely to develop a substance use disorder themselves. While genetics play an important role in this development, so do environmental and behavioral factors.

A person’s attitude towards substances can be vastly influenced by growing up in a household where at least one parent has an SUD. It has been evidenced that when this situation is combined with an unstable environment or an insecure attachment with the primary caregiver, the risk for an SUD increases significantly.

“Nature vs. Nurture”  is particularly relevant with SUDs. We understand that a person’s health is the result of active exchanges between genes and the environment. We know that high blood pressure, for example, is caused by both biology and lifestyle factors such as diet, physical activity, genes, and stress.

Children also have a propensity to imitate the behavior of the adults around them. If they are in an environment where risk-taking behaviors are present, they will be more likely to exhibit those behaviors themselves.

A young person’s brain is at a critical stage of development from birth until approximately the age of twenty-two. This is a vulnerable time period for developing often lifelong behaviors, attitudes, and biological reactions. The prefrontal cortex, which controls decision making and impulsivity, is the last area of the brain to fully form.

Due to this late development of the prefrontal cortex, most mental health disorders present themselves in early adolescence as the brain and aptitudes of the individual take shape. By understanding the heightened susceptibility of young people to biological, societal, and environmental factors, more can be done to mitigate the onset of an SUD.

Breaking the Cycle

Although substance use disorders have an epigenetic link, they do not determine one’s fate or destiny. The best treatment for an SUD is to avoid ever trying substances. Perhaps this is easier said than done, but if there is a hereditary connection, it would of course be wise to distance yourself from substances, regardless of type or amount.

Early intervention is essential for anyone struggling with an SUD. Treatment helps people break free from the cycle and teaches resilience and healthy coping mechanisms. With the right treatment, nearly everyone can overcome family history, environmental factors, and mental health issues.  

Instead of passing on the characteristics of an SUD, let your coping skills and healthy attitude about life be the legacy you leave your children.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates.  Call 800-335-0316 or email


[1] Lipari, Ph.D., Rachel N. et al. “Children Living with Parents who have a Substance Use Disorder”. SAMSHA, 2019, Accessed 18 Aug 2021.

[2] Peleg-Oren, Neta, and Meir Teichman. “Young Children of Parents with Substance Use Disorders (SUD): A Review of the Literature and Implications for Social Work Practice”. Journal of Social Work Practice in the Addictions, vol 6, no. 1-2, 2006, pp. 49-61. Informa UK Limited, doi:10.1300/j160v06n01_03. Accessed 18 Aug 2021.

[3] Joseph Biederman, Stephen V. Faraone, Michael C. Monuteaux, Jennifer A. Feighner Pediatrics Oct 2000, 106 (4) 792-797;

[4] “Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health”. SAMSHA, 2018, Accessed 18 Aug 2021.

[5] Prescott, Carol A., and Kenneth S. Kendler. “Genetic and Environmental Contributions to Alcohol Abuse and Dependence in a Population-Based Sample of Male Twins”. American Journal of Psychiatry, vol 156, no. 1, 2009, pp. 34-40. American Psychiatric Association Publishing, doi:10.1176/ajp.156.1.34. Accessed 18 Aug 2021.

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