Family Roles in the Risk of Serious Mental Illness Among Youth with Substance Misuse: A Systematic Review


avatar Mubashir Zafar 1 , *

Imam Abdul Rehman Bin Faisal University, Dammam, Saudi Arabia

how to cite: Zafar M. Family Roles in the Risk of Serious Mental Illness Among Youth with Substance Misuse: A Systematic Review. Health Scope. 2022;11(4):e129712.



Psychological disorders, such as depression and anxiety, are common among young people with substance misuse. Preventive strategies can diminish the negative impact on the society, especially family function.


The objective of this study was to systematically review the family functions in the risk of serious mental illness among youth with substance misuse.


The main databases Web of Science, PubMed, and SCOPUS were searched for studies published during January 2018-December 202. “Prevention”, “anxiety”, “coping”, “family”, “parents”, “patients care plan”, “adjustment”, “community”, “youth”, and “drug addiction” were the keywords searched in the databases. The present review was conducted in 2022.


After the screening of articles based on the exclusion criteria, we selected seven studies. The studies were classified as affianced, patience, pulling out, social support, and emotional stability actions. Society and parents, who are the core family members, feel anxious following the drug misuse of the youth. The youngsters felt that these substances were harmful for their health, especially reproductive health. The parents felt very secluded from family and friends. There are different preventive strategies to overcome this behavior.


Results of different evaluated studies showed that using emotional strategy is the common tool to prevent substance abuse. Social status and cultural perspective are effective in preventing this issue.

1. Context

Substance misuse among youth has become a global social problem (1). This multifarious public health concern is growing around the world (2). Hard drinks, tobacco, and opioids are the main substances consumed by youngsters (2). It is estimated that alcohol, tobacco, and over-the-counter drugs account for 15.1% of the causes of death (3). Substance misuse causes the highest death rate in global burden of disease. In addition, it ranks the third among the ten causes of death in the world and the second in the central Asian countries (4). Mental disorder is the common outcome of alcohol addiction (5). Common mental disorders and attention deficit disorders are associated with anxiety and depression (6). These mental disorders affect the society, especially family members (7, 8). It is likely that any drug misuse will have a high impact on the daily living activities of family members (9). Drug misuse and alcohol intake have caused anxiety, financial issues, poverty, and family life disruptions (9-12). Relationship disruptions are common among the family members of nuclear or combined family systems (12). Another study revealed that family members with drug addiction lack awareness regarding social support (13). Families with alcohol addiction have experienced higher anxiety and depression than families with only mental disorders without any substance addiction. In addition, families often face difficulties to access medical care. According to the literature, families living with drug addiction are unlikely to know the source of support. Family members also have problems accessing the counselling services and social support. Moreover, they are afraid of social stigma (14).

This systematic review aimed to determine the risk factors of substance abuse for family function. Moreover, the preventive strategies for substance misuse among young people are evaluated. Identifying preventive predictors related to anxiety resilience can help future research and health providers to maintain family support.

2. Methods

This systematic review was conducted according to the PRISMA methodology (15). The search for articles was performed in January 2021. Three online databases, Web of Science, PubMed, and Scopus were searched, and studies published during January 2018-December 2021were included in the current review (Table 1). The keywords used for searching the articles were “prevention”, “anxiety”, “coping”, “family”, “parents”, “patients care plan”, “adjustment”, “community”, “youth”, and “drug addiction”.

Table 1.

Search Strategy

Data SourceSearch Terms
Web of ScienceFamily OR Parents AND Community OR Preventive AND Alcohol OR Drug AND Mental OR Psychosis AND Substance OR Drug
ScopusFamily OR Parents AND Young adults or YouthAND drug OR Substance
PubMedFamily OR Parents AND Young adults or YouthAND drug OR Substance

2.1. Inclusion Criteria

The inclusion criteria for studies entailed investigations on family experiences, anxiety experiences, prevention and adjustment, and family preventive strategies with youth substance misuse. The exclusion criteria were irrelevant research, studies without complete data, duplicate studies, and papers for which the full text was not available (Figure 1). Only seven articles were included in the analysis because similar articles were excluded. The quality of articles was assessed by STROBE checklist. The total scores were in the range of 75 - 80 (Table 2).

Table 2.

Included Studies

References TitleSample Size and CountryMethod Data AnalysisMethod Data CollectionResult
Taylor et al. (4)Substance use and abuse, COVID-19-related distress, and disregard for social distancing: A network analysis3075, USA and CanadaTo determine the Preventive strategies by the parents of victim of youth for substance misuse. phenomenological analysisTwo main themes were found that illustrate how study participants deal with their drug disorder: (1) looking for credible information (2) Seeking preventive strategies.
Fuchs et al. (8)Family values and family aid behaviors: Protective and determinants for substance use among Mexican–American adolescents 604, USADetermine the counter measures of youth behavior by parentsEthnography analysisParents used coping strategy through emotions and preventive strategy for withdrawing symptoms responses
Calvano et al. (16)During COVID-19 parental stress and unpleasant youth experiences—study in Germany1024, GermanyExperiences of parents living with a young child with substance misuse disorderGrounded theorySubstance misuse by young person due to conflict between parents
Kendler et al. (17)Childhood determinates alcohol use among adolescence7168, USAYouth substance misuse experience by parents Cross-sectional surveyThe parents experienced that their young youth used drug for a long time. Support from the social agency that included a reduced sense of isolation, an increased awareness of drugs and drug-related issues, and social support for their family
Miguez Varela Mdel and Becona (12)Cigarette, alcohol, and cannabis use related to gambling among Spanish youth1447, SpainDetermine the parents experience for taking caring of a child who used opioids Case-controlParticipants experienced personal challenges
McCann and Lubman (18)A Counter plan for drug abuse by parents31, AustraliaDetermine the counter measures of drugs misuse by young adults through behaviors therapy Grounded theoryPositive behaviors are the best tool for counter measures for drugs misuse among young adults by parents
Matuszka et al. (19)Smoking and alcohol use related to aggression among youth 944, HungryAlcoholism and drug addiction: the experience of parentsNarrative reviewConnected therapy through social contact is the best tool for counter physical aggression.
Flowchart according to PRISMA guideline
Flowchart according to PRISMA guideline

2.2. Publication Bias

Publication bias was detected by Egger’s linear regression and Begg’s rank correlation test. A publication bias was found in the severity of hyperactivity/impulsivity. Comprehensive meta-analysis software was used for data analysis.

The horizontal line represents the summary effect estimates, and the dotted lines are pseudo 95% CIs.

Results of different studies found that healthcare professionals, including nursing staff, doctors, and technicians, who had substance misuse avoided being admited to hospitals for treatment due to social stigma. Solid line of figure showed the estimate effect, and dotted line showed pseudo 95% confidence levels. Different studies also found wider heterogeneity (Figure 2)

Funnel plots with pseudo 95% confidence limits
Funnel plots with pseudo 95% confidence limits

3. Results

3.1. Substance Misuse Effects on Family Relationship

Most of the families were not aware of the impact of substance misuse on siblings. Most of the parents believed that the behaviors of youngsters change as they grow and time passes (16, 17). The family functions were disturbed by their youngster being involved in substance misuse. They felt they had fizzled to end up guardians because they were embarrassed due to the behaviors of their young children (18-20). About 21% of families utilize the inspiration technique to overcome family function disorder, particularly those related to forceful behavior (19). Parents believe that punishment of their children will help change their unethical behaviors into ethical behaviors (16, 19).

Other studies revealed that parents feel displeasure because of their young child having drugs misuse (16, 21). Other thinks about uncover that family individuals feel deceived, which there's a misfortune of believe within the family individuals of medicate clients (22). Families cannot believe that their once-trusted family members were lying to people around them (23). It was found that the family felt perceived by young people who utilize drugs was the event of family work clutters such as misfortune of believe and family disharmony (16, 19, 21).

They talked about the impact on their passionate or physical well-being. Guardians showed how they had ended up separated from family and companions. For a few, this was self-imposed, as they had decided not to inform anyone of the issue. This was common because they were humiliated or embarrassed of their child or experienced stress during the treatment of their child because of what others would think or how they might respond (23-25).

3.2. Role of Sentiments in Preventive Strategies

Family members were involved when the victim of substance misuse had serious medical disorders (12, 18). A study found that mothers have adapting reaction when managing issues in the youth (26). They observed an assortment of complex adapting components expressed by the members (27). The adapting that emerges could be a matter of center coping and enthusiastic adapting (17). The complexity of adapting demonstrated in different ways that the same adapting approach is connected by moms (24). Maternal adapting reactions are impacted by personal variables (12, 24). Sentiments center plan is the best used preventive strategy in families (28).

3.3. Responsible Feeling for Care of Youth

A research found that families utilize diverse techniques to cope with the drug misuse of family members (29). First, the data are collected, the source of data is found and analyzed, and the best strategy for coping with the family function disorder is adopted (28). This data help to find out which strategies are more helpful and what type of substance abuse was identified to start the coping strategies for preventing family function disorder.

3.4. Supervision of Family

It has been investigated how mothers react to their teenager children substance misuse. It was demonstrated that parents do not respond consistently. In other words, an adapting reaction by a mother for managing drug abuse may result from more than one component. A mother might react with resilience in discussion with her child.

4. Discussion

The results of this systematic review showed preventive strategies for drug abuse among youngsters through family functions. Results revealed that parents had different strategies for coping with the addiction of their children through engagement and social support (22). Mothers of the youth had special roles in the coping strategies, such as continuing surveillance for their youth activities. The main reason for substance misuse was that parents did not engage their youth in home activities (21). Another study found that a few guardians started by denying that their youngsters had issues related to drug abuse. However, inevitably guardians looked for help for managing their affected youngster (17). First, the risk factors for youngsters being involved in substance misuse are identified. Then, start the counseling for the family (17, 18, 22-25, 28, 29).

Research recommends that a rearranged viewpoint is needed to understand the strategies for preventing drug misuse among their youth (24). Preventive approaches are difficult, and emotion is important and essential for coping with this issue. The risk factors of substance misuse disorders among youth need to be further investigated. The major strength of this review is that it is the first review that addressed this major issue in the society and will help policymakers to incorporate the results in revising the policies for this issue. The limitation of the current review was that few studies had investigated this issue, and there is a need for a national-level survey to determine the factors associated with this issue.


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