Almost no support exists for people harmed by someone else's drinking: a systematic review

What is it about?

Over 100 million people worldwide experience significant harm as a result of a family member or close friend's alcohol use, including partners, children and adult dependants. Most existing interventions in this space are designed to help the drinker change their behaviour, meaning their effectiveness depends on the person causing the harm being willing and able to engage. This systematic review and narrative synthesis, pre-registered on PROSPERO, searched 11 databases to identify evaluations of psychosocial interventions designed to support the affected other person directly, independently of whether the drinker engages or changes. Only seven studies met inclusion criteria, drawing on participants from the UK, USA, Korea, Sweden, Mexico and India. The majority of participants were female. Interventions evaluated included cognitive behavioural therapy, motivational interviewing, guided imagery and anger management. The review documents the striking scarcity of evaluated interventions targeting this population in their own right.

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Why is it important?

The near-total absence of rigorously evaluated interventions for people harmed by others' alcohol use represents a serious and underacknowledged gap in the alcohol harm reduction field. Public health framing of alcohol harm has historically focused on the drinker, yet the burden on families, partners and children is substantial and well-documented. People in this position frequently experience poor mental health, relationship breakdown, financial hardship and their own increased risk of alcohol problems, yet are largely invisible in treatment and support systems. A systematic review establishing that only seven evaluations exist globally sets a clear research and commissioning agenda and provides the evidence base for funders and policymakers to prioritise this neglected population.