title: The families and friends of heavy drinkers: Caught in the cross-fire of policy change?
abstract: Research highlights the need to better understand the impact of alcohol-related harm on families and communities. Scottish policy initiatives to reduce alcohol consumption and alcohol-related harm include the planned introduction of a minimum unit price for alcohol. We aimed to explore existing and proposed changes in alcohol policy, from the standpoint of heavy drinkers, through accounts of their involvement and repercussions for family and friends.
  
  
  
  Interviews were conducted with 20 heavy drinkers, recruited from hospital alcohol treatment centres in Scotland's two largest cities. Participants were part of a larger longitudinal mixed methods study. Interviews explored experiences of alcohol-related harm and the impact, or potential impact, of alcohol policy changes on drinking patterns, risk-taking, consumption and wellbeing. Data coded for 'family and friends' were thematically analysed using a constant comparison method.
  
  
  
  Family and friends were portrayed as important for aiding moderation and abstinence, but more often for sustaining continued heavy drinking. Heavy drinkers with complex needs and those living in deprived communities suggested that increased alcohol prices could exacerbate the detrimental effect on their health and social circumstances, and that of their family, should their consumption remain excessive.
  
  
  
  Population level policy initiatives to reduce alcohol consumption, such as minimum unit pricing, will impact on the families and social networks of heavy drinkers in addition to the drinker. The most vulnerable may be affected disproportionately. Alcohol policy changes and evaluations need to consider consequences for drinkers, families and communities. [O'May F, Whittaker A, Black H, Gill J. The families and friends of heavy drinkers: Caught in the cross-fire of policy change? Drug Alcohol Rev 2017;36:192-199].
authors.affiliation: School of Health Sciences, Queen Margaret University, Musselburgh, East Lothian, UK.
authors.forename: Fiona
authors.identifier: 0000-0003-4417-2819
authors.initials: F
authors.lastname: O'May
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Whittaker
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Black
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Gill
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D000434:Alcoholic Beverages / Q000191:economics; D003132:Commerce / Q000331:legislation & jurisprudence; D005195:Family Relations; D005260:Female; D033062:Friends; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012309:Risk-Taking; D012606:Scotland / Q000453:epidemiology; D012944:Social Support
keywords: alcohol; family; policy; qualitative method; substance-related disorders