Crack cocaine smokers as adult children of alcoholics: the dysfunctional family link.

The paper presents data on a sample (N = 61) of crack-cocaine-dependent patients who were treated on an inpatient detoxification unit. The investigation explores adult child of an alcoholic status as a possible etiological factor in the development of addiction to crack cocaine. Data suggests the prevalence of adult child of an alcoholic (ACA) status in this population (61%). Adult child of a dysfunctional family (ACDF) status is also explored as possibly playing an important role as an antecedent or determinant of addiction. The vast majority of patients are adult children of a dysfunctional family (ACDF) of one kind or another (97%); for example, patients experienced domestic violence (25%) and physical abuse (28%). Perhaps as a result of less than ideal object relations in dysfunctional families, many patients were also diagnosed as having personality disorders (31%) or affective disorders (21%). Case vignettes augment research findings, supporting the contention that childhood development in a dysfunctional family constitutes a specific etiological factor in the development of crack cocaine dependence. The paper recommends matching crack-addicted ACAs/ACDFs to treatment modalities that address and remediate the personality and emotional problems that characterize ACAs/ACDFs.