Associative stigma and other harms in a sample of families of heavy drinkers in Lithuania

Introduction: The main aim of this study is to identify and contextualize the harms Lithuanian families experience when they include a heavy drinker. Methods: Twenty-four qualitative interviews with cohabiting spouses, and ex-partners of heavy drinkers were conducted in 2013–2014 and analysed for emergent themes. Results: Interviewees experienced an array of harms. These were categorised as: direct harms caused by the drinker; drinker-centred coping strategies which did not take children’s (and other adults’) needs into account and affected family members indirectly; abdication of or redirection of the drinker’s responsibilities to other family members; associative (reflected) stigma and isolation. Discussion: The direct harm caused by the drinker is only one fragment of alcohol’s harm to others. The drinker’s family members are stigmatised and commonly take on the usual roles and responsibilities of the drinker, with this particularly the case for women and their children. Internalisation of responsibility and drinker-centred coping styles also result in neglect of other family members’ needs. Conclusions: There are multiplicative effects from one family member’s heavy drinking on others, affecting adult members and children as they develop