Addiction in the family is a major but neglected contributor to the global burden of adult ill-health

► Globally 100 million adults are likely to be affected by their relatives' addiction problems. ► Affected family members experience multiple stresses, coping dilemmas, and lack of information and support. ► They are at heightened risk for ill-health and the results are very costly personally and for public services. ► The stress-strain-coping-support model offers a non-pathological way of understanding their circumstances. ► A flexible and adaptable five-step procedure for responding to affected family members is described.