Objective: Growing up with an adult withanalcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined twoquestions concerning the livedexperience of growing up in ahome with AUD. Method and Results: The first question asked how adults entering AUDtreatment (n =402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at ayounger age, more times having been arrested and charged,and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n =277 dyads) and patients’ treatment outcomes 3months later. The associations between patients’ lived experience and better treatment outcomes were stronger when patients’ concerned others had aconcordant lived experience. When patient–concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant livedexperiences with regard to growing up in ahome with AUD; effect sizes were small. Conclusions: Concordance and discordance on this lived experience could be considered in treatment planning for patientswith AUDand theirconcerned others. Provid-ers could ask about each member’s childhood and aim interventions at helping dyads discuss their childhoods in ways thatvalidate each other’s needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad orone member. (J. Stud. Alcohol Drugs, 82, 395–400, 2021).