Addiction: The Elephant in the Family Room

How Different Family Members’ Addictions Affect a Family 

Adults Living as Partners 

Partners of someone with an SUD often play the family role of “provider.” Being in a relationship with someone living with an SUD most likely brings economic and psychological consequences. Money can become a huge issue for the couple. The partner with an SUD will use their own money to purchase their substance of choice, leaving their partner to take financial responsibility or use the couple’s joint finances, which can result in more problems for the relationship.

Psychological reactions to a substance use disorder may include:

• Denial
• Protecting the partner with an SUD
• Chronic anger
• Stress
• Anxiety
• Hopelessness
• Inappropriate sexual behavior
• Neglected health
• Shame
• Stigma
• Isolation

In this dynamic, it’s important to recognize that both partners need their own form of treatment. Each partner’s recovery will ultimately affect both, so the couple should consider seeking a treatment facility that makes both of them feel welcome. Family therapy can still be an option for the couple, even if they aren’t actually married.

In addition to couples participating in treatment together, questions of codependency may arise. This topic has recently become popular in the field of addiction study. Groups like Codependents Anonymous (CoDA) have formed to help people with further assistance during treatment. CoDA defines codependency as being overly attentive to another person’s issues to the detriment of one’s own wants and needs.

Some examples of a codependent person’s patterns of behavior include:

• Being controlling
• Having low self-esteem
• Denying feelings
• Being excessively compliant
• Compromising one’s own values
• Oversensitive
• Overly loyal

Previously, “codependent” was most often used to describe the spouse/partner of a person with an SUD, but is now used to refer to any relative of a person with a substance use or mental health disorder.

Addicted With Children 

Being the child of a parent with an SUD can be difficult. Children may feel responsible for their parent’s addiction or think that it’s their fault. They may have been exposed to illicit or illegal activities — like being present while their parent misuses substances or attending a drug deal.

Children who have a parent with an SUD endure long-term effects that include cognitive, behavioral, psychological and emotional consequences. One of the biggest developmental issues a child may encounter is learning to trust. When a parent has an SUD, it becomes difficult for a child to trust them. Effects of parental substance misuse on children may specifically include:

• Impaired learning capacity
• Increased risk of developing an SUD
• Adjustment problems
• Increased rates of divorce
• Increased rates of violence
• The need for control in relationships
• Depression
• Anxiety
• Low self-esteem

Having a parent with an SUD affects unborn children as well. Mothers who have an addiction and continue to misuse substances throughout pregnancy can cause numerous complications and detrimental long-term effects for their unborn child. Some of these complications may include fetal alcohol syndrome, neonatal abstinence syndrome and sudden infant death syndrome. When children become adolescents, a parent’s SUD can cause them to experiment with drugs themselves or manifest in other behaviors like skipping school. They are also at an increased risk of developing a substance use disorder themselves.

In these cases, the person’s spouse or partner is most likely going to take on the role of parenting the children. If both parents have an SUD, this role may shift to an extended family member, grandparent, neighbor or even foster parent.

Adolescent With a Substance Use Disorder 

When an adolescent develops an SUD, siblings may feel neglected. They may feel their needs and concerns are being ignored and minimized because their parents are constantly focused on and reacting to the sibling with the SUD.

Many families that have a child with an SUD also has a parent with an addiction. In some cases, the parent with an SUD may form an informal alliance or partnership with the child where they hide their disorders from the other sober family members.  

In other cases, parents or other family members are in denial about their teen’s substance abuse or inadvertently enable them to continue using or misusing substances. This can allow addiction to develop or worsen over time. 

What Family Members Can Do To Help a Person With an Addiction

Having a support system is critical to recovery from an SUD. Studies have shown a strong support group and resources can help people move from short-term abstinence to long-term sobriety. While providing encouragement, love and support are valuable ways to help someone in recovery, there are additional ways in which a family member or loved one can help someone in recovery from an SUD.

Some other ways family members and loved ones can actively get involved in a person’s healing process include:

• Attending meetings or support groups
• Educating themselves and other family members and friends about SUDs
• Working with the whole family to create a stable, sober home environment
• Going to therapy sessions to learn how to communicate and set boundaries
• Addressing their own behaviors that could possibly be enabling their loved one’s SUD

Related: Creative Ways to Help Families Heal Through Recovery (Video)

Family and friends of a person with an SUD can also access resources designed for them, including:

• 12-step groups for families: Al-Anon, Alateen, Codependents Anonymous, and Families Anonymous are 12-step groups for the loved ones of people with SUDs. Most of these are national organizations, so while every group may not be available in every city, there should be at least one option available nearby.
• National Association for Children of Alcoholics (NACoA): This nonprofit organization provides education and advocacy services to help children whose parents have an SUD. The NACoA’s goal is to be certain that these children get the help and support they need to grow up in a safe and healthy environment.
• The Recovery Village Family & Friends Portal: We publish news, tips and other resources to help family members understand addiction, help their loved one seek the treatment they need and learn how to support them through the entire recovery process.
• SAMHSA: This organization collects substance misuse and mental illness statistics in the United States through annual national surveys. There are several substance misuse resources available through their website.

There are also local-level support groups available for the loved ones of a person with an SUD. Community mental health centers, spiritual groups and volunteer organizations are just a few examples where loved ones can connect with others who have similar experiences, fears and hopes.

Support Vs. Enabling 

When a family member is trying to be a support system for a person with an SUD, there is a boundary between being supportive and enabling the person to continue with their addiction. Codependency can exist as an underlying factor for many families that deal with addiction. The codependent family member often isn’t even aware that they are enabling or contributing to their loved one’s SUD because it occurs so subtly.

It’s essential to know the differences between supporting and enabling a person living with an SUD. A supportive family member will do things like hold their loved one accountable, go to meetings or therapy with them and refuse to accept or participate in addictive behavior. Enabling behaviors can include things like giving the person with an SUD money to pay bills, taking blame to cover for their loved one or making excuses for them when they miss counseling sessions or other treatment appointments.

The Importance of Family Therapy for Addiction Recovery 

Addiction is a family disease. It affects everyone in the family in one way or another. At some point, the family must confront their loved one’s disease. In addition to individual therapy, it’s important that the family learns how to communicate and how to continue sober living once they are all in recovery.

Family therapy may begin at a treatment center, but sometimes it starts with an intervention. Family members can seek an intervention specialist to help them approach their loved ones, usually therapists, social workers, or other trained professionals. The family member often chooses a treatment center ahead of time, so they can begin family therapy sessions immediately following the intervention.

Family therapy is a critical aspect of addiction treatment, even if the person with an SUD is estranged from their family or has limited family contact. Discussions or communication with family members can uncover issues that can be relevant to treatment. It’s not necessarily important how many family members are present, but more so how they interact with one another.

Family therapy and communication are integral parts of the recovery process for people with substance use disorders. Having everyone in the family involved is important because each family member has likely been impacted by the addiction and has a role in the affected person’s life.

During substance use disorder treatment, family therapy usually consists of:

• Teaching the family about addiction as a disease
• Helping family members and the person with the SUD reestablish lost connections
• Explaining the addiction treatment process and the family’s role
• Differentiating between support and enabling
• Explaining the role of codependency in addiction and its dangers

Related: Healing Families from Addiction (Video)

After treatment, we encourage you to continue seeking support in the community. Most communities have a counselor or family therapist that specializes in addiction-related issues. Family members and friends of a person with an SUD are also encouraged to seek support from other organizations like Al-Anon and Families Anonymous.

If someone you love is struggling with a substance use disorder, the addiction impacts everyone. Convincing your loved one to get help can be the first step to helping your family heal. Many of our helpful representatives are in recovery themselves or have loved ones in recovery. They can help answer your questions about treatment and help you get started on the path to recovery.