The side effects of addiction are not isolated to a single family member. Whether it’s waiting to be picked up from school by a parent who never shows up, having to get a lawyer for a child charged with a DUI when they aren’t even old enough to drive, or having a card declined at the grocery store because a partner spent all the money at a bar — addiction is a family disease. In fact, 46 percent of adults in the United States claim that they have a family member or close friend who is currently struggling with a substance use disorder (SUD) or has in the past. Because addiction is a disease, is it passed on from generation to generation like heart disease or cancer?  

In a recent study conducted by The Recovery Village, approximately 400 participants were surveyed in an effort to better understand the public’s perception of addiction and the family’s influence on addiction. Of those 400 participants, 69 percent reported that they had a history of drug or alcohol addiction in their family. Twenty-nine percent agreed that if addiction runs in the family, they are more likely to develop an addiction. Family therapy and communication is an integral part of recovery for people with substance use disorders. Having everyone in the family involved is important because each family member has a role in the affected person’s life.

How Different Family Members’ Addictions Affect a Family 

Adults Living as Partners 

The family role that the partner of someone with an SUD often plays is that of “the provider.” The type of consequences of being in a relationship with someone grappling with an SUD are most likely to be economical and psychological. Money becomes a huge issue for a couple because 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
  • Protection of 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. The recovery of each partner will ultimately affect both, and the couple should consider seeking a treatment facility that makes both of them feel welcome. Family therapy should still be an option for the couple, even if they aren’t actually married. 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.

In addition to a couple 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 those with further assistance during treatment. CoDA defines codependency as being overly attentive to the issues of another person 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

“Codependent” originated as a term used to describe the spouse or partner of a person with an SUD, however, it is now used more to refer to any relative of a person with a substance use or mental health disorder.

Married With Children 

Being the child of a parent with an SUD is difficult. The children may feel responsible for their parent’s addiction or think that it’s their fault. The children may be exposed to illicit activities — like being present during their parent misusing substances — and may even have to participate in an illegal action on their parent’s behalf, such as being present during 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 a 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 problems like truancy, drug experimentation and create an increased risk of their own SUD forming.

The spouse or partner of the parent with an SUD is most likely going to take on the role of being the protective and provider for the family. If both parents have an SUD, an extended family member, grandparent, neighbor, or even foster parent will have to assume responsibility for the child(ren)’s care.

Adolescent With a Substance Use Disorder 

For an adolescent, one of the effects of having a parent with an SUD is that they are at an increased risk of developing an SUD themselves. However, even children without a parent who is struggling with an addiction can develop an SUD. When a child develops an SUD, siblings may feel neglected or that their needs and concerns are being ignored and minimized because their parents are constantly reacting to the sibling with the SUD.

In families that include children with an SUD, many also include a parent with an addiction. In some cases, the parent with an SUD may form something like an alliance or partnership with the child in which they hide their disorders from the other parent or siblings who are sober.  

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

Having a support system is critical to recovery from an SUD. According to Substance Abuse and Mental Health Services Administration (SAMHSA), people in recovery who have a strong support group are able to maintain their sobriety and long-term recovery. While providing encouragement, love and support is a pertinent part of helping 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 contributing to the person’s SUD

In addition to these methods for supporting a loved one’s recovery, there are also resources for the family and friends of a person with an SUD, including:

  • 12-step groups: 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 nationwide.
  • National Association for Children of Alcoholics (NACoA): This organization is a non-profit that provides education and advocacy services to help the children of parents with an SUD. The NACoA’s goal is to be certain that children who have parents with an SUD get the help and support they need to grow up in a safe and healthy environment.
  • 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 of 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, it’s important to remember that there has to be 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 or enabler often isn’t even aware that they are 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 struggling with an SUD, some of the distinctions may include:

  • Underlying motives: A codependent family member or friend may take the role of enabler, giving the person with an SUD money to pay bills, or participate in substance misuse with them. They subconsciously do this because instead of wanting their loved one to get better, they want them to remain reliant on them. A supportive family member or friend would go to meetings with their loved one, go to counseling, encourage them to seek treatment, and refuse to accept or participate in the addictive behavior.
  • Level of attachment: While a supportive family member or friend would be concerned about an addicted person’s destructive behavior, they wouldn’t necessarily sacrifice their own self-interests. On the other hand, a codependent may be willing to give up their time, money, and endless emotional energy to “help” the person with an SUD.
  • Strength of Boundaries: A codependent family member typically has weak boundaries or no boundaries at all when it comes to their loved one suffering from addiction. A codependent may accept verbal and physical abuse, risk their health, or allow themselves to take the blame for criminal charges to cover for their affected loved one

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 one way or another, so in addition to individual therapy, it’s important that the person with the SUD and their family learn how to communicate and how to continue sober living once they are in recovery.

Family therapy can take place before, during, or after treatment. Typically, a family member will seek an intervention specialist to help them approach their affected loved one. The family member can also choose a treatment center ahead of time, so they can begin the therapy sessions immediately following the intervention.

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

  • Teaching the family about the disease of addiction
  • Helping family members and the person with the SUD re-establish lost connections
  • Explaining the addiction treatment process and the role of the family
  • Differentiating between support versus enabling
  • Explaining the role of codependency in addiction and its dangers

After treatment and at the beginning of the recovery, it is encouraged 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.

At The Recovery Village, they believe family involvement is a crucial part of recovery. At most of their facilities, family communication is typically established within the first 48 hours of a patient being admitted. The facility may participate in family weekends and family therapy sessions. What often happens during these visits is that the family members and the person with an SUD come to the realization that addiction is a family disease.