Friends and family play vital roles in the recovery process. Recovering addicts with a strong support system have a greater chance of completing treatment successfully and maintaining their sobriety at home. But helping a loved one recover from addiction isn’t just a matter of providing encouragement or moral support. While your support is crucial, you must also be prepared to get actively involved in the healing process in the following ways:

Addiction is rarely an isolated problem involving a single person. It’s usually a sign of dysfunction in that individual’s home life, personal relationships, or social network. Addiction treatment often brings up troubling issues in a family’s life, such as relationship conflicts, substance abuse in the household, domestic abuse, or past traumas. While delving into these issues can be uncomfortable or even painful, it’s absolutely necessary that the family heal together so that each member can become healthy and strong.

Spotting the signs of addiction

Friends and family are often the first to notice the signs and symptoms of addiction. However, they may be reluctant to intervene, either because the reality of substance abuse is too painful, or because they’re afraid of driving their loved one even deeper into self-destruction. In many cases, family members don’t interfere with substance abuse because it serves a purpose in the family system. Allowing a hardworking spouse to drink heavily on weekends may help the family sustain their income, for example. Keeping an addicted parent supplied with tranquilizers or painkillers may help the rest of the household avoid a difficult confrontation.

For the sake of your own health and the well-being of your family, as well as the health and safety of your loved one, it’s vitally important to respond to the signs of addiction when you notice them. Listed below are a few of the most common physical indications that a loved one has a problem with drugs or alcohol:

  • Changes in appetite or body weight
  • A pale or reddened complexion
  • Bloodshot or watery eyes
  • Pinpoint pupils
  • Shakiness or tremors at certain times of day
  • Poor motor coordination
  • A stumbling gait
  • Changes in sleeping patterns
  • Needle marks or bruises on the arms
  • Sweating without excessive physical activity
  • Unusual body odors

Some of the most noticeable red flags involve changes in a loved one’s moods, appearance, or behaviors:

  • Isolation from friends or family
  • Loss of interest in favorite activities
  • Failures at school
  • Poor performance on the job
  • Constantly borrowing (or stealing) money
  • Dramatic mood swings
  • Depressed mood
  • Anxiety and restlessness
  • Uncharacteristic outbursts of anger or aggression
  • Poor hygiene and grooming
  • Secretive behavior
  • Unusual or inappropriate clothing (sunglasses after dark, long-sleeved shirts during the day, t-shirts with alcohol logos or references to drug use)

These physical or behavioral changes don’t always point to addiction. Weight changes, unusual clothing, depression, and self-isolation could be signs of an eating disorder. Self-isolation, weight gain, and mood swings or anxious episodes could indicate that your loved one has a psychiatric disorder. If you’re like most concerned friends or relatives, you’re probably reluctant to jump to conclusions or damage your relationship. However, it’s critical that you take steps to help the person you care about, no matter what their underlying problem may be.

Support vs. enabling

For many families, codependency is one of the underlying factors in addiction. Codependency is a behavioral pattern in which one member of a relationship enables another’s addiction in order to gain approval, love, or power over the other. This enabling often occurs in such subtle ways that it’s hard to tell the difference between genuine support and codependency. In many cases, the codependent partner isn’t even aware that he or she is contributing to the loved one’s destructive behavior.

How can you tell the difference between supporting and enabling a loved one? Here are a few key differences:

  • Underlying motives. A supportive family member’s goal is to help the loved one recover from addiction. A codependent relative unconsciously wants to keep the addict sick so that he or she relies on them for help. Supportive friends will attend meetings with their loved one, go to counseling, and refuse to accept or participate in the addictive behavior. Codependents will lie to cover up an addict’s drug abuse, give them money to pay bills, or use drugs with them in order to keep them “safe” at home.
  • Level of attachment. A supportive person may be deeply concerned about a loved one’s destructive behavior, but not to the point of sacrificing his or her own self-interest. A codependent is willing to give up time, money, and endless emotional energy to “help” an addicted loved one. A codependent’s sense of self-worth is so deeply intertwined with the addict that breaking the attachment can cause emotional trauma.
  • Strength of boundaries. A supportive friend or relative is ready to help the addict, but he or she can also set boundaries against inappropriate or threatening behavior. A codependent has very weak boundaries — or no boundaries at all. A codependent will accept verbal or physical abuse, risk her health, or expose herself to criminal charges on a loved one’s behalf.

Codependency itself is a form of addiction. Most codependents cannot recover their emotional integrity without intensive therapy and behavioral modification. In addition to attending support groups like Al-Anon, codependent family members can seek individual counseling, read literature on codependency, and attend family therapy sessions at a treatment facility.

Getting a loved one to seek help

Woman reviewing substance abuse treatment options

It’s normal to feel scared, helpless, or overwhelmed when you’re faced with the reality of an addicted loved one. How do you confront someone who seems to be intent on destroying themselves? What do you say to a partner, parent, or child you no longer recognize? In many cases, communication has already broken down by the time someone decides to take action. Reaching out at this point might seem impossible, but in fact, it’s more important than ever that you intervene now.

You can initiate the healing process by having an honest, heart-to-heart discussion with your friend or relative. Tell them directly what you’ve noticed and how you feel. Let them know that you support them completely, and that you’ve spoken up out of love and concern. Try to avoid criticism or judgment at this point, even if your loved one has hurt you or other people you care about. You’ll have the opportunity to go into these issues with professional therapists when your loved one gets into treatment.

If you’re uncomfortable with a one-to-one discussion, or if you’ve tried talking to your loved one without success, talk with a trusted professional who has experience in substance abuse treatment. A substance abuse therapist, marriage counselor, health care provider, 12-step sponsor, or spiritual advisor can give you valuable advice about how to deal with a loved one who may be addicted to alcohol or drugs.

When addictive behavior has begun to threaten the well-being of the individual or of other family members, it may be necessary to hold an intervention to persuade the addict to get help. An intervention is a rehearsed, formal meeting in which the significant people in the addict’s life gather to voice their concerns about his or her behavior. The participants also describe how the addict’s behavior has affected them personally.

Sometimes the addict will agree willingly to go to treatment after being confronted with the effects of his or her disease. But an addict who is in deep denial is likely to refuse help unless he or she is presented with consequences for refusing treatment. For instance, an addicted father may lose custody of his children if he refuses to go to rehab, while an alcoholic wife may be faced with a marital separation. A treatment contract ensures that the individual will agree to enter a recovery program or accept the consequences of continuing with his or her substance abuse.

Staging an intervention is a sensitive process. In order to maximize the effectiveness of the meeting, the participants must rehearse the confrontation in advance, preparing for anything that might happen. Some individuals react with anger when they’re confronted about their drug abuse, while others break down into tears or close themselves off completely. A substance abuse therapist who specializes in interventions can guide you and your family in developing a plan to get your loved one into treatment.

As part of the intervention process, you should choose a treatment center for your loved one ahead of time. It is likely that you’ll need to provide transportation to the treatment center, possibly as soon as the meeting is over. The sooner you can initiate detox and recovery, the sooner your loved one can begin to heal from this life-threatening disease.

Along with genetic, biological, and social influences, familial behaviors contribute significantly to an individual’s chances of becoming addicted to drugs or alcohol. According to research from Columbia University, children who grow up in a household where one or more adults abuse drugs or alcohol are significantly more likely to develop a substance use disorder than children raised in drug-free homes. By the same token, positive family relationships reduce the risk of substance abuse. Teens who have a strong relationship with at least one parent have a 25 percent lower risk of developing a problem with substance abuse, notes Columbia, and those who have a strong relationship with both parents are 40 percent less likely to become addicted.

In substance abuse treatment, the individual client has traditionally received the lion’s share of attention from psychiatrists, therapists, and social workers. But in more advanced treatment programs, all the members of the household are included in the therapeutic process. Spouses, partners, parents, grandparents, children, and anyone intimately related to the addict are strongly encouraged to take part in these therapeutic activities:

  • Group counseling sessions
  • One-on-one therapy for individual family members or close friends
  • Classes and workshops on addiction, recovery, and relapse prevention
  • Behavioral modification training to improve communication skills
  • 12-step meetings like Alcoholics Anonymous, Al-Anon, or Alateen
  • Aftercare activities designed to support family members
In family systems therapy, addiction is addressed as an issue involving the entire group, not just the individual admitted to treatment. Each person in the home — and many relatives or friends outside the household — participates somehow in the cycle of addiction. As a result, the family must be assessed, evaluated, and treated as a unit. According to the Substance Abuse and Mental Health Services Administration, family therapy in addiction treatment has several key goals:

  • To identify the strengths and positive qualities of the family unit
  • To find ways to use those strengths to create a sober living environment
  • To determine how substance abuse has affected the family
  • To help the family recover from the damage caused by addiction
  • To connect the family with resources (psychosocial, medical, financial, occupational, or educational) that they can use to improve their quality of life.

Family members are often unaware of the ways they participate in the drama of addiction, or of the full extent of the damage caused by substance abuse. Through educational classes, workshops, and group counseling sessions, the addict’s family members can develop a deeper understanding of this devastating disease. If any other members of the household are struggling with substance abuse, family therapy gives them the opportunity to reach out for help in a safe, confidential environment.

Recovery doesn’t end with drug detox or rehab. Maintaining sobriety is a lifelong process that requires ongoing support from family and friends. After graduating from a recovery program, your loved one will need access to a wide range of aftercare services, which may include the following:

  • Case management and discharge planning
  • Educational assistance
  • Occupational counseling
  • Legal counseling
  • Access to a transitional residence (sober living or extended-care housing)
  • Medication management for psychiatric or anti-addiction drugs
  • Primary medical care
  • 12-step support groups
  • Community-based sober activities

It’s equally important for family and friends to continue to take part in recovery activities after rehab. When you’re choosing an addiction treatment program, look for a credentialed facility that offers a full continuum of care, including aftercare services. Case managers can help with the transition back to the community by helping your loved one connect with resources and support groups.

If you and your loved one feel that he or she needs more time in a structured environment, extended-care housing can provide a safe, smooth transition. Extended-care housing offers the security of a sober community with a higher level of autonomy and flexibility. Residents can continue to attend meetings or counseling sessions at an outpatient treatment center while living in a semi-structured environment within their community.

Resources for family and friends

As someone who cares deeply about an addicted individual, you’ve undoubtedly experienced a lot of conflicting emotions. Fear, anger, frustration, resentment, hope, grief, guilt, and anxiety are common reactions to a loved one’s addiction. You can process these emotions effectively and get help for your own unresolved inner conflicts by seeking support from others. Here are a few resources to help you get started:

  • 12-step groups. The principles of Alcoholics Anonymous, Cocaine Anonymous, Marijuana Anonymous, and other 12-step support groups aren’t just for addicts. These highly effective steps have been applied to help friends and family deal with the impact of addiction. Al-Anon, Alateen, Codependents Anonymous, and Families Anonymous are dedicated to helping the loved ones of addicts and alcoholics recover from the effects of addiction. Not all of these groups may hold meetings in your community, but there’s a strong chance that you can find at least one regular meeting near your home.
  • National Association for Children of Alcoholics (NACoA). This non-profit organization provides educational materials and advocacy services to help the children of alcohol-dependent parents. The goal of NACoA is to ensure that the children of alcoholics get the help and support they need to grow up in a safe, healthy environment.
  • National Institute on Drug Abuse (NIDA). This government agency conducts nationwide research on substance abuse and presents the results to the public in an accessible, easy-to-understand format. NIDA offers a wide range of online resources about drug abuse, substance abuse treatment, and long-term recovery.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). This organization gathers statistics on substance abuse and mental illness in the United States through annual national surveys. Its goals are to educate the public, track trends in substance abuse, and connect members of the public with affordable, effective treatment resources. Numerous substance abuse resources are available through the SAMHSA website.

In addition to these nationwide resources, you can find many sources of support at the local level. Community mental health centers, spiritual groups, and volunteer organizations are just a few of the places where you can connect with others who share your experiences, fears, and hopes.

At The Recovery Village, we believe strongly that family involvement is critical to each client’s healing. Our team of experienced, compassionate professionals is available to give you the support you need to complete your own recovery. If someone you love is being threatened by the disease of addiction, call us today for information about our advanced treatment programs.