Addiction does not discriminate; it could happen to any of us and to any of the people that we care for, depend on, love, and/or respect. The effects of addiction go beyond just health, financial, emotional, and mental complications for the person using. Family members of those who suffer from substance use disorder, or SUD, can suffer from stress, financial burden, communication barriers, emotional distress, health complications, domestic violence, and role reversals. Addiction can tear families apart or alter the functional family structure. There are several forms of addiction: substances, sex addiction, food addiction, gambling, shopping (add others), etc. This blog will focus on substance use disorder and addiction to drugs and/or alcohol.
Emotional Distress
The person addicted to substances is not the only one who suffers detrimental and long-term physical, emotional, and mental impacts from the addiction. Family members may be hyper-focused on taking care of the addict; they stop taking care of themselves or even their relationships with other members of the family. The lack of communication can cause further distress, not knowing, not having control, and fearing the worst. Substance use disorder can be messy, difficult to grasp, and challenging to process. One may feel guilt, shame, loneliness, helplessness, overwhelmed, and/or lack of agency. You may have lived with this your whole life; this may come on later or in waves; whatever it may be, you may be searching for an answer for a reason. There may be doubt, “Was this my fault?” “What if I did this to stop it?” “Did I trigger them to relapse?” “Was it something I did, said, didn’t do or didn’t say?”. When one person is suffering from addiction, there is a ripple effect throughout the lives of the family. If your parent is the one using it can create a home that is physically and emotionally unsafe. It can cause further family problems and challenges such as finances, loss of trust, communication barriers, loss of the family system, fear of losing them altogether, etc. It could feel like a recurring mourning process for the family.
Role Reversal
A child can become the caregiver for themselves or other members of the family if their parent or guardian suffers from SUD. You may be familiar with a dramatized example from the TV show Shameless. The father of the Gallagher family, Frank, suffers from alcohol addiction. His children have to take care of the house and each other, worrying about financial bills such as electricity and food, caring for younger siblings who need childcare and assistance in schooling, and caring for their father when he comes home intoxicated and cannot feed himself. Also, other people in the family, especially the children of the user, may seek out substances that could cause addiction to cope with their stress. It is seen as an appropriate way to manage challenges by the family, especially if they are or were seen as a role model or caretaker. You can see this in The Shameless as well; many of the Gallagher children use drugs and alcohol to escape from stress. If there is a history of another person in the family having substance use disorder, then the severity of another person’s SUD is increased. Intergenerational trauma can cause a repetitive cycle in the family.
Boundary Setting
You can use tools to help cope with this stress, such as boundary setting. It feels good to feel needed and valuable. Sometimes, it may feel good to be the family member that someone using substances needs and relies on. Constantly maintaining the cost of using can be a financial burden on the individual using and could affect the family if boundaries are not set on the limits of support provided. Family reliance on money and support can start early and become detrimental to family structure and finances. Without boundaries to your support, this could enable the person with SUD.
Interventions:
There is no one-size-fits-all approach to managing, intervening, or coping with a family member’s addiction. There are different types of interventions used to help the family member who is addicted, which in turn can also help the family heal.
- Johnson Intervention is essentially a confrontation of the person with SUD, which needs to be planned out, and encouraging the substance abuser to receive treatment.
- Unilateral Family Therapy focuses on educating caregivers on how to change their own behavior with the person using substances.
- Pressures to Change Procedure discourage incompatible activities, such as going to a restaurant, friend’s house, or bar, where they usually avoid enabling and negotiating contracts rewarding for good behavior.
- The CRAFT Approach encourages healthy, constructive, positive change for the family by using positive reinforcements, taking steps toward awareness, and learning to communicate positively even when things aren’t going well.
Even if interventions are applied, addiction is not easy and can be an extreme stressor. Sometimes, conflict feels so normal that it may seem like the family will never be rid of it. One way to cope personally or as a family is therapy, which could be an outlet to express frustrations and decide on potential interventions for your family members. Another option could be support groups, which can help them find a community to relate to, free of judgment or ridicule; it can also get them out of the cycle of the stress of addiction and help the family to “learn to live with fear and anxiety.”
Conclusion
Most people have some connection to someone who suffers from addiction. An individual can overcome addiction. There are resources out there to support you. There are also ways to access harm reduction, such as naloxone, an opioid overdose reversal, fentanyl test strips, access to clean syringes, and safe injection sites that could help the person suffering from substance use disorder use safer. It is not easy; it can uproot your family structure, friendships, feelings of safety, and trust. There is support out there; you are not alone in this fight.
References
Family Members of Adults with Substance Abuse Problems (apa.org)
The role of family history in addiction severity and treatment response – ScienceDirect
