When a loved one lives with an addiction, it’s important to learn how addiction affects the family because family healing is essential for recovery.

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When a loved one lives with addiction, the entire family is affected. You may worry about your loved one so much that you neglect your own needs, or you may feel hopeless as if there is nothing you can do to help. Fortunately, resources are available to help families and friends navigate the world of addiction treatment and learn strategies for supporting their loved one’s recovery.

Understanding Addiction

One of the first steps in supporting a loved one is understanding that addiction is a legitimate medical condition. Your family member’s behaviors can be upsetting and, in some cases, quite damaging. But it’s important to recognize that these behaviors are symptoms of the disease and not something you should take personally.

When a person has an addiction, they can be clinically diagnosed with a substance use disorder (SUD). Someone with an SUD experiences changes in brain structure and functioning, which leads to intense drug cravings, difficulty with judgment and changes in behavior and personality.

Spotting the Signs of Addiction

If your loved one has developed an addiction or substance use disorder, they are likely to show some or many of the following signs:

• Strong cravings for the drug of choice
• Inability to cut back on drug use, even if they desire to do so
• Giving up hobbies and other activities in favor of drug use
• Continuing to use drugs even when it leads to worsened physical or mental health
• Using drugs in dangerous situations, such as driving while under the influence
• Ongoing drug use, even when it makes it difficult for the person to fulfill their role at work or care for their family
• Spending a significant amount of time using drugs
• Developing a tolerance so that larger amounts are needed to receive the same effects from the drug
• Showing withdrawal symptoms when not using the drug
• Continued drug use despite relationship conflict arising from drugs
• Using larger amounts of a drug than intended

How Addiction Affects the Family

Addiction doesn’t just affect the person struggling with substance misuse; it takes a toll on the entire family. Research shows that when someone in the family has an addiction, there is increased family conflict and even an increased risk of domestic violence. Families may also struggle with the negative stigma surrounding addiction, and they may even be blamed for the development of the addiction.

A loved one’s addiction can create stress and disharmony in the entire family system. The following factors related to addiction can cause distress for the family:

• Worrying about the relative with the addiction
• Financial strain from drug abuse
• Concern over the effects of addiction on children
• Communication breakdown and relationship conflict related to the addiction
• Aggressive behavior from the person with the addiction
• Family members sacrificing their own well-being for the sake of the person with the addiction
• Negative emotions in family members, including anxiety, depression, fear and despair
• Anger toward the person with the addiction

Ultimately, the strain associated with a loved one’s addiction can lead to mental health problems for family members, as well as a deterioration of physical health as relatives neglect their own self-care for the sake of the person with the addiction.

Family Roles in Addiction

When one family member or more experiences an addiction, other members may take on various roles. This does not mean that family members are responsible for the addiction; instead, these roles are survival strategies that they employ in an attempt to cope.

Some common family roles in addiction include:

• The family hero: This family member is high-achieving and perfectionistic and never seems to make a mistake. This person may have a thriving career, achieve athletic success or be a straight-A student. The role of this family member is to remind the rest of the family that “it’s not all bad.”
• The lost child: This child is quiet and self-sufficient, and they seem to blend in or go unnoticed. While the family may think they don’t need to worry about this child, internally, the lost child is sensitive and self-conscious. This person has simply learned to hide their feelings so as to not cause additional stress to the family.
• The scapegoat: In families affected by addiction, the scapegoat is rebellious and non-conforming. The rest of the family may blame this person for all the problems in the family in an effort to take the focus off of the person with the addiction.
• The mascot: Think of the family mascot as being the “class clown.” This person may keep things lighthearted and humorous as a distraction from the problems in the family.

Supporting vs. Enabling

Another family role that occurs in addiction is that of the enabler. It’s important to recognize the difference between supporting and enabling. An enabler has the best of intentions and feels that it is their responsibility to fix or save the person with the addiction. While this role may help the family survive, in the end, it actually reduces the likelihood that the person with the addiction will recover.

For example, a grandmother concerned about a grandson who is addicted may take the grandson’s 3 a.m. phone call to bail him out of jail after he’s been arrested for drug possession. This is an example of enabling. Because the grandmother saves the grandson from the consequence of spending the night in jail, the addiction continues. On the other hand, a supportive family member would empathize with the grandson’s frustration over being in jail and offer to help him with locating a treatment program instead of bailing him out.

Getting Your Loved One Help

The good news is that if your loved one has an addiction, there are numerous treatment options available. One option is inpatient rehab, in which a person lives onsite at a treatment center while enrolled in a program. An alternative is outpatient treatment, in which a person lives at home while attending appointments at a treatment center during the day. A professional addiction treatment center can help determine the best option for a person’s unique situation.

Talking to Your Loved One

The first step in getting help for your loved one is having a conversation about getting into treatment. This can be a difficult conversation, and there are some do’s and don’ts that can guide you along the way.

Do:

• Remind your loved one that addiction is a legitimate medical condition and that treatment can help
• Express that you are concerned for your loved one because you care about their well-being
• Ask how you can be supportive
• Offer assistance with locating a treatment program
• Communicate that you are available to talk when they are ready
• Be prepared for the fact that your loved one may become upset
• Offer specific examples of concerning behavior, such as your loved one losing their job or spending less time with their children

Don’t

• Approach your loved one when they are under the influence of drugs
• Attempt to argue with your loved one if they become upset
• Call names or blame your loved one for their problems

What To Expect When Your Loved One Goes to Rehab

When your loved one enters rehab, you can expect them to participate in a variety of services, which can include individual and group counseling, support groups and medication management. A quality addiction rehab program will create an individualized treatment plan that meets your loved one’s unique needs. While their length of time in treatment can vary, people typically need to spend at least three months in addiction rehab to achieve long-term recovery.

The specifics of your loved one’s time in rehab will vary based on the type of program they choose. If they select an inpatient rehab program, you can expect them to be away from home for a period of time while they’re in treatment. They will live on-site at a facility, eat all of their meals there and have access to 24/7 care and support.

On the other hand, if your loved one is in outpatient rehab, they will attend appointments at a clinic or treatment center and then return home afterward. This means that they can still work and care for family while being a part of a rehab program.

Family Involvement in Treatment

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Whether your loved one chooses inpatient or outpatient care, you can expect the rehab center to involve family in the treatment process in some capacity. You may be invited to the rehab center for family therapy sessions, or complete them virtually. Rehab centers may refer family members to support groups or individual services to help them overcome the negative effects that addiction has had in their lives.

When family members participate in their own services, they can develop coping strategies to help them address problems like anxiety, depression or fear that have arisen from the loved one’s addiction. They can also learn strategies to improve their communication patterns and support their loved one’s recovery. Family therapy sessions can provide a safe setting for healing broken relationships and moving forward from the effects of addiction.

Additional Resources for Families & Loved Ones

If you’re coping with the effects of a loved one’s addiction, the following resources can also be beneficial:

• Al-Anon: Al-Anon provides support for the families of those with addiction. Group meetings are located in most states and help connect families concerned about their loved one’s drinking in these meetings.
• Families Anonymous: Families Anonymous is a mutual support group program for loved ones of people with drug or alcohol addictions.
• ACOA: Adult Children of Alcoholics is a program that provides support group meetings for adults who grew up in homes and families affected by alcohol misuse.
• The Herren Project: This non-profit provides consultation services and resources to families of those with addiction.
• AA: Alcoholics Anonymous is a support group for individuals who struggle with alcohol addiction.
• NA: Narcotics Anonymous provides support to people who suffer from drug misuse.
• SMART Recovery The SMART Recovery program helps family and friends develop skills for supporting a loved one with an addiction.
• GRASP: This group provides support and resources for those who have lost a loved one to substance use.
• NAMI: The National Alliance on Mental Illness offers support group meetings to people with a loved one with a mental health condition.
• Learn to Cope: This is a peer-led support network for families of those with addiction. They offer both virtual support meetings and in-person meetings.
• Recovering Couples Anonymous: Recovering Couples Anonymous offers support groups for couples in recovery.