Are you worried about a loved one’s substance abuse? Do you see his or her behavior becoming more erratic and self-destructive? Maybe it is time to finally get help.
Many families start the recovery process by calling a family drug helpline. Making that call could seem difficult or uncomfortable at first. It takes courage, but the results can be life changing.
So when should you call a family drug support helpline? What signs should you look for in your loved one? One of the best indicators is listening to your instincts. What does your gut tell you? When considering making the call, some people tend to make excuses or justify a family member’s behaviors. Others think they may be overreacting. These are common reactions for people unsure how to deal with their loved one’s addiction.
If you have a strong feeling you need to call, don’t talk yourself out of it because of uncertainty or fear of the unknown. Our drug helpline is happy to receive calls from any family member seeking help.
Table of Contents
- 1 Addiction is a Family Disease
- 2 Role of Family Members in Addiction
- 3 Behavior Patterns in Families Battling Addiction
- 4 Impact of Addiction on Children
- 5 Children of Alcoholics and Drug Addicts: Facts and Figures
- 6 Parenting Teenagers with Addiction
- 7 Being Married to an Addict
- 8 Social Effects of Addiction
- 9 Domestic, Sexual, and Child Abuse
- 10 Financial and Legal Difficulties
- 11 Overcoming Addiction and Re-Establishing Family Connections
Addiction is a Family Disease
It is a common misconception that battling a substance use disorder is a personal experience. However, alcohol or drug abuse does not have devastating effects on the user alone. There is a growing body of evidence that suggests substance abuse has severe and lasting effects on families. People who are in the grips of addiction may not take into consideration that their family members are directly affected by their drug or alcohol use. But make no mistake, addiction affects the entire family. Spouses, children, parents, and members of the extended family who witness a family member struggling with addiction experience a range of emotional, legal, financial, and health consequences.
Drug and alcohol abuse can turn what was once a peaceful, happy family into one that is divided by conflict and strain. Over time, trust begins to erode, secrecy becomes the norm, and communication becomes frustrating. Many people deal with the trauma of alcohol and drug abuse in the family by developing unhealthy coping mechanisms, resulting in a lifetime of mental health problems.
Every family member is uniquely affected by the use of harmful substances by a relative. The effects can range from unmet needs to impaired relations, economic hardship to legal problems, emotional distress to violence and abuse. 1Children are at particularly high risk of suffering the consequences of addiction in the family. Studies show that children of drug and alcohol abusers are more likely to develop a substance use disorder themselves. 2
For the reasons mentioned above, addiction treatment that focuses only on the affected individual may have limited success. Social workers, healthcare providers, and addiction treatment experts must recognize the importance of providing care in the context of the person’s family environment. Studies have shown that family-based approaches for the treatment of drug abuse have superior results compared to individual or group-based therapies. 3
Role of Family Members in Addiction
Over the last few decades, family structures in the United States have become more complex. Not everyone lives in a traditional nuclear family. There are single-parent families, foster families, step families, and multigenerational families. In each family unit, the various members play one or more roles that help the family function and maintain stability and balance. When you add the effects of alcohol or drug addiction to these complex dynamics, there is a shift in family roles. For example, if one parent is abusing alcohol, the non-addicted parent becomes a “superhero,” taking on additional responsibilities and focusing on caring for the children.
Six main roles are used to describe family dynamics. In the context of drug or alcohol abuse, these roles take on even greater importance. 4
Enablers: These are family members that take care of everything that needs to be done, including things that are the addict’s responsibility. This can include anything from ensuring the children are fed to taking care of finances. Enablers make excuses for the addict in professional or social situations. Examples of enablers include a non-substance abusing spouse or an older sibling in a single-parent household. Enablers are often in denial about the addiction and find ways to justify the addict’s behavior.
Heroes: This is a role typically assumed by an overachiever or a confident, serious member of the family. For example, an older child may take on responsibilities that exceed what’s appropriate for their age. Heroes tend to be perfectionists, but with time, the responsibilities in an addiction-affected household mount and it becomes increasingly difficult to maintain the role.
Scapegoats: These are people, usually children, who respond to the trauma of alcohol or drug abuse in the family by misbehaving and defying authority. This gets them into trouble at school and home, and as they grow older, it gets them into trouble with the law. They are scapegoats because their defiant behavior is nothing but a reflection of the chaotic or unhealthy atmosphere at home.
Mascots: Some people cope with difficult situations by turning to humor. Mascots are aware that there is a problem with addiction. They use comedy for temporary relief and to try and restore some semblance of normalcy in the family.
Lost Children: These are members of the family who withdraw from friends and family and become isolated. Lost children often have difficulty interacting with people in social situations as a result of the negative home environment. They might use fantasy as a means of distraction from the family situation.
Addicts: The person who is abusing drugs or alcohol can be consumed by feelings of guilt, shame, and remorse about the hardships they are causing to their family. However, due to the nature of the disease, they are unable to stop substance abuse. This can lead to resentment and anger among family members who may feel that the addict does not care about them.
Behavior Patterns in Families Battling Addiction
In addition to the roles various family members assume, certain characteristic patterns of behavior are often present in families where a person is abusing alcohol or illegal drugs. 5The various roles and behavioral patterns that get established in families battling addiction continue to evolve and play out over time.
Negativity: In families struggling with addiction, criticisms, complaints, and other expressions of displeasure are commonplace. Over time, the mood in the household is dominated by these negative emotions. Any attempts to encourage positive behavior are either ignored or lead to a crisis. Moreover, the desire to escape from these negative emotions can reinforce substance abuse. In other words, addicts may use drugs or alcohol to avoid the negative mood in the household.
Inconsistency: In households battling alcoholism or drug abuse, rules are erratic and their enforcement is inconsistent. This lack of predictable parental response can confuse the minds of children. In such cases, children are unable to tell right from wrong. Some children behave badly to get their parents to set clear boundaries.
Denial: It’s common for many families to be in denial about a drug problem or heavy alcohol use. For example, even when social services intervene, many parents will take the stance that it’s all a mistake and their teenager couldn’t possibly be doing drugs. This is despite obvious warning signs and symptoms of substance abuse.
Misdirected anger: In homes affected by drug abuse or alcoholism, family members are often emotionally deprived. Relatives may be afraid to express their anger at the addict’s use of drugs or alcohol. The repressed anger and outrage often find an outlet in social situations, where a person might misdirect their anger and frustration on others.
Self-medication: Family members of drug addicts and alcoholics may start self-medicating with drugs or alcohol themselves to cope with the feelings of anxiety, depression, isolation, and helplessness.
Expectations: Children of parents who abuse drugs or alcohol can be difficult to discipline. They get away with a lot by pointing out the parent’s shortcomings and their battles with substance abuse. This can lead to low expectations and lost academic and career opportunities. On the other hand, some children respond to addiction in the family by becoming overachievers and perfectionists, sometimes pushing themselves to burnout.
Impact of Addiction on Children
While every member of the family is affected by addiction, the effect is particularly harsh on children. Children learn by example. Exposure to damaging influences, such as drug abuse, by an adult family member, can have lifelong consequences. In other words, the effects of parental drug addiction and alcoholism can last well into adulthood.
Studies have shown that children of alcoholics and drug abusers are at risk of a variety of behavioral problems, such as anxiety, depression, low self-esteem, and cognitive deficits. 6These adjustment issues can lead to more severe problems later in life, such as domestic violence and increased divorce rates.
Children in addiction-afflicted families may be exposed to violence, aggression, and physical or emotional abuse. Parents who abuse drugs or alcohol sometimes force children to engage in illegal activities on their behalf. It is not unusual for these children to feel isolated, emotionally neglected, and unsafe. The trauma of growing up in such a family can lead to mental health issues that can last for the rest of the child’s life. Some of the effects of parental substance abuse on children include: 7
- Lower socioeconomic status
- Access to fewer resources
- Poorer academic performance
- Emotional, behavioral, and social problems
- Parental neglect
- Parental abuse
Children of Alcoholics and Drug Addicts: Facts and Figures
There are nearly 9 million children aged 17 or younger in the United States who live in households where at least one parent has a substance use disorder (alcohol or illicit drugs). This figure includes:
- 1.5 million children aged 0 to 2
- 1.4 million children aged 3 to 5
- 2.8 million children aged 6 to 11
- 3.0 million children aged 12 to 17
Not only are these children at risk of negative outcomes, but they also have a higher likelihood of battling drug and alcohol problems themselves. Addiction runs in families and there is a biological risk in children of addicts.
Studies show that children of parents with substance use disorders are more than twice as likely to have alcohol or drug problems during adulthood compared to peers who grew up in non-substance abusing families. 8The risks are greater if the parents have a co-occurring psychiatric disorder (anxiety, depression, antisocial personality) and if both parents use harmful substances rather than just one parent. 9
Besides the genetic predisposition, children of addicts are more likely to experiment with drugs or alcohol because they’ve witnessed these behaviors at close quarters. Children may think drug abuse is okay, even acceptable, and many may not realize this behavior is not normal. Also, the presence of drugs in the household makes it easier for children to procure these harmful substances and experiment with them.
Parenting Teenagers with Addiction
Although it is illegal for anyone under 21 to purchase alcohol in the United States, underage drinking is rampant. Adolescents and young adults in the 12-20 years age group drink over 10% of the total alcohol consumed in the US. Drinking alcohol is almost considered a rite of passage for teenagers. More than 90% of the alcohol consumed is during binge drinking sessions and underage drinkers consume more alcohol per occasion than adults. Binge drinking is associated with a higher risk of alcohol addiction.
The CDC reports excessive alcohol consumption is responsible for more than 4,300 deaths of American youth each year. 10In addition to alcohol, many teenagers experiment with dangerous drugs. In particular, marijuana use is common among adolescents. Nearly 6% of 12th graders report daily marijuana use. 11
Parenting adolescents with substance use disorders can be extremely challenging. Teenagers who are abusing alcohol or drugs can have a direct and severe impact on family dynamics, including:
- Strained relationships
- Reckless behavior
- Poor performance at school
- Psychiatric problems
- Impaired development
- Stealing or getting into trouble with the law
- Running away from home
- Risk of unwanted pregnancy or sexually transmitted diseases
Drugs and alcohol are a leading cause of violent deaths in teenagers from suicide, homicide, and accidents. Also, when an adolescent in a family is using drugs or alcohol, their siblings may be neglected or ignored while the parents respond to the crisis involving the addicted youngster.
Being Married to an Addict
Addiction affects every aspect of family life, but living with an addict is perhaps the most difficult for a spouse. Being married to a person who is abusing harmful substances often means assuming the role of a provider while dealing with difficult emotions like anger, anxiety, stress, hopelessness, and isolation.
Addiction creates a lack of trust, chaos, emotional confusion, instability, and unpredictability in intimate relationships. Even in families where the addict is getting help, people often do not realize that the partner also needs care.
In families where one adult is dependent on drugs or alcohol and the other is not, a phenomenon called co-dependency can occur. A co-dependent person’s behavior is characterized by:
- Controlling behavior based on the belief that others cannot take care of themselves.
- Low self-esteem and denial of their feelings.
- Excessive compliance and compromise of their integrity and values to avoid anger or rejection.
- Oversensitive reactions.
- Hypervigilance to avoid conflict or trouble.
- Remaining loyal to others despite the other person not deserving it.
Studies show that co-dependency is significantly higher among women who are married to addicted men. 12
Social Effects of Addiction
The effects of drug and alcohol use on a family go well beyond the four walls of the family’s home. Some of the social effects of addiction include: 13
Stigma: Family members may not share what they’re going through with friends or colleagues for fear of being judged or treated differently.
Isolation: Because of the stigma attached to drug abuse and alcoholism, families can isolate themselves from friends, communities, and social networks.
Abuse: Members of a family struggling with substance abuse are at higher risk of emotional and economic abuse by others due to a lack of familial bonding and support.
Homelessness: Substance abuse can lead to financial difficulties, poverty, and homelessness. Studies have found that every third person seeking treatment for substance abuse is homeless. Not only is substance abuse a risk factor for housing instability, but homelessness is associated with more serious drug and alcohol problems. 14
Criminal behaviors: There are significant links between substance abuse and criminal behavior in both men and women. 15 People with addictions are at risk of being both victims and perpetrators of crime. Substance abuse can lead to incarceration for violent crimes like assault and homicide. Family members, in particular children of incarcerated individuals, face a host of challenges.
Unemployment: Problematic use of drugs and alcohol increases the risk of unemployment and decreases the chances of holding down a job. 16 The loss of employment can be difficult for the family, especially if the addict is the only earning member of the family. Also, it can become a vicious cycle because unemployed individuals are more likely to indulge in heavy alcohol use, prescription drug misuse, and illicit drug abuse.
Sexually transmitted diseases: Drug abusers are at high risk of acquiring sexually transmitted diseases like HIV/AIDS and hepatitis due to IV drug use or risky sexual behaviors under the influence of drugs or alcohol. Incurable illnesses like HIV/AIDS have a severe impact on families and can lead to isolation, anger, guilt, and changing family roles.
Domestic, Sexual, and Child Abuse
Unfortunately, addiction often leads to domestic violence, sexual abuse, and child neglect and abuse.
Abuse and addiction share several behavioral characteristics, such as loss of control, preoccupation or obsession, tolerance, and continuation of the behavior despite negative consequences. 17
Studies have shown that substance abuse is involved in more than 70% of cases of child abuse and neglect. Children whose parents abuse harmful substances are more likely to be abused and more likely to be neglected compared to children who do not fall into this category. 18
Besides children, adults in the family of an addict are also at risk. Substance abuse is identified in roughly 60% of incidents of intimate partner violence. 19 Women are up to 8 times more likely to be victimized than men by an intimate partner. Alcoholism and drug addiction can incite or worsen violence in the home. Moreover, women in abusive relationships are sometimes coerced into using drugs or alcohol by their partner.
There is a great deal of evidence linking substance abuse to physical abuse and sexual assault. The vast majority of data has been collected in women. Women who use drugs are at increased risk of assault. 20Studies have also shown that nearly two-thirds of samples collected at rape treatment centers in the United States contain alcohol and/or drugs, mainly alcohol, marijuana, and other illicit drugs. 21
Financial and Legal Difficulties
Drugs and alcohol don’t come cheap. An addiction can be a financial drain on the family. As the alcohol or drug use becomes more compulsive and frequent, addicts may run out of financial resources to feed the habit. A drug habit can also lead to loss of employment, redirecting money meant for other things (such as children’s education), and stealing money to fuel the habit. There may be defaults on payments and mortgages. Families may lose heating in the winter or lose a roof over their heads, leading to all kinds of hardships.
Besides, drug users often associate with people who engage in illegal activities like selling or distributing drugs. This can lead to legal problems, including arrests, jail time, fines, and a permanent criminal record. All of these financial and legal problems place an incredible amount of stress on the family.
Overcoming Addiction and Re-Establishing Family Connections
Drug and/or alcohol abuse takes a heavy toll on families, but all is not lost if a member of the family is battling addiction. Comprehensive treatment of a substance use disorder can support families in their efforts to get back on track. In addition to individual and group therapies, family interventions play a key role in helping those impacted by substance abuse. Family therapy helps various members support the addict as well as address their own reactions to the drug abuse. Some of the strategies that are effective for families in recovery include:
- Engaging and involving the family in the addiction treatment process.
- Providing education about the symptoms, causes, risks, and treatments of drug or alcohol abuse.
- Including couples or family counseling sessions to address the emotional burden of addiction.
- Teaching skills to cope with the fallout of substance abuse.
- Educating family members about the signs of relapse.
- Meeting the needs of family members and helping them make positive changes.
- Focusing on children and addressing their feelings, concerns, and questions.
Last updated: July 26, 2020
- Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health. 2013;28(3-4):194-205. doi:10.1080/19371918.2013.759005
- Zimić JI, Jukić V. Familial risk factors favoring drug addiction onset. J Psychoactive Drugs. 2012;44(2):173-185. doi:10.1080/02791072.2012.685408
- Baldwin SA, Christian S, Berkeljon A, Shadish WR. The effects of family therapies for adolescent delinquency and substance abuse: a meta-analysis. J Marital Fam Ther. 2012;38(1):281-304. doi:10.1111/j.1752-0606.2011.00248.x
- Family Roles in Homes With Alcohol-Dependent Parents: An Evidence-Based Review. Peter M. Vernig. Pages 535-542 | Published online: 24 Aug 2010. https://doi.org/10.3109/10826084.2010.501676
- Center for Substance Abuse Treatment. Substance Abuse Treatment and Family Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2004. (Treatment Improvement Protocol (TIP) Series, No. 39.) Chapter 2 Impact of Substance Abuse on Families.Available from: https://www.ncbi.nlm.nih.gov/books/NBK64258/
- Johnson JL, Leff M. Children of substance abusers: overview of research findings. Pediatrics. 1999;103(5 Pt 2):1085-1099.
- The Substance Abuse and Mental Health Services Administration (SAMHSA). Children Living with Parents Who Have a Substance Use Disorder. No date. Available online. https://www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html
- Chassin L, Pitts SC, DeLucia C. The relation of adolescent substance use to young adult autonomy, positive activity involvement, and perceived competence. Dev Psychopathol. 1999;11(4):915-932. doi:10.1017/s0954579499002382
- Solis JM, Shadur JM, Burns AR, Hussong AM. Understanding the diverse needs of children whose parents abuse substances. Curr Drug Abuse Rev. 2012;5(2):135-147. doi:10.2174/1874473711205020135
- Centers for Disease Control and Prevention. Alcohol and Public Health. Underage Drinking. No date. Available online. https://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm Accessed July 25, 2020
- The National Institute on Drug Abuse Blog Team. Teens’ Drug Use Is Lower Than Ever (Mostly) . National Institute on Drug Abuse for Teens website. https://teens.drugabuse.gov/blog/post/teens-drug-use-lower-ever-mostly. January 08, 2018. Accessed July 25, 2020.
- Panaghi L, Ahmadabadi Z, Khosravi N, Sadeghi MS, Madanipour A. Living with Addicted Men and Codependency: The Moderating Effect of Personality Traits. Addict Health. 2016;8(2):98-106.
- Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal. 2013;21(4):S73-S76. doi:10.1016/j.jfda.2013.09.038
- Krupski A, Graves MC, Bumgardner K, Roy-Byrne P. Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics. J Subst Abuse Treat. 2015;58:84-89. doi:10.1016/j.jsat.2015.06.007
- Lammers SM, Soe-Agnie SE, de Haan HA, Bakkum GA, Pomp ER, Nijman HJ. Middelengebruik en criminaliteit: een overzicht [Substance use and criminality: a review]. Tijdschr Psychiatr. 2014;56(1):32-39.
- Henkel D. Unemployment and substance use: a review of the literature (1990-2010). Curr Drug Abuse Rev. 2011;4(1):4-27. doi:10.2174/1874473711104010004
- Irons R, Schneider JP. When is domestic violence a hidden face of addiction?. J Psychoactive Drugs. 1997;29(4):337-344. doi:10.1080/02791072.1997.10400560
- Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2000. (Treatment Improvement Protocol (TIP) Series, No. 36.) Chapter 1—Working With Child Abuse and Neglect Issues.Available from: https://www.ncbi.nlm.nih.gov/books/NBK64904/
- American Society of Addiction Medicine. Intimate Partner Violence and Co-Occurring Substance Abuse/Addiction. No date. Available online. https://www.asam.org/Quality-Science/publications/magazine/read/article/2014/10/06/intimate-partner-violence-and-co-occurring-substance-abuse-addiction Accessed July 25, 2020
- Liebschutz J, Savetsky JB, Saitz R, Horton NJ, Lloyd-Travaglini C, Samet JH. The relationship between sexual and physical abuse and substance abuse consequences. J Subst Abuse Treat. 2002;22(3):121-128. doi:10.1016/s0740-5472(02)00220-9
- Slaughter L. Involvement of drugs in sexual assault. J Reprod Med. 2000;45(5):425-430.