If someone in your family is struggling with drug addiction, you know how tough it is. The addiction affects every member of the family, and you likely want to do everything in your power to help your loved one get well.
Navigating drug addiction can be tough for any family, but there are steps you can take to make the process manageable.
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How Does Addiction Hurt Relationships?
Medical science is working hard to understand addiction and substance abuse so that these conditions can be treated in the best way possible.
Currently, the best understanding among medical professionals is that addiction is a chronic illness involving structural changes in the brain, primarily to the reward system and several neurotransmitters. These changes trigger alterations in behavior, particularly related to compulsive behaviors like drinking or doing drugs, regardless of negative consequences.
Some of the adverse consequences of addiction are damaged relationships with friends, family, and other loved ones. Even if the person knows they are struggling with an addiction and that their substance abuse is harming their interpersonal relationships, the nature of the illness means they cannot quit these compulsive behaviors without help. In fact, many people who struggle with addiction try to quit abusing a substance like opioids, alcohol, or cocaine but find that the withdrawal symptoms are so intense that they relapse.
This is not a moral failing. Addiction is a chronic illness, meaning it will require long-term, focused, and ongoing treatment.
One crucial aspect of successful addiction treatment is support from loved ones — spouses, children, parents, and friends. The American Psychological Association (APA) notes that interventions from friends or family often prompt treatment because an appropriate intervention can highlight how serious the individual’s struggle with addiction has become.
Understanding how to appropriately support someone struggling with addiction is important to their long-term health as well as your own long-term health.
How Can You Know If a Loved One Is Addicted to Drugs or Alcohol?
If someone you care about struggles with addiction, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), which is the latest edition of the DSM, has 11 criteria that clinicians use to determine if someone is struggling with addiction.
- The person consumes the substance, like alcohol, opioid painkillers, or stimulant drugs, for longer than they intend or in larger quantities than they intend.
- They want to cut down on the drug or stop using it altogether, but compulsive behaviors have caused them to relapse — often, more than once.
- They spend a lot of time acquiring, consuming, and recovering from the effects of the substance.
- They have intense cravings to use the drug.
- Their substance abuse patterns mean they have trouble meeting responsibilities at work, at school, with family, or with friends.
- They keep abusing the drug even when they know it is harming their relationships with others.
- They start giving up important hobbies or events to abuse more of the drug.
- They continually abuse drugs even when they are in physical danger because of intoxication.
- They experience a physical or mental problem, such as a mood disorder or liver damage, but keep abusing the drug anyway.
- Their brain requires larger doses of the drug to produce the original effects (tolerance).
- They experience withdrawal symptoms when they try to quit or when they are not able to take the drug (physical dependence).
A person struggling with addiction may also neglect their hygiene, lose their job or fail out of school, lose or gain weight due to changes in exercise and eating habits, change their sleeping habits, or end up hospitalized because of an accident while they are intoxicated.
It is important to know the signs of addiction so that you can offer the person as much help as you can.
This includes talking to them about your feelings and your concern for their well-being while they are sober. This can be a formal intervention, or it could be a preplanned, one-on-one discussion. How this expression of concern and help occurs will depend on your relationship with the individual.
Family Relationships Affected by Addiction
Parents Helping Children
Adolescents and young adults are the most at risk when they abuse drugs or alcohol, but they are also the most likely age groups to develop problems with these substances. It is important for parents to know the signs of substance abuse in their children, especially around middle and high school. These include:
- Changes in peer groups
- Changes in grades, particularly poor academic performance
- Missing classes or skipping school
- Loss of interest in previous activities
- Loss of focus on personal hygiene
- Changes in sleeping habits
- Missing curfew
- Greater mood swings or emotional discord
- Changes in relationships with family and friends
- Getting in trouble at school or with the law
- Smelling like drugs or alcohol
- Drug paraphernalia in their room, around the house, or in the garbage
Many parents are deeply concerned about the potential that their child will begin “experimenting” with drugs due to new friends or changes in their lives. It is important for parents to ask their children if they are concerned about potential warning signs, such as suddenly poor academic performance or the loss of previously close friends.
While there are many other reasons a child’s behaviors may change, maintaining open communication and providing emotional support during this time can help to reduce the child’s risk of abusing drugs or alcohol.
If a child has started abusing substances, they are at risk of developing compulsive behaviors and physical dependence associated with addiction. Talk to your child about the risks of abusing drugs and alcohol from an early age, and discuss your concerns if you notice warning signs.
However, children who struggle with addiction, much like adults who struggle with addiction, will resist discussing the topic. They may lie or downplay the seriousness of their substance abuse, or they may resist getting help.
Parents whose children abuse drugs or alcohol can involuntarily admit their children to treatment. Adolescents may not stop abusing substances until they are compelled by their caregivers or the law to get help.
Children Helping Parents
Adult children of parents struggling with addiction may be able to get help for themselves, find productive ways of structuring a conversation or intervention with their parent, and support their parent through treatment. Younger children, even older teenagers, cannot be expected to take on this burden. Instead, school officials, other family members, or medical professionals should understand the signs of addiction and get counseling assistance for the children.
Harm to children, including academic and social outcomes, is higher when both parents struggle with addiction or when one parent also has co-occurring disorders like depression or schizophrenia, which they are self-medicating with drugs or alcohol.
Family environments for children whose parents struggle with addiction tend to be more unstable and unpredictable. At least one caretaker is not reliable; the child may end up being their own or their parent’s caretaker; their residence and nutrition may be under threat; there may be marital or relationship strife between caregivers; or there may be other family stressors.
This may lead to adjustment issues for the child, but this does not inherently mean poor academic performance. The child could also exhibit social isolation, intense anxiety, and mood swings. They become an overachiever with a lot of time spent on schoolwork and after-school activities, like sports.
Especially for younger children, signs of stress may include inattention, lashing out verbally or physically, changes in academic performance, malnutrition or rapid weight loss, exhaustion, or mood swings.
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When children of parents struggling with addiction exhibit signs of problems at home, it is important for others to step in to help. Children cannot, and should not, provide support for their parents to enter addiction treatment while the child is still a dependent. Instead, other family members, school officials, counselors, and even government officials should step forward to provide help, which may include temporarily removing the child from the home, court-ordered substance abuse treatment, and other steps.
At the same time, it is crucial that the child receives care and support as a caregiver undergoes addiction treatment. The child must know they are not being used as leverage and that their parent’s treatment is focused on improving everyone’s lives.
Spouses or Intimate Partners
The term codependence first appeared in surveys of one spouse supporting another who struggled with alcohol use disorder — typically, a wife keeping her husband afloat through social engagements, work deadlines, and family events. The concept of codependence has a broader application in psychology in modern times, but it is still easy for people in romantic partnerships, intimate relationships, or marriages with someone struggling with addiction to fall into codependent behaviors.
You want to think the best of them, so you make excuses for their behavior, including why they are too intoxicated during the holidays, missing work, or getting into accidents.
It is important to recognize this behavior and understand that it is not the best approach to supporting a loved one who struggles with addiction. Compulsive behaviors, mood swings, and being visibly intoxicated can all be embarrassing for you, but hiding the problem does not help anyone.
At the same time, blaming your partner for their addiction or their behavior while they are intoxicated is not useful.
The best way to support them is to discuss your concerns for their health and safety, and encourage them to get treatment for substance abuse. If you are worried about having this conversation with your partner, seek help for yourself first.
Support groups and therapists can both be great avenues to helping you understand any codependency you struggle with. They can help you start a conversation that may serve as an informal intervention.
Drug Treatment: Involuntary Commitment vs. Voluntary Commitment
If you are in a position to discuss, without blame, your concern for a loved one and your belief that they should seek addiction treatment, you can consider an intervention. In essence, an intervention is a discussion with someone who struggles with addiction that highlights how substance abuse has hurt their interpersonal relationships, their health, and their work or school prospects.
Interventions may be a friend to another friend, between spouses, in a small group of trusted friends and family, or led by a professional interventionist, counselor, doctor, or religious leader. The goal of the intervention is for the person struggling with addiction to acknowledge they have a problem and to voluntarily enter addiction treatment.
Many people who struggle with addiction remain in denial that they have a problem or that there is anything they can do to solve this problem. Since the 1980s, drug courts across the United States have required people to get help in a substance abuse program if they have been found guilty of driving under the influence, possessing drugs, or being intoxicated in public. This is a form of involuntary commitment, which has had statistically mixed success.
People who are sent to treatment through the court system may not have the support of friends, family, and coworkers to overcome their addiction, so they may more easily relapse back into substance abuse when they return home. They may struggle with undiagnosed and untreated co-occurring disorders, but a court system may not send them to an appropriate treatment program, which could increase the chances that they will relapse when they get out. They may not have financial stability or good insurance, so they cannot get intensive treatment and may drop out after their minimum court-ordered treatment stay.
Still, drug courts have shown some success in getting people help when they are otherwise ambivalent. This has led to a movement to increase civil commitment, in which family members or spouses petition civil courts to involuntarily commit someone struggling with substance abuse.
As the opioid epidemic grows worse across the nation, this movement is picking up traction as a method for families to force the legal and medical system to help someone suffering from opioid addiction.
Some evidence suggests that people who are ambivalent toward getting help or in denial about their problem benefit in the long run from some level of involuntary treatment; however, more people benefit from entering treatment on their own terms, with social support from friends and family. This is the best approach, but if people are putting themselves and others at risk, involuntary commitment may be the answer.
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The Necessity of Long-Term Care
Since addiction is a chronic illness, it will require long-term treatment. This may involve returning to detox and rehabilitation repeatedly throughout the person’s life.
Maintaining support for your family member as they go through this process will encourage them to stay sober. Your support can be invaluable in their ongoing journey toward recovery.
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(July 2018). The Science of Drug Use and Addiction: The Basics. National Institute on Drug Abuse (NIDA). Retrieved March 2019 from https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
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(January 2016). What to Do If Your Teen or Young Adult Has a Problem with Drugs. National Institute on Drug Abuse (NIDA). Retrieved March 2019 from https://www.drugabuse.gov/related-topics/treatment/what-to-do-if-your-teen-or-young-adult-has-problem-drugs
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(July 20, 2017). Intervention: Help a Loved One Overcome Addiction. Mayo Clinic. Retrieved March 2019 from https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
(August 2016). Involuntary Commitment for Individuals with a Substance Use Disorder or Alcoholism. National Alliance for Model State Drug Laws (NAMSDL). Retrieved March 2019 from http://www.namsdl.org/IssuesandEvents/NEW%20Involuntary%20Commitment%20for%20Individuals%20with%20a%20Substance%20Use%20Disorder%20or%20Alcoholism%20August%202016%2009092016.pdf
(April 2, 2018). Civil Commitment for Opioid and Other Substance Abuse Disorders: Does It Work? Psychiatric Services. Retrieved March 2019 from https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201800066