When functioning well, families can add immense happiness, stability, and support to a person’s life. Unfortunately, when there is intense
conflict, such as that which tends to come with an addiction, all family members can suffer overwhelming stress, insecurity, and unhappiness.
Substance abuse and addiction have the power to disrupt even the strongest familial relationships, but there are actions you can take to help. Learn what you can do as you attempt to get help for your parent, sibling, child, or other member of your family.
How Do I Know if a Family Member Is Addicted?
Knowing that your father, sister, child, or other family member has developed an addiction can be difficult because your family member may have gotten very good at lying to others and even themselves.
If you ask your mother about her drinking, for example, she might minimize the amount and the frequency of use in a very convincing way. She may also hide the evidence to make her behaviors more challenging to uncover.
Several potential signs could point to a family member abusing drugs or alcohol, such as:1,2,3
Physical warning signs:
- Unexplained weight loss or gain
- Decline in dental health
- Eyes that appear red or glassy, extreme pupil size changes
- Neglect of appearance/personal hygiene
Emotional warning signs:
- Short-tempered/quick to anger
- Sadness and depression
- Seeing or hearing things that are not there
- Expressing strange or odd thoughts
- Appearing more anxious than usual
Behavioral warning signs:
- Increased isolation
- Changes in social groups
- Changes in energy and sleeping patterns
- Lying or appearing secretive
- Failing to pay bills
- Criminal involvement
Your family member may have a drug problem even if they’re not using illegal drugs. Abuse of prescription drugs or even some over-the-counter drugs may result in noticeable changes to your loved one.
If your family member is displaying some of the signs of drug use, it does not necessarily mean they are addicted. If, for example, your brother drinks heavily on the weekends and is short-tempered when he drinks but has no problem stopping when he chooses to, he may not yet meet criteria for a diagnosis of substance use disorder, or addiction. However, if you’re noticing that your brother is prioritizing alcohol over everything else and continuing to use despite the problems it causes, he might have a problem that requires professional help.
The following are some of the diagnostic criteria professionals use to assess whether a person suffers from a substance use disorder:1
- Using more of the drug than they intended or for longer than they intended to.
- Spending a big portion of time in getting, using, or recovering from their drug of choice.
- Trying to quit or cut back but failing in those attempts.
- Failing to keep up with their work, schoolwork, or responsibilities at home due to prioritizing drug use.
- Struggling to maintain happy relationships because of their drug use.
- Using the drug even when they expect it to impact their health, finances, and legal status.
- Feeling a strong desire for the substance when none is around.
- Increasing the dose to achieve the same effects (i.e., tolerance).
- Feeling ill or unwell without the drug in their system (i.e., withdrawal).
If your family member is displaying some of these signs, their substance abuse may be progressing, or has progressed, from casual use to compulsive use that they may no longer be able to control.1
Why Do Drugs Seem More Important than Our Family?
As a person begins prioritizing drugs over other areas of their life, it may begin to feel like drugs are more important than anything else in that person’s life. For example, seeing your wife continue to use substances despite your pleas for change can make it feel like she cares more about drugs than you. This is not true. If she is facing an addiction, it does not mean she loves drugs more than your family. Rather, she is responding to the influence of drugs in her body and the compulsive drive to continue using them.
Over time, substance use may be accompanied by certain neurochemical changes in the brain that make quitting extremely difficult and much more complicated than simply making the choice to stop.4 All people seek out pleasure and rewards during their life. Natural rewards like food, water, sex, and love help people feel good while encouraging their own survival and survival of humankind.5 Drugs may also create a feeling of reward, and one that may be more intensely reinforcing than those associated with natural rewards; very quickly, an individual may begin compulsively seeking out that reward by drinking or using drugs again and again, even as the reward diminishes over time. As time goes on, natural rewards may become relatively less pleasurable and less prioritized as the addicted person becomes unable to find any satisfaction without drugs. People trying to quit may feel flat, depressed, or altogether feel a loss of a sense of pleasure.5,6
Like any other chronic disease, professional treatment may help people achieve long-term recovery.7
How to Know if You’re Helping or Enabling
It is only natural for you to want to help the people you love. You may, for example, want to shield your adult child from the consequences of his drug use by calling in sick for him when he’s unable to work because he’s hungover. However, you may be enabling his drug use when you think you’re helping.8
Differentiating between helping and enabling is complex because the intention behind both is usually good. A good way to tell the difference is by looking at the long-term benefit.
If your action helps only in the short-term, it might be enabling. For example, if you pay this month’s rent and your child keeps spending his money on drugs, you may be enabling. Conversely, an action that may not see an immediate payoff, and that may even make your child angry in the moment, may be more helpful in the long-run. This might be something like taking your child to a doctor to discuss their substance use.
Examples of enabling behaviors include:9
- Lending money over and over, paying legal fees, or otherwise protecting them from the repercussions of their actions.
- Making excuses for or lying for them.
- Ignoring their drug use/denying there’s a problem.
- Avoiding problems or conflict and keeping your feelings inside.
- Allowing them to use in front of you/in your home (e.g., so you can make sure they’re safe).
To fight back against the urge to enable:
- Acknowledge that you are not responsible for their drug use or for their recovery.
- Communicating your expectations clearly and concisely.
- Establish and enforce clear boundaries and follow through on consequences for violating them.
- Offering plenty of love and support for healthy, sober choices.
- Allowing your family member to endure the uncomfortable consequences of their drug use.
- Encouraging professional treatment on a regular basis.
Having a loved one, especially a close family member, who is struggling with addiction can be tremendously taxing on your well-being. Over time, your mental health and physical health may suffer under the weight of your family member’s addiction.
It’s important to remember that your health matters too. You need to take care of yourself to support another person fully. Practicing self-care helps you balance your resources between yourself and your family. After all, if you do not properly take care of your needs, there is no way you can offer them the love and support they need.
There are many ways to practice self-care; these include methods to take care of your physical health and your mental health:10,11
- Getting enough sleep is essential to feeling good, and exhaustion can lead you to become angry more quickly and make poor decisions. Practice good sleep hygiene and make getting enough rest a priority.
- Eating poor quality foods or skipping meals may only make you feel worse and can contribute to low energy. Focus on eating nutritious meals.
- Prioritizing physical activity may seem silly when a loved one is struggling with addiction, but exercise is one of the best ways to improve your mood and relieve stress.
Types of mental health self-care include:12
- Watching someone you love suffer is extremely stressful, so trying relaxation techniques will be key to staying healthy mentally and emotionally. Relaxation involves more than coming home and popping on the TV. Try deep breathing, guided imagery, progressive muscle relaxation, or yoga.
- Constantly thinking about addiction will wear you down. Give yourself permission to be distracted by going for a walk, turning on music, taking a long bath, or participating in any other activity you enjoy.
- Navigating a close relationship with an addicted family member is intensely isolating for many. Make time to connect with friends and other loved ones who can support you and with whom you can share your feelings.
Other ways to attend to your own needs include:
- Going to therapy yourself and/or participating in family therapy with your loved one.
- Finding and taking part in a support group for family members like Al-Anon or Nar-Anon.
Find Addiction Treatment for a Family Member
The field of professional substance abuse treatment offers a tremendous variety of available services. From around-the-clock care to monthly check-in appointments, options exist to accommodate your family member’s treatment needs.
At times, you may feel compelled to try a drastic strategy, but take caution. Interventions like those shown on TV can result in violence and hostility from your loved one.4 You cannot force your mother, father, sister, brother, son, or daughter into treatment, but you can strongly encourage and support their journey into recovery.
Addiction comes with the baggage of shame and isolation, so an angry confrontation that places blame on your spouse may only push him further away. Instead, try coming from a place of love, support, and understanding when talking to him. It may take many talks for your spouse to finally accept that they need help, but keep trying. Along the way, look into treatment options, so you will be prepared with programs they can enter quickly when they finally express interest in treatment.
If your loved one is thinking about treatment, go with them to their primary care physician or offer to schedule them a screening at a substance abuse or mental health treatment facility.
Each treatment center will provide a unique set of services. Look for ones that offer:13
- Expert staff with the right training and many years of experience.
- Accreditation from the Joint Commission or the Commission on Accreditation of Rehabilitation Facilities.
- Proven treatment approaches (evidence-based therapies).
- Individualized care to target the exact needs of your loved one.
- Aftercare programming or diligent aftercare planning to help prevent relapse once treatment ends.
There are many types of addiction treatment. To avoid becoming overwhelmed with your options, you can follow the recommendation of a trusted treatment professional. They may suggest:14
- Inpatient/ residential treatment – Options that offer 24-hour care in a controlled environment for severe addictions and/or co-occurring disorders.
- Outpatient care – Options that allow the person to live at home while attending scheduled treatment sessions.
- Group therapy – Sessions with other people in recovery that allow for collective learning and sharing and a safe environment to practice new skills.
- Detoxification – A monitored program for the safe withdrawal from drugs and/or alcohol.
- Medications – Combined with therapy, medication may be used at all stages of treatment to treat withdrawal symptoms, alleviate cravings, manage underlying psychological disorders, and prevent relapse.
Many people begin with a more structured and intensive level of care like inpatient or residential rehabilitation before stepping down to various outpatient treatment settings. Completing several different levels of treatment can help you continue receiving professional support while gaining increased freedom and real-world chances to practice newfound coping skills.
Family therapy refers to any form of treatment that involves you, your addicted family member, and potentially other family members in a session with the therapist.13
Family-based treatments can occur in the home or treatment center. They seek to improve communication and problem-solving skills in the family unit. Dysfunction within the family that is not addressed may lead to relapse in the recovering family member and continued stress and anxiety in the rest of the family.
Seeing your parent, sibling, child, or spouse struggle with addiction can be immensely difficult and confusing. If you find yourself being negatively influenced by the addiction of someone in your family, reach out to us for more information about starting the treatment process. The path to recovery can start today.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
- National Institute on Drug Abuse. (2018). Commonly Abused Drugs Charts.
- National Institute on Drug Abuse. (2016). What to Do If Your Teen or Young Adult Has a Problem with Drugs.
- National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
- National Institute on Drug Abuse. (n.d.) The Neurobiology of Drug Addiction.
- Crits-Christoph, P., Wadden, S., Gaines, A., Rieger, A., Gallop, R., McKay, J. R., & Gibbons, M. (2018). Symptoms of anhedonia, not depression, predict the outcome of treatment of cocaine dependence. Journal of substance abuse treatment, 92, 46–50.
- National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction.
- Substance Abuse and Mental Health Services Administration. (2005). Substance Abuse Treatment and Family Therapy.
- University of Pennsylvania Health System. (n.d.). Stairway to Recovery.
- U.S. Department of Veterans Affairs. (n.d.). National Caregiver Training Program Caregiver Workbook.
- American Psychological Association. (2011). The exercise effect.
- Office on Women’s Health. (2019). Caregiver Stress Fact Sheet.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.
- National Institute on Drug Abuse. (2019). DrugFacts: Treatment Approaches for Drug Addiction.