As a clinician who works with individuals who struggle with substance use disorders, I see how addiction not only negatively impacts the client but how it affects the entire family system as well. Addicts falsely conclude that their using does not affect others around them. As a result, they continue their negative behavior patterns while their families are left to feel the devastating consequences. Families report the turmoil they experience when they have a loved one in active addiction. They describe how the disease of addiction undermines the mental health and stability of each person in the system. Family members may feel angry that the person has put them in a situation to deal with family issues on their own. They may also suffer from depression or sorrow because they feel like the situation will never get better. There may be feelings of uncertainty, and confusion over what will happen next within the relationship.

Often times, family members share that they have encountered considerable financial strain as they try to manage their loved one’s addiction. Drugs are expensive and addicts may resort to stealing cash and credit cards. Even if the person wants to stop using and enters treatment, the associated financial costs to the family can be significant.

The issues of grief and loss are powerful emotions family members may experience. Often they are consumed with worry about losing a loved one who suffers from addiction. The fear of overdose and death are ever present as is the somber realization that the person that they once knew and loved has actually been gone for quite some time. Drug use causes profound changes in an individual’s brain chemistry and behavior. As using escalates, family members may see their loved ones become rebellious and defiant; they may experience mood swings, irrational anger and intense paranoia. Other behavior changes may include verbal and physical abuse against others. Family members are no longer able to rely on or trust their loved ones. Families grapple with feeling responsible for the role they’ve played in the development of the addiction and as well as with the extreme sadness they encounter as they grieve someone who is still living.

Addiction kills relationships. Those who are in its grips experience a loss of control over their behavior. In order to sustain their using, addicts will often compulsively manipulate and lie to those around them. Over time, these negative behaviors erode meaningful relationships and create a downward spiral of shame and isolation. Family members struggle with their own sense isolation, loneliness, anger, sadness and shame. They report feeling cut off from others and describe the same feelings of hopelessness and helplessness that addicts themselves feel.

The impact of addiction is profound and deep. The effects are widespread and the ripple extends to every member of the family structure. The stress and conflict that this disease causes can feel overwhelming. It is important to understand that while addiction cannot be completely cured, it is highly treatable. There are many effective treatment options that can help an individual and their family heal. While there is no one approach that works for everyone, interventions that focus on the person struggling with the addiction and their whole family system tend to have more successful outcomes. Family-based therapies that address issues such as effective communication, conflict resolution, rules, boundary setting and co-occuring mental disorders can help break negative patterns and assist families to develop a healthy functioning environment. Seeking professional help and community support through 12-step, or other groups is important. These avenues can provide a sense of hope and are instrumental in assisting the entire system towards health and recovery.

Sally Anderson