guide for family members

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The disease of addiction throws the family ecosystem out of balance. Spouses, children, and other loved ones are often the unintended victims of a person’s addiction and can fall into certain family roles of addiction. On the other hand, families can make a huge difference in their loved one’s recovery. Here you’ll learn why addiction is often called a family disease and how you can support your loved one in their recovery. 

Defining Family

Family can be defined in many ways. When we talk about family, we don’t always mean the traditional nuclear family (mother, father, children).

Family can include the extended family (grandparents, cousins, aunts and uncles, etc.) It can also include individuals who are not biological family members but chosen family, e.g., godparents or close friends that serve as chosen family (sometimes called “fictive kin”).

Essentially, family includes those who have consistent emotional involvement in a person’s life. While families are usually connected by blood, they are almost always connected by strong emotional ties. In deciding who should be involved in family therapy, a counselor or therapist will often ask the client who is most important to them and who they consider family. Those people may then be invited to take part in family therapy sessions.

Addiction Impacts the Whole Family

Addiction is a pervasive disease. Its impact extends to all the people who love the individual with the Substance Use Disorder (SUD). According to the American Society of Addiction Medicine (ASAM), addiction is even transmitted between families. For example, women married to men with addiction problems are more likely to become addicted themselves. Spouses who separate from addicted partners are more likely to reduce their own substance use.

Effects of Addiction on Family Life

The family of someone struggling with a substance use disorder may suffer greatly alongside their loved one. As the disease of addiction develops and intensifies, family life tends to become chaotic. Family members may not know what to expect from day to day and may begin feeling helpless to change the situation. Families may experience problems including:

• Emotional struggles
• Financial difficulties
• Legal issues
• Violence

Parental Substance Abuse Effects on Children

Children of individuals suffering from addiction may also have developmental needs that go unmet or develop unhealthy attachment patterns. They may also find themselves reversing roles with their parents and having to take on an inappropriate amount of responsibility. These children, as well as other family members, are also more likely to develop substance use disorders themselves.

While families often bear the burden of the consequences of their loved one’s substance use disorder, they can also play a huge role in their family member’s recovery.

In many cases, the addicted person becomes unable to take care of themselves or their responsibilities in the way they used to, and one or more family members begin acting as a caregiver. The weight of being a caregiver is a heavy one, and it often comes with feelings of stress, anxiety, depression, fear, and anger.  Caregiving is also associated with an increased risk for mental health disorders such as depression.

According to ASAM, family involvement in a person’s recovery from addiction has significant benefits for both the addicted patient and other members of the family.

Common Roles in Families with Addiction

Being a member of a family where addiction is active is not easy. There are several emotions that develop at this time, many of which can be complicated to manage in a healthy manner. While everyone exhibits different reactions to having a family member with a substance use disorder, it is common for members of a family unit to fall into a role that either allows them to feel in control or helps them cope with the chaos surrounding them.

The Addicted Individual

The family member who is struggling with substance use can find themselves living in a continual state of disarray, as their primary focus remains on obtaining and using addictive substances. As a result, their behaviors can change to include the following: 

• Continued substance use despite any negative consequences that occur because of it
• Neglecting responsibilities at work, home, or school because of substance use
• Experiencing cravings for the substance(s)
• Developing tolerance, which occurs when an individual must increase the amount of substance they are using to achieve the desired effects
• Experiencing withdrawal symptoms when unable to use

The Enabler/Caretaker 

The enabler, or caretaker, in the family where addiction is occurring is often the individual who is attempting to protect the family member with an SUD from the negative effects of their substance use. Rather than allowing them to experience the impacts of their use, the enabler personally handles the impacts instead. They may also neglect their own needs to care for the family member with an SUD.

The Hero

The role of the hero is most taken on by the oldest child in the family unit. Similar to the enabler, the hero strives to take care of the individual with an SUD and has a sense of responsibility for them and their actions. The rest of the family may rely on them, which can cause the hero to feel overwhelmed.

The Scapegoat

When addiction is affecting a family unit, the scapegoat becomes the one who distracts everyone’s attention away from the individual with the SUD by developing negative behaviors. Despite witnessing the effects of addiction, the scapegoat is the family member who is most likely to participate in substance use themselves. This can lead to increased risk for future personal and professional problems to develop.

The Mascot

The mascot makes attempts to avoid further distress by distracting the family with humor or charm. Unfortunately, this coping mechanism often creates complications in adulthood, as they may struggle with handling problems effectively and developing healthy relationships.

The Lost Child

The lost child often does not get their needs met or their achievements recognized by other members of the family. They may isolate themselves from their family and experience loneliness and sadness. The lost child tends to lack relationships with others.

The Importance of Family Support in Recovery

Family members and loved ones of those dealing with addiction or another mental health disorder play important roles. Family support in addiction recovery may look like:

• Intervening in a crisis situation.
• Finding treatment options and helping them get into treatment.
• Providing necessary information about their life and substance use that will help the treatment professionals provide the right type of care.
• Maintaining health records and providing them to treatment providers as necessary.
• Advocating for their needs and rights.
• Helping them stick with their treatment and aftercare plans and watching for any significant behavioral changes that may signal an impending relapse.

Your involvement has so many benefits for your loved one. Studies show that when families take part in the treatment and recovery process, the recovering person is:

• Less likely to be hospitalized or experience a slip.
• More likely to adhere to treatment.
• More likely to recover from the disorder.
• Less likely to be involved in the criminal justice system.

Family members themselves can also benefit from taking part in the treatment process. They may receive education on the disease of addiction and learn healthy coping strategies to be positive contributors to their loved one’s recovery efforts.