When a person struggles with a substance use disorder, their family struggles too. Addiction is often called a family disease, because family dynamics contribute to and are affected by substance use. When families come together to support a loved one in recovery, and support each other, they can learn to change behaviors and enjoy a more positive and healthy home environment.

Substance Use Disorder is a Family Disease

Calling a substance use disorder a family disease is not meant to place blame or spread harm, but rather highlights the important role family has to play in both addiction and recovery. Each family member affects everyone else in the family, both in good ways and bad. When one member is struggling with addiction, every other person in the family has some role to play and both impacts and is impacted by the person who is misusing drugs or alcohol.

At the most basic level, families contribute to addiction because genetics play a role. Family history is a major risk factor for addiction, although not everyone with addiction in the family will have their own issue with drugs or alcohol. Families can also contribute to substance use disorders in people in more complicated ways. According to research, factors such as relocating a lot and experiencing other transitions, family conflicts and trauma can all contribute to a person’s substance use disorder.1

Family members may contribute to addictive disorders, but they also are negatively affected by them. According to the National Council on Alcoholism and Drug Dependence, addiction is a family disease because it puts stress on the entire family.2 Substance use disorders interrupt routines, create instability, impact finances, divide families and affect the physical and mental health of each member. The damaging effects of addiction on a family can last for years.

Issues of Enabling and Co-Dependency

Family members often enable loved ones who have a substance use disorder, often without realizing they are doing it. For example, providing someone with money, because they say they can’t make rent, is a way of enabling a loved one to continue using. Unless you pay their landlord directly, you don’t know if the money is being used to pay the rent, or if your loved one is going to buy drugs or alcohol.

The enabling family members are also often stuck in co-dependent relationships with the addicted person. Co-dependency is a psychology term that was first used to describe how a person relates to a family member with an addiction. It describes a relationship in which two or more people have an unhealthy attachment, with one person giving too much and the other becoming overly reliant.

It is easy for these unhealthy relationship dynamics and coping strategies to become normalized within a family. The concept of homeostasis helps to explain it—it means that a family unit tends to establish equilibrium in response to changes. Whether a change is positive or negative, the family adjusts to a new normal. In terms of addiction, habits that are not healthy become ingrained as the group settles into equilibrium.

Because of homeostasis, when a family member gets treatment, attains sobriety and makes positive behavioral adjustments, it can be easy for the rest of the family to try to stick with the old, unhealthy habits. This resistance to change can be fought when the whole family gets involved in treatment, but it helps to explain why families and individuals tend to maintain dysfunctional behaviors.

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Family Can Help Create a Positive Environment for Recovery

While families can unfortunately play a role in the development of substance use disorders, they can also help in recovery. Family members may be the first to recognize signs of addiction in a loved one and can be the first to offer help and support. When a family member does decide to get treatment for addiction, there are several ways that the rest of the group can provide support and a positive environment for ongoing recovery:3

  • Learning more about addiction and what someone struggling with it is experiencing
  • Talking to a family member about what they are feeling and going through and about any concerns or worries
  • Accepting that the family member needs support, including professional treatment
  • Taking steps to recognize and change enabling and co-dependent behaviors
  • Encouraging the family member to keep up with ongoing treatment
  • Avoiding drugs or alcohol and creating a safe, sober environment at home

Support for Families During Recovery

Because addiction is a family disease, the family members supporting a loved one also need support. It is important for those who are trying to help a family member in recovery to reach out as needed for their own well-being. This could mean joining a support group, such as Al-Anon or Nar-Anon, that helps family members of addicts, attending family therapy sessions or simply relying on all members of the family to share the responsibility of supporting the loved one in recovery.

Support for families is important, because it helps them learn how to better help their loved ones. It also helps individuals develop their own healthy coping strategies, and guides them to better understand negative behaviors from the past and how to change them to support a positive family environment going forward.

Family Outreach Services

Families can take advantage of family outreach services when a loved one is in treatment for a substance use disorder. These services may include support from addiction professionals through phone calls and texts, family check-ins, conference calls with family members and guidance for how to plan for life after treatment and how to create a positive home environment. When families are engaged with a loved one’s recovery, the outcomes are much more positive.

  1. Genetic Science Learning Center. (2013, August 30) Environmental Risk Factors. Retrieved February 26, 2018 from http://learn.genetics.utah.edu/content/addiction/environment
  2. National Council on Alcoholism and Drug Dependence. Family Disease. https://www.ncadd.org/family-friends/there-is-help/family-disease
  3. National Council on Alcoholism and Drug Dependence. Helping a Family Member or Friend. https://www.ncadd.org/family-friends/there-is-help/helping-a-family-member-or-friend
  4. Scientific American. Is Your Relationship Codependent? And What Exactly Does That Mean? https://www.scientificamerican.com/article/is-your-relationship-codependent-and-what-exactly-does-that-mean/
  5. Kelly, Virginia. Addiction in the Family: What Every Counselor Need to Know. Books.Google.com
  6. Nevada Division of Public and Behavioral Health. Families in Recovery: Share Experiences to Support Recovery. http://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Programs/ClinicalBHSP/dta/Training/families-in-recovery.pdf
  7. Psych Central. Family Involvement is Important in Substance Abuse Treatment. https://psychcentral.com/lib/family-involvement-is-important-in-substance-abuse-treatment/
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