Family Addiction: How Does Addiction Affect Families?

Addiction In the Family

Family can be one of our greatest sources of physical security and emotional support. But family environments can also foster destructive emotions and behaviors, including substance misuse and addiction. The genetic ties that make blood relatives so close can also hold the seeds of compulsive or addictive behaviors, and the self-harming actions that children observe in their parents can become habits that affect their lives as they grow. Partners or spouses may feel deeply betrayed or abandoned if the person they love turns to alcohol or drugs. Understanding the nature of addiction and the treatment options can help family members avoid the cycle of addiction or remain close if substance use affects their lives.

No matter how much an individual knows about addiction, it can still come as a shock to find out that a relative has a substance use problem. While facing the reality that a loved one is addicted can be heart-wrenching, it is easier to confront that reality with the support of professionals and experts who understand the disease of addiction. Substance use counselors, family therapists, marriage counselors, spiritual leaders, school counselors, and intervention specialists are a few of the guides who can help families cope with the effects of addiction and mend broken bonds. Learning about the experiences shared by families struggling with substance use, and the resources available to cope with those experiences, can make it easier to overcome this all-too-common disease.

How Does an Addiction Develop?

Addiction is a chronic health condition characterized by compulsive substance-seeking behavior and use despite harmful consequences. While addiction may arise as a result of several contributing factors, a significant part of the development of addiction involves changes in brain function.¹ Drugs and alcohol can interfere with the way the network of neurons that process and transmit information in the brain function. Over time, heavy and chronic substance use can alter feelings, perceptions, thought processes, and behaviors in a way that reinforces continued, problematic substance use.^2,3

The use of alcohol and certain types of drugs can increase the activity of dopamine—a chemical messenger responsible for things like motivation and the reinforcement of repeating certain behaviors—activity in the brain. The body naturally releases dopamine during pleasurable activities like spending time with loved ones or having sex, so when addictive substances artificially increase dopamine activity, it can serve as a powerfully reinforcing signal to continue drinking or using the drugs in question. Over time, this can contribute to an individual prioritizing substance use over other pleasurable things, including relationships.⁴

With regular, prolonged use, an individual can lose the ability to control their substance use. Additionally, once the body and brain become accustomed to having the substance present, stopping use or cutting back can cause uncomfortable withdrawal symptoms to surface, which can contribute to the ongoing cycle of substance use and addiction.⁴

Substance Abuse: How Big is the Problem?

In popular cultural stereotypes of the American family, drugs and alcohol are not part of a happy household. Yet statistics indicate that the problem of substance misuse affects people from all walks of life, including parents, children, spouses, and partners living in otherwise “normal” homes. According to the 2023 National Survey on Drug Use and Health (NSDUH), 70.5 million Americans aged 12 and older used illicit drugs in the past year. Marijuana was, by far, the most commonly used illicit substance in 2023. Others included prescription psychotherapeutics—such as pain relievers like OxyContin, Percocet, Vicodin, and fentanyl—central nervous system stimulants, and opioids.⁵

Besides illicit substances, alcohol misuse continues to be a prevalent problem in many American households. Among the 134.7 million Americans aged 12 and older who reported drinking alcohol in 2023, 16.4 million were past month heavy drinkers and 61.4 million were past month binge drinkers, according to the NSDUH.⁵

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08%. For a typical adult, this pattern is associated with the consumption of 5 or more drinks in a 2-hour period for men and 4 or more drinks in the same period for women. Heavy drinking is defined as the consumption of 5 or more alcoholic beverages on any day or the consumption of 15 or more drinks in a week for men. For women, consuming 4 or more drinks in a day or consuming 8 or more drinks in a week constitutes heavy drinking.⁶

Signs and Symptoms of Substance Abuse

No matter how well we think we know the people we share our homes and hearts with, every individual is capable of keeping secrets. Addiction, by its nature, drives the individual to suppress painful emotions and harmful behaviors in order to fuel episodes of drinking or using drugs. The signs of addiction can range from obvious to subtle, revealing themselves in an individual’s appearance, behavior, moods, mental function, occupational status, or finances.

Perhaps most importantly for families, addiction can affect the quality of interpersonal relationships. Addiction can undermine formerly strong relationships, creating an atmosphere of distrust and provoking feelings of betrayal.

When looking for the potential signs of addiction, remember that substance misuse affects many areas of an individual’s life, and can mirror other mental health conditions such as depression or anxiety. Only a healthcare professional can diagnose an individual with a substance use disorder, however, it can be beneficial to understand the criteria which clinicians use to determine the likelihood and severity of a substance use disorder.

Signs of Addiction in the Family

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the criteria for a substance use disorder includes:⁷

1. An individual takes the substance in greater doses or for longer than they intended.
2. The person wants to cut down or stop using the substance but are unable to do so.
3. They spend a good deal of their time getting, using, or recovering from the substance.
4. The individual craves the substance.
5. The person is unable to complete tasks at school or work as a result of the substance use.
6. They continue to use the substance even when it causes problems within their relationships.
7. The individual gives up important work, social, and recreational activities because of the substance use.
8. The person uses the substance repeatedly even though it puts them in danger.
9. They continue to use despite the fact that substance use is causing a decline in their physical or mental health.
10. The individual requires more of the substance to get the desired effect. In other words, they’ve built a tolerance to the substance.
11. The person experiences withdrawal symptoms when not taking the substance, and they can only relieve their symptoms by taking more of the substance.

The last two criterion are not considered to be met for individuals taking prescription medications under medical supervision.

If you’ve said yes to at least 2 of the above, you should strongly encourage your loved one to make an appointment with their doctor. Sometimes, it can be tempting to mask the problem by attributing it to outside circumstances (“She’s going through a rough time since she got divorced,” or “He’ll stop drinking once he’s done with this stressful project.”). However, a pattern of problematic substance use indicates that the person, as well as the entire family unit, needs help and support in order to recover from this disease.

How Does Addiction Affect the Family?

Substance misuse and addiction affects a family on every level—emotional, psychological, financial, and social. A parent’s preoccupation with getting drunk or high can lead to neglect or abuse. The use of alcohol and drugs can lead to financial hardship, poverty, or bankruptcy. Shame and embarrassment over a family member’s intoxicated behavior can lead to social isolation and the avoidance of friends or relatives outside the home. These factors can create a destructive cycle in which substance misuse leads to emotional pain or mental instability, which can trigger an even greater craving for alcohol or drugs.

Worst of all, addiction undermines the loving, trusting relationships that sustain a healthy family. Children may be forced into a parental role by parents who can no longer function independently. Spouses may hide their addictions from their partners, lying about their actions or expenditures. Parents of addicted children may go to great lengths to rescue a son or daughter from a destructive lifestyle, only to experience the heartbreak of seeing their child return to that lifestyle again and again. Restoring those relationships, which were often damaged long before the substance misuse began, requires time, patience, and the support of knowledgeable addiction professionals.

How Addiction Affects Children

The United States national and state estimates indicate that 21 million American children lived with at least one parent who misused alcohol or drugs, and more than 2 million lived with at least one parent with a substance use disorder.⁸ Children of parents, who misuse drugs and alcohol, are at an increased risk of neglect, poverty, and mistreatment, as well as a higher risk of developing a substance use disorder themselves.

There is no doubt that parental substance misuse interferes with the physical and emotional development of children, yet addiction also affects the health of the family as a whole. For all members of a household to have rewarding relationships and healthy lives, substance use treatment must address everyone in the family, not just the individual who uses drugs or alcohol.⁹ When researching the resources available for families affected by addiction, it is important to consider the emotional, psychological, and physical needs of all individuals who occupy the home.

How to Approach Addiction in the Family

It’s never easy bringing up the subject of substance misuse with a family member, but in most cases, the person with the problem will not be the one to initiate this conversation. Whether your loved one is your child, parent, or partner, there are certain techniques you can use that will help to make this difficult discussion a little easier and less painful. By the same token, some approaches and attitudes should be avoided to reach your goal of getting help for your loved one.

What is an Intervention?

An intervention may seem necessary when a loved one is either unaware of their problematic substance use or has previously declined to get treatment.

Interventions typically involve several loved ones, who gather together in a safe space, to talk to a family member or close friend about their substance use. It’s a time for everyone to express their concerns and encourage the individual to get help.

Some professionals can help with this. You might seek help from a doctor, a mental health professional, or an addiction care specialist before approaching a loved one with an intervention.

Many believe that interventions can be an effective approach to convince a loved one to seek treatment, and with the appropriate planning and guidance, this may be the case.

Still, researchers don’t have enough evidence to understand the efficacy of interventions. That’s because, while interventions can be effective in helping someone start treatment, they may be ineffective in helping them complete treatment or sustain their sobriety.

How to Get Your Loved One Into Treatment

There are several reasons why individuals don’t seek treatment, including denial, the belief that they can quit whenever they want, fear, the stigma associated with substance misuse, privacy concerns, the cost of treatment, the geographic location of the treatment facility, admission availability problems, and more.^10-12

Convincing them to get help is going to take patience and effort. You’ll want to do your research on addiction and rehab options:¹³

• Detoxification. Often the first step in a more comprehensive treatment program, drug detox allows the body to rid itself of the substance and other toxins while under the supervision of a medical professional. During medically managed detoxification, your loved one progresses through withdrawal as safely and as comfortably as possible.
• Inpatient rehab. Inpatient or residential treatment can be very effective, especially for individuals with a co-occurring mental health disorder. Your loved one lives at the facility for the duration of treatment, where they receive 24-hour care, including counseling, medication, and therapies that help them understand the thoughts, emotions, and behaviors that led to the substance misuse in the first place and teach them effective ways to cope.
• Outpatient programs. Outpatient services often mirror inpatient care, but your loved one remains at home or in a sober living residence and visits the facility for individual, group, and family therapy sessions and behavior therapy services, too. This option may work well if you retain a supportive, substance-free home environment.
• Aftercare. Once formal treatment concludes, ongoing services help your loved one avoid relapse and maintain long-term recovery. Programs may include mutual-help groups, counseling, alumni events, and more.

If your loved one is ready to get addiction treatment, American Addiction Centers (AAC) can help. Each of AAC’s addiction treatment centers, scattered throughout the country, provide evidence-based therapies. Call to speak to a knowledgeable and compassionate admissions navigator, who can listen to your needs, answer your questions, explain your options, and help you get your loved one on the path to recovery.