Drug Addiction and the Family

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1. Addiction as a Family Disease
2. Enabling Family Members
3. Addiction and Lying
4. Family Roles
5. Treatment Options

Drug addiction can cause serious problems for the person who abuses drugs, but it can also cause a significant amount of distress for the members of that person’s family. Watching someone spiral down into illness is never easy, and many of the behaviors the person might engage in can cause severe strain on family relationships.

While getting that person into treatment is a good first step, there is often much more work that must be done to ensure that the addiction issues don’t continue in the future. Sometimes, family members must enter their own treatment programs as part of this process. This article will explain how these programs work, and why they are so important to the long-term health of both the family and the person in recovery.
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Addiction as a Family Disease

There are many ways in which addiction can be considered a disease of the family. At a simplistic level, the susceptibility to addiction seems to be a trait passed down through genes. A study published in the journal Addiction, for example, found that genetic information had a moderate to high influence on addiction. This study examined the issue using data from siblings who were raised in separate households, so these are results that can be trusted. It seems that the susceptibility really does start with nature, rather than nurture.

If a family has a genetic predisposition to addiction, it’s entirely reasonable to believe that other members of the family could have addictions of their own, running alongside the addiction of the person in treatment. All family members will need to overcome their addictions if true healing is to take place, as the home will be filled with temptation if one person continues to use.
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Enabling Family Members

Addicts may take the path to addiction on their own, but often, they receive a bit of help from the members of their family. Sometimes this help is overt, as family members with their own addiction issues may not want to live with a family member who is sober, but often this help is completely covert and subtle. In fact, some family members who help to foster an addiction may be devastated to learn that the behaviors they engage in actually help to keep that addiction alive.

This behavior is known as enabling, and according to the addiction support group Co-Anon, it can be further defined as “… doing for others what they are capable of doing for themselves.” People who enable might:

Enabling could be seen as caring behavior anyone would do when someone is sick, but it can have more sinister consequences in the field of addiction. By caring for the person in this way, the family is shielding the person from feeling the consequences of addiction. They are smoothing the road, and this can make the idea of recovery seem unnecessary.

Enabling is quite common in addiction. In fact, according to a study published in the journal Addictive Behaviors, some women in therapy felt that their romantic partners were their greatest enablers, and that they did not provide constructive support. It’s easy to see how this environment could help lead a person back to an addiction problem.
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Addiction and Lying

Addictions to drugs can become incredibly expensive, incredibly quickly. As the user continues to abuse drugs, he/she may find that larger and larger doses of drugs are needed in order to bring about the same effect. A habit that was once worth just a few dollars a day could quickly become a habit that costs hundreds or even thousands of dollars each day to feed. For some addicts, the only way to get this amount of money is through theft. They may overtly steal from family members, or they may steal by claiming to have paid bills when they have actually spent the money on drugs. These sorts of lies can have a devastating effect on the finances of the family.

Some addicts lie about their drug use itself. They may desperately want to stop using, and they may have even managed to stop for a day or two at a time, but as the addiction called out to be fed, they relapsed into drug use once more. These lies hurt the addict, but they also serve to break down trust between the family members, as it can feel impossible to trust anything that person says.

These issues have an important role in the recovery process. If the addict goes through therapy alone, the addict will emerge changed but will return home to a family that doesn’t see or believe in that change. This family might question, blame or control the person in recovery, causing pain and resentment that could quickly develop into relapse. The addict might think, “They already believe I am using drugs. Why shouldn’t I just prove them right?”
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Family Roles

The person who enables the addiction may play a significant role, but the rest of the family may also change in ways that keep the addiction viable. They may not directly support the addiction, but their actions serve to indirectly shore up the addiction in progress. These roles are relatively easy to identify, according to the Colorado State University Extension, and commonly defined as:

All of these roles serve to keep the addiction in play as they keep the family in balance. The hero and comedian allow the family to feel as though all is normal, while the scapegoat serves as a target of abuse. The family may truly believe that all would be well, if only the scapegoat would change.
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Treatment Options

Family therapy attempts to help families understand addiction from a systems perspective. While the addiction hurts the addict, the addiction also hurts all of the other people, and they respond to this hurt in ways that can further spur the addiction. Therapy aims to break this cycle and help families develop new relationships and a stronger sense of connection.

Just as every family is different, every form of family therapy is just a bit different. While there are many therapy types available to help families recover, these are a few highlighted as popular by the Substance Abuse and Mental Health Services Administration:

• Behavioral contracting. The family develops a written contract outlining the drug-free environment they will provide in the home. They then rehearse techniques they’ll put to use when they sense a relapse is about to occur.
• Bepko and Krestan. The focus here is on the person in treatment, but families are coached to take responsibility only for their own actions. The family moves focus from supporting drug use to supporting sobriety and self-reliance.
• Behavioral marital therapy. This therapy focuses on issues occurring now, not things that happened in the past. Couples learn better communication and problem-solving skills, and they become adept at talking to one another about issues before they become abuse triggers.
• Brief strategic family therapy. This approach is commonly used on teens who abuse drugs, and the therapy attempts to help parents adjust their parenting styles to better support the teen in recovery. Conflict-resolution skills are enhanced, and the parents learn to use an adaptive style that adjusts to the child’s age and current needs.
• Multidimensional family therapy. Here, the idea is to engage all of the systems in an abuser’s life to bring about change. Parenting skills are covered, but social skills for the addict are also enhanced with therapy.

Some therapists use only one form of therapy throughout their program, working with small groups or individuals and then bringing the entire family back together for larger sessions. Other therapists use multiple types of therapy, depending on the evolving needs of the family as they move toward healing.

If you’d like to learn more about drug addiction and the family, and how we at Alta Mira use family therapy to help our clients improve, please contact us today. We’d love to tell you more about this important tool in the fight against addiction.
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