If a family member has a substance use disorder, pointing them toward supportive resources and treatment plans can help.
The repeated misuse of a substance, despite an adverse impact on health, is known as substance use disorder (SUD).
Though challenging, taking an empathic approach to someone with SUD can help them seek professional help.
When you live with SUD, you become dependent on a substance. The urge can impact how you treat those around you.
Substances can include:
- hallucinogens, including LSD and phencyclidine
- opioids, such as heroin or prescription medications
- sedatives, hypnotics (sleep-inducing medications), or anxiolytics (anti-anxiety medications)
- stimulants like amphetamines or cocaine
Ben Brafman, MS, CAP, is a licensed mental health counselor based in Tamarac, Florida, explains how SUD can affect the entire family.
“On one hand, you love them,” he says of the person living with SUD. “On the other hand, you’re angry at them. You’re sad, hopeful, and scared all at the same time.”
Any family member can experience SUD, and the role that family member plays can shape how SUD affects a family.
Parental SUD has been associated with short- and long-term effects for children, including pregnancy complications and adverse parenting habits as children age.
Children who grow up with a parent living with SUD may be more likely to develop the condition in adulthood.
If you’re a parent with a child who has a SUD, you may experience feelings of guilt or despair.
Your child may be more likely to engage in harmful behaviors, and they may distance themselves from you and other meaningful relationships.
According to psychologist Zahabiya Bambora, siblings are often referred to as the “invisible victims” in a family.
“Parents are completely consumed with the addictive disorder of their child,” Bambora explains. “Frequently, the other children are forced to watch from the sidelines. Siblings experience a range of feelings, including bewilderment, irritation, humiliation, animosity, and more.”
When helping a family member with substance use disorder, you may feel torn between wanting to do everything you can to help them while wanting nothing to do with them.
Brafman says it’s essential that families focus on their family dynamic and still find ways to support the loved one living with SUD.
Substance use disorder is a health condition that a licensed mental health professional can diagnose.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5, SUD is diagnosed after meeting 11 symptoms:
- taking a substance longer than intended, or in larger amounts
- multiple unsuccessful efforts to stop use
- a significant amount of time dedicated to obtaining, using, or recovering from the substance
- failure to meet work, school, or home obligations because of substance use
- continued use despite deteriorating relationships
- skipping important events or enjoyable activities to use the substance
- risky use of the substance or using in risky situations
- using the substance despite knowing it’s causing negative health effects
- tolerance (needing more of the substance to achieve the desired effect)
- symptoms of withdrawal when not using the substance
Depending on how many of these symptoms a person shows within 12 months, SUD can be diagnosed as:
- mild: 2–3 symptoms
- moderate: 4–5 symptoms
- severe: 6 or more symptoms
As a family member, you may not know your loved one is using a substance. You might notice changes in their daily routines, such as:
- social withdrawal
- increased harmful behaviors
- erratic mood changes
- complaints of physical discomfort such as gastrointestinal issues
- an overall appearance of being unwell (pale skin, circles under the eyes, thinning hair, weight changes)
- unexplained financial hardship
- becoming secretive or paranoid
- sudden change in friend group
If you begin noticing changes in your family member’s behaviors, it may be time to think about what treatment options can look like.
Helping a family member with SUD often requires professional guidance. It’s OK to feel overwhelmed when trying to help your family with SUD. You can only support them and help them explore options for themselves.
A trained healthcare team will work together to address the physical and mental complexities of SUD treatment.
While not all substance use disorder experiences are severe, the general course of treatment includes:
- Detoxification: This is the process of weaning your body off a substance. Depending on the severity of SUD, you may need to do this process slowly and safely while in supervised professional care.
- Rehabilitation: Often an inpatient service, rehabilitation give you healthcare services around the clock to help ease possible effects of withdrawal.
- Psychotherapy: Many people living with SUD benefit from cognitive behavioral therapy (CBT), which can start during the rehabilitation process. Motivation enhancement therapy can also help.
- Medications: Medications may help ease many of the symptoms associated with withdrawal. They may also be good for treating related mental health conditions, such as anxiety or depression.
- Outside support: Once your family member finishes the physical aspects of substance use disorder recovery, they could leave supervised care behind in exchange for other support options. Meeting groups, online communities, housing options, and mentorship programs can all help you stay on track after substance use disorder.
It’s not always easy or simple to encourage a family member living with SUD to get treatment. It may take months or years before the person feels ready to take a step toward treatment.
Until professional treatment is an option, you have other ways to support your family member with SUD.
“In order for the family to heal, it’s important to learn how to communicate with one another,” says Chris Howard, CADC-III, Los Angeles.
Communication can take work. It may be something that could benefit from professional guidance. Learning how to communicate well can help everyone understand each other, so things feel clearer.
While it might not stop SUD behaviors, clear communication may help address feelings related to misunderstandings, secrecy, or erratic behavior.
Like recovery groups and meetings, community support can help your family member living with SUD.
But sometimes, it can be a challenge to get them to participate.
Howard recommends starting slow. Helping a family member into a supportive community — like a yoga class — may help them stay connected in their social life while enjoying a healthy activity.
Be kind, but direct
When your family member is living with SUD, you might find it difficult to speak with them about the impact of SUD on their lives.
You care about them, yet you may not want to be the one who has to deal with any negative responses from your family member.
Howard suggests that the more effective option is to be open and honest while still supportive.
“Be sure when you have a loved one who is struggling with addiction or SUD that you let them know you’re there to love and support them, and they are making decisions that are undermining their existence and the interpersonal relationships they value most,” he says.
This lets your family member know you don’t excuse their actions, but you’re there to help them make positive changes.
Allow them the experience of consequences
When you care about someone, it’s natural to want to swoop in and help them avoid mistakes.
When it comes to SUD, this may prevent them from learning the consequences of their actions. Though it’s hard, this can be a valuable learning experience for everyone.
“Often, this is the only thing that will encourage them to seek help and engage in some sort of solution,” Howard says. “Remember that every experience they have while in the grips of their disease will ultimately be a learning experience for them.”
Someone living with SUD may come to a stage of acceptance about their substance misuse — this can be incredibly moving and empowering for everyone.
Take care of your own mental wellbeing
It’s essential to have boundaries with other people, especially if they’re living with SUD.
Brafman recommends looking after your mental well-being when helping a family member living with SUD.
Don’t be afraid to speak with a mental health professional about your own life. This could help ease the tensions you may be feeling. They can also provide you with helpful new coping skills to support you and the rest of your family.
SUD can affect your entire family. You can encourage someone you love with SUD to start taking steps toward recovery today.
You can speak with a qualified SUD support member or find local treatment services by calling the SAMHSA National Helpline at 1-800-662-4357.
You can also learn more about SUD and participate in online support communities by visiting:
- Smart Recovery. A support network for a variety of substance use disorders.
- Al Anon Family Groups, a support group for families and friends of those with alcohol use disorder.
- Nar-Anon Family Groups, a support group for families and friends of those with SUD.
- Narcotics Anonymous. A 12-step recovery group for SUD related to drugs.
- Alcoholics Anonymous. A 12-step recovery group for SUD related to alcohol.
- Double Trouble in Recovery. A 12-step community that supports people living with substance use disorders as well as co-occurring mental health conditions.