Family: Effects Of Substance Abuse On Families

Impact of Substance Abuse on Families

Since family structures are taking on various forms, families have become more complex and evolving from the traditional nuclear family to single parent families, stepfamilies, foster families, and multigenerational families. When a family member abuses substances, the effects on the family may differ depending on the structure. Extended family members may experience feelings of abandonment, anxiety, fear, anger, concern, embarrassment, or guilt; they may wish to ignore or cut ties with the person abusing substances. Effects on families may continue for generations. Neighbors, friends, and coworkers also experience the effects of substance abuse since the person who abuses substances often is unreliable.

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Living with an adult who abuses substances and lives alone or with a partner the effects are likely to be economic and psychological. Money may be spent for drug use; the partner who is not using substances takes on the provider role. Psychological consequences may include; denial, protection of the abuser, chronic anger, stress, anxiety, hopelessness, neglected health, shame, stigma, and isolation. In this situation, it is important to realize that both partners need help as well restructuring of the family system to support the abuser and those affected. (1)

Children of those with parents have substance abuse problems feel guilty and responsible for the parent. Children whose parents abuse illicit drugs live with the knowledge that their parents’ actions are illegal and that they may have been forced to engage in illegal activity on their parents’ behalf. If both parents abuse alcohol or illicit drugs, the effect on children increases. Extended family members may have to provide care as well as financial and psychological support. Increasing number of grandparents are now taking the role of primary caregivers because substance abusing parents are unable to care for their own children. Effects show that a parent’s substance abuse problem can have cognitive, behavioral, psychosocial, physical and emotional consequences for children. Lifelong problems reported are impaired learning capacity; a disposition to develop a substance use disorder; adjustment problems, including increased rates of divorce, violence, and the need for control in relationships; and other mental disorders such as depression, anxiety, and low self esteem. Although children with parents who abuse substances are at increased risk for negative consequences, positive outcomes have also been reported. Some children seem better able to cope than others; the same is true of spouses. Because of their early exposure to the hardship of a family member who abuses substances, children develop means to respond to extreme stress, disruption, change, including mature judgment, capacity to tolerate uncertainty, independence, willingness to shoulder responsibility, and moral assurance. (1)

There are many clients who abuse substances belong to stepfamilies. Stepfamilies present unique challenges. Substance abuse can intensify problems and become an impediment to a stepfamilies integration and stability. Such issues might include: parental authority disputes, emotional or physical abuse, self esteem problems for children, undermine stepparents authority, impair a family’s ability to address problems and sensitive issues. Stepparents living with an adolescent who abuses substances may feel overwhelmed and regret entering the relationship as well as resent the time and attention the adolescent requires from the biological parent. Stepparents may demand that the adolescent leave the household and live with the other parent. A child who is abusing substances is not likely to be welcomed in either household. (1)

When an adult, age 65 or older, abuses a substance, it is common to be alcohol or prescription medication.

The diagnosis of this type of substance use disorder often is difficult because the symptoms of substance abuse can be comparable to the symptoms of other medical and behavioral problems that are found in older adults, such as dementia, diabetes, and depression. Many healthcare providers underestimate the extent of substance abuse problems among older generation, therefore, do not screen older adults. Seniors often live with or are supported by their adult children or other family members because of financial necessity and with their substance abuse it is placing additional financial hardship on supporting families, as well as the psychological damage. If the older adult’s spouse is present, they are likely to be an older adult as well, and may be perplexed by their partners new and disruptive behaviors and may not be able to understand the addiction. Therefore, their spouse may not be in a position to help assist in recovery. Their children may take on a parental, caretaking role. This role reversal can be stressful, painful, and embarrassing. In some cases, grown children may stop providing financial support, physical abuse, and assert emotional control because it is the only influence they have over the parent. Children may cut ties with the parent due to their substance abuse. Cutting ties have only increased the parent’s isolation and may worsen the predicament.

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People who abuse substances are likely to find themselves isolated from their families. They prefer associating with others who abuse substances or participate in some other form of antisocial activity. These companions support and reinforce each other’s behavior. There are characteristic patterns of interaction, one or more of these can be present in a family that includes parents or children. (1)

“Negativism: Any communication that occurs among family members is negative, in form of complaints, criticism, and other expressions of displeasure. The overall mood of the household is decidedly downbeat, and positive behavior is ignored. In such families, the only way to get attention or enliven the situation is to create a crisis. This negativity may serve to reinforce the substance abuse.
Parental inconsistency: Rule setting is erratic, enforcement is inconsistent, and family structure is inadequate. Children are confused because they cannot figure out the boundaries of right and wrong. As a result, they may behave badly in the hope of getting their parents to set clearly defined boundaries. Without known limits, children cannot predict parental responses and adjust their behavior accordingly. These inconsistencies tend to be present regardless of whether the person abusing substances is a parent or child.
Parental denial: Despite warning signs, commonly the parental stance is: (1) “What drug/alcohol problem? We don’t see any drug problem!” or (2) after authorities intervene: “You are wrong! My child does not have a drug problem!”
Miscarried expression of anger: Children or parents who resent their emotionally deprived home and are afraid to express their outrage and use drug abuse as one way to manage their repressed anger.
Self medication: Either a parent or child will use drugs or alcohol to cope with intolerable thoughts or feelings, such as severe anxiety or depression.
Unrealistic parental expectations: If parental expectations are unrealistic, children can excuse themselves from all future expectations by saying, in essence, “You can’t expect anything of me—I’m just a pothead/speed freak/junkie.” Alternatively, they may work obsessively to overachieve, all the while feeling that no matter what they do it is never good enough, or they may joke and clown to deflect the pain or may withdraw to side‐step the pain. If expectations are too low, and children are told throughout youth that they will certainly fail, they tend to conform their behavior to their parents’ predictions, unless meaningful adults intervene with healthy, positive, and supportive messages.” (1)

Addiction destroys families as well as the individual. Living with an addict is both heartbreaking and exhausting. Family members are torn between how to help the addict and how to avoid being sucked into the addict’s world.

Things You Can Do For Yourself
“Take care of yourself. Living with an addict is exhausting. You also need time to recover.
Avoid self-blame. You can’t control another person’s decisions, and you can’t force them to change.
Do not work harder than the person you’re trying to help. The best approach is to not do things for the addict, but instead to be an example of balance and self-care.
Being a caretaker is not good for you or the addict. Understand that there is only so much you can do to change another person.
Ask for help. Talk to a professional. Go to a support group such as Al-Anon. (More support groups are listed below.)
Do not argue or try to discuss things with the addict when they are under the influence. It won’t get you anywhere.
If at all possible, try not to be negative when dealing with the addict. That may only increase their feelings of guilt and push them further into using.” (2)

Nar-anon is for family members of addicts. It is a 12-step program designed to help relatives and friends of addicts recover from the effects of living with an addicted relative. (3)

Family therapy in substance or drug abuse treatment can help by using the family's strengths and resources to find ways for the person who abuses alcohol or drugs to live without substances of abuse and to alleviate the impact of dependency on the patient and the family. (4)

Some substance abuse treatment programs provide some assistance for family members, most counselors and programs will not include a client’s family in early treatment.

Most treatment programs will work with the family once a client has achieved some level of abstinence. When the client enters treatment, some treatment providers usually refer family members, including children, to a separate treatment program or to self help groups. These educational support groups can provide an age appropriate understanding about addiction as well as opportunities for members to discuss their experiences and learn an assortment of coping skills, few treatment programs provide such groups. School-age children can also be referred to student assistance programs at their schools.

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