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If you suspect that a family member may be addicted to drugs or alcohol, know that you’re not alone. Millions of families in the United States are struggling with the same issue. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2018, 20.3 million people had a substance use disorder (SUD), 1 which means that millions of families are in the same situation as you.
This guide will help you understand more about addiction and practical ways you can help your family member.
People who are abusing drugs or alcohol may display at least some of the following physical, social, and behavioral warning signs, including:2
Keep in mind that these signs can vary by person as well as substance. Your family member may display only a few of these or none at all.
Though there may be some similarities, these general physical, social, and behavioral warning signs of drug abuse aren’t exactly the same thing as the diagnostic criteria for a substance use disorder (SUD). This is a defined set of symptoms that the American Psychiatric Association has laid out to help professionals determine whether a person has an SUD. These criteria include the following:3
It can be incredibly disheartening to watch a family member begin to fall into a pattern of compulsive substance use and start prioritizing alcohol or drugs over their family relationships. If your husband begins to isolate himself and drink alone, for example, and ignores the rest of the family and his normal obligations, you might begin to believe he loves alcohol more than you.
However, it’s important to know that certain changes in the brain associated with addiction may underlie increasingly compulsive patterns of use as a person begins to put drugs and alcohol ahead of important people and areas of their life. Although it can certainly feel like it, it doesn’t mean they love drugs more than family. What it does mean is that they have lost control of their lives due to addiction.4
Addiction is a brain disease, the development of which is accompanied by certain neurochemical alterations and changes in brain functioning. While the person does make a choice to begin using drugs or alcohol, they gradually lose self-control over time. This is at the core of addiction; an addicted person will lose the ability to control their drug use despite all the problems it causes in their life. Brain imaging studies suggest that people who use drugs experience critical alterations in regions of the brain responsible for judgment, decision-making, learning, and control. These changes are associated with compulsive substance use. 4
Many substances of abuse exert a significant influence in the brain’s reward system by increasing the activity of dopamine. Dopamine is a neurotransmitter often referred to as the “reward chemical” because it causes good feelings associated with healthy and life-sustaining activities, such as eating and procreating. But when a person abuses drugs, they experience a euphoric high that reinforces drug use and makes natural rewards pale in comparison. Natural rewards simply cannot compete with the reward provided by drugs of abuse, and over time the brain adapts in ways that make it difficult for the person to person find any pleasure in healthy, rewarding activities. Even the drugs themselves won’t produce the same pleasure that they once did due to tolerance; however, the brain will continue to seek it out in attempts to recreate the original high. Additionally, many drugs are associated with physical dependence, which means just attempting to quit can cause the person to feel physically sick and/or experience troubling psychological symptoms. 4
Your loved one is not voluntarily choosing drugs over your family; they have a complex disease that often requires professional help to overcome.
Enabling is sometimes hard to distinguish from helping, and it often stems from good intentions, making it all the more difficult to avoid. For many people, family comes first, and the urge to protect family can be incredibly strong. But sometimes what actually helps can be counterintuitive. It could be that refusing to provide immediate help could be more beneficial to your family member in the long run.
Helping becomes enabling when it allows your loved one to avoid the consequences of their drug or alcohol use. 6 Without having to face the ramifications of their substance use, your family member may be more free to continue on as normal while, in some cases, you are left to deal with the consequences yourself. This can put extreme stress on you and does little to motivate your loved one to change.
Helping becomes enabling when it allows your loved one to avoid the consequences of their drug or alcohol use.
Sometimes it can be painful to avoid enabling behaviors, especially when it’s an established pattern to which the family has become accustomed. As an example, you may feel compelled to bail your daughter out of jail when she’s arrested for a DUI, but this only shows her that she can continue this behavior because you’ll always be there to rescue her. Or you may continue to allow your brother to live with you despite threatening to kick him out because of his drug use. You make excuses for the person’s behavior, such as by saying, “If I kicked him out, he’d be homeless.”
Other examples of enabling include:
The best way out of enabling is to set limits and maintain healthy boundaries. This isn’t always easy; it takes practice, but it will help you stay healthy and let your family member know that they cannot continue to take advantage of your good will. Some of the ways you can set boundaries include: 7 p. 8
Talking to your family member about treatment can be challenging, especially if they don’t want help. Remember that you can’t force your loved one to seek treatment, but you can provide encouragement and help them see the benefits of starting a recovery program.
Explain that it takes a lot of strength and courage to recognize the need for help. Listen to their concerns and let them know that you will be there to support them.
Research treatment programs that best suit your family member’s needs and present them with a list of appropriate options. Call around to treatment centers or look online—you can find recovery centers on SAMHSA’s Treatment Finder website. Some of the things to look for in a treatment program include:8
The impact of substance abuse is rarely isolated to the addicted individual alone.
The impact of substance abuse is rarely isolated to the addicted individual alone. Family-based treatments involve family members in the recovery process. These treatments include:9,10
Paying for treatment can seem daunting, but insurance and other options may be available to cover the costs. Many insurance plans cover all or part of the costs of treatment. You can check insurance coverage for free by completing a quick and easy benefits verification here.
If your family member doesn’t have insurance or their insurance doesn’t cover the entire fee, you can also consider financing or other flexible payment options. Some people use credit cards or ask family members for loans. A number of recovery centers also offer sliding scale fees or scholarships based on ability to pay.
Having an addicted family member can be stressful and draining, so it’s important to take care of yourself and attend to your needs. Some of the ways you can do this include:
At Laguna Treatment Hospital, we know firsthand how difficult living with addiction can be. You are not alone. Learn more about our program and how we can help you bring your family back together.