Nearly 37 million Americans (ages 12 and older) have tried cocaine at least once, according to a 2008 National Survey on Drug Use and Health report, and almost 2 million used the drug in the past month. And according to the National Institute on Drug Abuse, drug abuse and addiction carries an incredible financial burden in the U.S. -- all told, it costs us more than half a trillion dollars annually. Substance abuse also causes health problems: Long-term alcohol abuse is known to cause physical damage, including liver disease, certain cancers and neurological damage, as well as mental health problems such as depression and anxiety. But beyond the financial burden, physical and mental health problems, what about the damage this "equal opportunity destroyer" can inflict on an addict's family? There are no statistics on the chaos caused by an addict in the family. However, there are ways family members can cope when a loved one suffers from substance dependency. From educating yourself about addiction to setting boundaries, we have 10 coping strategies to help families facing this insidious disease. And that is the best place to start -- understanding that addiction is a disease.
10: Understanding That Addiction Is a Disease
What does drug and alcohol dependency have in common with Type 2 diabetes, heart disease and cancer? They are all chronic illnesses, with roots based in genetic and environmental causes. Substance dependency is not a question of willpower. Just like you don't choose to have cancer, you don't choose to be an addict.
A person with a substance dependency will keep using drugs, no matter the consequence, because of chemical changes in the part of the brain's pleasure system: the mesolimbic dopamine system (food, sex and other things trigger this system, making us feel good). When addicts repeatedly overuse drugs, it overstimulates their pleasure system and they lose the ability to control and satisfy their cravings.
9: Educate Yourself
Family and friends of a person suffering from an addiction may feel it's their fault, in addition to anger, frustration, confusion and helplessness.
Learning about the disease can help ease the anxiety, social and emotional stress that addiction can place on a family. If you or your loved one had a new cancer diagnosis, you'd likely do as much research as possible, and maybe join a support group. Addiction is no different.
Recovery meetings, such as those held by Al-Anon, Alateen and Nar-Anon, help family members and friends deepen their understanding of substance dependency by sharing personal experiences and seeing that no one has to do this alone. You can't control a person's behavior, just like you can't control a cancer diagnosis. In addition to their closed meetings, Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) both hold open meetings where family and friends of alcoholics and addicts are welcome to attend.
8: Are You an Enabler?
"Enabling" and "detachment with love" -- these are concepts families should learn about when coping with addiction.
In a family where an addict's behavior is creating chaos, enablers make excuses for the addict's behavior, and never talk directly about the problem or recovery. This type of family dynamic destroys personal boundaries and individual sense of self. There are tools families can use to help restore the balance between being responsible for or responsible to others.
Learning to "detach with love" is one of those tools. Taught at groups like Al-Anon and Nar-Anon, it is a concept where family members allow the addict to make mistakes and learn from them, rather than helping the addict avoid the consequences of the addictive behavior. This tool is based on loving the person but detaching oneself from the person's disease to avoid emotional turmoil and pain as well as physical pain and stress.
7: Attend Family Therapy
Support groups such as Al-Anon and Nar-Anon are available for the friends and family of people suffering from addiction (alcohol and drugs, respectively). While these support services are important for making connections with others who may be trying to navigate day-to-day life with addiction in the family, so is seeking professional therapy as a family. Meeting with a therapist as a family can help improve communication among family members, rebalance the family dynamic and give family members a safe environment to express their anger, fear and other concerns. Family therapy may also be helpful in preventing the children of addicts from succumbing to the disease themselves.
For families who have someone currently in a treatment facility, there are programs and services available to family through those facilities that can be helpful in dealing with addiction as well as how to come together as a functional family after the patient comes home.
6: Seek Professional Financial Counseling
A financial counselor can help you -- as an individual and as a family -- find solutions to current financial problems by working with you to create a budget and a plan for the future.
Consider what appropriate boundaries are. Maybe that means closing shared accounts, divesting yourself of shared financial responsibility, or not lending money to the addict.
Keep a close eye on your credit -- you're entitled to one free copy of your report each year -- because the sooner you notice any surprises on your credit report, such as a substantial debt increase or new accounts opened, the better. Negative comments in your credit report such as late or missed payments stick with you for up to seven years (bankruptcy sticks with you for up to 10 years).
5: Seek Legal Counsel
While not necessary for all families who are coping with or trying to recover from the behavior of a loved one's addiction, seeking legal counsel may relieve some anxiety, at the very least. For example, if you decide to file for bankruptcy, it's not a bad idea to also seek the advice of a lawyer (there are lawyers who specialize in bankruptcy cases).
Legal counsel may also be important for the addict to help manage the legal consequences that sometimes coincide with addiction, including everything from arrests for driving under the influence to stealing. An attorney can also help protect an addict from employment discrimination, insurance discrimination (as well as ensuring that medical and treatment records remain confidential) and illegal drug testing.
4: Attend Individual Therapy Sessions
Individual therapy for each family member, not just the addict, is important for the mental health of both the addict's spouse or partner and children.
When seeking professional therapy, be sure to look for programs or counselors who are accredited or licensed (ask about what professional credentials, certifications and licensure they have). Does the therapist specialize in the issues you want to work on? Also, ask about therapy methods and approach -- not all practice the same flavor of therapy, and approaches vary from methods such as cognitive therapy to behavior modification to psychotherapy (also known as "talk" therapy).
Other things to consider are insurance coverage and expense, but ultimately the right therapist is the one with whom you feel most comfortable.
3: Maintain Open Communication
Open, constructive communication is important to re-establishing and maintaining a healthy family dynamic, during and after the addicted family member's treatment.
Healthy, open communication includes clear and specific statements. Be problem oriented, not person oriented (don't blame the addict, blame the disease). Be respectful of how others feel and be honest about your own feelings. When the lines of communication fail, consider family therapy -- at the very least, the therapist can help you begin to communicate in a healthy way and can mediate difficult conversations.
Constructive communication isn't all about what you say and how you say it, though. Remember to be a good listener.
2: Maintain "Normal" Family Activities
Maintaining a "normal" (that definition is going to vary from family to family) family dynamic, or at least giving it your best shot, can help the whole family cope with family addiction.
Don't ignore the problems of addiction -- that kind of "everything's fine" behavior sets the stage for denial and enables the addict. Recognize it but don't hold the disease up as the center of the family universe. For example, if your wife used to attend your daughter's soccer games but is now at a residential treatment facility, try to be present at as many games as you can. If you're the parent of a teen with an addiction, be sure the addict isn't the center of your attentions. Recognize that you'll need to devote time to that child's recovery process but not at the expense of the time spent with your other children.
1: Take Care of Yourself
Often people who live with a loved one suffering from addiction put the addict's needs ahead of their own. But caring for yourself first, both emotionally and physically, will not only benefit you but your family as well.
Caring for yourself may include everything from reducing your stress level, getting regular sleep to eating healthy meals. Exercise can help with all three. Consider yoga, which combines poses and meditative breathing that have been found to not only induce relaxation, but reduce stress and anxiety and generally improve mental health. And even something as simple as walking a minimum of 20 minutes a day has been linked with stress-busting benefits such as improved mood and depression relief.
For more information regarding addiction, peruse the links on the following page.
Lots More Information
- 16 Unusual Facts About the Human Body
- 25 Steps to a Healthier You
- 9 Medical Myths
- Top 10 Items You Should Have in Your Medicine Chest
- "Americans prefer drugs for depression, survey finds." Reuters. 2010. http://www.reuters.com/article/idUSN0126519620100601
- "Children of Alcoholics: Important Facts." National Association for Children of Alcoholics. 1998. http://www.nacoa.net/impfacts.htm
- "Cocaine Facts & Figures." Office of National Drug Control Policy. http://www.whitehousedrugpolicy.gov/drugfact/cocaine/cocaine_ff.html
- "Detachment, Love, and Forgiveness." How Al-Anon Works for Family and Friends of Alcoholics. Al-Anon. http://www.al-anon.alateen.org/pdf/B22_11.pdf
- "Drug Abuse and Addiction: One of America's Most Challenging Public Health Problems." National Institute on Drug Abuse (NIDA). National Institutes of Health. 2005. http://archives.drugabuse.gov/about/welcome/aboutdrugabuse/index.html
- "Exercise and stress reduction." U.S. National Library of Medicine. National Institutes of Health. 2009. http://www.nlm.nih.gov/medlineplus/ency/article/002081.htm
- "Generation Rx: National Study Confirms Abuse of Prescription and Over-the-Counter Drugs." The Partnership for a Drug-Free America. 2006. http://www.drugfree.org/Portal/DrugIssue/Research/Teens_2005/Generation_Rx_Study_Confirms_Abuse_of_Prescription
- Harwood, H. "Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data Report." National Institute on Alcohol Abuse and Alcoholism. 2000. http://pubs.niaaa.nih.gov/publications/economic-2000/
- Hazelden Foundation. 2010. http://www.hazelden.org/
- Heron, MP; Hoyert, DL; Murphy, SL; Xu, JQ; Kochanek, KD; Tejada-Vera, B. "Deaths: Final data for 2006." National Vital Statistics Reports. National Center for Health Statistics. 2009. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf
- National Foundation for Credit Counseling. 2010. http://www.nfcc.org/
- "NIDA InfoFacts: Understanding Drug Abuse and Addiction." National Institute on Drug Abuse (NIDA) http://www.drugabuse.gov/infofacts/understand.html
- Phoenix House's Center on Addiction and the Family. 2010. http://www.coaf.org/
- "Physical Activity and Health At-A-Glance." A Report of the Surgeon General. National Center for Chronic Disease Prevention and Health Promotion. http://www.cdc.gov/nccdphp/sgr/ataglan.htm
- "Prescription Medication Abuse: A Growing Problem." The Partnership for a Drug-Free America. 2006. http://www.drugfree.org/Portal/DrugIssue/Feature/Prescription_Medicine_Misuse
- Smith, C; Hancock, H; Black-Mortimer, J; Ecker, K. "A randomized comparative trial of yoga and relaxation to reduce stress and anxiety." Centre for Allied Health Evidence, School of Health Services, University of South Australia. 2007. http://www.ncbi.nlm.nih.gov/pubmed/17544857
- "Substance Abuse Treatment and Family Therapy." Treatment Improvement Protocol (TIP) Series, No. 39." Substance Abuse & Mental Health Services Administration. 2004. http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hssamhsatip