Impact of addiction on the family

Drug and alcohol misuse, and its associated consequences, are pervasive problems that impact not only upon the user but also on those around them. This includes parents, children, other family members, and people in the wider social environment. In recent years, the recognition of the impact that substance misuse has on the family of people affected by addiction to substances has slowly increased.

In order to produce a working model to help develop realistic, effective solutions and advice for these families, a research project was conducted by Gemma Salter and Professor David Clark of WIRED. They interviewed parents of children with addiction to discover how their child’s problems had affected them as individuals and as a family at different stages of their child’s dependency: from the initial shock of discovering the problem, through dealing with the consequences of addiction, the treatment system, recovery and ‘getting back to normal’.

Eight key themes were identified from transcripts of the interviews. These themes appear to be core issues that family members face and will be referred to as:

1. Confusion
2. Pervasion of the problem
3. Heightened negative emotions
4. Family support
5. Coping
6. Outcomes /Consequences
7. Family outcomes
8. Additional stressors
9. Conclusion

This article describes these themes and briefly discusses them, providing example extracts from the interviews.

1- Confusion

The first reaction of parents when finding out about their child’s addiction is mostly surrounded by confusion. They are unsure about what substances are being misused and the seriousness of use; the following factors can affect this confusion:

• Lack of knowledge: For most parents, this confusion is influenced by a lack of knowledge relating to substance misuse issues.“I just knew nothing about drugs, it was totally alien to me or my generation…” Confusion is often worsened by the process of realisation.“… Looking back, I think I must have been blind, because he was a very caring boy… but gradually that changed. And it was such a gradual process that you don’t notice…”
• Deceitful nature of the user’s behaviour: The user often denies their addiction, or only admits partially to it, which adds confusion, as parents are often unaware of the true extent of the problem. Sometimes parents self-deny the fact: “… I didn’t want to deal with it, ‘cos I didn’t know how, so I blocked it off…” or … it’s like anything, you hold onto that last thread that it’s not happening…

2- Imbalance/pervasion of the problem

Many parents’ lives are taken over by problems associated with the user to an extent that the problem user dominates them. This dominance over their lives is characterised by worries, fears and negative expectations, often related to the user’s health and safety as this parent reveals: “… I was frightened we were going to have a phone call to say he was dead or he was in hospital with an overdose… we were just waiting for a… knock on the door to say they’d found him in the gutter or something like that…”

• Self-neglect / neglect of others: Parents’ preoccupation with the user is so overwhelming that they restrict the providing the needs of others within the family, especially siblings as well as the parents themselves. Many parents report restriction in social activities or work life: “…My life stopped with my boy, I mean I wasn’t going anywhere, I wasn’t doing anything, I wasn’t going out with my friends…”

3- Heightened Negative Emotions

Anxiety surrounding the substance misuse is associated with various heightened negative emotions.

• Against the user: Parents show heightened negative emotions directed towards the user. Such hatred and dislike sometimes is so extreme that they extend to hoping that the user will die. “… … when things have been bad. I really hated him… and there have been times that I thought I hope I go home and find him dead. The thing is they make you feel that bad on occasions…”
• General negative emotions: This includes feelings of isolation, grief/sadness, and anger. “… I was… so ashamed, I felt so isolated, I really felt that only us were having this problem…”

4- Family support/treatment

Family support groups provide kind and hopeful social environments; help to reduce isolation, and an opportunity to help others. Learning from other’s experiences can help family members put their own problems into perspective, whilst the external environment (removed from the family) allows them to talk freely with others. The ability to talk to others with common experiences is a crucial element of support for family members: “I came out feeling marvellous… these people know what I’m going through, nobody else had known. I thought I was the only one that was going through this terrible time… Listening to these people’s stories I realised how other people… had coped, how things had got better…”

5- Coping

Family members adopt various methods of coping, which tend to change or vary over time. Some main methods of coping are:

• Non-confrontational coping: Refers to the tendency of participants not to directly confront the substance misuse problem or the user. This involves things like giving the user money, buying substances for the user, and caring for the user.
• Avoidance: Parent avoids accepting or actively dealing with the problem and its consequences. Examples of this method include denial by the parent, concealment of the problem, rejection of the user, and refusing to let the user move back to the family home.
• Active coping: Actively trying to do something to improve the situation, for example, by threatening or giving the user an ultimatum, or aiding the user’s treatment.
• Coping on a day-to-day basis: For some people, this means living in uncertainty, not knowing what will happen next. For others, this can be a learnt and improved method of coping (either from treatment or personal experience), allowing them to be more flexible and less disappointed if promises or plans are broken: “… we do tend to look at things day-to-day now instead of long-term planning… I tend to look at today, got plans for tomorrow but if it doesn’t work out, it doesn’t… I’m a bit more happy-go-lucky than I used to be…”

6- Outcomes /Consequences:

• Psychological/physical health problems: The substance misuse problem of their child often makes parents so depressed that they need antidepressant therapy. It can also cause physical health problems, including eating and sleeping problems, high blood pressure, stomach problems or irritable bowel syndrome, and tension aches.
• Financial impact: Paying for the user’s treatment, the user’s debts, and funding the user’s habit often have a strong financial impact on the family.
• Social impact: Social activities, such as going out socially or to holiday, are often disrupted because parents don’t feel well enough to socialise or cannot afford to do so. Others fear these activities could compromise the user’s health/safety, or they might not want the user to be alone in the house in case they steal from the family: “… we were afraid to go out, ‘cos we didn’t know what we would come back to…”

There is often also an altering of views, including a change in opinion on issues of addiction and the use of different substances. This can often be a turning point for some family members, resulting in practical changes in their lives, such as becoming more involved in or working within the substance misuse/counselling field.

7- Family outcomes

Substance misuse has a great impact on both the immediate and wider family:

• Negative effects in the parent’s relationship with the user: This is due to the disruptive nature of the user, who is often unpredictable, and disrupted family events or got involved in criminal/thieving activity (to fund the habit), as well as frequently moving in and out of the family home. Dealing with the user’s problems, also led to neglect or restriction in providing for the needs of other family members. …

While there is often a general lack of active and practical wider family involvement, friends can often be an important source of emotional support and distraction from the substance misuse problem: “…we were so frightened to tell people…and yet your friends are the best ones to tell…they were so helpful…a shoulder to cry on…”

8- Additional Stressors

• Long process of treatment: This often left families responsible for caring for and/or living with the user for long periods before they received treatment, which may cause extreme frustration, as the user often relapsed, or their habit developed during this time and think what is the use...
• Stigma: Some of the participants tend to conceal the problem for the fear of stigmatism. This even prevented some from forming new relationship because they just “don’t want them to find they have an addicted person in the family”

9- Conclusion

The overall substance misuse problem can lead to various negative consequences/outcomes like affecting physical and psychological well-beings of parents and influences their finance and social lives as well as having disastrous family outcomes. However one positive outcome may be the altering of views on substance-related issues, which may have been influenced by both personal experience and treatment/support.

The above article is a summary of the research project: “The Impact of Substance Misuse on the Family: A Grounded Theory Analysis of the Experience of Parents.” By Gemma Salter and David Clark - WIRED
Copyrights permission has been granted to FARS services for summary and translation into Farsi by WIRED. For the direct link and full version of this research project click on: http://www.wiredinitiative.com/pdf/impactofsubmisuse.pdf