• Substance use disorder (SUD) affect families in many different ways. Today, one of the most prevalent substance misuses is prescription painkillers, or opioids. In 2020 alone, almost 10 million people 12 years or older misused opioids, 9.3 million of them misused prescription pain relievers, with the rest using heroin (NSDUH, 2020). According to the Centers for Disease Control, the use of opioids in America is at epidemic proportions, with an average of 128 Americans dying every day from an opioid overdose.
• When a family member suffers from SUD, the family unit can develop dysfunctional patterns as relationships are strained due to the stress of the family struggling to maintain normalcy in their lives. SUDs often influence family system dynamics, creates conflict, and fractures family closeness. Almost all families where substance misuse is present, experience trauma due to coping with their own unique brand of family dynamics. Addiction is a family affair in that everyone in the family, not just the person with substance use disorder, is impacted.
• As the drug problem increases and takes center stage in the family, the relationship between family members become more strained in response. Connections between parents and children, children and siblings seem to all bend under the weight of the SUD, and understanding how best to respond to it.
• The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), categorizes substance use disorders as either mild, moderate, or severe to indicate the level of criticality, which is determined by the number of diagnostic criteria met by an individual. SUDs occur when the repeated use of a substance causes significant medical, mental or practical impairment, and dysfunctions at work, school, or home. According to the DSM-5, a diagnosis of SUD is “based on evidence of impaired control, social impairment, risky use, and pharmacological criteria” (Zickafoose, 2018, p.42).
• For individuals suffering with mild to moderate SUDs, treatment through either public or private primary healthcare system may suffice, however, for those suffering with a more severe SUD, (in other words, an addiction), may require more specialty treatment (Medina, 2015). Substance use includes a range of disorders and treatment approaches. In order to adequately address the full array of problems, a continuum of care must be adopted to give persons the spectrum of service options available, including prevention, early intervention treatment, and recovery support.
• Common Physical warning signs and symptoms of substance misuse may include the following:
- Bloodshot eyes and frequent bloody noses
- Changes in daily routines
- Lack of concern for personal hygiene
- Shakes, tremors, or slurred speech
• Behavioral signs of drug abuse
- Neglecting responsibilities at school, work, or home
- Unusual need for money; financial problems
- Changes in personality and behavior (lack of motivation and irritability)
- Newly adopted secretive behavior
- Sudden change in friends and extracurricular activities
• Psychological warning signs of drug abuse
- Unexplained change in personality or attitude
- Sudden mood swings, irritability, spaced-out, or angry outbursts
- Appears fearful, anxious, or paranoid, with no reason
• Signs of SUDs will often depend on what substance or substances are being used. If you suspect a family member of substance misuse and you observe one or more of the signs present above, here are some valuable Do’s and Don’ts:
Don’t:
- Don’t wait for your loved one to hit bottom.
- Cover up for them, make excuses, or hide or destroy substances.
- Shield them from the consequences of their actions.
- Leave them with a sense of worthlessness by taking over their responsibilities.
- Argue with the person when they are under the influence.
- Take responsible for their actions or feel guilty for their behavior.
Do:
- Speak up. Discuss your concern for the family member and offer your help and support, without judgment.
- Take care of yourself. Don’t become so emotionally attached to the problem that you neglect your own emotional needs. Make sure you seek out support and someone to talk to.
- Avoid self-blame. Do all you can to support your family member with an SUD to seek treatment, but understand that you cannot force them to change.
• Because addiction is a disease that impacts family members along with the user, concerned family members should understand that addiction adversely affects the entire family, making family recovery efforts essential. Family members may receive tremendous benefits from learning healthy coping skills, and understanding how to navigate increased stress levels.
• In an effort to maintain family stability the continuous exposure to SUDs can lead to psychological, emotional, and behavioral pathology for family members. The result is a need for individual recovery for the family unit along with the recovery of the addicted member.
• As a general rule, every individual family member should seek out of recovery services. Research suggests that, it is not unusual to find individual family members adopt behaviors similar to the drug user, such as denial of the worrisome nature of their own internal thoughts, feelings, and actions (Wegscheider-Cruse & Cruse, 2012). The family as a whole should come to their own admissions of the need for recovery and their overall collective wellness.
• Early treatment for both the family and the individual member caught in the throes of a substance use problem is the most effective means of assistance, for all involved. Consequently, SUD screening is being offered more often within the general healthcare system in an effort to get ahead of the opioid epidemic and provide early intervention (Medina, 2015).
• Here is a non-exhaustive list of local available treatment resources where family members can get more information and support for family members of addicted persons:
- http://www.al-anon.alateen.org/ Ala-Teen for teenagers affected by an individual with a substance abuse problem in the home.
- http://www.aa.org/ Alcoholics Anonymous (AA) http://www.na.org/ Narcotics Anonymous (NA)
- http://www.smartrecovery.org/ Self-Management and Recovery Training (SMART)
- http://helpingotherslivesober.org/ Helping Others Live Sober, “Helping helps the helper” stay sober.