Alcoholics Anonymous began in the 1930s with 12-step meetings that helped people with drinking problems get sober. Since then, men and women addicted to alcohol and drugs have started their journeys toward recovery with AA’s essential first step: “We admitted we were powerless over alcohol — that our lives had become unmanageable.” It is a statement with profound implications, both for the people who are ready for their lives to change and their family members.
“Addiction is a family disease that stresses the family to the breaking point, impacts the stability of the home, the family’s unity, mental health, physical health, finances and overall family dynamics,” according to the National Council on Alcoholism and Drug Dependence (NCADD). It is often difficult to understand and remember that addiction is a complex, chronic brain disease. However, treatment is available and lasting recovery is possible. Furthermore, professionals who treat addiction believe that viewing the condition as a family disease needs to be part of the healing process.
Current Research on Addiction
Genetics play a role in addiction. A study published in Clinical Pharmacology & Therapeutics explains that both genetic and environmental variables cause a person to begin drinking alcohol or using drugs. A person’s risk for addiction is related to whether they have relatives with addiction. That risk is highest with cocaine and lowest for hallucinogens, according to research that compared 10 different kinds of addictive agents, including alcohol, cigarettes and marijuana.
When one member of a family is addicted to alcohol or drugs, others suffer. As a result, addiction impacts more people than statistics indicate. A 2014 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that approximately 24 million Americans ages 12 and older abuse or are dependent on alcohol or drugs. Only 2 million of those individuals are receiving treatment.
In addition to genetics and low treatment rates, the high likelihood of relapse also works against families battling addiction. According to the National Institutes of Health (NIH), 90 percent of alcoholics are likely to experience at least one relapse within the four years following treatment. The relapse rate for drug addiction is between 40 and 60 percent.
Family Involvement in Addiction Treatment
Family therapists have borrowed the biological term homeostasis to refer to a family’s tendency to maintain stability or equilibrium. When a change is introduced, whether it’s good or bad, families can struggle to keep that balance.
For example, the early stages of addiction can place a lot of stress on other members of a family, resulting in unhealthy coping skills. But soon, this can become the new sense of normal for a family. When the individual seeks treatment or successfully completes treatment, families can fight to maintain that homeostasis, and dysfunctional behaviors can remain.
“Put simply,” author Jerome Levin says in Introduction to Chemical Dependency Counseling, “human beings and their relatives do not change gladly.” Some families will cling to the status quo, even when it is unhealthy.
Common Issues and Roles
Family members can experience common issues and fill similar roles in an effort to cope with addiction. Two of the most common problems are codependency and enabling.
Codependency occurs when a family member is controlled by the addict’s behavior. The spouse or other family members often feel compelled to take care of the addict, to the detriment of their own wants and needs. The SAMSHA publication Substance Abuse Treatment and Family Therapy describes the codependent as someone who is excessively compliant, wants to avoid rejection, is oversensitive and remains loyal.
Enabling takes place when someone helps or encourages the addict to keep using alcohol or drugs, directly or indirectly. This person, who is often also a codependent, might give the addict money hoping that it will lead to recovery. An enabler might also lie for the addict or hide the addict’s behavior from loved ones.
In an effort to cope with the addict’s behavior, family members can develop, to some degree, certain codependent roles. They often exist in children, but can be used to describe adults that take on the same characteristics. The unhealthy roles add to the dysfunction of a family facing addiction.
- The Hero: The hero tries to make the family look good, often by overachieving and being successful. This person seems put together and balanced, but often feels isolated and unable to express his or her feelings.
- The Mascot: The mascot tells jokes and keeps things on a superficial level to turn the focus away from the painful truth of the situation. Although this can distract others, the mascot is often fearful, embarrassed and angry.
- The Scapegoat: The scapegoat engages in negative behavior to turn attention away from the addict or to react to positive attention that the hero receives. In trouble at work or school, the scapegoat often turns to high-risk behaviors such as drugs or alcohol.
- The Lost Child: The lost child is the family member who withdraws from the situation. He or she cares deeply, but emotionally checks out to avoid trouble and drama.
- The Caretaker: The caretaker wants to make everyone happy and feels responsible for keeping the family going. As a result, the caretaker enables the addict by taking over the person’s problems and duties; the caretaker also enables other codependent family members.
Inpatient and outpatient programs are available to treat addiction. An outpatient program takes place during the day and allows the patient to return home in the evenings, while an inpatient program involves staying at a facility full time, typically for 30 to 90 days.
Family involvement in the treatment process is greater with an outpatient program, since the patients are not separated from their normal home environment. This is not the case for an inpatient program. Family involvement can happen occasionally, helping both the patient and the family take a step back from a negative environment. But isolation is not the goal; families can still support loved ones in an inpatient program. Visitation throughout the week and weekends is common, and workshops can educate families and provide an ideal atmosphere for family recovery.
Family members play a critical role in the treatment process. Not only do they provide support, but families can receive needed rest from the presence of addiction. This, along with services at the treatment program and help from outside resources, can strengthen family members.
Family members of addicted individuals are strongly encouraged to attend meetings at a support group, which can help them address their loved one’s addiction while also giving them the opportunity to interact with other families going through the recovery process. The addict does not need to be seeking or receiving treatment for family members to look for a support group.
The following organizations offer support groups that are free to attend. Each is based on a 12-step recovery program, but they are unaffiliated with each other. Meetings are confidential and often small, with perhaps five to 25 people in attendance.
- Al-Anon: Al-Anon groups provide fellowship for families and friends of alcoholics.
- Nar-Anon: Nar-Anon programs are for friends and family members of drug addicts.
- Families Anonymous: Families Anonymous meetings are designed for relatives and friends of people who have a substance abuse or related behavioral problem.
Individuals whose lives have been touched by addiction may be inspired to pursue a career in this field. This calling can be an opportunity to make a significant difference in the lives of others, including addicts and their families.
At Alvernia University, an online B.A. in Behavioral Health with a concentration in Addiction Studies provides students with the knowledge and training to compassionately treat people who are trying to get clean and sober as well as their concerned family members. Graduates are prepared for potential careers that include:
- Crisis intervention
The program is taught by experienced behavioral health faculty members, including national educators and published professionals, as well as top-level administrators who are actively involved with the constant changes occurring in health care. Learn more about serving others on the road to recovery today.