Alcohol and Substance Use Disorders: Family Issues

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KEY POINTS

• A person with an alcohol or substance use disorder (SUD) may be undependable, abusive, or harmful to family members in other ways.
• This can cause other family members to have problems with relationships, self-esteem, or mental or physical health problems. You need to take care of yourselves and get support.
• You are not to blame for the person’s SUD, but there are some things you can do to help.
• Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others.

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How does alcohol and drug use affect family members?

A person in your family with a substance use disorder (SUD) can cause problems for others in the family. The person abusing drugs or alcohol may:

• Have sudden mood changes, such as getting angry or violent
• Be emotionally or physically abusive to others in the family
• Seem confused and have memory problems
• Do embarrassing things in public
• Spend the family’s money on alcohol or drugs
• Make promises that they don’t keep
• Show up late or miss work and risk losing their job
• Feel isolated or depressed and attempt suicide
• Do things that are dangerous, such as driving while under the influence (even with children in the car) or having unprotected sex
• Have accidents or be violent, which can lead to arrests, fines, and loss of a job

It may be hard to understand why they just can't stop these behaviors. You may feel angry, guilty, embarrassed, resentful, sad, or scared. Family members of someone with a substance use disorder (SUD) may:

• Feel like it’s their fault or blame themselves
• Avoid inviting friends home
• Try to calm everyone down to smooth over troubles
• Become super-responsible, and try to control everything
• Feel angry and constantly fight with the substance abuser
• Feel depressed and helpless because they can’t change things
• Make excuses for or cover for the person so that they don’t get in trouble
• Have problems in school or at work
• Have unexplained physical symptoms like headaches or stomachaches
• Abuse drugs or alcohol themselves or engage in other risky behavior
• Worry all the time about whether the person who abuses alcohol will get sick or injured, become violent, or abandon the family

How can I help someone who doesn’t want help?

Several things will not help when a person has a substance use disorder (SUD):

• Lecturing and giving reasons why drinking or using is “bad”
• Nagging, crying, or begging the person to quit
• Threatening, yelling, or fighting about the substance abuse
• Getting drunk or using drugs yourself
• Covering up for the person's behavior
• Giving the person money that could be used for alcohol or drugs

When a person in your family has a substance use disorder, it is up to them to stop using drugs or alcohol. You didn’t cause it and you don’t have the power to do it for them. However, there are some things you can do that might help:

• Make sure your home is free from alcohol and drugs.
• Keep a list of nearby substance abuse treatment centers and offer rides to treatment and support groups.
• Invite your family member to join you in fun and relaxing activities that don’t involve drinking or drugs.
• Talk with a mental health professional who has experience treating substance use disorder. A counselor or therapist can help you create a list of treatment options. You may want to have a family intervention.
  • In an intervention, family and friends get together and tell the person how their behavior has negatively affected those who care about them. Meeting and rehearsing ahead of time can help you be calm and prepared for the actual intervention.
  • During the intervention, it helps if you can be supportive and positive. If the person feels that you are judging or attacking them, they may not listen. Use "I" statements to describe how you feel and why, like "I feel angry when…" rather than more blaming "you" statements, like “You always…” or “You never….” Treat the person with respect. Don’t yell or scream and don’t be physically violent.
  • If the goal is for the person to go to a treatment center, make arrangements ahead of time. It will be easier for the person to get help if everything is already arranged.

Get emergency care if you or a loved one has serious thoughts of suicide or self-harm, violence, or harming others.

How can I help myself?

Don’t ignore your own needs. You have the right to take care of yourself, and be more than a caretaker or problem-solver. It’s okay to leave, or to have your loved one leave if things get to be too much.

• Contact your healthcare provider or a therapist if you want to talk with a professional.
• Get support. Talk with family and friends. Join a support group in your area. Talking with other people who face the same challenges can help. Check for Al-Anon or Families Anonymous meetings, which are for family members of people who are abusing alcohol or drugs. These meetings give you a chance to talk about the stress of having a relative with a drug or alcohol problem.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed
• Get out and have some fun once in a while. Go to a movie, or have lunch or coffee with a friend or another family member. Set aside time when you can do something you enjoy.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Have an emergency plan to get away if things get bad. People who abuse drugs or alcohol are more likely to physically or sexually abuse family members. Know where you will go and how to get there at any time of day. In an emergency, call the police or 911.

For more information, contact:

• Families Anonymous
  800-736-9805
  http://www.familiesanonymous.org
• Al-Anon
  888-425-2666
  http://www.al-anon.alateen.org
• The National Council on Alcoholism and Drug Dependence
  800-622-2255
  https://www.ncadd.org/
• The National Institute on Drug Abuse Referral Hotline
  800-662-4357