Here are some tips for families of addicts and alcoholics from an addiction specialist. It will be a tough road you need to travel so take some advice.
As a clinician, I often have contact with families of addicts and people with alcohol problems. It’s devastating to see your spouse or relative in the grips of addiction and alcohol abuse (1).
The idea that you can be the one to change them is a desperate delusion. You can’t. You are too close, and you can’t be objective. The emotional attachment you have to that person clouds your vision about what can be done.
Substance misuse (substance use disorder) is powerful and takes over your loved one’s life. For you it’s horrible and you’re also emotionally affected by what’s happening.
So, no matter how much you love them, or have good intentions, you need to step back.
Addiction specialists are trained to handle the situation. Let us do our job. We can be objective, and very clear and truthful with the substance abuser.
How does recovery begin?
There are two points where drug and alcohol abusers are ready to come into recovery.
1. The first is when they realise their use is out of control, and they need help.
Typically this is when the person is a functioning, secretive abuser where they hide their addiction at work, but they can’t stop using. If they enter recovery treatment at this stage, they still may have many resources available to them.
2. The second is when absolute disaster has happened.
The second point is when the person has overdosed, the family have left them, they’ve lost their home, savings, or they’ve gone into organ failure.
Recovery begins when the person decides it’s time to reach out for help.
You can’t force or bully them into getting help because they won’t be ready to own being an addict.
The only time addiction recovery works is when the patient themselves is 100% committed, no less. You can give them information, but they must make the decision themselves.
Addicts make things up
This is not a judgment but a fact. All addicts are delusional. They’ve lost touch with reality. They don’t understand what the addiction is doing to their body and lives.
Addicts make things up to justify the addiction like it’s cool, exciting, they’re expanding their minds, or it helps them cope with stress and a whole range of other justifications (2).
Some of these they believe and some they are just telling you to try to and convince you their addiction is useful. They will lie directly to you because to them the addiction has a higher priority than the relationship with you.
None of this is about you. They’re not trying to ruin your life or punish you, it’s just part of being an addict.
Stages of recovery
Many people recovering from addiction try to cheat, which damages their recovery. You can’t cheat recovery. No one can. You can’t try to do it by short cuts.
One of the first stages is stopping using the substances, but that in itself, is not recovery. Many rehabs are just expensive holidays where people go to not use for 6 to 12 weeks. When they come out, they often start using again (3).
For someone to become a non-using addict they have to change their life and who they are. There’s no other choice. There’s no other choice because who they were was an addict and substance abuser.
The changes facilitate them living their lives as an addict, and they will always be an addict, without using.
You, the relative or spouse, must change as well
Like it or not, you may be part of the problem. Families operate a network of interpersonal relationships. For the addict to be a healthy part of your family again, the family must change (4).
Repeatedly I’ve seen relatives protesting saying, ‘But I’m not addict’. You are, however, connected to the addict via family relationships. Those relationships now must change to support the person’s recovery.
One of the things you need to do is maintain a clean and sober home: that means no alcohol, and no drugs. You can’t claim that you want to save the person’s life by getting them to stop and then take those very substances in front of them. If you do that, your words are hollow.
You also need to support the recovering person in every way you can. That doesn’t mean you treat them like a child, but you do need to spend time with them and give them your attention.
Reframe from being negatively critical
The last thing an addict needs is a friend or relative criticising or blaming them. They didn’t mean to be an addict. It wasn’t intentional or a slight against you.
Anyone could become an addict under the wrong circumstance. That’s just a fact. You’ll never fully know why your loved one became addicted, and the last thing they need is someone else to make them feel worse or guilty.
Sure, addicts and alcoholics do some terrible things to feed their addiction (5) (6). They may borrow from you, steal, sell your possessions, but that’s part of the desperation that comes with addictions.
Separate the actions of the person you once knew from the person. Addiction changes a personality and takes people to dark places. Under different circumstances that could’ve been you.
Set solid boundaries
No one would dream of bringing drug or alcohol into my home. It’s well established that we are a drug and alcohol-free zone. Anyone who did that, against our wishes, would be shown the door.
As a specialist in addiction, it would be hypocritical for me to tell people to stop using those substances, and then go home and use them myself.
It’s been known for some considerable time that you need to make it clear to the recovering addict or alcohol abuser what’s acceptable and what’s not. This includes not mixing with addicts (7).
To keep you and them safe you need to establish very good boundaries for your relationship with the recovering addict. Then you need to enforce them.
Don’t interfere with the treatment
You’re not a specialist in addiction. Don’t think you know more about the person’s recovery than the specialist because you’re related to the addict. You don’t.
I‘ve treated over 10,000 addicts, week after week after week, for decades. As specialists we spend years training to do what we do. We know what works and what doesn’t.
You won’t understand some of the things we do, and you don’t have to. Some of what we do will be completely beyond your understanding. We have very clear, solid stages and benchmarks that we put addicts through to recover.
We monitor and assess patients each time we see them and along the course we may change the treatment according to what we find. My special field is fast recovery by hypnotherapy, but all the time I’m still monitoring the patient’s progress.
Your job is simple as a relative: Support and be kind to the recovering addict. Respect they’ve had a very difficult journey. You can do so much to help as a family member but be careful that it’s supportive, not accidentally sabotaging (8).
Helping pay for recovery treatment
I have a rule in my clinic: If a relative is paying for the therapy, the addict must pay them back. I’m very clear on this arrangement, and it’s not negotiable.
Recovery from addiction begins with the person taking responsibility for their own life. That includes paying for their own treatment. It’s no one else’s addiction but the patient’s.
One of the worst sabotages of addiction recovery is overcompensating relatives who give money to the addict out of pity or guilt.
Your loved one is an addict or alcoholic. If you give them money, they’ll spend it on their addiction, no matter what they’ve told you. Also, some families try to do addition recovery on the cheap and that rarely goes well.
Having said that, families will need to budget for the cost of recovery. It’s not cheap but it’s cheaper than the cost of losing your family member.
Certainly, people with mental illness are more susceptible to addiction and alcohol abuse (9). They may have impaired judgement, are easily led, or find the effects of those substances harder to deal with.
There are also those who develop mental illness due to their exposure to drugs and alcohol. Cumulatively the risk of mental illness escalates the longer the use continues. However, for some people, even a single exposure can cause mental health problems.
What’s most common is the user having a substance-induced psychotic episode. This is when they begin to hallucinate, can’t function and may need to be hospitalised.
Substance abuse recovery is more complicated in this group of people. There needs to be extended mental health monitoring and treatment.
Get help for yourself
You’re not superman or superwoman. Having a spouse, friend or relative who’s an addict can be highly stressful.
It’s a very unpredictable situation and there are times when you don’t know what’s going to happen next. It can be like living in a war zone at times.
Getting help just for you and talking through what’s happening with professionals can really help you get through the situation.
You can join a relatives of addicts and alcohol abusers support group where you get to talk with other people in your situation. You may be surprised how helpful that can be.
Dr Tracie O’Keefe DCH, BHSc, ND is an addiction specialist, psychotherapist, hypnotherapist, clinical naturopath, published author, and PACFA-registered mental health professional. She has helped more than 10,000 addicts and their families. You can consult her in the office or by Zoom from anywhere in the world.
Call our central booking for your FREE telephone consultation with Dr Tracie O’Keefe DCH. Phone 0403 398 808. Health funds.
- Lander, L., Howsare, J., & Byrne, M. (2013). The Impact of Substance Use Disorders on Families and Children: From Theory to Practice. Soc Work Public Health, 28(0): 194-205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725219/
- Caetano, T., Pinho, M., Ramadas, E., Lopes, J.,Aerosa, T., Ferreira, D., & Dixe, M. (2023). Substance abuse and susceptibility to false memory formation: a systematic review and meta-analysis. Front Psychol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196796/
- Klingemann, H.(2020). Successes and failures in treatment of substance abuse: Treatment system perspectives and lessons from the European continent. Nordisk Alkohol Nark, 37(4): 323-337. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8899245/
- Daley, D. (2013). Family and social aspects of substance use disorders and treatment. J Food Drug Anal, 21(4): S73-S76. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158844/
- Pierce, M., Hayhurst, K., Bird, S., Hickman, M., Seddon, T., Dunn, G., & Millar, T. (2017). Insights into the link between drug use and criminality: Lifetime offending of criminally-active opiate users. Drug Alcohol Depend, 179: 309-316. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608072/
- Dela Cretaz, B. (2016). Some are in debt through no fault of their own. Not me. The Guardian. https://www.theguardian.com/commentisfree/2016/jun/20/debt-addiction-recovery-my-life-in-the-red
- Cermark, T. (2013). Co-addiction as a disease. Psychiatric Annals, 21(5):266–272 https://doi.org/10.3928/0048-5713-19910501-05
- Bradshaw, S., Shumway, S., Wang, E., Harris, K., Smith, D., & Austin-Robillard, H. (2015). Hope, Readiness, and Coping in Family Recovery From Addiction. Journal of Groups in Addiction & Recovery, 1094): 313-336. https://doi.org/10.1080/1556035X.2015.1099125
- Carey, K. & Correia, C. (1998). Severe mental illness and addictions: Assessment considerations. Science Direct, 23(6):735-748. https://www.sciencedirect.com/science/article/pii/S030646039800063X