To the Family Members...

Compiled by Jon Weeldreyer, MA, LLP, CAC

Substance abuse and addiction have enormous impact on the family members and loved ones of those with substance use disorders. It is easy for those outside the family to give what seems to be simple common sense advice. Often this comes in the form of "You don't have to take that… just move out!" or "I'd ground him if he were my son." In almost every case, these solutions have been attempted long before the family member was even willing to talk about the problem.

The family structure is often compared to a mobile - an art medium in which a number of objects, balanced on sticks and strings, is hung from the ceiling. When one part of the mobile (or one family member) is moved, all parts of the structure are affected. In a family where substance abuse becomes common, members of the family learn roles to cope with the constant instability of life. The outcome of this has been called co-dependency. Co-dependency is the reaction to chemical dependency by a family member.

Once a significant pattern of substance abuse has started, it is common that the substance abuser becomes unable or unwilling to change their use patterns. If this is true for the person using the chemical, imagine the near-impossibility of another person to impact that pattern. There are few things family members can do, and many, even when done well, don't end up with the results desired. Here are some that frequently seem to help those involved.

• Separate the behavior from the person. Your loved one is not the substance abuse. The person you care about exists and can return if the using stops.

• Take care of yourself. Make sure you are not sucked into unhealthy relational patterns or even into using the substance yourself.

• Talk about it. It is easy to be held hostage by silence. As often as possible, be honest, open and willing to accept help from others. Talk openly within the family, with friends, and at support groups such as ALANON (a companion to the AA/NA fellowships, set up as support for loved ones of those with drinking or other drug use problems). Many therapists specialize in treatment for the family members of alcoholics and addicts.

• Set boundaries. With the input of others, make a decision about how much you are willing to accept, and have a consequence if the substance abuser disrespects that boundary. For children, this can include restriction of privileges. For marriages or committed relationships, this can range from making the home an alcohol-free zone to separation or police involvement.

• Let the substance abuser feel the consequences. This is perhaps the most difficult and most important. It is painful for other family members if the drinker/user loses a job, gets arrested, or has to find somewhere else to sleep. However, the wisdom from recovering alcoholics and addicts is that "when there is enough pain, change will come."

If you find yourself in this bind, the most important thing to do is to have contact with a therapist or others who have been through this disease with their loved ones. Fears of judgment and shame disappear quickly once the veil of secrecy is lifted. Those persons know the pain and frustration involved, and wisdom is often yours for the asking.