Is Addiction a Family Illness?

Addiction is frequently thought of as a disease that affects just one person. This person is usually dependent on the addictive substance and is unable to break a cycle of abuse. This is a common and understandable misconception that a lot of people have.

However, addiction and substance abuse can have significant and life-changing effects on people around the person directly suffering from the addiction.

It’s widely known that addiction has mental, physical and social health effects. However, these effects extend to people who may have never used a drug or alcohol before; from friends to family and colleagues.

If you or someone you’re related to is struggling with an addiction, then it’s important to seek help and understand the effects and consequences of the addiction is having.

The Burden on Loved Ones

The impact and effect addiction can have on family and loved ones are vast and life-changing and their reactions can change from day to day. People supporting those with an addiction may feel;

  • A sense of denial and disbelief
  • Fear
  • Constantly worrying about now and the future
  • A sense of guilt
  • A sense of responsibility
  • Anger with themselves or the individual suffering

Why Does Addiction Affect the Family too?

When you’re part of a family, everything and every decision you make has an effect and directly influences other members of the family in both direct and sometimes indirect ways [1].

This is because all families are what is known as a ‘system.’ Each family has their own way of communicating, dealing with and resolving issues. It’s these patterns of interaction that give each family system a sense of equilibrium and disequilibrium.

Change or disruption to the family system by any one family member leads to changes in the system and the family as a whole. Typically, when someone suffers from an addiction they usually underperform in the role within the system. This often leads to tension, frustration and disequilibrium. This change can be either conscious or unconscious.

Unhealthy Patterns Form

As loved ones trying to gain control over the addiction and situation, many negative and unhealthy patterns form, including [1];

  • Misguided expectations; you may expect more of your loved ones and find yourself continuously disappointed when they fail to live up to your expectations of who they are or should be.
  • Negative communication styles, complaining and criticising often.
  • Self-medication in an attempt to manage stress.
  • Misdirected anger by taking anger out on other people inside or outside of the family.
  • Inconsistent rule-setting, with issues setting boundaries and limits.

Family Stigma

Stigmas are defined by prejudices that are placed against a group of individuals that are often fueled by stereotypes and misinformation [3]. Addiction can often result in stigmas against you and your family.

Stigmas are often unfair and dangerous because they often;

  • Stop individuals from seeking or starting treatment
  • Perpetuate stereotypes and discrimination
  • Keep people isolated and disconnected from support and others

Symptoms of Family Addiction Stress can include: [2]

  • Persistent stress
  • Anger and resentment
  • Increased anxiety
  • A sense of hopelessness
  • Depression
  • Shame
  • Isolation
  • Ignoring your basic needs in an attempt to look after them
  • Financial issues stemming from your loved one’s addiction

In particular, substance abuse puts children at an increased risk of the ill effects of addiction and can include [2]

  • Depression that stays with them into adulthood
  • Long term anxiety
  • Low self-esteem
  • Impaired relationships in the future.
  • Higher rates of divorce.
  • Increased likelihood of abusing substances themselves.
  • Violence.
  • Diminished capacity for learning

The Effect Addiction has on Children in the Family

When a family member is addicted to a substance, be it alcohol and drugs, the effect and resulting scars often left on a child can be devastating and life-changing. More often than not, when a child grows up in a household with at least one parent who suffers from an addiction, this causes the cycle to continue over generations to come.

Often the child then grows up looking to harmful substances as a way to cope with their trauma, or they learn from the mistakes they have witnessed growing up and decide not to follow in the same footsteps.

Deep psychological issues, anxiety and emotional instability are all common side effects of children who have grown up with one or more parents who are addicted to substances.

Many studies have shown that children who grew up in a household with parents suffering from addiction are more likely to also suffer and struggle with addiction issues themselves later in life [1,2,4].

Having said this, it is worth noting that developing an addiction disorder can be due to many factors, including the interaction of both environmental and genetic factors passed down by and generated by a partner or caregiver.

Addiction and Family Roles

When someone in the family is suffering from an addiction, it’s typical for each family member to assume a different role in an attempt to control or understand the situation.

According to Sharon Wegscheider-Cruse, author of ‘Another Chance: Hope and Health for the Alcoholic Family’ [5] there are typically five common roles that family members assume.

The most common family roles in addiction include:

1. The Enabler

The enabler is most often the person who’s closest to the person suffering from the addiction, and can consciously or unconsciously know that they are contributing to the enablement of the addiction.

The enabler’s behaviour allows the addict to continue their actions and behaviour and, along with the addict, ignores the consequences of their actions.

This person is often in denial about the seriousness and extend of the situation at hand, supports and frequently makes excuses for them.

2. The Hero

The Hero is, more often than not, the oldest person or child in the family. Their often ‘ahead of themselves’ in terms of responsibility and development and often assume the role of parent when needed.

3. The Scapegoat

The Scapegoat is usually the person that the family tends to give the most attention to in an attempt to distract themselves from focussing on the issues at hand regarding the addiction. As time goes on, they often get into trouble due to the added attention and pressure put on them by the family.

4. The Mascot

Due to the unpleasant environment caused by the addiction, one family member often assumes the role of the Mascot. The Mascot uses humour to cope with the unpleasant situation, which often brings some relief to the family.

5. The Lost Child

The Lost Child is known as the quietest and timid child within the family unit. They struggle making conversations and feeling comfortable in social situations and often feel isolated from their family members.

This, in turn, makes it difficult for them to develop relationships outside of the family, leaving them with little support during the family struggle.

If you or someone you know can identify with one of these family roles then it’s important to understand the effect your family is having on you, and the effect your role has on the family.

What is Family Therapy

Family therapy is often used to treat families suffering from the effects of substance abuse. Family therapy has two main purposes [6].

The first is to use the family’s natural strengths, ideas and capabilities to solve issues and develop strategies to live without substance abuse. Secondly, it tries to make the impact and effects of the addiction on both the person suffering and the family better.

Family therapy can help to answer questions the family may have, such as [6]:

  • Why do children or adolescents need to be involved in therapy or treatment?
  • What is the impact of substance abuse on family members who do not abuse substances?
  • What impact does a parent who abuses substances have on their children?
  • How does adolescent/teenage addiction impact parents and other adults in the family?

If your or a family member is suffering from addiction, and if it’s having an impact on the family then it may be important to seek family therapy.

By providing the person suffering from the addiction with support in a family or group therapy environment, it may encourage them to seek further and serious help for their issues.

[1] Dinwiddie SH, Reich T. Genetic and family studies in psychiatric illness and alcohol and a drug dependence. J Addict Dis 1993;12(3):17-27.

[2] Meller WH, Rinehard R, Cadoret RJ, Ton ET. Specific familial transmission in substance abuse. Int J Addictions 1988;23(10):1029-1039.

[3] Substance Abuse and Mental Health Services Administration. (2016). Words Matter.

[4] (McGue M, Iacono WG, Legrand LN, Elkins I. Origins and consequences of age of first drink. II. Familial risk and heritability. Alcoholism Clin Exper Res 2001;25(8):1166-1173.

[5] Sharon Wegscheider-Cruse. Another Chance: Hope and Health for the Alcoholic FamilyPaperback – December 1, 1989.

[6] Treatment Improvement Protocol (TIP) Series, No. 39.Center for Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2004.