When Your Loved One May Be Addicted: Guide for Families
This guide will help you recognize the warning signs of addiction in a loved one, offer education about different types of substance abuse treatment, and explain how you can provide the best help to get your loved one started on the path to recovery.
If you suspect your loved one is struggling with addiction, it can be difficult to know what to do or how to help. You may feel stressed, anxious, or overwhelmed by the idea that the person may have an addiction.
Signs of a Substance Use Disorder
It’s helpful to be able to identify signs of addiction, especially since people who struggle with substance use disorders may try to hide or deny that they have a problem. While it’s difficult to acknowledge when someone is addicted, ignoring the problem won’t make it go away.
The signs and symptoms of addiction can vary from drug to drug, but some of the general physical signs of drug abuse may include:1
- Changed speech patterns, like slurring or rambling.
- Losing or gaining weight.
- Constricted or dilated pupils.
- Psychomotor incoordination.
Substance abuse can also bring about changes in a person’s mental or emotional state, and they may exhibit behavior such as:1
- Mood changes, like increased aggressiveness, irritability, or anxiety.
- Abrupt shifts in personality and/or mood.
- Difficulty remembering or holding attention.
- Sleepiness or restlessness.
Some of the general behavioral changes that a person with addiction may exhibit include:1
- Taking more frequent doses of the substance.
- Giving up important activities in order to use.
- Continuing to use despite the person knowing that they have a relationship/work/social/academic problem that is likely caused by substance use.
- Being unable to meet responsibilities at work or home.
- Using in physically dangerous situations, such as driving or operating machinery.
- Cravings, meaning strong physical and psychological urges to use.
What’s the Difference Between Helping and Enabling?
Enabling is a way of accommodating your loved one’s addiction that protects them from fully experiencing the consequences of their actions. Enabling is counterproductive because it allows the person to continue to live irresponsibly and perpetuates the addiction.2
Some examples of enabling behaviors can include:2
- Bailing your loved one out of jail or paying legal fees for arrests related to drug or alcohol use.
- Making excuses for their behavior to others.
- Giving them money.
- Keeping secrets from others (i.e. “don’t tell Mom that I used again”).
Is My Loved One Choosing Drugs Over Our Family?
It’s not uncommon to wonder why your loved one seems to choose drugs over family and friends.
Know that addiction is not a choice, and although your loved one decided to start using drugs, it’s not as simple to stop using. Addiction involves a series of chemical changes in the brain that make quitting very difficult, though not impossible. It’s not necessarily that your loved one is choosing drugs over you, it’s more that they no longer know how to function without the substance.3, 4
The reasons one person develops an addiction while another doesn’t are complex and involve a combination of biological, environmental, and developmental factors.
When people with addiction use a substance, their brain experiences changes to the areas involved in pleasure, stress, behavior, and self-control. One of these changes includes surges of dopamine, a neurotransmitter (or brain chemical) that reinforces behavior perceived as pleasurable.
Additionally, people often cannot just stop using because they may have developed a physical dependence, which means their body needs the drug to function normally. When a dependent person stops using, they will develop withdrawal symptoms. Withdrawal can be so unpleasant and uncomfortable that a person will start using the drug again just to avoid these symptoms.5
Choosing the Best Substance Use Treatment for Your Loved One
Not everyone is ready to seek help, and it is not up to you to fix your loved one’s problem. Your family member needs to want to attend treatment. However, even if your loved one doesn’t yet want help, there are still things you can do to provide assistance and to educate yourself on the available options.
The first step is to speak with your loved one and let them know that you are concerned about them. Listen to them and don’t lecture or criticize. Let them know that you care about them no matter what and that you’re willing to help them find treatment.3
Even if your loved one doesn’t want help yet, you may be able to convince them to seek an evaluation from their doctor. You might call health professionals in advance to see if they are comfortable offering advice about addiction, and if not, ask for a referral to someone who can help.3
If your loved one wants help, let them know that you will stand by their side and provide whatever assistance and support you can. Reaffirm that they are making the right decision to enter treatment and acknowledge that it takes a lot of courage to admit the need for help. You can then start the process of seeking a treatment facility that meets your loved one’s needs.3
What to Look for in a Treatment Facility
If your loved one is ready to enter treatment, you should look for recovery centers that have specific features, including:6
- A professional, licensed staff of addiction experts.
- Treatment programs for your family member’s specific substance abuse or co-occurring disorder.
- Treatment tailored to your family member’s needs/preferences (including age, ethnicity, gender, etc.). For example, not all treatment centers accept adolescents, and some centers specialize in gender-specific treatment.
- A focus on evidence-based treatments (such as medication-assisted treatment and behavioral therapies or other research-backed treatment approaches).
- A plan to adapt treatment as your family member progresses through the program.
- A continuum of care from start to finish. For example, when treatment is completed, the treatment center should offer aftercare or encourage participation in 12-step groups.
The Continuum of Care
The continuum of care includes the entire treatment process, from detox to aftercare and everything in between. Knowing what the treatment process generally looks like can help you and your loved one know what to expect.
Often referred to as “detoxification” or “detox,” withdrawal management is a set of interventions designed to help your loved one safely stop using drugs. Detox may take place in a specialized detox center, a physician’s office, or treatment center. Medication is often used to lessen the effects of uncomfortable or dangerous withdrawal symptoms, but it doesn’t address the social or psychological reasons for addiction. Your loved one should continue to a formal treatment center to engage in the recovery process once detox is complete.4
People usually enter inpatient or outpatient treatment after detox. The best type of treatment for your loved one depends on their specific needs.4
Inpatient vs. Outpatient
Inpatient treatment involves a residential stay at a recovery center. Outpatient treatment means that your loved one lives at home and travels on a regular schedule to a treatment facility.4
People with severe addictions usually benefit from inpatient treatment initially and may transition to an outpatient center for ongoing care.
The recovery process does not stop once treatment ends. People should engage in some form of aftercare (such as 12-step or non-12-step groups or individual or group counseling) to continue their recovery and help prevent relapse.7
Family-based treatment may take place in outpatient, inpatient, or community treatment centers. The goals of family-based treatment are to help the person engage in treatment, reduce the risk of relapse, provide addiction education to loved ones, and support the person throughout their recovery.8
Family behavioral therapy, including many family-based treatments. These are some of the most extensively studied behavioral models for adolescent substance abuse and are based on the idea that family environments play a crucial role in the development of and recovery from addiction.9
This may include a wide range of treatments such as multidimensional family therapy, cognitive-behavioral family therapy, or brief strategic family therapy. These therapies involve family education and family therapy sessions to help improve an adolescent’s functioning and to encourage healthier family relationships.9
Paying for Substance Use Treatment
Depending on your plan and coverage, your health insurance may cover substance abuse treatment services. Many insurance plans cover inpatient stays, but verify your coverage with your carrier and inquire at the specific treatment center as well.
If your insurance doesn’t cover treatment, or if you do not have health insurance, some centers may offer low-cost or sliding scale fees.3
Self-Care and Support
Self-care and seeking treatment and peer support are crucial for recovering from an addiction, but it’s equally important for family members and loved ones of the person in recovery as well. You may spend a great deal of time worrying about your loved one, which can create stress, anxiety, and depression.
Taking care of your own needs and paying attention to your psychological and physical well-being can help you be better prepared to support and care for your loved one.
Methods to Care for Yourself
Care for yourself throughout your loved one’s recovery. Some of the ways you to do so include:
- Eating well and ensuring that you are receiving proper, balanced nutrition.
- Staying physically active.
- Getting enough rest.
- Asking for and accepting help from others.
- Joining a support group for loved ones of people with addictions (such as Al-anon or Nar-anon).
- Making time for yourself.
- Taking care of your health.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA, US: American Psychiatric Publishing, Inc.
- Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorder on families and children: from theory to practice. Social Work in Public Health 28(0), 194-205.
- National Institute on Drug Abuse. (2016). What to do if your adult friend or loved one has a problem with drugs.
- National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services. (2012). Principles of drug addiction treatment, a research-based guide, third edition.
- National Institute on Drug Abuse for Teens. (2018). Is there a difference between physical dependence and addiction?
- National Institute on Drug Abuse. (2013). Seeking drug abuse treatment: know what to ask.
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment, treatment improvement protocol (TIP) series, No. 45. Rockville, MD: Center for Substance Abuse Treatment.
- Scruggs, S.M., Meyer, R., & Kayo, R. (2014). Community reinforcement and family training support and prevention (CRAFT-SP). Washington, DC: Department of Veterans Affairs, South Central Mental Illness Research, Education, and Clinical Center.
- Hogue, A. & Liddle, H.A. (2010). Family-based treatment for adolescent substance abuse: controlled trials and new horizons in services research. The American Journal of Family Therapy 31(2), 126-154.
- S. Department of Health and Human Services: Office on Women’s Health. (2019). Caregiver Stress.
- S. Department of Veteran’s Affairs. National Caregiver Training Program: Caregiver Workbook.
- National Center for Biotechnology Information The Impact of Substance Use Disorders on Families and Children: From Theory to Practice