Relationships and Substance Abuse

In recovery from alcohol or drug abuse, the strength of personal relationships is truly put to the test. For the partner, supporting a loved one through recovery requires a tremendous amount of patience and compassion.

For the individual who is struggling with addiction, recovery means confronting the guilt, resentment, and remorse that can come from substance abuse.

In addition, a recovering addict must often learn to accept the reality of an underlying mental illness, such as a mood disorder or anxiety disorder. Co-occurring medical or psychiatric issues can add to the complexity of recovery and present additional challenges for the couple involved.

To recover successfully from addiction, the partnership itself requires as much support as the individual client. Couples who struggle to cope with the effects of substance abuse alone are often caught in a cycle of self-destructive behavior, relapse, and mutual harm. Family or couples counseling, educational programs, support groups, and intensive family workshops are essential to the recovery process. Above all, it is important for spouses, partners, and families to know that the problem of addiction is too complex for anyone to solve alone.

Statistics on Relationships and Substance Abuse

Over 21 million Americans age 12 and older, or approximately 8 percent of the country’s population, had a substance use disorder in 2013, according to the National Survey on Drug Use and Health. Nearly all of these individuals have relationships that have also been affected by addiction. The American Association for Marriage and Family Therapy notes that among unhappy couples, those relationships that involve drug or alcohol abuse are usually the most troubled and cause the most pain to both parties.

Substance abuse creates a chaotic and unpredictable living environment for the adults and children living in a household. The neurochemical effects of alcohol and drugs can predispose the user to mood swings, outbursts of aggression, self-isolation, and depression. Without any emotional, material, or financial stability, neither partner in a couple can feel secure about the future. This constant uncertainty creates anxiety and stress in all areas of life. Although it is difficult to quantify the impact of addiction on relationships, statistics paint a portrait of how this disease affects the lives of couples:

There is some controversy over whether substance abuse causes domestic violence, or vice versa. However, statistics consistently show that acts of violence, assault, and homicide are more likely to occur when one or both parties are under the influence of alcohol or drugs. Even when domestic violence is not a concern, the problems caused by substance abuse create an atmosphere of conflict and poor communication, in which couples are more likely to argue and less likely to find constructive solutions to their differences.

• Up to 50 percent of men enrolled in domestic violence intervention programs have substance abuse disorders (National Resource Center on Domestic Violence).
• Men are up to eight times more likely to batter a spouse or partner when they have been drinking (National Resource Center on Domestic Violence).
• Increases in the rate of alcohol consumption in the US have led to a corresponding 20 percent increase in the divorce rate in this country (Journal of Studies on Alcohol).
• Married or cohabiting individuals who abuse drugs or alcohol are up to six times more likely than the general population to have experienced domestic violence in the past year (International Journal of Environmental Research and Public Health).
• Approximately 25 percent of American children under the age of 18 are exposed to alcoholism or alcohol abuse in the home (American Journal of Public Health).

There is some controversy over whether substance abuse causes domestic violence, or vice versa. However, statistics consistently show that acts of violence, assault, and homicide are more likely to occur when one or both parties are under the influence of alcohol or drugs. Even when domestic violence is not a concern, the problems caused by substance abuse create an atmosphere of conflict and poor communication, in which couples are more likely to argue and less likely to find constructive solutions to their differences.

What Is Codependency?

The disease of addiction involves a complex interplay of neurological, psychological, and socio-environmental factors. An individual’s environment, which includes relationship status, plays a key role in the development of addiction and the progression of destructive behaviors. In codependent relationships, the addicted individual has a partner who tacitly encourages the addictive behavior through actions that support the abuse of drugs or alcohol. Meanwhile, the addicted partner comes to rely on the codependent to make excuses to employers or friends, obtain alcohol or drugs, cover unpaid bills, and other enabling behaviors.

Codependents share another common feature – although they devote much of their energy to caring for others or compensating for negative behaviors in their partners, they are often unable to care for themselves. As a result, codependency is frequently accompanied by depression, anxiety, anger, and resentment. Although codependency varies from one individual to another, WebMD notes that codependents typically engage in the following behaviors:

• Making sacrifices for others at the expense of their own emotional, physical, or financial welfare
• Expending a great deal of energy trying to convince their partner to change, while continuing to enable the addiction
• Lying, apologizing, making excuses, or otherwise covering up the addicted partner’s behavior so that the person doesn’t have to face the consequences
• Paying the addicted partner’s bills, personal debts, or legal fees because the person is unable to work
• Taking personal responsibility for an addicted partner’s destructive or harmful behavior (“He wouldn’t drink so much if I would stop nagging him,” or “If I hadn’t had an affair, she wouldn’t have turned to drugs.”)

Psychology Today defines codependency as a “dysfunctional helping relationship,” in which the codependent encourages the partner to be weak, incompetent, and irresponsible so that the codependent partner can feel stronger and more capable. Ironically, while codependents may spend a great deal of time trying to persuade an addicted partner of the need for change, they are also responsible for enabling the behavior. This pattern, which is often subconscious, reflects the ambivalence of the codependent’s mind. Although the codependent may desperately want the substance abuse to stop, the codependent also derives a certain amount of ego gratification from controlling the person struggling with addiction and serving as a primary source of support.

Resolving codependency is just as complex as treating the addiction itself, which is why the condition is widely considered to be a mental health disorder in its own right. In order for the partnership to be saved, both the codependent and the partner struggling with addiction must undergo intensive treatment. In therapy, the codependent partner learns self-care techniques and communication skills, while working to resolve underlying issues of emotional security, depression, and poor self-esteem. If both partners learn how to be competent and strong, they can build a healthier, more gratifying relationship in sobriety.

Can a Relationship Interfere with Recovery?

As stressful as it can be to live with someone who is addicted to drugs or alcohol, recovery does not always prove beneficial to relationships. In many cases, sobriety sheds light on unresolved problems that both individuals have suppressed. Confronting those problems can cause new conflicts that must be addressed in order for the couple to move forward on a new footing. In addition, after months or even years of living with the effects of addiction, couples must get used to the demands of sobriety. This may require changing their social and recreational activities, eliminating alcohol from the home, and finding new ways to deal with stress and conflict.

In codependent relationships, alcohol and drugs are often used as a way to control the addicted partner. Without that means of control, the codependent partner may suddenly feel insecure or resentful.

Codependency is a form of addiction that demands intensive therapy in order for both partners to feel emotionally stable in recovery.

Separation and divorce are not uncommon in recovery. In the clarity that comes with sobriety, some individuals realize that their relationship is destructive or harmful, and therapy may indicate that it can’t be saved. Before making a decision about ending a long-term relationship, it is helpful to have counseling to determine whether the partnership has a potential to evolve in recovery.

How Can Relationships Support Recovery?

The news about relationships in recovery is not entirely negative.

In fact, relationships can be one of the most significant factors in helping individuals struggling with addiction to complete rehab and maintain long-term abstinence.

An article published in PLOS states that rates of drug use and drug dependence are higher among separated, divorced, or never-married individuals than among married men and women; likewise, married individuals are more likely to have successful outcomes in drug cessation programs. In strong marriages, the partnership can provide a sense of stability and security that the addicted partner can rely on in recovery. Even in partnerships that have been threatened by chemical dependence, the element of companionship can provide a sense of safety, along with a starting point for beginning a healthy new life.

The need to maintain or preserve a relationship is often the motivating factor that prompts individuals to enter recovery. Individuals who are still uncertain about giving up drugs or alcohol may decide to attempt rehab if they are encouraged by a partner. Partners can actively provide support to an intimate spouse or significant other in the following ways:

• By openly and honestly expressing their desire for the partner to enter rehab
• By taking steps to learn about addiction and the process of recovery
• By helping their partner locate and enroll in a suitable treatment program
• By participating fully in family counseling sessions, support groups, and workshops
• By following the necessary steps to create a sober living environment at home
• By seeking individual therapy for their own internal conflicts or past traumas
• By taking part in alumni programs, family intensive workshops, and other programs in the aftercare process

The National Institute on Alcohol Abuse and Alcoholism stresses the importance of expressing support for the addicted partner’s efforts to change, even if it means overcoming negative feelings. When a partner enters recovery, it is natural for the spouse or significant other to feel resentful or even angry. Feelings like “She should have been in rehab months ago,” or “This is too little, too late,” are very common. However, verbal expressions of support, along with actions that help the partner meet recovery goals, can make a very positive difference in the final outcomes of treatment, creating a more positive environment for everyone in the home.

In more extreme cases, the possibility of losing a significant relationship can propel an addicted person into substance abuse treatment, especially if it is part of an agreement signed during an intervention. An intervention is a prearranged meeting, at which the individual’s loved ones confront him or her about the effects of the disease. At the culmination of the meeting, the individual is presented with a proposal for recovery, in which the person is given the alternative to enter rehab or face specific consequences, such as a separation, divorce, or loss of child visitation rights. Often, the threat of losing an important personal relationship represents the turning point in an individual’s progression from addiction to recovery.

Therapies for Couples in Rehab

At one time, addiction was considered to be the result of a person’s poor character or lack of moral strength; by the same token, rehab was considered to be an individual effort. Now that addiction is viewed as a chronic disease, with both neurobiological and socio-environmental causes, rehab professionals recognize the importance of bringing partners, children, and other significant relationships into therapy along with the individual in treatment. To bring about healing within a partnership or family, the following therapies or programs may be included:

• Cognitive Behavioral therapy (CBT): CBT is a solution-focused therapy that works to improve the individual’s thought patterns and daily functioning through practical exercises. CBT has been applied successfully to the treatment of addiction in individual rehab clients. In specialized forms, it has also been applied to the restoration of healthy relationships. Behavioral Couples Therapy, or BCT, addresses the partners’ behaviors as a couple as well as individual thoughts and actions that prevent them from functioning in a healthy way. Abstinence may be promoted with a recovery contract that clearly defines the limits of acceptable behavior and the consequences for violating those limits. Clinical research on BCT, according to the Journal of Substance Abuse Treatment, shows that couples who engage in BCT as part of a rehab program have better relationship functioning and longer rates of abstinence than those who do not participate in behavioral modification therapy.
• Family Systems Therapy: Family Systems Therapy takes the position that addiction does not occur in a vacuum; it is the end result of dysfunctional relational patterns in the individual’s home and social environment. In households where one or more persons are addicted to drugs or alcohol, substance abuse becomes the organizing principle for the entire unit, or system, resulting in maladaptive behaviors as the members try to cope with the disease. In order for the individual to heal, the whole family — or “system” — must participate in therapy, so these maladaptive behaviors can be identified and addressed. Family Systems Therapy is applied as a treatment modality in many rehab programs, both through individual counseling and group therapy.
• 12-Step groups: The healing principles of 12-Step recovery are available to the loved ones of addicted persons, as well as to the individuals struggling with addiction. Fellowships like Al-Anon, Alateen, Adult Children of Alcoholics (ACoA), and Co-Dependents Anonymous (CoDA) were established to support the close friends, partners, and relatives of people who are struggling with addiction, regardless of whether those people are in recovery themselves. Membership in 12-Step fellowships is free, and meetings are held in most major communities throughout the world. In particular, the 12 Steps can help members gain a sense of serenity, resolve old resentments, and acquire a sense of acceptance and detachment about their role in recovery.
• Aftercare programs: Relational support is extremely important to the recovery process. With a strong personal network of loved ones in place, a client completing rehab is more likely to avoid relapse and achieve long-term recovery goals. Aftercare programs, which are part of a comprehensive substance abuse treatment plan, acknowledge the importance of significant others through intensive family weekends, educational workshops, social media networks, and other activities.

Relationships after Rehab

Recovery is not “complete” when a client is discharged from rehab. In fact, the completion of rehab is just an initial milestone in what will be a lifelong process of growth. During this process, maintaining a relationship can be an important incentive in remaining abstinent and participating in aftercare programs. On the other hand, the issues that arise in day-to-day life as a couple can be triggers for a relapse. Many couples lack the proper communication skills to resolve conflicts without losing their tempers. One or both partners may have difficulty setting or respecting boundaries, which can result in resentment, hostility, and arguments. In therapy, the most important issues to address include:

• Learning how to express wants and needs
• Defining the limits of acceptable or unacceptable behavior
• Addressing conflicts in the early stage
• Resolving past resentments that may interfere with recovery

Recovery applies to relationships as well as to individuals. The couple must work together to rebuild broken bonds, reestablish trust, and heal old wounds if the partnership is to last. While not all marriages or partnerships will survive the test of rehab, those relationships that remain can become stronger in sobriety with the help of a comprehensive recovery program.

If you or someone you love is struggling with addiction and are ready to start discussing treatment options, call us today at . There, a compassionate treatment navigator can help you create a plan to attend treatment at one of our rehab facilities across the United States. River Oaks, American Addiction Centers’ substance abuse rehab facility near Tampa, Florida, may be a good fit for you. Call us today to find out more.