Substance Abuse Is a Family Problem

Some of you know what it’s like to experience alcohol or drug abuse in the family. For those of you who don’t know it firsthand, an analogy found in How Alcoholism Affects the Family, Study.com, 23 June 2015 (study.com/academy/lesson/how-alcoholism-affects-the-family.html), gives a good picture. “Imagine a distant cousin, who we will call Al, wants to visit your family. It seems like fun to get to know Al better, so you agree to let him stay at your house. Having Al around is fun at first but before long, he is causing problems. Al has become an unwanted guest that you can’t get to leave. Your daughter wants her room back and is becoming anxious. Your wife feels abandoned as Al demands more and more of your time. Stress levels are higher than usual because he starts to get on everyone’s nerves. There is more arguing. You have also found your family budget stretched tight because you’re paying all of Al’s expenses while he stays with you. The effect your cousin Al is having on your family is comparable to dealing with alcoholism in the family. Each person in the family is affected in a different way, and the impact is usually negative.”

Alcoholism and drug abuse affects everyone around them. Since family members are the closest to the person with the disease, they are the most severely impacted. General problems in the family may include domestic abuse, financial concerns, and overall dysfunction. Well over half of the reported domestic abuse cases involve alcoholism as the cause. Substance abuse is an expensive problem. The cost of alcoholic beverages or drugs can create financial strain. A person who abuses substances is also more likely to experience job loss. This loss of income can place an even greater financial burden on the family unit.

Substance abuse can affect different individuals within a family. Children of alcoholics are likely to have low self-esteem, unusual feelings of guilt or despair, a fear of abandonment, chronic depression, and elevated levels of anxiety. They are less likely to establish positive personal relationships or attend college. In addition, children of alcoholics are more likely to be physically, sexually, or mentally abused and are more likely to have problems with the law. They are also more likely to become alcoholics themselves. A spouse or partner is usually the one who must deal with the consequences. Divorce rates among couples where one or both partners drink are much higher than average.

So, what can you do? Talking with Al in a nonconfrontational manner that includes empathy, respect, and highlighting the pros of changing and the cons of remaining the same, may nudge him toward self-motivation. Motivational Interviewing was developed by Miller and Rollnick (1991). It is a therapeutic technique designed to explore the substance abuser’s mixed feelings and strengthen the change process.

• Ask open-ended questions, seeking both positive and negative aspects of the problem.
• Listen non-judgmentally and explore their mixed feelings about change.
• Affirm and support their efforts to change with statements of appreciation and understanding.
• Summarize their thoughts and feelings to reinforce their sense of agency to change.

Al may cycle through the following stages of change: (Prochaska & Velicer, 1997)

• Precontemplation (Not yet acknowledging that there is a problem behavior that needs to change)
• Contemplation (Acknowledging that there is a problem but not yet ready or sure of wanting to make a change)
• Preparation/Determination (Getting ready to change)
• Action/Willpower (Changing behavior)
• Maintenance (Maintaining the behavior change) and
• Relapse (Returning to older behaviors and abandoning the new changes)

We can’t change Al, but we can nudge him toward change as we set boundaries for ourselves and our family.

But, that’s another topic for another time.