For Families

It was such a relief to talk to someone who was sympathetic to my situation and who didn’t judge me for having the feelings I had. Talking to someone about how I was feeling gave me the strength to cope with things better.

UNDERSTANDING THE ISSUES

Discovering that a loved one uses drugs or has an alcohol problem can be shocking, scary and stressful. You may have found out suddenly or the realisation may have crept up on you over time. Either way, it can be an anxious time.

Many family members know little about drugs or about alcohol dependency, and many hesitate to seek out this information, not wanting to associate themselves with issues that can be stigmatised, misunderstood and scary. We have all seen media representations of those who struggle with these issues which can often be prejudiced and judgmental.

However, learning a bit more about the issues can reduce your stress and give you a better understanding of what your loved one is experiencing, and what you can do to help yourself and them.

 

Recovery and treatment

RECOVERY

Many people recover from drug or alcohol problems. However it is rarely as simple as just deciding one day to stop drinking or using. Recovery can be a long and winding road and navigating it can take a lot of patience for all concerned.

Many people have differing views on what recovery is but three useful definitions are:

  • a voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society” (UKDPC – Recovery Consensus Statement – 2008)
  • a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential” (SAMHSA – 2011)
  • a lived experience of improved life quality and a sense of empowerment; …the principles of recovery focus on the central ideas of hope, choice, freedom and aspiration”. (RSA – The Potential of Recovery Capital)

TREATMENT

There are different approaches to treatment for different substances. We would always recommend speaking to your GP as a first step. If you would like to look for specialist help for drug or alcohol use have a look on our ‘You and your loved one’ page.

The treatment services should involve you and work with you too as you support your loved one.

A useful model to help understand the process of recovery is known as the ‘cycle of change’. This is explained below, along with some of the best ways to support your loved one at each stage of the journey.

 

The effects on the family

Different substances have different effects on the users’ mental and physical health, and behaviour. We recommend DrugScience as a well informed and evidence-based overview of the impacts substance use can have.

However, the effects of drug and alcohol use in the family go well beyond the direct effects on the person using them. Living with a loved one who uses drugs or alcohol has a huge impact on the whole family. Here are some of the ways families are affected:

Stigma

People often feel that they can’t share what they are going through with family or friends for fear that others will judge them or treat them differently as a result.

Isolation

Stigma and the stress of dealing with substance use in the family can lead people to isolate themselves from friends, family, activities and social networks.

Stress and anxiety

Living with a substance user can be unpredictable and causes stress and anxiety in many different ways. Especially when people feel they have nowhere to turn this can build up over time to high levels that are very difficult to live with.

Trauma

Substance users can sometimes act in ways that cause trauma to those around them. This might be through abusive behaviours or a dramatic change in relationship dynamics.

Relationships

Substance use can put huge strain on relationships, not just with the user themselves but throughout the wider family and social networks as everyone struggles to find their own ways to cope.

Financial impacts

Family members are sometimes the victim of criminal behaviour by their loved ones such as theft of property to sell for money to buy drugs or alcohol. Others pay off substantial drug debts. If a substance user is unable to work or remains financially dependent this can also put additional strain on finances. Some family members find themselves needing to reduce working hours to cope with the situation or may even be unable to work due to the stress it causes them.

Mental and physical health

Stress, anxiety and feeling out of control for sustained periods can cause mental and even physical health problems for families, which further contribute to the stress and difficulty of coping.

The effects of substance use on families are many and varied. That is why Adfam exists to highlight the need for family support, develop best practice and enable families to find support. We know support for families can reduce and mitigate these effects and improve wellbeing so families can get back a sense of control over their lives.

 

Understanding addiction
In order to provide support for a drug/alcohol user, it helps to understand their behaviour and the motivations behind it. A popular model for explaining the stages a user goes through is the Cycle of Change. A user typically goes through the cycle several times as part of their recovery journey; the model helps explain that lapse and relapse are a common part of the journey for people trying to give up any substance.

The cycle of change also shows how family members should understand which stage the user is at and not attempt to provide inappropriate support – for example providing information on rehabs too early. See the diagram below for ways you could help in the different stages of the cycle.

1. PRE-CONTEMPLATION

In this stage the substance user has no desire to change. They do not see their using as problematic, even if others do.

How to help in the pre-contemplation stage: As the user doesn’t see there is anything to change, the most appropriate support is limiting the impact and harm of their substance use to them and to everyone else. You can also help the user to become aware of the consequences of their use and associated behaviour.

2. CONTEMPLATION

At this stage the substance user starts considering their situation and whether they want to change. They are more aware of their situation and may want to get out of it. However, they are still using at this stage.

How to help in the contemplation stage: support at this stage continues to be about minimising the impact and harm of substance use. In addition, support can be given by helping to motivate the user to change, such as exploring with them the choices they have and offering them information to better inform their choice.

3. PREPARATION

Here the user makes a decision to change their substance using behaviour and starts to prepare themselves to do so.

How to help in the preparation stage: appropriate support involves helping and encouraging the user to make the changes they want to make, whilst acknowledging their anxiety about changing.

4. ACTION

At this point the user takes practical steps to bring about a change to their substance using behaviour, such as using less or deciding to give up completely.

How to help in the action stage: appropriate support is about encouraging the positive changes the user is making in their behaviour.

5. MAINTENANCE

When someone reaches maintenance they have achieved a change in their substance using behaviour. A substance user may have either stopped using drugs or alcohol, or moved to a more controlled, less harmful way of using and is maintaining that change. As we all know, sticking to the changes we make in our behaviour can be the hardest part of the process.

How to help in the maintenance stage: supporting the changes that have been made by the user, such as removing triggers to use from the home. It is important also to adjust to changes in family life and in the relationship with the user, which are likely to have resulted from the user’s changed behaviour. Some families can be tempted to blame drugs for all the problems they’ve experienced, so when there are still relationship difficulties without drugs, this can be very distressing and confusing. In this case it is important to maintain open and honest dialogue about problems, feelings and aspirations and try to work through them.

6. LAPSE AND RELAPSE

A lapse is when the user briefly returns to their old substance using behaviour. It is possible for them to go from lapse back to any stage of the cycle. However, a relapse is when the user fully returns to their old substance using behaviour and then needs to go all the way through the Cycle of Change again.

How to help in the lapse and relapse stages: appropriate support to the user is about reducing harm from substance use and helping the user re-engage with treatment, so a lapse doesn’t become relapse.

 

Why they use drugs/alcohol
Family members are often at a loss to understand why their loved one uses drugs or alcohol. Many (especially parents) blame themselves, but it is important to know that you are not responsible for your loved one’s choices.

There are many reasons why someone might experiment with drugs or alcohol, including:

  • to help them cope with difficult feelings or circumstances
  • to ‘self-medicate’ mental health problems
  • socialising in a context where it is ‘normal’, or as a result of peer pressure or to ‘fit in’
  • to have a new experience (especially during adolescence when young people often take more risks)
  • because they enjoy the feeling of increased confidence, energy or relaxation that drugs can bring.
  • Most people who use drugs don’t become dependent. It is not fully understood why some find it harder to regulate their own drug
  • or alcohol use and become dependent or addicted, while others can simply stop.

It is important to realise that if someone has an addiction, they are no longer able to ‘just stop’ drinking or taking drugs. Addiction creates and results from changes in brain chemistry which can make a person’s ‘need’ for drugs overpower all other considerations. Understanding this can help family members take it less personally if their loved one seems to act selfishly, no longer care or almost seem like a different person.

It is normal to feel scared, frustrated, angry and confused when you find out that a family member is using drugs or drinking dangerously.

Read more about specific drugs at DrugScience

 

 

USEFUL STRATEGIES

Avoiding 'enabling'

‘Enabling’ is the term used to describe a situation when family members inadvertently ‘enable’ their loved one’s drug or alcohol use. Most family members would like their loved one to stop using alcohol or drugs and would never deliberately support or encourage this behaviour. However, providing money, food or shelter, or rescuing your loved one when they get into a tricky spot can prevent them experiencing the true consequences of their choices and remove any incentive to change. Family members can end up running around picking up the pieces of their loved ones choices while the user remains relatively unaffected by their own choices.

Just as with setting boundaries, it can be very difficult to stop ‘enabling’ and very painful to watch your loved one experience the consequences when you no longer pick up the pieces. But many family members say that taking these decisions was essential in effecting change and in regaining a sense of normality for themselves and the rest of the family.

Coping with their behaviour

It is normal to feel helpless, frustrated, worried and upset by a loved one’s substance use. Drug and alcohol users can have very erratic behaviour, and it can be difficult to know how to act around them. Their substance use may lead to patterns of behaviour that can be distressing, distant, cold or even aggressive, angry and violent. Some drug users may commit crimes and go to prison.

Each family is different but family members often take one or more of the following approaches:

  • Denying – ignoring the problem, hoping it will go away
  • Enabling – inadvertently enabling drug/alcohol use to continue by paying debts, lying to cover up for the user, tolerating very difficult behaviour, giving them money which goes on drugs/alcohol etc.
  • Controlling or ‘Fixing’ – trying to take control of the user’s life and drug/alcohol use in an attempt to make them stop using.
  • Apathy – withdrawing, giving up.

Although common and natural responses, these approaches rarely help. It is important to:

  • Keep yourself safe
  • Establish and maintain clear boundaries
  • Think about your own health and wellbeing
  • Explore the other pages in this section for more tips.
How can I help them?

Family members are often desperate to help their loved one stop drinking or using drugs. Ultimately, whether your loved one recovers is up to them. You can’t take that decision for them, difficult though that may be to accept at first. However, there are some steps that you can take to support them.

Get support for yourself

It may sound counter-intuitive, and you may have never considered getting support yourself, but a family who is healthy and supported is in a much stronger position to influence their loved one to seek help.Explore the other pages in this ‘Help for Families’ section to find local services in your area.

Inform yourself about the substance they use

Those who use drugs and alcohol sometimes exploit their loved one’s fears and lack of knowledge. The better informed you are the less able they will be to manipulate you or play on your worries.

Find out about treatment services in your area

Your loved one may not be interested in getting help yet but have the information to hand or casually leave it in their way (if safe to do so). It may plant a seed and it will mean that you are better informed about what treatment involves when the time comes to support them in it.

Maintain clear boundaries

Work out your boundaries, communicate them to your loved one and stick to them. Read more about setting boundaries.

Be positive

This can be extremely challenging, especially if you have experienced a string of disappointments or broken promises. But finding ways to communicate to your loved one that you believe in them and are there to support them when they are ready to seek help can make all the difference. Recognising successes, however small they may seem (a small reduction in the drugs/alcohol used or a thoughtful gesture which comes out of the blue) can play an important role in motivating someone to change.

Keeping safe

Those who use drugs and alcohol may sometimes put their loved ones at risk. Here are some examples:

  • Threatening, aggressive, violent and abusive behaviour when under the influence or in an attempt to get money to buy drugs / alcohol.
  • Drug dealers coming to the home to collect debts.
  • Using the home for illegal or anti-social activities.
  • Acting irresponsibly when in a position of responsibility for children.
  • Acting irresponsibly when in a position of responsibility for property e.g. causing a fire whilst trying to cook whilst drunk or high.

Whilst you cannot control the risks someone takes with their own health or safety, you can take steps to protect yourself, and others.

  • Establishing clear boundaries about when your loved one will or will not be allowed in your home.
  • Involving the necessary authorities if you feel there is a risk of harm to children.
  • Ring the free, 24/7, confidential NSPCC helpline on 0808 800 5000
  • Making a plan to have somewhere else to go to keep yourself safe should the need arise.
    Seek support if experience abusive behaviour. Ring the free, 24/7, domestic violence helpline on 0808 2000 247.

If you ever feel you, the substance user or a third party is at risk of immediate physical harm don’t hesitate to call 999.
These decisions can be extremely difficult and can take time to work through. It is always a good idea to seek support for yourself to talk through your options and hear how others have coped in similar situations.

Listen to personal stories

We have worked with relationships charity OnePlusOne over the past couple of years to create an audio resource that tells the stories of couples affected by alcohol and drug misuse in their families and the effect on their relationship.

We know couples living in families affected by drug and alcohol misuse often live with acute worry, putting a strain on their relationships. To help, the project has created an audio collection of short stories and practical advice from real people living in families affected by drug or alcohol misuse.

You can listen to Relationship Realities here:

Please do give us your feedback on the project by completing the very short evaluation form at the bottom of this page.

The project is funded by the Department for Work and Pensions (DWP) and forms part of a wider contract for Relationship Support Services – Culture Change between One Plus One and the DWP.

Create your user feedback survey

Managing conflict

Drug or alcohol use in the family often leads to a lot of conflict. Here are some simple tips to reduce and manage conflict:

  • Try to identify when arguments tend to take place and make a choice to respond differently or avoid getting drawn in. For instance do you try to discuss your loved one’s drink or drug use when they have just arrived home under the influence, or first thing in the morning when they are hung over? What about leaving these emotive discussions for a different time?
  • Think about the tone and language that you use.
  • Aggression or accusations (even in retaliation) are rarely constructive and are very likely to lead to conflict.
  • Walk away. If things are getting heated, explain calmly that it would be better to return to the conversation at a later time, and remove yourself from the conflict.
  • Try to find something positive to say!
  • It can be easy to fall into negative communication cycles and for the drink or drugs to take over family life. A kind gesture or a word of thanks for something, however small, can do wonders for a relationship and make life a little bit happier for everyone.
Positive communication

Many family members ask why they should have to do anything differently when they are not the one with the problem. Of course, your loved one’s substance use is not your fault and you should not take responsibility for it. However, psychology shows that we can have a huge influence on those around us through the way that we interact.

You may not want to maintain or build your relationship with your loved one, and you may be at the stage of wanting to take a step back. In that case these tips may not be for you. But many families affected by drugs and alcohol report huge improvements after they took some simple (but sometimes challenging!) steps towards more positive communication.

  1. Avoid accusations, blame, aggressive tones and nagging
    These feed a cycle of negativity and rarely succeed in persuading loved ones to do what we are hoping they will do.
  2. Keep communication clear, simple and brief
  3. Look for positives and thank your loved one for them (doing the washing up, coming in when they said they would, saying ‘good morning’ rather than ignoring you – anything!) We all like to feel recognised and valued. These kinds of interaction create a chemical reaction in the brain which can be similar to the effects of drugs and can lead to a positive cycle of reinforcement (but don’t hold your breath! It can take time.)
  4. Find ways to have fun together.
    Life can end up revolving around the drug or alcohol use and simple pleasures can fall by the wayside. Obviously depending on the level and pattern of your loved one’s substance use, are there ways to build in fun together that takes the focus off the substance use and rebuilds trust and positivity in the relationship if these have been lost?
Self-care & stress

Living with or caring for a loved one who uses drugs or alcohol can take a huge toll on family members. One of the benefits of support for yourself is that it can help you to think about your own needs. Often life has come to revolve around the substance user and it’s a long time since you thought about your own wellbeing. Here are some of the things that families often find helpful:

  • Carving out a small slot in the week to do something just ‘for you’. Re-read a favourite book, take a walk in the park, curl up with a magazine, take a bath, paint your nails, re-discover a long lost hobby.
  • Mindfulness. There are now many apps and local classes to help us practice mindfulness which is scientifically proven to improve wellbeing and reduce stress.
  • Re-connect with old friends. Families affected by drugs and alcohol often become isolated from previous social networks.
    Get some exercise. A brisk walk, a cycle or a favourite class has many health and wellbeing benefits, not least that it will release endorphins which improve your mood.
  • Take a break. Many family members of those who use drugs or alcohol feel unable to get away because of the unpredictability of their loved one’s behaviour. But a change of scene, even for a weekend, can make a huge difference to the rest of the family.
    Family support services may have groups, information and facilities to support you in taking steps to improve your own wellbeing.
  • Visit our SUPPORT PAGE to see what support or help is there or near you.
Setting boundaries

Many families of substance users put up with far more than they are really comfortable with. You might have told your loved one that if they behave a certain way ‘one more time’ then something will change – you’ll call the police or they won’t be able to come on holiday with you, or even that it won’t be possible for them to continue living with you. But it can be easy not to follow through on these statements. However, setting and maintaining clear boundaries is essential for both you and your loved one. Not doing so results in chaos and uncertainty.

Have you ever issued an ultimatum and then not followed it through? What happened? Did you mean it when you said it? Are there steps you could take to make it possible to implement (if that is what you want)? Try not to make empty threats. Think through your limits, communicate them clearly and then follow through and do what you said you would do. If you aren’t willing to do it, don’t say that you will. It can be easy to make bold ultimatums in the heat of the moment. Try to avoid this. Instead, sit down with your loved one in a calm moment and communicate your decision clearly.

Some common areas to think through in terms of boundaries with your loved one:

  1. Money. Do you give them money? Is this appropriate for their age? Can you afford it? Are you comfortable with it? Does something need to change?
  2. Providing food, electricity etc.
  3. Cooking meals, doing laundry, running errands.
  4. Covering for them e.g. calling in sick to their workplace when they’re hung over after a night out.
  5. Allowing them in the home when under the influence.
  6. Driving them around when under the influence.
  7. Having them live with you.

It can be very difficult to decide what is appropriate. To provide food, shelter, some meals and laundry for a teenager may be normal but what if they’re still using and still expecting this several years later? Helping out in a time of crisis can easily become a way of life. What seems reasonable when someone is participating in family life can feel unreasonable if relationships break down and it feels like they are using you like a hotel. When is enough enough? Families feel scared or anxious of what would happen if they stopped doing these things for their loved ones. Would they look after themselves? Would they be homeless? Where would they go?

However, the toll on families can be huge. Sometimes there is no incentive for a drug or alcohol user to change because life is very comfortable for them as a result of this kind of practical support and a time can come when family members feel that things must change.

Finding local support can help you work through these questions and decide what is best for you and your loved ones.

LOSING A LOVED ONE
Losing someone you love as a result of their drinking or drug use can be emotionally devastating, challenging and isolating. If you have lost someone in this way it is important to know that you are not alone. Please find below a range of information and support that is available:
  • Adfam and Peter Cartwright have produced a series of video support sessions available on our website. This includes a video specifically on substance-related bereavement that you can watch here.
  • Adfam’s Journeys Resource provides advice to anyone suffering from a drug or alcohol-related bereavement.
  • Adfam and Alcohol Change UK co-produced this information toolkit on alcohol-related bereavement: VISIT WEBSITE 
  • DrugFAM provide support to families that have been bereaved as a result of a loved one’s drug/alcohol misuse, phone 0300 888 3853 or VISIT WEBSITE for more information.
  • Scottish Families Affected by Alcohol and Drugs provide support to families in Scotland who have lost someone who used alcohol or drugs. VISIT WEBSITE for more information or call their telephone helpline on 08080 10 10 11.
  • Families Anonymous run a virtual group for those who have lost a loved one as a result of the use of drugs or alcohol. Meets via Zoom on the second Thursday of each month, 7-8.30 pm. Contact office@famanon.org.uk.
  • The Compassionate Friends has a resource for parents bereaved through drug and alcohol use. This resource discusses the days immediately after a loss, the effect on the wider family and talking to non-adult children about loss.
  • The Good Grief Trust have supportive information on its website including a map of bereavement support organisations. You can contact them at hello@thegoodgrieftrust.org.
  • Suicide & Co provide support to those that have been bereaved by suicide, including a counselling service. VISIT WEBSITE for more information.
The following telephone helplines are also available:
116 123 Samaritans
For anyone at any time for any reason
0800 2600 400 Sudden Bereavement Helpline
10am and 4pm, Monday to Friday – immediate support
0800 448 0800 National Bereavement Partnership Helpline
7am -10pm for emotional support
0808 808 1677 Cruse Bereavement Care
Nationwide bereavement support
0808 802 0111 Grief Talk
Monday to Friday 9am – 9pm
0800 634 9494 Bereavement Advice Centre
Practical advice (9 – 5pm)
0800 435 455 Bereavement Trust
Emotional and practical advice (6 – 10pm)
0345 123 2304 The Compassionate Friends
Open every day 10 am – 4 pm, 7-10 pm

FINDING SUPPORT

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