Addiction - A Family Disease

By Kirstyn K. Zalice, MSN, C.R.N.P.
Clinical Assistant Professor of Nursing
School of Nursing and Allied Health
Robert Morris University

December 2005
Alcohol and Drug Use-Scope of the Problem
The National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism estimate the total economic cost of alcohol and drug abuse to be more than $245 billion.

According to the 2004 National Survey on Drug Use and Health, about half of Americans age 12 or older, an estimated 121 million people, reported being current drinkers of alcohol. Results from the same survey revealed that approximately 55 million people age 12 or older participated in binge drinking, while almost 17 million people reported heavy drinking. Finally, 19 million Americans - almost 8 percent of the population over 12 - were reported to be current illicit drug users.

As startling as these statistics are by themselves, you may note that there is something missing: the number of family members-wives, husbands, children, parents, siblings-also affected by alcohol and drug abuse.

Impact on Family Members
Anyone who has ever watched a family member or loved one struggle with substance abuse or addiction, whether tobacco, alcohol, illicit or prescriptive drugs, knows how painful and disruptive it can be to family life. Substance abuse contributes to family conflict, erodes relationships, and generates high levels of expressed emotion, thus disturbing much-needed social support.

Health care providers often focus on the alcohol or drug abuser, the identified patient, yet may spend little time with family members. Health care providers, however, are uniquely positioned to assist families in coping with their loved one's addiction.

Family members often call their providers for advice regarding treatment options or accompany their loved one in his/her pursuit for treatment. The health care provider's approach to the family member is significant during this time of initial contact as family members often display feelings of guilt, sorrow, despair, hopelessness, and/or anger. Offering unconditional support and empathy, and utilizing a non-judgmental approach, will assist in decreasing feelings of shame and guilt by the family member. It is also important for health care providers to not only stress the need to treat the drug/alcohol abuser at this time, but to educate the family member on resources that are available to them, one of these being support groups.

Support Groups
Support for spouses and children exposed to addicted individuals is available in the form of groups such as Al-Anon , Nar-Anon and Alateen. Founded in 1951 by the wives of two Alcoholic Anonymous (AA) members and based on AA's Twelve Steps, Al-Anon offers free and confidential support for anyone affected by an alcoholic or problem drinker. Al-Anon also welcomes family members of individuals who are addicted to substances other than alcohol. Nar-Anon (Narcotics Anonymous) is another support group available for family members of individuals addicted to drugs.

Support groups offer members the ability to share their own experiences, strength, and hope with each other and to ultimately realize that they are not alone. Both Al-Anon and Nar-Anon begin with the principle that addiction is a "family disease" in that it affects all those who have a relationship with the addict. Family members who are closest to the addict get enmeshed in the disease and react to the addict's behavior. Their lives tend to revolve around the addict - wondering where they are, what they are doing, and whether or not they are using. Family members can become as addicted to the addict as the addict is to drugs and/or alcohol.

Al-Anon and Nar-Anon literature compare life with an addict to a drama where people develop stereotypical roles. Their behaviors center on the addict and are sometimes dominated by the following characteristics:

Obsessions - going to great lengths to stop the addict's behavior, such as searching the house for hidden stashes of liquor, secretly pouring drinks down the drain, and searching clothes for receipts and/or drug paraphernalia.

Anxiety - worrying constantly about the effects of the addict's behavior on the children, the bills, and the family's future.

Anger - feelings of resentment that result from being repeatedly deceived and hurt by the addict.

Denial - ignoring, making excuses for, or actively hiding the facts about the addict's behavior.

Guilt - family members' beliefs that they are somehow to blame for the addict's behavior.

Insanity - defined in Al-Anon as "doing the same thing over and over and expecting different results."

With help from their peers, Al-Anon and Nar-Anon members learn that they did not cause their loved one's addiction, nor can they control or cure it. Family members become empowered when they focus on taking care of themselves, changing the things that they can, and letting go of the rest.

Addiction truly is a "family disease." Family members often are so focused on getting their loved one treatment that they neglect themselves. Support groups are just one option available to provide both education and support in the family member's pursuit of his/her own recovery.