Family support

Addiction is often defined or referred to as a disease. This makes sense in that it is something which people have no control over, is progressive, incurable and can lead to serious health problems or even fatalities. Addiction can affect anyone and often those who use drugs and alcohol begin to use them because initially the experience is enjoyable. Sometimes people use because they want to block out feelings and then they come to depend on them as a way of coping with life, and this means that they begin to need to drink or use just to feel normal.

Whatever the route into drug and alcohol use, the result of prolonged and continued misuse leads an individual to the same destination, one of dependency. Once dependency sets in, life for the user and their family can become chaotic and unmanageable.

People close to those who are struggling with an addiction, especially parents, find themselves wondering if something they have done might have caused it. Families commonly experience powerlessness and terrible guilt, mulling over and regretting past actions or reactions. However, it is very important that family members keep in mind that a user is responsible for the choices they make and for their behaviour. This includes whether they use drugs and/or alcohol. Only the person misusing substances can make the choice to use or not use them, and only they can decide to stop.

Addiction is considered by many to be a family illness, and in order for both the addict and family member to recover, both need help to move forwards. Looking to apportion blame can feel like a natural reaction for both parties, but is helpful for no one.

It is a natural part of life that we make mistakes along the way. Trying to blame ourselves or others for them does not help, but prevents us from moving forward and keeps us stuck in a place of desperation and despair.

Drug and alcohol users can behave very erratically and it can be difficult to know how to act around them. Substance misuse often encourages people to act in very distressing ways. Perhaps they have become aggressive, angry and violent, or distant and cold?

Sometimes your family member will engage in criminal behaviour and may spend time in prison as result. Dealing with addiction and imprisonment can be very traumatic for you and your family, particularly if children are involved.

Seeing someone you love and care about struggling to cope can often make family members and friends feel very powerless. It can also be overwhelming having to deal with what may seem like a never ending list of challenging issues.

A good place to start helping is to gain an understanding of addiction and treatment.
Joining a support group or attending an information session or drop-in for family members or friends can be a good way to find out more about addiction and treatment. Knowledge is definitely power, and families and friends who can learn about drugs and alcohol, its effects on the user and their family are better placed to deal with it.

People whose lives have become unmanageable as a result of their addiction need professional help from many different people. This might include a doctor, counsellor, a drug and alcohol practitioner and support from those who have recovered from a drug or alcohol issue themselves. Many people also manage to get clean solely through attendance at 12-Step meetings such as AA (Alcoholics Anonymous), NA (Narcotics Anonymous) or CA (Cocaine Anonymous).

Recovery for everyone requires more than the person with the problem quitting drink or drug use, but requires a lifestyle change, a shift in attitude and change in behaviour.  This takes continued work and effort.

Drug and alcohol services exist in prisons and in the community throughout the UK. They offer professional support to a drug user at any stage, whether they are uncertain about stopping their substance use and looking for some advice to help them decide, if they are at a stage where they want to cut down, or if they are determined to stop using altogether.

For those negotiating recovery, there will be rewarding days and difficult days. These will happen because in order to find recovery, individuals and the families and friends supporting them have to make changes to their lives, and all change is difficult, even good change.

But recovery can be rewarding for all, simply because with the right help and support, everyone can get the chance to change their life for the better.

When someone goes into treatment, it requires a supreme amount of effort and dedication in order for them get well and stay well. They will need to work daily on rebuilding their lives and moving forwards. Recovery is not about an individual abstaining from their drug of choice – it takes much more than that. Sometimes it takes a long time for families and friends to see the results they are looking and hoping for, but in time these will come.

Your loved one is working on building a support system for his or herself for a lifetime of recovery. Addiction can have a life changing effect on everyone involved and a family in recovery will naturally need to function in a different way to maintain its new found health. Both you and your loved one will undoubtedly change as part of this process, but with the right care, attention, direction and support, this change will be positive.

The 12-Step programme has been in existence since the 1930’s and it is widely identified as a successful treatment pathway that has helped many people stop the use of mind altering substances. The original programme started in the USA, but it is now practised worldwide. The 12-Step programme has been adapted to address a range of issues and there are now many different fellowships, including Gamblers Anonymous, Overeaters Anonymous, Sex Addicts Anonymous and many others.

The fellowships – as they are often referred to – focus on members embracing a set of what they call ‘Spiritual Principles’. The philosophy of the 12-Step model is based on the belief that drug addiction and alcoholism (chemical dependency) is a disease in its own right, that having this illness is no-one’s fault, but that it can be addressed through working a 12-Step programme of recovery. This involves practising the spiritual principles of the programme, such as honesty, open-mindedness, humility, tolerance and patience in one’s life.

Those attending the fellowship and treatment programmes based on the 12-Step model do lots of intensive work that promotes healing and enables them to better understand themselves and their addiction.

The Steps also go some way to helping individuals to admit some of the things they have done to harm people as a result of their addictive behaviours. There is an emphasis on examining the reality of previous using behaviour, taking responsibility for recovery, and trying to repair harm caused while maintaining recovery on an ongoing basis. Those working the 12-Step programme try to find a way to come to terms with old ‘using’ behaviours and work to eradicate these, acknowledging as they do so the damage that has occurred as a result.

Yes! Addiction affects everyone in the family, which is why it is commonly referred to as a “family disease”. Parents, partners, siblings and children all develop coping mechanisms to help, “fix” or protect the addict and to cope emotionally themselves.

Patterns of behaviour within a family or system that is trying to cope with addiction become stuck and often unhealthy. The family becomes reactive; wanting to control, rescue, halt or change members in order that they conform and stop threatening the status quo.

These patterns emerge as a result of constantly trying to cope with high levels of stress, uncertainty and erratic behaviours.

This is no one’s fault and families do all they can to do what they feel is right in a situation, which can often prove unrelenting and extremely bewildering. Without support, family members and friends can feel that they are constantly under siege.

If families and friends are helped to identify some of these unhealthy patterns of behaviour and learn new and healthier ways to cope and react, they can significantly improve their own mental and physical well-being.

There is also good evidence to suggest that when family members access help in their own right, this results in considerable positive effects on their substance misusing loved ones. This often includes a reduction in drug use, better communication and falling levels of stress and anxiety.

Children living in homes where there is a substance use problem are likely to experience a variety of confusing feelings. These may include worry, sadness, fear and uncertainty. Although it might be considered important to protect children and young people from experiencing some of these negative feelings, it is often healthier if they are given appropriate and accessible information about addiction, as well as given an outlet to express how they feel.

Explaining a substance use problem to children can be difficult and it is very important they are given the right amount of information appropriate to their age group. Here are some guidelines to keep in mind when broaching the subject:

Toddlers and pre-school children understand simple, short sentences. They need concrete information and not too much technical language. Explain the problem simply and then try to make their lives as normal as possible. After explaining the problem, engage children in a fun activity.

School-aged children can handle more information than younger children. They might already have had drug information sessions at school, but do be prepared to answer their questions honestly.

Teenagers can manage most information and they may have received drug education lessons at school. They are likely to ask questions about the substance their relative is using. They may worry about what other people, especially their peers, think of them and their family. Sharing information and responding honestly encourages teenagers to talk more openly about their feelings and to ask questions.

Do take note of these important considerations when talking to children and young people:

Let children know that the family member has a problem with substances. Explain that this affects behaviour, mood and judgement; so when Mum, Dad, brother, sister or whichever family member affected by substance misuse are using, he or she may say or do things that they wouldn’t ordinarily do or say.

It is very important that children are reassured that they did not cause the problem. Often blame is internalised and children carry this burden with them. They need to understand that no matter what their behaviour, they did not cause the person to drink or use drugs, nor can they change or stop the way the person behaves. Children may need to hear this often.

Children and young people need to understand that it is not their responsibility to take care of the person with the substance use problem. If they are worrying about their family member’s health they should be reassured that it is not their problem to solve. It is an adult’s job, such as a doctor, counsellor or specialist drug and alcohol worker.

Encourage children to continue with regular routines and find other activities and interests outside the home that they enjoy, such as sports, interest clubs at school, play dates with friends and so forth. Children should be allowed to be children and should not take on the problems of the family home.

Children need to know that it is OK to have difficult feelings, even scary ones. They need to know that it is alright to reach out for help and to talk about their feelings. Having a healthy, caring, trustworthy adult in their lives to talk to can help them to cope. Opening up this channel of communication is vital.

If children need to talk to someone but want to stay anonymous, suggest they call Childline for free on 0800 1111

Sometimes parents are worried about talking to their children when there is substance misuse in the family, as they assume the children will be taken into care. However, drug misuse is not sufficient reason for a child to be removed from a family. In fact, if you ask for help and are seen to be acting in your children’s best interests, the authorities are likely to support you.

When a loved one begins to engage with a treatment programme, their family often find themselves in a place of high hope and high anxiety. Naturally, family members and friends will want to keep optimistic about things moving in the right direction and feel positive that all will be well.

There will be some ups and downs in early recovery, and the idea of your loved one having a relapse will undoubtedly seem a very scary and daunting prospect. This fear is not unreasonable as relapse can happen as part of the process of recovery, but in the event that it takes place, it may well lead to renewed commitment and motivation.

Drug and alcohol dependency can be like other chronic illnesses that often require more than one round of therapy, and just because someone relapses and needs another course of treatment, it doesn’t mean that their treatment has been unsuccessful or that they won’t be able to stay “clean” in the long run.

In the event of a relapse, try to remain encouraging and suggest that your loved one talks to their counsellor or sponsor, or that they go to a support meeting. Where possible, try to take a step back and remind yourself that it is not your mission or responsibility to make them well again.

Taking care of yourself is the best way to help someone who has relapsed. That may seem like a difficult thing to do, but it will benefit you to focus on you by taking care of your own emotional and physical health.

In a family where addiction is present, the move towards recovery for all members is a parallel and ongoing process, which takes time.

If you have been caring for someone who has been in active addiction for a long period, the experience for everyone involved may have had far reaching effects. These are unlikely to disappear overnight. It takes time to heal from difficult memories and the repercussions of challenging behaviours in any life situation.

Recovery for everyone requires more than the person with the problem quitting drink or drug use. It requires a lifestyle change, a shift in attitude and change in behaviour.  This takes continued work and effort.

Your loved one will need to be vigilant regarding their sobriety: one day at a time, for the rest of their life. It is helpful to understand that recovery is an ongoing journey and not a final destination.

It is not a case of your loved one ‘getting over’ their dependency and moving on. If it was that easy, it would have been done long ago. The path to recovery may be slow, with ups and downs and ignoring addiction or trauma, or pretending that they are not serious problems. This does not make them go away, it only makes them worse.

Particularly in early recovery, your loved one may need to attend regular support meetings and spend what may seem like an extraordinary time away from family and friends. If possible, try to support this process as much as possible. Sometimes family members, particularly partners, can feel displaced and abandoned. This is a natural response, but do try to understand that the work they are currently engaged in is an essential part of building the foundations for their ongoing recovery journey.

One of the most important things that a family needs to be aware of, when living with a recovering addict, is the importance of family members maintaining an alcohol and drug-free environment themselves.

Someone in recovery, particularly early recovery, can hardly be expected to remain sober and clean if there are drugs or alcohol readily available in their home. For recovery to work, the entire family must be committed to it. With addiction, it is best if you never offer someone in recovery a drink or drug, or drink or use in front of them. Keeping alcohol or drugs in the house if/when your family member is living with you is also not advised.

Recovery is about new ways of thinking, living and being, which can only take root and prove successful if there is support, understanding and a commitment to sustained lifestyle changes from everyone affected.