While all families periodically struggle to maintain a stable equilibrium, the challenge can be severely magnified when drug and alcohol misuse take up residence. The usual priorities recede into the background as a crisis management environment comes into establishment, replete with the frustration, anger and secrecy that can bring an embattled quality to the most ordinary interactions. Families in which a member is engaged in problematic substance use or in early recovery have often experienced a variety of deleterious consequences that may need to be addressed before a stable recovery and healing can begin. J.P. Foster works on the front lines and never loses sight of the need to assist family members as part of the treatment process….Richard Juman, PsyD
Recently I was asked to speak to a college class about some of the effects of substance misuse and its impact on families. The course focuses on the relationship between parents and children, and the potential maltreatment of children. About 33-66% of child maltreatment cases involve substance misuse and 12% of children in the United States could be impacted by a parent with a substance use disorder. I would argue that figure is low! If 10% of the population has a substance use disorder at some point in their life, think of how many children may be impacted by substance misuse? Not to mention spouses, partners, significant others, and parents. However, the alarming impact that substance misuse has on families should stop going unnoticed. “I’m only hurting myself,” is one of the biggest misnomers.
I work in an office that provides outpatient substance use treatment. I often tell the individuals I work with that one of my goals in their treatment is to help their children live better lives. I work with adults, but my passion is helping children impacted by substance misuse. Children are the innocent victims of substance misuse, though they are not the only family members impacted. Spouses, siblings, parents, etc., are also at risk of being negatively impacted by a family member’s misuse of substances.
But let’s start with the children. Children living with parents mired in substance misuse learn: “Don’t talk, don’t trust, don’t feel.” “Don’t talk” teaches children not to openly communicate about issues within the family. This also teaches children about secrecy, unfortunately enabling a parent’s addiction to continue. Another lesson learned is to turn a blind eye and ignore key issues. Children may battle the fear that if they bring up a parent’s drinking/using to others, they could be ridiculed or the parent may relapse.
“I remember being so fearful to speak up at times. I never knew how my dad was going to react. Just asking him a simple question could set him off. I was scared of him. Some days when he was drunk, he could be the best dad on the block, but watch out when he snapped. When he would go into a rage, I just hid in my room. This wasn’t something that I could talk about to anyone. I never invited friends over because I didn’t know how he would be around them. Talking to him about his drinking was never going to happen, I was too scared. My mom wouldn’t talk about it either. It was very scary at times, to say the least.”
Children also learn not to trust. They learn that trust leads to letdown and emotional pain. Kids may feel less important when a parent breaks a commitment, creating underlying issues of rejection. One adolescent was scolded by her father for making multiple plans—with one set of plans that included her parent and the other not—because she didn’t trust that her father would keep his commitment. Children also learn to question their reality: “But I know dad was drunk! What do you mean he was feeling sick?” These children begin questioning themselves and their reality, creating layers of denial and also confusion.
“My dad always promised he’d be at my games, but he never was. I felt embarrassed at times because it seemed like my dad was the only one not there. Trust is a big issue for me, even today. I struggle with trusting others or becoming vulnerable. I counter this by doing my best to follow through with commitments and be on time to places.”
Kids impacted by a parent using substances also learn that “Feelings are bad!” In a shame-based society, children learn to shut down their emotions, which often become painful and therefore should be avoided. Families that don’t openly discuss feelings can set children up for possible substance use later in their lives, as they learn to numb painful emotions.
“We didn’t talk about feelings in my family. I remember being told to stop crying as a kid, ‘Boys don’t cry!’ Feelings weren’t something that we talked about in my family. I can’t remember ever hearing my mother say, ‘I love you.’ The only emotions I remember experiencing were fear and anger. Today, feelings aren’t something I like to talk about.”
Children’s emotional needs often go unmet in families where one or both parents misuse substances. Many times, when a parent is mired in substance misuse, the child can become the surrogate parent for others or even for the parents themselves. Many such children have to forego their childhoods, becoming overly responsible at an early age. They are robbed of their childhood, creating underlying anger, grief, and loss. It’s not uncommon for these children to be responsible for making meals, supervising their siblings, waking themselves up for school, etc.—responsibilities that parents should be managing. The child’s need to be cared for and nurtured goes out the window in addiction, and the child’s survival skills kick in. A child growing up in homes where parents misuse substances learns, from a social perspective, that using is normal. This scenario has the potential to pass along substance misuse to the next generation, and the cycle continues.
“Once I was born, I think my parents were relieved. I was the first girl born into our family. As far back as I can remember, I had to take care of the others (brothers and sisters). Whether it was cooking, homework, baths, or cleaning up after them, I was the one responsible for it all. Dad was usually off drinking, and mom was God knows where. It never felt fair to me. I just got used to it. I was very angry with my parents for many years. It wasn’t until I was in my forties that I was able to find some forgiveness and let it go.”
Spouses and significant others can also be negatively impacted by substance misuse. One of the first areas of a relationship that is negatively impacted by substance misuse is trust. I’m continually amazed at the degree of dishonesty individuals engage in to conceal their substance misuse and continue using. Spouses (and parents) often tell me, “I can’t believe I didn’t know they were using!” But when the use is inevitably discovered, trust is shattered in the relationship. Feelings of betrayal are common for all family members, including children. Spouses are often “waiting for the other shoe to drop.”
“I always wanted to believe that she was going to stop using, but she never could. It felt like a double-edged sword watching her battle the anxiety. Which was worse, you know? She wouldn’t seek therapy for a long time. When she did finally stop for a couple of weeks, I was always on edge for something to happen at work where she’d revert back to the pills. Tense, to say the least.”
“My husband’s drinking was cyclical. Every 28 days or so, I knew that he’d drink. It was like clockwork. I keep a machine in the house to test him, because it got to the point where I could tell he’d been drinking, but he’d deny it. I thought I was going crazy for a while. No, I don’t trust him and not sure if I ever will. Every time he leaves the house, I worry that he’s going to come home drunk.”
“I made him give me his bank card and credit cards after rehab. I tried limiting his access to the money in the bank in the past, but he always found a way to get more. I don’t even know how much he spent over the past year using. I’m still fearful, even after this much time sober, that he’ll relapse and leave us broke. It’s scary.”
Anger and resentment are other common negative impacts of substance misuse on spouses. This area is often dulled (not expressed) until the substance user has stopped using or entered treatment/sobriety. Once the spouse is able to let down his or her guard, the anger can flow out almost immediately. Their anger is often concealed because the spouse is focused on keeping the family intact. Their anger can also be a byproduct of having to be overly responsible for the family, paying bills, shopping, cooking, laundry, getting children to school, etc. Without therapy, this spousal anger can continue to flare up, causing the spouse in recovery ongoing distress.
“I’m glad that she’s finally getting help. It took me making her leave the house, I mean move out, for her to see how bad her drinking had become. I’m so angry with her! Now that she’s in treatment, I do feel a sense of relief, but that’s quickly turning into more anger. It pisses me off that she would continually choose wine over our family. I couldn’t travel for work without someone staying with her and the kids. I really don’t know what to feel or how to process the anger. I guess over time it will begin to fade.”
Parents of children of all ages are also negatively impacted by substance misuse. Parents struggle with many of the same issues as spouses, and some that are specific to them. Many times, parents experience shame based on their child’s substance misuse. Many prominent families have children who continually struggle with substances, and they often feel that they have somehow caused their child to use. Examples of this can be seen when a child is the victim of abuse that went unreported. Many times, parents are manipulated by their children into enabling behaviors. Yes, sometimes parents are enablers, but they are also the victims of manipulation.
Another negative impact of substance misuse on parents is the financial repercussions. So often, parents provide the financial resources for their child’s treatment and related expenses, which may include housing costs and legal fees before and after treatment. Ever know a parent to pay a lawyer for their child? Unfortunately, parents are often the victims of their children stealing from them as well. The financial repercussions for parents with children afflicted by substance misuse is another negative impact.
“We spent over $20,000 on a lawyer! I do feel responsible to help him out of this situation. He’s young and has his whole life in front of him. I don’t think I could live with the guilt if he had a record and I had the money and didn’t spend it to help him out. Right or wrong, it’s what I did.”
“Our family has spent well over $150,000 on treatment, therapy, medications, housing, etc. over the past several years. I never imagined in my wildest dreams that this would be our life. But today, I’m done spending! I refuse to continue taking the financial hit for this. I love my daughter, but enough is enough.”
How many lost hours of sleep do parents lose each night? I remember my own mother saying to me as a teenager that she couldn’t sleep until I was home at night. What about adult children with substance use disorders who don’t reside at home? The stress of worrying about a child’s whereabouts is another negative impact.
“I lay awake at night worrying if he is okay or alive. You know, heroin kills people every day and that is my biggest fear, losing my child to an overdose. Learning how to let go has been the most difficult part. Just when I think I’m done worrying, something happens and I’m pulled right back in. I don’t think I’ll quit worrying until he’s been sober (in recovery) for several years.” love, Brenda
When someone tells me, “I’m only hurting myself,” I shudder to think of the wake of destruction I’m about to start wading through. For me, one of the most important goals of my work is to let family members know that they are not alone, and that I view their healing as an integral aspect of my work.
James P. Foster, LCSW, LCDC facilitates an Intensive Outpatient program in Dallas, Texas. Mr. Foster graduated from the University of Texas at Arlington in 2012 earning an MSSW, with thesis.