How to Help When Living with Loved Ones with a Substance Use Disorder

By Damon Davis, Prevention & Education VISTA, & Ashley Yaugher, PhD, Health & Wellness
Faculty

Living with a loved one that has a substance use disorder (SUD) can be challenging for family members. SUD, also known as "addiction," is a chronic disease that affects the way the brain and body function. It is a complex condition that may lead to severe physical and mental health issues as well as social and economic consequences (Daley, 2013). There are many different SUDs that a person can experience (e.g., Alcohol Use Disorder (AUD), Opioid Use Disorder (OUD), and Stimulant Use Disorder) (American Psychiatric Association [APA], 2013). The signs and symptoms of each may look different depending on the substance. Still, the key to each is clinically significant impairment in the person's activities, as well as distress that the individual experiences or that their SUD causes in their lives (e.g., no longer working, being unable to do activities they once enjoyed, being unable to fulfil important responsibilities, etc.)  (APA, 2013).

Family and loved ones are not immune to this mental health condition's impact on the lives of their loved ones and often themselves. Family and loved ones are frequently the first to notice changes in their loved one's behaviors, emotions, or thinking when substance use becomes significant (Lander et al., 2013). Thus, family and friends of people with SUD will benefit from learning coping strategies for themselves (McCrady & Flanagan, 2021). Leanor Brownn (n.d) states that we "cannot serve from an empty vessel," meaning to help our loved ones, we also need to care for ourselves. 

Loved ones can help those they care about with a SUD by encouraging treatment and recovery efforts, but also taking care of their own wellness needs (McCann et al., 2018). Coping strategies for living with a family member who has a SUD:

1. Educate yourself: It’s important to gain knowledge and insight into the nature of SUD and its effects on you and your loved one (Substance Abuse and Mental Health Services Administration [SAMHSA], n.d.). Become familiar with different treatment options and resources available and how best to support your family member in the process of recovery (e.g., 211.org).
2. Set boundaries: It is essential to set clear, well communicated boundaries with your family member and maintain those boundaries over time. This may include not supporting their substance use (e.g., not purchasing them substances or sharing old prescriptions) or not allowing them to engage in certain behaviors while in your home (Taylor-Olsen & Yaugher, 2021).
3. Seek support: Finding an appropriate support group or seeking individual counseling may be helpful for both the individual with the SUD and their family members (e.g., Community Reinforcement and Family Training or CRAFT). It can provide a safe space to share struggles and experiences as well as learn best practices. Encourage your family member to find evidence-based help for their SUD, which may involve comparing different treatment options or speaking to SUD treatment counselors (SAMHSA, 2004).
4. Practice self-care: Taking care of your physical and emotional health is essential while living with a family member with a SUD. Employ stress-reducing techniques such as meditation or exercise, and seek support from friends and family (McCann et al., 2018). Also keep in mind that we can only control our own behavior, thoughts, and reactions during difficult or trying times (Campbell & Yaugher, 2020).

Living with a family member with a SUD can be challenging and emotional. However, there is hope for recovery and change. By getting educated, setting boundaries, seeking support, and practicing self-care, you can manage your wellness needs while maintaining healthier relationships with your family member.  Additional resources and links to start this journey are below. 

Additional Resources:

•  Substance Abuse and Mental Health Services Administration (SAMHSA): https://www.samhsa.gov/
• Call or visit Utah 211 for local resources (e.g., housing, food resources, treatment providers, etc.): https://utah211.org/ 
• Community Reinforcement and Family Training (CRAFT): https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement
• Utah Support Advocates for Recovery Awareness (USARA): https://www.myusara.com/
• Mental Health First Aid (MHFA)Training: https://www.mentalhealthfirstaid.org/take-a-course/
• Call 988 Suicide & Crisis Line (988): https://988lifeline.org/ 
• How to Support a Loved One in Recovery: https://extension.usu.edu/relationships/faq/how-to-support-a-loved-one-in-recovery 
• Strengthening Communities to Support Recovery & Prevention Substance Use: https://extension.usu.edu/mentalhealth/articles/strengthening-communities-to-support-recovery-and-prevent-substance-us

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
• Eleanor Brownn. (n.d.). http://www.eleanorbrownn.com/
• Campbell, E., & Yaugher, A. C. (July, 2020). How to communicate during stressful times. Utah State University Extension: Relationships. https://extension.usu.edu/relationships/faq/how-to-communicate-during-stressful-times
• Daley, D. C. (2013). Family and social aspects of substance use disorders and treatment. Journal of food and drug analysis, 21(4), S73-S76.
• Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social work in public health, 28(3-4), 194-205.
• McCann, T. V., & Lubman, D. I. (2018). Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study. Journal of Substance Abuse Treatment, 93, 7–14. 
• McCrady, B. S., & Flanagan, J. C. (2021). The Role of the Family in Alcohol Use Disorder Recovery for Adults. Alcohol research: current reviews, 41(1), 06.
• Substance Abuse and Mental Health Services Administration. (n.d.). Recovery support tools & resources. Retrieved from https://www.samhsa.gov/brss-tacs/recovery-support-tools-resources
• Substance Abuse and Mental Health Services Administration (US); 2004. Center for Substance Abuse Treatment. Substance Abuse Treatment and Family Therapy. Rockville (MD): (Treatment Improvement Protocol (TIP) Series, No. 39.) Chapter 1 Substance Abuse Treatment and Family Therapy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64269/
• Taylor-Olsen, C., & Yaugher, A. C. (2021, April). Establishing boundaries: Essential or selfish? Utah State University Extension: Relationships.  https://extension.usu.edu/relationships/faq/establishing-boundaries-essential-or-selfish