When a Loved One is Struggling with a Substance Use Disorder

Written by John H. Lally, APRN, Executive Director Today I Matter, Inc.


Most of us will experience a time in our lives when we may feel overwhelmed, anxious, and alone. The majority of us will figure out how to cope with these feelings and they will eventually pass. For some, however, the feelings linger and become all-consuming to the point where they interfere with our functioning. Relationships, work, school, and healthy social outlets may become harder to maintain. This can deteriorate into a mental illness. Sometimes a substance use disorder may develop in an effort to “self-medicate” and reduce the uncomfortable thoughts or emotions. This can compound the mental or psychological distress the person is feeling.

When this condition occurs, the stress is felt by everyone in the family. Common family experiences are anger, frustration, sympathy, blame, misunderstanding, helplessness and despair. The effects can rip apart family relationships, or bring the family closer together in a united effort to help the individual suffering. Either way, it certainly challenges the normal patterns and resilience of family relationships.


Common Misconceptions

Often mental illness and substance use disorder is misunderstood by loved ones. The person experiencing these problems commonly does not display overt physical symptoms. The struggle is mostly psychological and internal, so what is obvious to others is only the outward behavior or emotional expression of the distressed individual. Others who do not understand the problem may feel the the individual struggling is “just lazy” and resistant to help. They blame the individual for “not trying hard enough” and bringing the problem unto themselves.


Family frustration with not seeing improvement can sometimes result in outright anger and rejection of the individual. At times the stress of the problem can be a detriment to others in the family, and the family’s best recourse may be to distance themselves from the struggling individual in order to protect their own mental health. This is commonly referred to as “tough love”. This situation often causes more sadness and hopelessness in the family, who may struggle with the belief that they are “rejecting” their loved one.


Family Challenges

It is commonly understood that substance use disorder is a family disease. When someone is in the throes of substance use disorder, other issues may challenge the family, such as dishonesty, stealing, and rebelliousness. Often a family may feel that the person struggling with substance addiction is refusing to get better and intentionally not following through with treatment. This can engender much frustration and anger within the family.


Families can also be frustrated with the ineffectiveness or unavailability of competent mental health or addiction treatment resources. This often leaves families feeling alone and exhausted.


It is usually helpful for families to educate themselves about these issues. A better understanding of these issues helps with maintaining compassion for the person struggling. Learning that mental illness and addiction are not the consequence of laziness, rebelliousness, or a moral failure, is a fundamental step in this education.


Mental illnesses, including substance use disorder, are proven to have bio-chemical and social determinants. Brain structure and function are adversely effected. Judgement, impulse control, reasoning, and understanding of consequences are often impaired. These factors interfere with the person’s ability to follow through and understand their own treatment needs.


Helpful Resources for Families

There is help for families. Starting with a trusted health professional, such as a primary care doctor, pediatrician, school counselor or independent therapist, can help with understanding and coping. The National Alliance on Mental Illness (NAMI) is a source for information and support for families struggling with mental illness. AL-ANON, and NAR-ANON are free support groups helping families cope with substance use disorder in a loved one. An easy internet search can help you find these or other resources in your area.



You can find more helpful resources for young adults and parents/caregivers on our website. You can also check out The C.A.R.E.S. Group.