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Part II – how recovery for the family offers much-needed hope and healing when it addresses substance abuse as a family disease.

Part I: Impact on the Family

The structural glue that binds families together, for better or worse, is the learned but largely unspoken rules that emerge over time. Spouses, partners, children, and others in the family unit learn to behave and often to think in ways expected of them according to established family rules. These rules play a vital role in providing predictability. For example: Are there family dinners? What topics are off limits for family discussion? How are disagreements resolved? Are displays of anger, sadness, and sorrow permissible? How are love, affection, and respect expressed, if at all?

Despite these rules, families are inevitably in a state of perpetual transition and evolution; they are living systems. Within this ever-changing environment, individuals hopefully learn healthy life skills, such as the ability to effectively communicate with others, form meaningful relationships beyond the family, effectively manage emotional needs, and cope with disappointment and loss. Understanding the family as a dynamic system, continually reshaping itself in response to events and circumstances, is vital to understanding how substance abuse impacts the family and how the family, often unknowingly, tends to respond in unhealthy and unproductive ways. 

Substance abuse often occurs gradually, beginning as isolated or periodic episodes that progressively increase in frequency or intensity, not uncommonly over the course of many months or years. Like the proverbial frog in the pan of water that is unaware of its plight because the heat on the stove is being turned up very slowly, family members experiencing the subtle and progressive effects of substance abuse by one of their own are often similarly unaware of the trouble that is brewing.

As the addicted family member is increasingly drawn to the use of his or her substance of choice, increasingly larger amounts of time and energy are devoted to seeking, using, or recuperating from the addictive substance. In a very real sense, another relationship – that between the addicted member and his or her drug of choice – has become part of the existing family system. The other family members may be vaguely aware that things have changed but are often unable to identify exactly what is happening. They only know that home is no longer a safe place; that tension and stress have replaced safety and predictability; and that the person they once knew is now chronically irritable, short-tempered, or too tired or disinterested to interact in a healthy way with the rest of the family.

The Family’s Response

In response to the changes, each member develops, often unconsciously, his or her own coping strategies that over time become an integral part of the emotional and behavioral fabric of the family.  The non-substance-abusing spouse, partner, or children are often forced to ignore their own needs, as well as the needs of other members, as they seek, for example, to avoid confrontations with the addicted family member, to excuse or cover up the problematic behaviors of the substance abuser, or to deal with the financial consequences of substance abuse. Family rules that formerly provided safety and predictability are no longer working, and new rules gradually emerge. Supported by these new rules, family members both consciously and unconsciously develop new behaviors to adapt to and lessen the impact of the addiction. These rules and behaviors grow to eventually become a central organizing feature of the family system impaired by substance abuse.

Spouses and partners of the addict typically react in a variety of ways.

They may:

Take over chores or duties that were previously the responsibility of the addict;

Try to hide and sometimes even deny the existence of a family addiction problem;

Feel that everything in the family would be fine if only the addict would stop or control his or her use;

Feel guilty or responsible in some way for the addiction problem;

Develop feelings of resentment and anger toward the addict;

Withdraw socially and reduce contacts with friends and colleagues outside the family;

Lose their sense of self-respect and self-worth.

Children with a substance-abusing parent are also affected by the unhealthy family dynamics.

They may:

Avoid activities with friends, especially in the family home, out of shame or fear;

Stay away from the family home because of the unpredictability of the addict;

Feel deprived of emotional and physical support;

Develop negative ways of dealing with their own problems and of getting attention from parents and others;

Feel torn between parents, feeling loyalty toward one and anger toward the other;

Feel a diminished sense of self-worth as a valued member of the family;

Experience confusion and a sense of loss of the person they once knew;

Develop an inability to trust others.

When alcohol or other drugs are abused in a family, each member is affected in his or her own way. To some degree, however, each will invariably be affected and each will, in turn, affect others both in and outside the family. For example, the wife who has taken on added family and financial responsibilities due to her husband’s substance abuse feels guilty about having to ignore the needs of her children, who are themselves showing signs of lack of parental attention; mom’s drinking requires dad to leave work early so that their child is safe at home after school; the family no longer invites friends over to the house for fear of embarrassing substance abuse incidents. Addiction in the family creates a complex network of unhealthy actions and reactions.

Successful recovery of the family means considerably more than mere abstinence by the substance-abusing member. For months and often years, the family challenged by substance abuse has been functioning in an unhealthy manner to accommodate the disease. Members will need to unlearn coping mechanisms that evolved to adapt to the disease and learn new healthy thinking patterns, emotional responses, and behaviors.

Douglas S. Querin, JD, MA  OAAP Attorney Counselor

Douglas S. Querin, JD, MA  OAAP Attorney Counselor

Kathy B. Querin, MA, MFT, LPC   Licensed Professional Counselor

Kathy Querin is a Portland therapist in private practice, specializing in helping couples and individuals affected by another’s drug or alcohol use. She can be reached at or by phone at 503-620-4000.

Substance Abuse – Additional Resources



It Will Never Happen To Me. Black, C.A. (1987). Random House.

Growing Up Again: Parenting Ourselves, Parenting Our Children. Clarke, J.I. (1998). Hazelden.

Another Chance: Hope and Health for the Alcoholic Family. Cruse, S.W. (1989). Science and Behavior Books.

Facing Shame: Families In Recovery. Fossum, M.A., & Mason, M.J. (1989). W.W. Norton & Co.

Beyond the Influence: Understanding and Defeating Alcoholism. Ketchum, K., & Asbury, W.F. (2000). Bantam

Web sites:

National Council on Alcoholism and Drug Dependence (NCADD):

National Institute on Alcohol Abuse and Alcoholism (NIAAA):

National Institute on Drug Abuse (NIDA):

Oregon Partnership:

Oregon Attorney Assistance Program:  503-226-1057; 1-800-321-6227