Loved ones can be as entrenched in the negative cycle of addiction as the substance abuser himself. Invariably, those involved in a relationship with a substance abuser – be it a parent, friend, or intimate partner – will come across the argument that they may be enabling the drug abuse in one form or another. They may even hear that they have a “codependent” relationship with the substance abuser. But what do these terms mean, and how are they different?
Enabling vs. Codependency
According to Allan Schwartz, PhD, codependent persons display enabling behaviors, though not all persons who enable a substance abuser are codependent. One of the hallmarks of codependency is that a loved one becomes so consumed with caring for, rescuing, or “fixing” the substance abuser’s life that she doesn’t live her own in a fulfilling, satisfactory way. The codependent person’s identity and feelings of self-worth get wrapped up in the illness of addiction. At this level of involvement, it can be exceptionally difficult for the codependent person to realize her negative contribution to the disease.
A codependent’s support can be dangerous. As Schwartz discusses, he has personal experience with the risks associated with a family’s enabling behavior. He recalls an occasion when friends asked for a therapist referral for their daughter, whom they described as depressed. In addition to being depressed, the daughter was in fact a long-time opioid abuser. The daughter was under the care of a psychiatrist, but for depression and not opioid abuse. Neither the daughter nor her parents disclosed her substance abuse to the psychiatrist. The daughter tragically passed away from an overdose. The parents had the best intentions for their daughter, but their enabling behavior – protecting the daughter from having to confront the opioid abuse – contributed to the loss of her life. An unfortunate detail, as Schwartz notes, is that the parents sincerely did not realize how they were enabling their daughter’s opioid abuse when keeping it a secret from everyone, including the psychiatrist.
A Family Disease
Addiction specialists are in agreement that substance abuse is a family disease. Family dynamics often play a role in the development of substance abuse and the maintenance of that abuse, and they can even contribute to a relapse. But on the other hand, families often play a key role in getting a substance abuser into treatment and assisting with aftercare (i.e., helping the substance abuser to maintain sobriety). In this way, the role of family in substance abuse appears to be like that of a poison/antidote.
As the National Council on Alcoholism and Drug Dependence explains, family and other loved ones misconceive of substance abuse as something that can be fixed, and once fixed, everyone will automatically be healed and have a “normal” life. There is often a misconception that the substance abuser is the one with the
“problem” – but this is often not the case. It may seem as if the substance abuser is the only addict in the family but that is not likely true. Codependency is a co-addiction and one that the family may not be able to see.
Loved ones of substance abusers may be able to describe in detail the positive contributions they have made to recovery, such as getting the substance abuser into rehab, but it may be far more difficult for them to see the ways that they enabled the initial use, and even helped to trigger a relapse. Substance abuse is often a sign that a family is in distress and needs to transforms itself from the inside out. The substance abuser alone does not need to recover as much as the entire family needs to recover from long-standing wounds.
What You Can Do When Relapse Happens
At the outset, it is important for family members and other loved ones to understand that a relapse is not a failure. Relapse often signals that a new treatment intervention is necessary. As discussed, there are several reasons why relapse occurs. In some cases, the treatment facility may not have been the best match (such as a dual-diagnosis client entering a rehab program that is not sufficiently set up to treat co-occurring disorders). However, even the most successful rehab programs cannot benefit a substance abuser who does not sincerely and adequately commit to the recovery process.
While there are many outpatient programs with successful recovery rates, some substance abusers may require the even greater round-the-clock care of an inpatient rehab service. One of the greatest ways a family can assist a relapsed substance abuser is to identify an appropriate rehab center, and ensure that it offers a comprehensive, thorough intake process, and well-structured treatment plan.
As discussed, substance abuse is a family disease, and it is most advisable that family members help treat addiction by working on themselves therapeutically. For those family members who have a loved one in rehab, the treatment center may offer a host of options, including family therapy group meetings, individual counseling, and educational programs. Outside of the rehab center, or if the substance abuser is not in rehab, family may seek individual psychotherapy sessions (which most health insurance plans cover) and attend Nar-Anon or other group recovery meetings.
Nar-Anon is a national network of group recovery meetings aimed at helping family members and loved ones affected by substance abuse. Nar-Anon groups replicate the traditional 12 steps of its parent organization Narcotics Anonymous. Family members are usually welcome to attend Narcotics Anonymous meetings with the substance abuser, but the focus of this group is on the user’s perspective, and the family members may not receive adequate support. Nar-Anon developed to address the specific needs of family members and loved ones.
Nar-Anon is founded on principles of spirituality and faith. Hallmarks of the program include recognizing the impact of the loved one’s addiction, engaging in honest and nonjudgmental communications between members, and providing one another with mutual support. Those who are interested in group recovery meetings but not drawn to the spiritual foundations of Nar-Anon are best advised to get a recommendation from an addiction specialist, psychotherapist, or research local opportunities online.
Recovery may start with the substance abuser, but it doesn’t end with him. Family members who recognize how their behaviors can unintentionally contribute to a loved one’s initial substance abuse or a relapse will also realize how actively taking steps to help themselves can help everyone.
At Orlando Recovery Center, help is available not only for those struggling with substance abuse, but for their loved ones as well. It’s our goal to provide family members with much needed information on how they can support the individual in recovery, as well as how to take proper care of themselves.