Addiction is a Family Disease
From the addict’s perspective they often see how their drug use behavior is only causing harm to themselves. But the people around them are affected by the deception, the failure to follow through on responsibilities, the inconsistent behavior, the crises and sometimes public embarrassment when their loves one’s behavior results in a story in the newspaper.
A troubled family system, no matter the cause, typically arranges for one member to serve as the “designated patient”. This is often the family member who presents for treatment first. Mistaking this person as the focus of treatment results in inadequate treatment. This focus misses the rest of the family members struggling with addiction in some form. Sometimes the struggles take form as emotional difficulties such as depression or anxiety. Other times the other family members develop their own substance use or addictive disorders.
One of the families I worked with recently connected with treatment services through their very bright and engaging college age daughter. Melissa had been asked by the school to take a medical leave of absence due to a violent incident with her roommates and the police after she ingested a substantial amount of alcohol and other drugs that she cannot identify. Melissa was a sophomore whose grades had been deteriorating as her drug use increased. She was binge drinking on the weekends that now began on Thursday evenings and also included large quantities of marijuana and occasional use of other drugs such as hallucinogens and benzodiazepines.
I regularly meet with members of a client’s family and found Melissa’s parents, Carol and Fred, eager to join us when I called to schedule an appointment. As I spoke with Carol and Fred our discussion quickly moved from a focus on Melissa’s problem to their own drug use. Fred readily admitted to “a few cocktails” every evening after work. Melissa and Carol then reminded him of numerous incidents at social gatherings where he needed to be driven home and at times made some embarrassing comments that required apologies the next day. Melissa then reminded her mother of their shared enjoyment of marijuana and asked the older woman to stop “borrowing” some of her stash without asking her. Carol and Fred looked sheepish but to their credit continued our discussion. I work really hard to maintain a non-judgmental attitude through these types of meetings and I think that might have helped.
We then began to discuss the other kids in the family, Melissa’s brothers and sister. Melissa was back living at home with a younger brother and sister in high school. There was also an older brother living in Washington, DC where he worked. Melissa, Carol and Fred all agreed that they were worried about the older brother’s alcohol consumption. Although he was successful at work and had a long-term girlfriend, he was on probation for a DUI charge and had been hospitalized twice for detox. Melissa’s younger sister was the source for the drugs in the house. A high school senior, she had dropped her AP courses, taken herself off the college track and spent most her time getting high in one way or another. Melissa’s younger brother, a high school sophomore had started smoking cannabis in middle school and now partied regularly with his older siblings.
As we reviewed the drug use and related consequences of each member of the family, I could see that Carol and Fred were gaining clarity on the difficulties within their family. They knew that their children were drinking and using drugs but were unaware of the extent. Their children are bright and resourceful and good at hiding their behavior from their parents. Both Fred and Carol were well educated and successful professionals who have done the best they could creating successful careers for themselves while raising four children. However, none of that success can completely protect a family from the problems of substance use and addictive disorders. The good news is that they are six strong people who are committed to each other and are willing to dive in to work on these problems.