DrugAbuse.GOV: Families

NAMI – When Mental Illness Enters The Family


Addiction is a Family Disease

Families of addicts, including both immediate family members and often extended family members as well, are affected in some way by the individual’s substance abuse. Addiction impacts a family’s finances, physical health, and psychological well being.

Family Roles in Addiction

In every family unit, each person plays a role (or multiple roles) to help the family function better and to maintain a level of homeostasis, stability, and balance. The effects of drug addiction on family members varies, but when substance abuse is added to this dynamic, the family roles naturally shift to adjust to the new behaviors associated with drug or alcohol use to continue maintaining order and balance.Including the addict, there are six family roles in addiction that are used to understand how the family functions around the substance abuser. Families of drug addicts include “the enabler,” “the mascot,” “the hero,” “the scapegoat,” “the lost child” and “the addict.”

  • The Enabler: This role is often assumed by a non-addicted spouse or an older child in single-parent homes. The enabler takes care of all of the things that the addict has left undone, including taking care of finances, ensuring children get to school and making justifications for the addict in social and business situations. The enabler is frequently in denial about the severity of the addict’s problem and will continually make excuses for him or her instead of getting them professional help like The South Suburban Council.
  • The Hero: This role is generally assumed by an older child in the family who overachieves and appears confident and serious. Heroes take on responsibilities in the home that seemingly exceed their developmental stage, and often assume parental roles. The hero is obsessed with perfection, so it makes the role increasingly difficult to maintain as addiction progresses and responsibilities continue to mount.
  • The Scapegoat: This is the child in the family who habitually misbehaves and displays defiant tendencies in the face of authority. These individuals often get into trouble in school and at home. As these children move toward adulthood, many get into trouble with the law as well. These behaviors are reflective of a poisonous and chaotic atmosphere in the house.
  • The Mascot: In an uncomfortable home environment, some individuals assume the role of the mascot and use humor as a coping mechanism. The mascot is aware that his or her comedy may be bringing a momentary sense of relief to the family and will continue to maintain this role in order to achieve balance and comfort in the home.
  • The Lost Child: The person in this role is isolated from other members in the family and has trouble developing relationships as a result. The lost child has difficulty in social situations and often engages in fantasy play to distract themselves both emotionally and physically from the negative home environment.
  • The Addict: Many chronic substance abusers feel great shame, guilt, and remorse about the pain and distress they’ve caused their families. However, there are also many addicts who do not want to cease their substance abuse. This choice can cause great anger and resentment throughout the family.

When these roles are established during childhood, they become behavioral patterns that continue to play out and evolve throughout adulthood.

The effects of drug addiction on family members when the addiction is developed later in life creates another set of issues, as many family roles have already been firmly set. The blurred line between parent/child relationships and parent/friend relationships also make the situation more difficult to remedy.

Children of Alcoholics and Drug Addicts

Addiction and family are closely tied but among all of the family members who are impacted by an addict’s disease, perhaps no one suffers as much as children. The effects of drug abuse on family members, specifically for children living with an addicted parent can be felt long after childhood and well into adulthood. Parental alcoholism and drug addiction can create poor self-image, loneliness, guilt, anxiety, feelings of helplessness, fear of abandonment and chronic depression in children. These problems can lead to more severe problems later in life. Maternal substance abuse during pregnancy can also lead to a host of behavioral and developmental disorders in children.

One in five adult Americans lived with an alcoholic relative at some point during their childhoods. Overall, these individuals are at a greater risk for behavioral and emotional problems when compared to children of non-alcoholics as these toxic alcoholic family roles form. Children who have alcoholic family members are four times more likely to develop alcoholism than individuals who were not raised by alcoholics. They are also more likely to have difficulty dealing with stress and highly likely to marry an alcoholic or abusive spouse later in life.

The effects of drug abuse on family members like children also extend to finances. The financial damage of an addiction can lead to a child being undereducated and malnourished. Children of alcoholics and other substance abusers are also likely to grow up in a highly unstable home. Children in these situations are unable to determine which parent they will get (sober or intoxicated) at any given moment and are often left to fend for themselves at times when adult supervision would be considered necessary. Going to school and having three meals a day is not as important as an addict’s next score. Basically, a person who grows up in a home with one or more addicts is often robbed of important aspects of his or her childhood. When illicit substances are involved, children are often unfairly exposed to illegal activities and may in some cases be asked to aid in these activities by lying about what their parents are doing. Additionally, parents abusing any substance are more likely to be involved with divorce, mental illness, unemployment, and legal problems, severely compromising their abilities to effectively parent.

Being Married to a Drug Addict

Addiction and family relationships do not mix well, but being married to an addict may be even more difficult. Especially in relationships where only one partner has a substance abuse problem, alcohol and drugs can ruin a marriage or long-term relationship. Alcoholism has been linked to higher divorce rates, and one partner’s addiction can lead to the other partner having to shoulder an unfair share of the household responsibilities.

A relationship with two addicts allows each partner to feed off of and enable the other.

When both spouses are equally addicted to drugs or alcohol, it may not increase the chance for divorce, but the household’s atmosphere will become much more toxic as a result. One sober partner can at least try to keep the house in order and encourage the substance abuser to get help. A relationship with two addicts allows each partner to feed off of and enable the other. This too will likely lead to the slow deterioration of the relationship, as both addicts will be primarily focused on feeding their addictions rather than cultivating the relationship or handling any household responsibilities.

The effects of drug addiction on family members can also cause codependency. It is an issue that often arises in spouses of addicts. The concept of codependency became widely popular during the 1980s. Broadly, it refers to an individual who is overly involved with another person to the point of dysfunction. When discussing codependency in addiction, the term refers to individuals who put the needs of the addict before their own, even when it is detrimental to their own wellbeing. Codependent people will often defend and make excuses for the addict and will do anything to remain in his or her good graces, being sure not to raise their ire. Early on, the term was often reserved for the wives with alcoholic husbands and drug addicts who relied on their spouse for financial wellbeing. Though codependent people are usually spouses, anyone who has an established relationship with an addict can become codependent.

Parents of Drug Addicts and Alcoholics

No matter how old a parent’s kids are, discovering that your children have an addiction problem can be an unpleasant, rude awakening. It may cause mothers and fathers to question their parental abilities or decisions they’ve made. Parents of addicts, much like children of addicts, often blame themselves for the development of the substance use disorder.

For teenagers and adolescents struggling with addiction, the problem can be perceived as being potentially more dangerous, because the child is not fully matured and has so much of his or her life ahead. This is also a critical time to try to stop the addiction before its grip is too strong.

  • Nine out of 10 Americans who meet the criteria for addiction began smoking, drinking or using other drugs before age.
  • 75 percent of all high school students have used an addictive substance. One in five of those students meet the criteria for addiction.
  • 46 percent of all high school students currently use an addictive substance, with 33 percent of them meeting the criteria for addiction.
  • 10 percent of all youth aged 12 to 17 are current illicit drug users.
  • An estimated 6 percent of 16- and 17-year-olds and 17 percent of 18- to 20-year-olds reported driving under the influence of alcohol within the last year.

At least when parents have teens and adolescents who have substance use disorders, they have some level of power in that they control the finances and the household. This power can be wielded to stage a professional intervention and to get them to accept treatment. With parents of adult addicts, however, the ability to impose consequences for substance abuse or the unwillingness to seek treatment is greatly diminished. This holds even truer when the parents live separately from the addicted daughter or son.

The effects of drug addiction on family members can even extend heavily to grandparents. According to the U.S. Census, the number of children being raised by their grandparents skyrocketed from 2.4 million in 2000 to 4.9 million in 2010. Two of the primary causes of this increase are addiction and mental disorder.13 When the addict has young children, the grandparents or other extended family members are often the ones who pick up the slack in parental duties.

Domestic and Sexual Abuse are Linked to Substance Abuse

Another connection between addiction and family relationships involves various types of abuse. There is an unfortunate and tragic cycle that includes substance abuse, sexual abuse/rape and domestic/child abuse. Several studies have found that a large percentage of child abuse and domestic abuse cases involve the use of drugs or alcohol. Other studies have found that individuals who were victims of abuse were more likely to abuse drugs or alcohol. This means individuals who grow up in a home with substance abusing parents are more likely to experience some sort of domestic or sexual abuse leading to trauma, which will then make them more likely to abuse drugs or alcohol themselves. If they have children as well, the cycle has a strong chance of continuing. If your family falls into this category, our domestic violence and addiction treatment may be able to help.

As many as two-thirds of all people in treatment for drug abuse report that they were physically, sexually or emotionally abused as a child.

  • A woman is beaten every nine seconds in the United States.
  • More than three million children witness violent acts against their mothers each year.
  • Between 30 and 40 percent of children who witness or experience violent acts will be at an increased chance of becoming involved in a violent relationship in adulthood.
  • Between 25 and 50 percent of men who commit domestic violence also have substance abuse problems.
  • As many as two-thirds of all people in treatment for drug abuse report that they were physically, sexually or emotionally abused as a child.
  • One in four women has been a victim of rape, sexual assault or domestic abuse.
  • As many as 80 percent of child abuse cases involve alcohol or drug use.
  • More than half of defendants accused of murdering their spouses (as well as nearly half of the victims) had been drinking alcohol at the time of the incident.

The effects of drug addiction on family members can change drastically when abuse is involved. A person who experiences or witnesses abuse, sexual assault or rape has a high likelihood of struggling with symptoms of post-traumatic stress syndrome and/or depression. Both conditions often lead individuals to use drugs or alcohol as a means to cope. This pattern then potentially leads to the development of tolerance and then full-blown addiction.

Discussion and Conclusion

Nearly every person in contact with an addict is impacted in some way.

It’s rare that the effects of an addiction are limited solely to the addict. Everyone around him or her is affected in some way. Frequently, the people who spend the most time around the addict are friends, family, and co-workers – these are the people who are likely to be most impacted by drug addiction or alcoholism. Family members, especially non-addicted spouses, are forced to pick up the slack for the addict, make excuses for his or her behavior, and potentially endure sexual, physical and emotional abuse. In many cases, extended family members and close friends have to help financially and in other ways to account for the ignored responsibilities by the addict. Children suffer in school and are more likely to be involved with drugs and alcohol as adults. Coworkers are not always as close to the addict, but they may also be affected by having to increase their workloads to make up for diminished job performance. Nearly every person in contact with an addict is impacted in some way. This is why a South Florida residential drug rehab can be so impactful. The recovery is also most successful when the friends and family members closest to the addict are involved. Since the effects of drug addiction on family members are so strong, addiction recovery needs to heal the whole family. If your family is suffering from a loved one’s addiction, our addiction family programs in Palm Beach may be able to help.


  1. NCBI – Substance Abuse Treatment and Family Therapy
  2. Pro Talk A Rehabs.com Community – Substance Abuse and the Impact on the Family System
  3. Addiction in Family – Unhealthy Families
  4. AAETS – Effects of Parental Substance Abuse on Children and Families
  5. American Academy of Child & Adolescent Psychiatry – Alcohol Use in Families
  6. Addiction.com – Alcohol Abuse Linked to Higher Divorce Rate
  7. Medical Daily – Heavy Drinking Will Lead To Divorce, Unless Both Partners Are Equally Alcoholic
  8. DualDiagnosis.org – Codependency and Substance Abuse
  10. NCCP – Adolescent Substance Use in the U.S.
  11. U.S. Census Bureau – Grandparents as Caregivers
  12. Psychology Today – Grandparents Raising Grandchildren
  13. NCADV – Domestic Violence Fact Sheet
  14. SafeHorizon – Domestic Violence – Afraid to stay, afraid to leave?
  15. NCBI – Substance Abuse Treatment and Domestic Violence.
  16. NCBI – Substance Abuse Treatment and Domestic Violence
  17. NIH – Exploring the Role of Child Abuse in Later Drug Abuse
  18. CDC – Sexual Violence, Stalking, and Intimate Partner Violence Widespread in the US
  19. NCBI – Preventing child abuse and neglect: programmatic interventions.
  20. Bureau of Justice Statistics – Violence between Intimates: Domestic Violence


Parents and Families

Access resources for families and family-run organizations supporting behavioral health recovery and resilience for children, youth, and adults.

Families affect and are influenced by the recovery experiences of children, youth, and adults with mental or substance use disorders. As caregivers, navigators, and allies, family members play diverse roles and may require a variety of supports.

Families and family-run organizations are vital components of recovery-oriented service systems. Family members train and support other families—sharing lived experiences and insights that instill hope, increase understanding, and contribute to systems transformation.

Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) partners with the National Federation of Families for Children’s Mental Health (NFFCMH), the National Family Dialogue on Substance Use Disorders, and others to support families of children, youth, and adults with behavioral health needs.

Help for Family-Run Organizations

BRSS TACS offers intensive, individualized technical assistance to help achieve goals and maximize impact. Subject matter experts can assist family-run organizations with developing:

  • Organizational infrastructure
  • Sustainability planning
  • Leadership and succession planning
  • Family peer support programs

Examples of technical assistance include:

  • Coaching, training, and intensive consultation
  • Peer-to-peer connections
  • Resource dissemination

Learn more about BRSS TACS training and technical assistance.

Increasing Family Engagement and Voice

BRSS TACS helps programs, organizations, and systems strengthen family engagement and voice. Our team includes family leaders with expertise in implementing models in a range of settings and can deliver consultation, resources, training, and facilitation.

Parents and Families Resources

The following resources can further assist families and parent-run organizations. Please read the SAMHSA.gov Exit Disclaimer for more information on resources from non-federal websites.

Access video trainings on parents and families, youth and young adults, and other topics.

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