When Someone You Care About Abuses Drugs or Alcohol

Published by: TELUS Health,

If you have a relative or friend who may have a drug or an alcohol problem, it’s important to know the warning signs of substance abuse. You’ll also need to understand how to approach the situation and learn about the resources available to the substance abuser, to you, and to any others who are affected by the problem.

Substance abuse is a very serious problem. When someone abuses drugs or alcohol, it can create serious impairment and lead to dependency on the substance, making it very difficult to stop using. The right kind of help can enable people to limit the harmful consequences, including health problems and damage to personal relationships.

Effects of substance abuse

On the abuser

Drug and alcohol abuse can cause serious problems, including significant health concerns. Untreated alcoholism can lead to conditions such as cirrhosis of the liver, increased cancer risk, heart disease, and damage to the brain. Drug abuse can lead to respiratory problems, weakened immune system, increased strain on the liver, heart conditions, seizures, stroke, brain damage, problems with memory and decision-making, death from an overdose, and other problems that are related to the drug that’s used. Alcohol or drug abuse can also result in:

  • family conflicts
  • loss of friendships
  • chronic feelings of guilt
  • low self-esteem
  • financial problems
  • difficulties at work
  • legal problems
  • mental health conditions such as anxiety, depression, psychosis or even suicidal depression

On others

Relatives and friends of substance abusers are also affected by the problem. The stress of living with or caring about someone with an abuse problem can lead to:

  • resentment
  • insomnia
  • anxiety
  • irritability
  • depression
  • frustration
  • guilt
  • embarrassment
  • social isolation

The effects of drug or alcohol abuse on a family member or friend can be dramatic. The substance abuser’s mood swings and crises are often felt by family members such as their spouse or partner, children, or a friend which may find their own lives becoming unmanageable.

Family members or friends may develop unhealthy ways of coping with the alcohol or drug problem. A spouse/partner or a loved one of an abuser may vacillate between hope and disappointment with increasing feelings of fear, confusion, anger, anxiety, and loss of self-esteem especially if there are numerous relapses. As the problem progresses, the partner or loved one may withdraw from others or feel more and more conflict, insecurity, and grief. They may eventually become an “enabler” or “co-dependent”—someone who supports the alcohol or drug abuse, often by “covering” for problems it causes. Someone who is co-dependent can become obsessed with trying to control an abuser’s substance use and dysfunctional behaviour.

Children may experience feelings of embarrassment, insecurity, and tension that develop into social withdrawal, powerlessness, and depression. As a parent’s substance abuse continues, the family may begin to live from crisis to crisis, and family members’ development may be affected.

Warning signs

The warning signs of alcohol or drug abuse aren’t always easy to recognise because the abuser may go to great lengths to hide the problem. Alcohol or drugs may have a negative effect on the person’s:

  • relationships with family members or friends
  • work
  • physical health
  • mental health
  • recreational activities
  • finances (caused by an inability to work or by spending money on drugs or alcohol)
  • legal concerns (which may include charges of driving under the influence of drugs or alcohol)

The person who is abusing drugs or alcohol may:

  • show personality changes under the influence of drugs or alcohol. For example, they may become extremely sad or happy. They may also be anxious and irritable when they do not have access to drugs or alcohol.
  • break commitments or promises because of the drinking or drug use, either while under the influence or while recovering from the effects.
  • experience significant behaviour changes. For example, they may become aggressive, violent or withdrawn, have obsessive thoughts or use denial. The person may miss work regularly.
  • seek out activities that include drug or alcohol use or change circles of friends.
  • put lives at risk by driving under the influence of alcohol or drugs.
  • be unable to stop using alcohol or drugs even when really trying, possibly to the point of hiding their drug usage.

Another common warning sign of substance abuse is that the person’s family, friends, or employer may express concerns about the person’s drinking or drug use. Even just one of these signs may mean that a person requires professional help.

Treatment options

Most people with drug or alcohol abuse problems need long-term support and professional help to stop using drugs or alcohol for good. Many kinds of help are available, depending on where the person seeking help lives and other factors:

  • Educational classes for learning about substance abuse and addiction.
  • Self-help support programs, that have a 12 step programme such as Alcoholics Anonymous and Narcotics Anonymous. These groups provide support and guidance about how to abstain from drugs and alcohol and also how to avoid relapse.
  • Detox retreats, where medical professionals can monitor a person’s wellbeing as they withdraw from alcohol or certain drugs.
  • Out-patient treatment, including individual and family counselling with a therapist or mental health counsellor experienced in treating substance abuse.
  • In-patient treatment, also called residential treatment which can be anywhere from 30 days to 12 months depending on the provider.
  • Combination out-patient/in-patient treatment.
  • Intensive out-patient treatment in which a person receives individual counselling, group therapy, family counselling, and educational groups that focus on addiction and relapse prevention. Participants attend sessions at least three times weekly.
  • Halfway houses, which provide longer-term emotional, residential, educational or vocational support.

Treatment usually starts with a formal assessment or evaluation to determine the extent of the problem and the best level of care. A trained substance abuse professional will perform a face-to-face assessment, either in a treatment centre or other professional setting. After the assessment is completed, a referral to an appropriate treatment provider is made.

Getting help for a substance abuser

Some people who abuse drugs and alcohol are aware of their problem and know they need help. Others have difficulty recognising their issues and admitting the seriousness of their problem. A variety of methods—sometimes called interventions—can help relatives and friends raise their concerns with someone who abuses drugs or alcohol. Those methods include one-on-one discussions between the abuser and a trusted family adviser, family meetings organised with the help of experts, and more structured formal interventions.

Getting help for you and your family

Many people and organisations can help if someone you care about is abusing drugs or alcohol, including the following:

Your doctor. Your doctor can refer you to a counsellor who works with families and friends of substance abusers. A GP may also advise you about helpful resources in your community such as advocacy agencies, support groups, and more.

Self-help groups for relatives and friends of substance abusers. You may want to look into Al-Anon or Nar-Anon Family Groups, which are self-help groups for relatives and friends of people who abuse alcohol or drugs.

Contact a treatment programme in your area. To find treatment providers and centres your area, go to the NHS Choices Drug Treatment Finder.

Abusing alcohol or drugs is a serious and sometimes life-threatening problem. Many substance abusers recover and go on to lead healthy and rewarding lives free from drugs or alcohol. You can help by encouraging the abuser to get professional help and, if you are having difficulty coping with the abuse, getting help for yourself, too.

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