Substance use disorder damages relationships through 6 routes: family and children, money, mental health, lost interests, risky behavior and codependence.
Substance use disorder harms more than the person living with it. The disorder reaches the people around them, and personal relationships take the damage first, through the effects on mental health, on finances and on behavior.
The 6 sections below set out each route and the signs that go with it.
1. How Does Substance Use Disorder Change Marriage, Family and Children?
How Does Substance Use Disorder Reach the Whole Family?
Drugs and alcohol strain family relationships through neglected duties, time lost to hangovers, legal problems and an inability to stop at will.
Substance use disorder (SUD) is the recurrent use of alcohol or illicit drugs, or both, to the point where a person loses control of that use. The person then fails to meet obligations and responsibilities, and spends an inordinate amount of time getting, using or recovering from the substance.
Drugs and alcohol consume the time and attention that relationships need, which is what puts family relationships under strain.
The National Council on Alcoholism and Drug Dependence names 4 ways drinking and drug use reach family members:
- Neglecting important duties
- Taking time away from commitments to manage hangovers
- Encountering legal problems from choices made under the influence
- Losing the ability to stop substance misuse at will
Drugs and alcohol are discussed in terms of physical and psychological health. The damage reaches the person’s family and friends alongside the person themselves.
Social health is the quality of a person’s relationships and their capacity to sustain rewarding ones. Healthy relationships are integral to recovery, because social health and a supportive network track directly with a person’s success, self-esteem and happiness.
How Does Substance Use Disorder Reach Children?
Children of parents who misuse drugs and alcohol carry a higher risk of emotional difficulty, and they are four times more likely to develop a substance use disorder themselves.
The American Academy of Child and Adolescent Psychiatry (AACAP) found that 1 in every 5 adult Americans lived with a relative who misused drugs or alcohol during their adolescence.
People exposed to alcohol during adolescence carry a greater likelihood of emotional difficulty than children raised without drugs or alcohol in the home. That exposure shapes the person’s later relationship with substances, and children of parents who misuse alcohol are four times more likely to misuse drugs or alcohol themselves.
The AACAP records that children notice behavioral changes in family members under the influence of drugs or alcohol, and conclude that they caused those mood swings. That conclusion produces self-blame, guilt, frustration and anger.
How Does Substance Use Disorder Change Friendships?
Drugs and alcohol narrow a person’s circle to people who use, and push away the people who raise concerns about the use.
Rising drug and alcohol use changes who a person spends time with. People with substance use disorder push away those who care about them and raise concerns about their drug or alcohol use.
The attitudes of a person’s friends shape their behavior below the level of awareness, so relationships with people who drink heavily or use drugs reinforce those same habits.
2. How Does Substance Use Disorder Change Money and Finances?
Drugs and alcohol drain income through the cost of the substance, impulsive spending, lost productivity and lost employment. Binge drinking alone costs the United States $249 billion a year.
Supporting an active addiction is expensive. People with substance use disorder spend significant sums obtaining drugs or alcohol, lose the capacity to hold a steady job, and turn to others for money, food or shelter. Some also ask for financial help to pay for a treatment facility or program.
Lowered inhibition drives impulsive purchases made without weighing the consequences.
Drugs and alcohol also degrade productivity at work and at school. College students who binge drink earn lower grades, and those grades follow them into their employment prospects and salary. Employees who binge drink or drink heavily miss more work than employees who drink moderately. People who drink excessively leave their jobs earlier than they planned, as a consequence of alcohol’s long-term effects.
The Centers for Disease Control and Prevention records that binge drinking produces $249 billion a year in healthcare costs and lost employee productivity.
3. How Does Substance Use Disorder Change Mental Health?
Drugs and alcohol and mental health conditions co-occur in 8.5 million American adults, and each one drives the other.
The Substance Abuse and Mental Health Services Administration recorded in 2017 that 8.5 million American adults carried both a mental health condition and a substance use disorder, which clinicians call a co-occurring disorder.
Drug and alcohol use coexists with depression and anxiety. Depression or anxiety arrives first, and the drug or alcohol use develops out of self-medicating those symptoms.
Addiction also produces depression and anxiety in the other direction, because drugs and alcohol alter the balance of brain chemistry. Alcohol relaxes a person at first, because alcohol enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and diminishes the effect of the excitatory neurotransmitter glutamate. The brain adapts to that change by producing less GABA and more glutamate, which produces more negative emotion whenever the person is not drinking. The same adaptation follows other drugs.
Why Does Substance Use Disorder Produce Emotional Volatility?
Long-term drug and alcohol use weakens the prefrontal cortex, the brain region that regulates emotion and impulse, which is what produces the temper loss and mood swings.
Drugs and alcohol produce emotional volatility, meaning a quick temper and mood swings. Lashing out follows constant anxiety and a sense of being threatened. The pattern is sharpest where a person feels a loved one stands between them and their drug or alcohol use, because the substance registers as a basic need that the loved one is withholding.
Brain imaging studies record that long-term drug and alcohol use weakens the brain’s prefrontal cortex, which regulates emotion and impulse. The same studies record weakened connections between that region and the rest of the brain, particularly the reward centers.
The prefrontal cortex also governs attention, planning and self-control, and it moderates the emotional responses generated in older parts of the brain. Heavy drug and alcohol use weakens that region, which leaves a person open to emotional swings.
Why Do People With Substance Use Disorder Become Secretive?
People who misuse drugs and alcohol become secretive because they expect disapproval that threatens the use, and because illicit drugs carry legal risk.
A person with substance use disorder becomes secretive and takes greater care to protect their privacy. The person turns less talkative and more suspicious under questioning, grows wary that others are extracting information, and spends more time alone rather than saying where they have been.
Two reasons drive that secrecy. The person knows that disapproval from friends and family stands between them and drinking or using drugs. Illicit drug use, or obtaining controlled substances illegally, adds the risk of legal trouble for the person and for the people around them.
4. Why Does Substance Use Disorder Replace the Things You Enjoy?
Addiction becomes the most important thing in a person’s life, and every other interest loses ground to it.
The defining characteristic of addiction is that it takes first place and pushes everything else aside.
Time with family, a favorite sport, an absorbing hobby: each one loses ground to substance use. That loss damages relationships, largely because people do not accept coming second to a substance.
5. Why Does Substance Use Disorder Produce Risky Behavior?
Drugs and alcohol impair the prefrontal cortex, which removes a person’s foresight, and lowered inhibition then drives risks such as sharing paraphernalia, unprotected sex and stealing from family.
Drugs and alcohol produce riskier and less ethical behavior. Prolonged drug and alcohol use impairs the prefrontal cortex, which removes the foresight a person needs to anticipate the consequences of that use.
Lowered inhibition then drives a person toward risks including sharing drug paraphernalia and unprotected sex.
That loss of foresight reaches close personal relationships directly, including stealing from loved ones to pay for drugs or alcohol.
6. What Is Codependence in a Relationship With Addiction?
Codependence is a relationship in which one person relies on another for their emotional needs and self-esteem, and enables the drug or alcohol use in the process.
Codependence forms between two people using drugs or alcohol, between family members or spouses of a person misusing them, and in the children of a parent with substance use disorder. In a codependent relationship, one person relies on the other to meet their emotional needs and supply their self-esteem. Codependence also describes a relationship that enables a person to continue self-destructive drug or alcohol use.
Codependence shares traits with enabling. The needs and actions of the loved one with addiction frustrate the codependent person, who carries a compulsive need to take care of that person at the same time. The result is a dynamic in which the codependent person relies on the person misusing drugs or alcohol as heavily as that person relies on them. The codependent person’s identity wraps around the martyr role, a compulsion to serve and to sacrifice for their partner, while meeting their own needs for attachment and closeness through it.
The Substance Abuse and Mental Health Services Administration (SAMHSA) names 5 behaviors of a codependent person:
- Controlling others, on the belief that the other person cannot function independently
- Carrying low self-esteem and focusing on their loved ones over themselves
- Compromising their own needs and beliefs to keep their loved one calm and content
- Tracking the emotional changes of others closely
- Maintaining loyalty and commitment to their loved one without reciprocation
Where Can You Get Treatment for Substance Use Disorder in Tampa?
Riverside Recovery of Tampa treats drug and alcohol addiction in Tampa, Florida, across family therapy, residential treatment, outpatient services and aftercare.
Reach out to the Riverside Recovery of Tampa admissions team to learn how treatment works, where drugs or alcohol are damaging your relationships or those of someone you love. Choosing the right treatment is difficult, and the route through family therapy, residential treatment, outpatient services and aftercare depends on what fits you and your family.
Contact our team today to learn more about the levels of care available and how to get your relationships back on track.
Sources
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Substance Abuse and Mental Health Services Administration. The NSDUH Report: Data Spotlight. samhsa.gov
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Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Source for the 8.5 million adults with a co-occurring disorder. samhsa.gov
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National Institute on Drug Abuse. Commonly Used Drugs Charts. nida.nih.gov
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National Institute on Drug Abuse. Drug Use and Families. drugabuse.gov
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Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment and Family Therapy. TIP 39. Source for the codependent behaviors and the effects on family members. National Library of Medicine
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Centers for Disease Control and Prevention. Excessive Drinking Costs. Source for the $249 billion annual cost of binge drinking. cdc.gov
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American Academy of Child and Adolescent Psychiatry. Children of Parents with Substance Use Disorder. Source for the 1 in 5 figure and the fourfold risk in children. aacap.org