Substance Abuse and the Impact on the Family System

“My biological father was an alcoholic, during my pre-teen/teenage years. He could drink beer and generally be fine – most times, he was usually happy and only occasionally sad. However, when he drank Jim Beam, he became very mean. I would avoid him when he drank that, because he could become verbally and sometimes physically abusive. Looking back at that situation through adult eyes, I’m assuming my father drank the heavier stuff to help him cope with his and my mom’s marital issues. He was very unhappy. However, because my mom tends to default to an overly sensitive and angry personality when she’s drunk – no matter what it is that she drinks – the fights between them could get very bad. I remember that they were so bad, I spent almost a whole summer living at my best friend Sarah’s house to get away from it all. I hated coming home and hearing/seeing the both of them go at it, so I tried to avoid coming home altogether.”
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) one in every three people will develop a clinically significant alcohol problem at some point in their lives, and one out of eight people will become dependent on alcohol. Given these statistics, it is important to consider the significant impact substance abuse has on the individuals within a family system and the family system as a whole.

Family rules, roles and relationships are established and organized around the alcohol and/or other substances…-Marni Low

Family rules, roles and relationships are established and organized around the alcohol and/or other substances, in an effort to protect the substance-abusing parent(s) and for the child’s own protection and safety. In other words, these roles are established in order to maintain the family’s homeostasis and balance. As addiction progresses, or the using stops, the roles that have been established need to shift in order to adjust to these new behaviors and reestablish any balance that has been lost. This readjustment builds on the family’s strength, resiliency and coping mechanisms.

Addiction & Family Roles

There are six roles, including the addict, that have been developed and are used to understand and define how the family system functions around the substance abuser. These roles are identified as “The Enabler,” “The Hero,” “The Scapegoat,” “The Mascot” and “The Addict.” These roles can often be fluid and shift among family members depending on the onset of the substance abuse, developmental stages of the children, gender, age, birth order, parent/sibling relationship status and marital status – to name a few.

• • The Enabler is often the role taken by the non-using spouse, or if it is a single parent home, the oldest child or the child closet to the substance abuser. This person does everything in their power to ‘pick up the pieces’ that the addict has left undone. This can include ensuring all bills are paid, making excuses for the addict in social and business situations, ensuring the kids are going to school, maintain communication with family members and friends. The enabler is often in denial about the severity of the addiction and continues to make excuses for the addict. These behaviors are a defense mechanism in an effort to present a picture of ease to those outside the nuclear family. These behaviors are a baseline for the fear, anger, guilt, shame, concern, etc. that have been internalized.

This person also assumes a role of parentification as evidenced by taking on responsibilities that far exceeded their developmental stage…-Marni Low

• • The Hero is defined in the family as the person who appears confident, overachieving and serious. This person also assumes a role of parentification as evidenced by taking on responsibilities that far exceeded their developmental stage as in comparison with their peers. These responsibilities can include making lunch for their younger siblings and providing support to the non substance-abusing parent. This person likely also strives for perfectionism by getting straight A’s and being the star athlete. Given the nature of how alcohol and drug addiction progresses, this role is often difficult to maintain as “The Hero” feels that he/she is constantly needing to take on more and more responsibility. These outward behaviors are a baseline for feelings and emotions, such as inadequacy and guilt, stress and anxiety, which the individual has likely internalized.

These behaviors are a way to deflect the negative experiences that are happening at home…-Marni Low

• • The Scapegoat is defined as the child in the family who acts out with oppositional and deviant behaviors, such as getting in trouble at school and at home, and as they get older, with the law. These behaviors are a way to deflect the negative experiences that are happening at home and place blame for the chaotic environment on this child. The negative attention separates him or her from the family system and aligns them with systems outside of the home. This person often feels anger and resentment toward the substance abuser and chaotic home environment.

• The Mascot is the child in the family who uses comedy when facing uncomfortable and difficult situations that stem from the insecure environment established as a result of parental substance abuse and behaviors of “The Scapegoat.” The Mascot is aware of the sense of relief he or she brings to the family and will continue to sacrifice his/her own needs to maintain this balance.

• The Lost Child is isolative, withdrawn and does not appear to connect with any person within the family system or outside the home. This child has difficulty engaging with others and developing social skills. As a result this child engages in fantasy play as a way to disassociate and protective themselves (physically and emotionally), from the negative and chaotic home environment.

• What About The Addict? How does the substance abuser perceive how his or her drug and/or alcohol use impacts the family system? There are many responses to this question. Many addicts feel a strong sense of remorse, guilt and shame for the pain and distress they have caused their spouses and children, in addition to their extended families, friends and business endeavors. Many addicts don’t want to stop using, which creates anger and resentment from the family toward the addict, and the addict toward the family for placing pressure on them to stop using.

It is important to be aware that the roles established in childhood become behavioral patterns that often continue to play out into adulthood, within their own relationships and family system. The late onset of substance abuse by a parent when there are adult children creates another paradigm of family relationship issues. These patterns stem from the adult children having, for the most part, already established identities within the family and socially. There is often a blurred line between a parent/child relationship and parent/friend relationship, which can be confusing and disrupting to the homeostasis that has been established in childhood.

A family evolves with each individual change, both positive and negative, creating an ever ebbing and flowing system.-Marni Low

A family evolves with each individual change, both positive and negative, creating an ever ebbing and flowing system. The impact of substance abuse on the family system can be very complex and if not addressed can have a significant impact on all members of the family, throughout all stages of life and into the next generation. Evidence suggests family therapy provides the best outcomes for the substance abusers and the family.