What Role Does Family Play in Addiction and Recovery?

March 23, 2020

Addiction is often called a family disease for many reasons. It tends to run in families as a result of both genes and learned behavior, often for generations. Dysfunctional family dynamics contribute to addiction risk and when one family member develops a substance use disorder, the whole family suffers. An ideal recovery situation is one in which the whole family recovers together. Here are some reasons why family is an integral part of addiction and recovery.


First, addiction has a significant genetic component. Studies of genealogy, twins, and adopted children have determined that about half of your addiction risk is genetic. That is if you have a parent or a sibling with a substance use disorder, it’s basically a coin flip whether you develop one too, regardless of other factors. Sometimes the connection between genes and addiction is very direct. For example, scientists have identified a variation on a dopamine receptor gene that is more common among people who are addicted to alcohol, cocaine, and opioids. Other genetic causes may be more oblique, such as when someone has a genetic predisposition to depression or schizophrenia. Because of this strong genetic influence on addiction, it’s not unusual to have three generations struggle with substance use. However, genes aren’t the whole story. 

Childhood Environment

Genes aren’t destiny; they only predispose you toward certain kinds of behavior. Childhood environment plays a big role too. Adverse childhood experiences, or ACEs, include challenges like physical or sexual abuse, neglect, witnessing domestic violence, having a parent go to jail, and others. Even fairly common events like divorce or having a parent with a mental health issue are considered ACEs. These have a major impact on addiction risk as well as the risk of developing mental or physical health problems. One study published in the North Carolina Medical Journal notes that people with five or more ACEs are seven to 10 times more likely to have drug and alcohol problems. As you might expect, having a parent with substance use issues significantly increases the risk of ACEs, since addiction makes it harder to provide a stable environment for a child. However, any sort of chaotic environment where a child feels unsafe increases the risk of ACEs and therefore the risk of addiction later in life.

Adult Relationships

Another way our childhood environment sets the stage for addiction later in life is that we often pattern our adult relationships on our childhood experiences. Dysfunctional family dynamics often lead to dysfunctional adult relationships. For example, abused children often end up with abusive partners and abuse is a major risk factor in depression and substance use. Another common pattern is that a child of a parent with a substance use disorder will learn that placating their parent makes life easier for the whole family. As a result, they often end up as the caretaker in a codependent relationship with someone who has a substance use issue. This is a significant risk factor for developing substance use issues of their own.

Encouraging Treatment

While the family often plays a role in developing an addiction, they can also play a role in recovery. The first thing they can do is to encourage treatment. Since someone’s substance use problem typically has negative effects on the whole family, it’s only normal for the family to feel hurt and angry. However, judgment and condemnation are not the way to help. Think of it as a knot—pulling on it only makes it worse. Instead, approach your loved one with compassion and concern. Listen and try to understand what they’re going through. Keep in mind that substance use is often a way to cope with pain or trauma. Try to help them see that life can be better and be willing to help them research treatment options and follow through. 

Participating in Family Therapy

Many treatment programs like to involve the family in treatment, typically through family therapy. As noted above, dysfunctional family dynamics often contribute to substance use and mental health issues. Often, families aren’t even aware they are dysfunctional. They are all just doing the best they can and their own family dynamic is the only one they’ve ever known. These dysfunctional dynamics are often characterized by poor boundaries; for example, certain family members may be domineering or manipulative, perhaps using threats or shame to get their way. Participating in family therapy can help you identify these dynamics and correct them. Family therapy also improves communication and boundaries among families, creating a much healthier environment for everyone.

Supporting the Transition Home

The transition from treatment back to daily life is often tricky. Clients go from living in a structured, supportive environment to the disorder of regular life. It’s important to have a safe environment to go back to after treatment. If the family is willing and able to provide that environment by keeping drugs and alcohol out of the house, staying sober themselves, and perhaps even continuing with family therapy, it can really help their loved one make a smooth transition and reduce the risk of relapse. 

Saying the family plays a role in addiction is not to say the family is to blame. Everyone is doing the best they can and we often behave badly with the best intentions. Parents with substance use issues are doing their best to cope with their own pain. However, it’s also important to recognize the context around addiction. It’s very hard to be healthy in a sick environment, so anything a family is willing to do to heal themselves will also help their loved one with a substance use disorder. At Steps Recovery Centers, we understand that recovering from addiction is a holistic process. We use time-tested 12-Step principles to help our clients heal and we do everything we can to help support their long-term recovery. To learn more about our programs, call us today at 385-236-0931 or explore our website. 

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