Can Family Help With Substance Use Challenges?

Medically reviewed by Andrea Brant, LMHC
Updated May 25, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

When someone struggles with substance use, it may create consequences for the person with the dependence and those closest to them. Friends, family, coworkers, and others may be directly or indirectly impacted. 

If a family wants to help their loved one cope with or heal from their substance use challenges, it may be beneficial to learn of the potential outcomes by offering support. While family support and love may help with substance use and addiction, learning healthy support methods can be most beneficial. 

Do you have a loved one who is struggling with substance use?

Family roles in addiction: Can family help?

Family, like friends, may help their loved ones struggling with substance use by being supportive, present, and loving. Addiction can physically change the brain and cause people who are experiencing dependency on a substance to act or speak differently than they used to while using.  

Families may choose to be mindful of these changes and learn how to healthily support the struggling loved one, ensuring they aren't harming themselves or others. Methods families can utilize to support a loved one with substance use challenges can include: 

  • Learning about addiction
  • Seeking individual or family therapy
  • Setting healthy boundaries
  • Prioritizing your own mental and physical well-being
  • Helping your loved one find professional support as needed

Different families may have different roles, and these can change over time. The extent to which someone can be there for their loved one may also vary depending on life circumstances and other factors.

What is substance use?

According to the Center on Addiction, 16% of people over 12 partake in substance use to the extent that it is unhealthy. Substances can include prescription drugs, illegal substances, alcohol, or nicotine. Some struggle with more than one type of substance. 

Potential signs that someone is struggling with substance use may include:

  • Behavioral changes such as increased anger
  • Changes in social interactions with others
  • Changes in sleep schedule
  • A difference in physical appearance, such as a sudden lack of bathing or personal grooming 
  • Loss of appetite
  • Dishonesty and lying
  • Paranoia
  • Depression

These symptoms can also be associated with other mental and physical health conditions. Though a few of these signs may be present in your loved one, try not to make assumptions. If you know they are using or have reason to suspect that they are, there may be ways to support them. 

Family roles in addiction

Knowing that someone you love and care about is struggling with substance use can feel challenging to accept. It can be natural to want to find a way to help them through recovery. At the same time, you may feel negative emotions around the addiction.

For example, you could feel sad watching your loved one make poor decisions that negatively impact them. Or you may feel angry that they, such as parents consuming excessive amounts of alcohol, continue to struggle with substance use without seeming to care about its impact on themselves and your family.

You might also feel embarrassed about what others think of your family if they discover the addiction. These varying emotions can lead people to take on different family roles to cope with substance use. The different roles someone might take on include:

  • Caregiver/Enabler 
  • Hero 
  • Scapegoat
  • Mascot
  • The Lost Child
Getty/MoMo Productions

The caregiver/enabler

Someone who takes on the caregiver or enabler role often does it out of concern and care. However, it may indicate underlying self-serving behavior. For instance, they may be embarrassed that other people find out there is a struggle with substance use in the family. So, instead of allowing their loved one who is addicted to fail or experience consequences, they could make excuses for them to hide the addiction.

According to the American Psychological Association, an enabler may subconsciously enable or support a person's addiction. They may see a problem exists but don't know how to stop it. 

For example, it might be difficult for a parent to watch their adult child struggle because of their decisions and actions. The parent may try to help their child avoid consequences for their behaviors. They may worry that the consequences of their child's actions could cause a worsening in their mental health or dependency. 

The enabler could believe they are helping their loved one, but they may do the opposite. When someone struggling with addiction doesn't see and experience the consequences of their actions, they could believe their actions aren't harming themselves or others. 

Find yourself trying to help or "fix" someone's addiction for them. It may be more beneficial to refer them to professional services or counseling with a therapist or behaviorist that is equipped to handle the symptoms. 

The hero

The hero in the family may be a high-achieving individual with high standards for themself and their life. If the hero is a child and the people struggling with substance use are their parents, the child may be out to disprove what others think they will be capable of. Like the enabler, the hero may try to help their parents look acceptable to others.

While the hero may be successful, their behavior often comes with risks. They might find it difficult to process their emotions and work through challenging situations. Their quest to make things appear perfect could cause them to struggle when life brings challenges, and they may feel overwhelmed due to taking on so much responsibility.

The scapegoat

The scapegoat may be a family who struggles with behaviors, emotions, or communication. They might act out at home or be the subject of conflict in the family. If they are a child, they may be disrespected or neglected by their parents. The scapegoat may struggle with mental health concerns. 

Scapegoating is common in a family with unhealthy dynamics. Families might pinpoint this individual's behavior to try to avoid or take away from the behavior of the person experiencing substance dependency. 

The mascot

Mascots are often the comedians of the family. They may use humor to break up any tension created by substance use and addiction. When a situation is dangerous, they may make jokes or act silly to lighten the mood.

The lost child

The lost child may be considered a "positive influence" because they stay in the background and try to avoid the problem. Instead of looking for a way to help distract from the behavior, the lost child could withdraw. Withdrawal might include spending time alone in a different room or staying quiet when everyone else is chatting about a subject. 

The lost child's behavior may help keep them out of stressful family situations, but it could also cause them to struggle quietly and have issues asking for help when needed. They may feel lonely, neglected, or disrespected by their family. 

How family can help with substance use challenges

Awareness of your family's different roles may help you see which role you fall into and what you should look out for. Additionally, you can try to support your loved one through the following methods. 

Educate yourself about addiction 

Online resources, eBooks, or physical books may be available to help you learn more about addiction and substance use disorder. Dependence and addiction refer to conditions in which a person becomes reliant on something in their life. Dependence and addiction refer to conditions in which a person becomes reliant on something. Some use the terms interchangeably, but dependence vs addiction actually refers to two different stages of substance reliance. Reading about addiction may help you better understand how it happens. You might also gain empathy for the situation of your family. 

If you find resources for families of those struggling with dependency, you may learn what healthy behaviors might work and which could be more harmful. Asking your family how their addiction impacts them could also offer insight. 

iStock/JLco - Julia Amaral
Do you have a loved one who is struggling with substance use?

Try family therapy 

It can be helpful for a family to attend therapy together. Going as a group may allow each individual to express themselves and be heard in a safe, non-judgmental environment. Additionally, the therapist might provide addiction resources or coping mechanisms for the families to try at home when issues occur. 

Focus on your mental health 

When someone you love is struggling with addiction, it can be easy to prioritize their health and well-being over your own. However, it could be harder to cope with stressful situations when you're tired and experiencing mental burnout.

Focus on sleeping each night simultaneously, exercising into your days, and choosing healthy food options. Take time to participate in activities you enjoy so you can unwind, refresh, and be there for those you love.

Set boundaries 

Boundaries are often defined as rules you set with other people that teach them how you expect to be treated. They may help you stay healthy and avoid mistreatment.  

Boundaries can be physical or emotional and might be focused on time or space. Setting boundaries with your loved one could help you maintain your own mental health and keep the addiction from harming you and your life.

Addiction treatment options for substance use

There are different types of treatment options available for addiction, including inpatient and outpatient centers, as well as support groups. If you have insurance, you can check with your insurance provider to see if there are treatment options available with coverage. You can look for a therapist in your area or speak with your doctor to get more information about your options.

Opening up to family or friends about addiction may feel difficult, shameful, or embarrassing. You might not want to attend in-person therapy or commute for a session. In this case, you might talk to an online therapist. 

Online therapy can be a viable option for those struggling with a substance use disorder. It can also assist individuals who have been affected in some way by their loved one's addiction. One study found that internet-based therapy was an effective treatment option for those experiencing substance use disorder and other types of addiction. 

Recognizing a problem with substance use is often a first step toward getting help. Whether you or a loved one is struggling with an addiction, know that support is available. You can sign up for an online platform, such as BetterHelp, which allows you to reach care using a phone, tablet, laptop, or computer.


Substance use challenges can affect those experiencing them and their family and social circle. Family can help their loved ones in their journey toward recovery by ensuring they set boundaries, care for themselves, and act empathetic toward those they care about. If you are ready to try counseling, consider reaching out to a therapist to get started.
Seeking to explore family concerns in a supportive environment?
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