The stigma and shame associated with substance use often means families and caregivers suffer in silence. To find out that someone you care about is using substances can leave you feeling angry, fearful, and confused. Family members of drug abusers commonly exhibit shock; isolation arising from societal stigma; victimization from being treated as social outcasts; shame associated with the taboo issue of drugs; hopelessness, and grief. Short-term effects include stress, loneliness, anxiety and guilt. Longer-term effects include major changes in physical health, such as ulcers or high blood pressure, as well as psychological problems, including depression, behavioral disorders, panic attacks and nervous breakdowns. Relatives report the deterioration of family relationships, an increased likelihood of domestic violence, and a negative impact on their social life and finances.
The degree of trauma on parents and siblings varies. Family members who find their child or sibling collapsed in bed nearly dead from an overdose of any drug, who experience a surge of adrenalin to handle the emergency, most likely have never processed the crisis and may have haunting recollections and nightmares. There is a psychological injury that results from protracted exposure to prolonged interpersonal trauma, a disempowerment or feeling trapped, which parents or siblings suffer, knowing they are responsible for keeping the drug dependent from grave danger.
Many of these families are in need of professional or informal support and information. Those who live with and look after substance abusers are a hidden and isolated group, mainly due to feelings of shame and guilt. Services focus primarily on the needs of the substance abuser and not on the needs of the affected family members. Society must have a positive approach to dealing with affected families by empathizing, being compassionate and most importantly, not treating drug abuse as a taboo topic.
Coming from an affected family myself, I suggest that such parents be counseled not to feel guilty for seeking help and not to brush the issue under the carpet.
The devastation to parents when their children turn to drug addiction is incomprehensible. When society behaves insensitively by making or giving out vibes like, “look at your enabling behavior,” these affected families are rightly offended and further traumatized by the lack of empathy for their current state of grief. The emotional toll is therefore very high on affected families. The most painful thing that parents have to deal with is integrating drug abuse patients back into society. Parents are sometimes made to feel guilty for openly seeking medical, psychiatric and psychological help for their adult children who are caught in the grip of addiction.
Coming from an affected family myself, I suggest that such parents be counseled not to feel guilty for seeking help and not to brush the issue under the carpet by playing ostrich. If we see a stranger standing on the ledge of a 14-story building about to jump off, wouldn’t we at least call emergency services and try to save a life? If we would do that for a stranger, why not for your own child, who sadly is standing on the proverbial window ledge of addiction? We need to realize that precious lives are at stake.
Without fail, along the way, family members suffer severe abuse from the addict patient too. This abuse comes in several forms: overt, structured, impulsive and covert. Overt abuse is clear-cut and easily recognizable. Cursing, name-calling, fighting and verbal threats are obvious forms of abuse. If a beloved son or daughter is standing in the kitchen threatening parents with a knife, it is easy to describe. If a young drug abuse patient is throwing things, kicking at doors, one has evident visible damage.
Sometimes addicts manifest what is known as structured abuse, abusing everyone around them, including relatives, friends and authority figures, not just parents. The abuse is predictable and everyone gets a fair share. Some addicts are more impulsive and unpredictable. They are nice at times but sometimes they strike ‘out of the blue’ in a flurry of chaos. One never knows when the rage fit will hit.
Covert abuse, on the other hand, revolves around the abuser’s need to assert and maintain control over their family members. Covert abuse may not be visible to others, who continue to see the drug abuser as charming. They will say, “Oh, you are making a big deal out of nothing.” Or, “They will grow out of it, quit nagging them.” Covert abuse is emotional and manipulative. It takes advantage of trust and costs parents their self-esteem and confidence. Covert abuse is made all the more painful because others do not see the emotional damage – they only see a seemingly ‘crazy person’ dealing with the aftermath of addiction.
Finding out how other parents, including mine, have dealt with this menace can be reassuring. These are brave parents and caregivers who share their traumatic experiences. From a truly delightful and loving son, Usman (name changed for privacy) was the most caring and kind son any parent could have wished for; adored by all around him. Now his family’s life is a roller coaster; never knowing what he is up to and never truly trusting him. He does not seem to care about anything or anyone, least of all himself. From being healthy, good looking and sociable, he is now fat, paunchy and reclusive. It has been the most heart-breaking experience to see their beloved son gripped by the evils of drugs, not to mention the associated lying and deceitfulness that accompany his habits. His parents are at risk of losing their friends and family, who can only take so much. Drug addicts like Usman have left those around him feeling despair, loneliness and hopelessness. They mourn the death of the son they once had. Addiction does not just attack the drug user. It whittles away at the people around them.
Drugs and alcohol have unfortunately taken a foothold amongst our younger generation on an epidemic scale. Today, we see a high percentage of first-generation drug abusers. Validating the stress that families endure would be the first step in the right direction. Self-help and support groups can be an easily accessible source of support and information. Helping families recognize and heal their traumas, and helping the addict show empathy towards those who love them, should be the main focus of all medical stakeholders, including doctors and rehabilitation counselors. We can help these brave but highly traumatized families in fighting the long battle against drug addiction.