Ask the Therapist: Alcohol, Addiction and the Family

Last year when COVID-19 hit, alcohol became an essential coping mechanism for many Americans, spurring a 54 percent increase in U.S. alcohol sales, according to a study by Nielsen Media. “Many of these people became dependent on the drug,” says Brien Garcia, a mental health therapist at Baptist Health’s Recovery Village. “And, yes, alcohol is a drug, along with opioids, cocaine and morphine.”

In a study published by the American Psychological Association, nearly one in four adults (23 percent) reported drinking more alcohol to cope with their stress during the coronavirus pandemic. The numbers rose even higher (52 percent) for parents of elementary school children five to seven years of age.

What is Drug Addiction?

According to the American Society of Addiction Medicine (ASAM), addiction is a chronic, treatable medical disease with the possibility of remissions and recovery. “The description defines any individual who is dependent on a drug,” says Mr. Garcia, who specializes in substance abuse, marriage and family therapy. 

What Prompts Addiction?

“The main reasons people turn to drugs is to escape a situation or issue that needs to change in their lives but for whatever reason they’ve been unable to make that change,” Mr. Garcia says. “As a therapist, I recognize many common situations among my patients. Perhaps they live in a dysfunctional family or maybe they’re depressed – consciously or unconsciously – because of some unresolved issues.”

As time passes and those issues remain unresolved, Mr. Garcia warns, the short-term satisfaction can turn into a long-term disability. In some cases, such as a traumatic experience or a similarly significant situation, it could take two to three years after the event for a substance use disorder to become apparent, he says.

When a parent is an alcoholic, the children are negatively affected as well, according to Mr. Garcia. “The child becomes the parent, or the ‘parentified child,’ because the parent or parents are not responsible,” he says. Teachers and therapists have learned to recognize some of the symptoms of neglect, he adds. “Maybe the child is underfed and malnourished,  or is having issues at school. Sometimes stress and anxiety can cause kids to act out in inappropriate ways or exhibit symptoms that can mimic Attention Deficit/ Hyperactivity Disorder, or ADHD.”

How Does Addiction Work?

“Developing an addiction is a neurologically complex process,” Mr. Garcia notes. “You ingest a substance – whether it’s alcohol, marijuana, opioid, cocaine or whatever – and the neurochemicals in your brain begin to flood the brain with dopamine. The dopamine increases those feel-good sensations, which are typically associated with exercise, food and sex. Once the body gets addicted to the substance, the body adjusts to the chemical and the body no longer feels good without the drug.” 

Eventually, Mr. Garcia adds, you find you must take more and more of the drug in order to feel “normal,” and if you stop using the drug, your brain experiences withdrawal symptoms. “Even though you may think your cravings have been reduced, the neurological pathways in your brain are asking for the drug and your brain entices you to relapse,” he says.

There are many ways a person may become addicted, notes Mr. Garcia.  The chronology of how easily and innocently addiction can occur goes something like this:

• A student goes to high school, has no major issues, befriends someone who is an influencer and a user and gets attached. The student begins to use the substance regularly, gets anxious and depressed, and becomes addicted.  
• A person who may have difficulty socializing sees how easily their self-esteem increases with the use of drugs which enables them to survive socially. Hence the motivation to continue using the drug.
• Boredom prominent relapse factor that is being recognized by individuals using substances today. If a person is at home alone and has nothing to do, the mind begins to wander and promote anxiety, leading to a potential relapse. Boredom has been known to be a significant relapse factor.
• Drinking a beer or a glass of wine can help a person escape from stress. However, if you have chronic stress, anxiety or depression, excessive drinking may lead to addiction, in cases where an individual wakes up feeling depressed and begins drinking at 9 a.m. to reduce their symptoms.
• Drug abuse can happen anywhere and anytime. People use drugs everywhere, and nobody is immune to substance use.

Addiction Affects the Entire Family

“As Aristotle once said, ‘The whole is greater than the sum of its parts,’ quotes Mr. Garcia, who says better outcomes are possible if you treat not just the patient but the entire family as a unit.

“Everyone in the family affects each other, recognizes the addicted individual as the problem and is negatively affected by them. ” Mr. Garcia explains. “In some families, however, there may be an underlying issue where the family becomes the enabler. Instead of saying ‘We’re not going to facilitate your addiction,’ they tend to ignore and support it.”

There are several common issues that develop within families who have addicted members. Included among them are:

• Trust Issues – The person using substances says they’re going to quit, but people tend to lie and manipulate in order to find some way or someone to find the drugs, doing anything to get them.
• Increased Stress on Partner – When the addicted individual can’t keep up with the demands of daily living unable to fulfill their responsibilities at home or work, that leaves one person – you! – doing all the work.
• No Clarity – Not knowing what to expect from one day to the next can be very stressful for every member of the family.
• Explosive Behavior – This includes domestic violence, tension and anxiety, and is typically more prevalent in males. There has been a significant increase in explosive behavior during the pandemic. 
• Financial problems – The person can’t keep a job, isn’t performing at optimal levels, or spends all their savings. Substance use can be very costly – 50 to 100 dollars a day or more depending on the drug and amount of use.
• Abuse – This includes domestic violence, drug use, sexual abuse, and physical, psychological or emotional abuse.

Coping Strategies for the Family

• Communicate: attempt to talk with the individual when they are sober, not under the influence. Provide information about health risks, share how the individual is being negatively affected by their addiction.
• Bring an interventionist to the home, or someone in the family – the more people, the better.
• Don’t enable the addicted individual.  
• As a parent, recognize there may be a feeling of guilt associated with having an addicted child or young adult.
• Consider group or family therapy where everyone comes in and communicates and the therapist is the mediator – it improves your communication skills and builds your emotional vocabulary.
• Get therapy yourself to reduce anxiety and depression. Other people in the family might be feeling anxious, too.
• Consider rehab – There are some phenomenal treatment programs and protocols that can include detox, medications to wean them off the drug, and other therapies.
• If you’re experiencing panic attacks or overwhelming sensations, learn breathing techniques which help stay anchored in the “here and now”, bring down your heart rate and calm you down.

“Take care of yourself before helping others,” Mr. Garcia advises, “because chasing an individual who doesn’t want to be helped is not within your control, and you don’t want to be two individuals on a sinking boat.” 

If you or someone you know is struggling with addiction, think about reaching out to a medical professional, a primary care physician or a therapist to talk about what’s going on, Mr. Garcia suggests. “Over the past year and a half, with the pandemic, telemedicine platforms such as Baptist Health Care On Demand have made it easier than ever to connect with people who can help you,” he says.