Question

Lets look at drug abuse on the home setting. What are some of the impacts that drug abuse can have on the setting of a home. What factors if any contribute to rebuilding the home setting after drug abuse has been discovered in the household? What factors could cause the issue to spiral out of control if not addressed?

Answer 1

Family structures in America have become more complex—growing from the traditional nuclear family to single‐parent families, stepfamilies, foster families, and multigenerational families. Therefore, when a family member abuses substances, the effect on the family may differ according to family structure. For example, the non–substance‐abusing parent may act as a “superhero” or may become very bonded with the children and too focused on ensuring their comfort. Treatment issues such as the economic consequences of substance abuse will be examined as will distinct psychological consequences that spouses, parents, and children experience.

The effects of substance abuse frequently extend beyond the nuclear family. Extended family members may experience feelings of abandonment, anxiety, fear, anger, concern, embarrassment, or guilt; they may wish to ignore or cut ties with the person abusing substances. Some family members even may feel the need for legal protection from the person abusing substances. Moreover, the effects on families may continue for generations. Intergenerational effects of substance abuse can have a negative impact on role modeling, trust, and concepts of normative behavior, which can damage the relationships between generations. For example, a child with a parent who abuses substances may grow up to be an overprotective and controlling parent who does not allow his or her children sufficient autonomy.

People who abuse substances are likely to find themselves increasingly isolated from their families. Often they prefer associating with others who abuse substances or participate in some other form of antisocial activity. These associates support and reinforce each other’s behavior.

Any communication that occurs among family members is negative, taking the form of complaints, criticism, and other expressions of displeasure. The overall mood of the household is decidedly downbeat, and positive behavior is ignored. In such families, the only way to get attention or enliven the situation is to create a crisis. This negativity may serve to reinforce the substance abuse.Children or parents who resent their emotionally deprived home and are afraid to express their outrage use drug abuse as one way to manage their repressed anger.

The effects of a substance use disorder (SUD) are felt by the whole family. The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder. Family systems theory and attachment theory are theoretical models that provide a framework for understanding how SUDs affect the family. In addition, understanding the current developmental stage a family is in helps inform assessment of impairment and determination of appropriate interventions. SUDs negatively affect emotional and behavioral patterns from the inception of the family, resulting in poor outcomes for the children and adults with SUDs

• Residential rehab programs offer 24-hour monitoring and structure in a more home-like setting. These programs represent a step down from inpatient detox. At this stage of recovery, the client is ready to begin the therapeutic work of rehab. Advantages include distance from the stress of daily life, access to many amenities, and the opportunity to focus entirely on recovery. Disadvantages include separation from children and higher treatment costs.
• PHPs represent a middle ground between inpatient and outpatient treatment. Clients attend recovery activities, such as counseling and support groups, at a hospital or treatment center during the day, while returning to their home or a transitional facility at night. PHPs offer more autonomy and the opportunity to maintain contact with family and keep up with personal obligations; on the negative side, the lack of 24-hour monitoring may increase the risk of a relapse, especially in an individual whose motivation to stay clean and sober is not very strong.
• Outpatient treatment programs provide most of the therapeutic services of inpatient and residential treatment — including therapy, support groups, medication management, and psychosocial services — without the round-the-clock monitoring or clinical support of inpatient treatment. Clients meet with therapists or counselors, attend classes, and participate in group meetings during the day at an outpatient treatment center, clinic, or other facility. After hours, they stay at home or in a sober living environment. IOPs allow the client to remain part of the community and to fulfill parental responsibilities or stay in close contact with family. In addition, health insurance providers are often more willing to cover outpatient treatment than residential care. On the downside, the absence of a structured living environment exposes the client to more stressors and triggers that can lead to a relapse.

In order to seek help and complete a rehab program, parents must be able to overcome barriers to recovery, such as the social stigma against addiction and the fear of public exposure or shame. Parents who abuse alcohol and drugs are often viewed in the public’s eye as irresponsible, abusive, and dangerous. One of the greatest needs of parents going through therapy is a motivational approach that encourages and empowers them to accept responsibility for their past actions while facing the challenges of recovery and looking forward to a more hopeful future. A comprehensive aftercare program provides the support and resources that parents need to cope with the challenges of parenting while maintaining their sobriety.