Continuing the qualitative research project conducted by Gemma Salter, a talented undergraduate student working with me back in 2004. The research involved interviewing nine parents and one grandparent (who had assumed the role of parent) of people with a drug and/or alcohol problem. The participants were recruited from West Glamorgan Council on Alcohol and Drug Abuse (WGCADA) in Swansea and Drug and Alcohol Family Support (DAFS) in Blaenau Gwent, South Wales.
…. It doesn’t take long for the effects of stress to manifest itself in physical and psychological health problems. Physical symptoms come in the form of eating and sleeping problems, high blood pressure, stomach problems, irritable bowel syndrome and tension aches. Some parents are prescribed antidepressants by their GPs.
‘I lost two stone in weight because of not eating properly. My husband developed two ulcers… We weren’t sleeping… My oldest son thought we were having problems in our marriage because we’d both gone to looking terrible.’
Other practical concerns can soon weigh in, not least the financial implications of paying for the user’s treatment, paying off their debts and, in some cases, actually paying for drugs to support the user’s habit.
Parents often put their social life on hold, fearing for the health and safety of their child every time they go out, or worrying what condition their house might be in when they return. They might not feel well enough to socialise, or they might simply not be able to take a holiday anymore because of lack of money.
Immediate members of the family feel the disruption, as they become wary of the unpredictable, and sometimes thieving, nature of the user. Often the user repeatedly returns to the family home after living away, and the parents are faced with a grown adult being dependant on them again.
‘I would not have expected to still be responsible in the way I feel responsible for a son of 30… It feels almost as though I still have a child in the home… even though in some ways he is an adult… Overall, it’s like still being responsible for a child.’
Arguments and tension increase, which is not helped when there are contradictions in the way that different members of the family feel and act. The user often steps in to divide the parents, creating further problems between them.
‘I approach it a completely different way my wife approaches it…I mean at the end of it she was telling me I can’t go on with this, he’s gotta go. And at that time I was saying no, we’ve done so much work… So we bicker about that quite a lot.’
With all attention on the user, it is not surprising that the user’s siblings can be neglected. The parent spends so long worrying about the user, that they have little time to see to others in the family—they are left to look after themselves. Relations between the user and their brother or sister sometimes have little hope of staying civil.
The wider family may provide whatever support they can by talking about problems, but there is rarely any active involvement. This is not usually intentional—merely a symptom of a lack of understanding of the issues involved, or how best they could help.
Parents use different coping methods—these are sometimes helpful and at other times cause further stress. Some parents are deliberately non-confrontational, giving the user money, buying substances for them and caring for them—but not confronting them directly about their problem.
Others use avoidance coping, avoiding actively dealing with the problem and its consequences, denying the problem, concealing it, and refusing to let the user move back into the family home. Many parents try their best at active coping, trying to do something to improve the situation by threatening, giving the user an ultimatum, or helping them with their treatment.
Many parents also reported coping on a day-to-day basis. Some parents feel that this way of getting by is an improvement, at least offering them flexibility and exposing them less to the risk of feeling let down if plans or promises are broken. Others feel this is a negative approach.
‘You’re just living day-to-day. I come home from work thinking… what am I going to expect now? What have I got to deal with now… You can’t look ahead because there isn’t a way forward. You just live day-to-day and hope you can cope with it.’
For many parents, it is important to be able to explain, or attribute some cause to, their loved one’s substance use problem. They might turn to the disease model of addiction, or look at blaming themselves or others. There is no consistent method of coping and parents are likely to vary their method in response to different problems, and in an effort to find the best way to cope. The fluctuations in coping may clash with their partner’s opposing fluctuations, further increasing tension within the family.
Parents who belong to a family support group find tremendous support from sharing experience with others in the same situation. Learning about various issues relating to substance use is, in itself, a way of learning to cope, and the groups reduce isolation by bringing people together into an empathetic and hopeful social environment. Parents report that they can put their problems into perspective and feel better by having the opportunity to help others.
‘I came out feeling marvellous… These people know what I’m going through, nobody else had known. I thought I was the only one that was going through this terrible time… Listening to these people’s stories I realised how other people… had coped, how things had got better… Every week I go… I get something out of it, and if I don’t get anything out of it then at least I think I’ve helped somebody else.’
Many of the barriers that parents experience, in trying to get family support, relate to ‘the system’. Parents find that there is a lack of services dedicated to families—or if they are there, they don’t know about them, or how to find them.
Sometimes the long delay in accessing treatment is more about personal barriers. Parents are often reluctant to talk about or admit that there is a substance use problem in the family. Often, they are simply too preoccupied with the user’s needs to seek help for their own.
Finally, it should be noted that parents often alter their views on substance-related issues, through their personal experience and interacting with the treatment system. Many make practical changes in their lives and some start to work in the substance use and counselling fields.
‘I think I’ve become a lot more tolerant to addictive behaviour… Whereas before my initial reaction was… making a moral judgement…I’ve really moved away from that to… feeling a bit sorry for people who’ve fallen into what I see now is a trap.’
‘It pushed me down a really different road to which I would have gone… I think I’m a lot stronger now… and I think I’ve achieved something since then. I got back into education, I’ve become a counsellor, I’ve done a management course, I’m running this [family support organisation].’
The present research study of family members who have accessed a family support group was small-scale, but intensively analysed. The insights from it show the multi-faceted nature of the impact of substance misuse on the family.
One message was clear: society must learn to attend to the many needs of the families and carers of people with a substance use problem. The same applies today as it did then.
