The following is a column from EHN Canada:
Family members of individuals with addiction often struggle with addiction themselves. However, even if an individual grows up in a family with addiction and doesn’t develop an addiction themselves, they’ll still be more likely to struggle with trauma, mental health, and developmental disorders. Furthermore, the many family roles in addiction can produce codependent or enabling behaviours that perpetuate the addiction.
This article describes the various family roles in addiction and how the pain of an individual’s addiction is felt throughout their family. We’ll discuss how parents can affect their children, and vice versa, as well as the roles of a spouse or partner with addiction.
How Parents’ Addictions Affect Their Children
Individuals with drug or alcohol addiction tend to struggle to balance the needs of their family with satisfying their addiction. People will often have to prioritize their addiction—not out of selfishness, but simply to ensure that they can continue to function. Typically, individuals with drug or alcohol addiction must use consistently to avoid incapacitating withdrawal symptoms. As such, they must satisfy the needs of their addiction before they can put energy into family members and other relationships.
Parents with drug or alcohol addiction know that struggling with withdrawal symptoms will make it impossible for them to care for their children. Hence, maintaining their supply of drugs or alcohol is necessary to ensure that they can function well enough to care for their children. Unfortunately, this reduces the time, energy, and responsiveness with which a parent with addiction can attend to their children’s needs.
Inadequate care and attention from a parent can adversely affect a child’s development. Furthermore, the erratic and often unpredictable behaviour patterns of parents and other family members with addiction can also negatively affect a developing child.
Parents’ Addictions Increase Their Children’s Addiction Risk
Parents’ drug and alcohol addiction can contribute to the likelihood of their children developing addictions themselves. Addiction is a family disease that influences all family members.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States, as many as 1-in-10 children (7.5 million) in the United States live in households with at least one parent who struggles with alcohol addiction. Around 1-in-35 (2.1 million) live in households in which one parent has an illicit substance use disorder.
Using data gathered from households in which children were raised by addicted parents, the SAMHSA report estimates that these children are more likely to engage in harmful substance use themselves.
Additional research confirms that children of parents who regularly use marijuana are more likely to use it themselves. These children were also much more likely to show a favourable attitude towards the use of marijuana.
Sometimes, the opposite effect is also possible. Ryan Philips, a 35-year old British Columbia man with a history of party-related drug and alcohol consumption, describes how his parents’ alcoholism resulted in his cautious attitude towards alcohol.
“Because I had been around alcoholism for so much of my life, I avoided it. Alcohol terrified me. I didn’t begin drinking until I was 25, and I feel that I was much more responsible because of it. I never understood the appeal of getting blackout drunk.”
However, evidence suggests that children born to parents with addiction may be predisposed to developing substance use disorders themselves. Researchers at the National Institute on Drug Abuse found that an individual’s genetic makeup can make them more likely to develop an “addictive personality.” 
This area of research is known as “epigenetics.” Epigenetics studies the expression of certain genes. A gene that is “switched on” is said to be expressed. The expression of specific genes in the brain is a significant factor in drug and alcohol addiction.
Intergenerational Trauma Increases Children’s Addiction Risk
The term “intergenerational trauma” refers to trauma that is passed down from one generation to the next. Without any direct exposure to the original traumatic events that their parents experienced, by observing how their parents react to trauma triggers, a child can acquire the behavioural responses associated with trauma exposure, through social learning.
There is also a growing body of research suggesting that trauma may be passed on epigenetically. Traumatic experiences may activate certain genes through which behaviour patterns and reactivity to certain types of stimuli could be passed on to offspring.
Psychological trauma is one of the leading causes of addiction. Nearly 25% of children and adolescents have experienced some form of trauma. These traumatic experiences, in turn, increase individuals’ risk of developing addiction.
While it is difficult to gather data on the prevalence of intergenerational trauma, it may increase children’s likelihood of developing addiction. A study that followed 23 mothers with substance use disorders observed the potential impact of intergenerational trauma.
The impact of trauma on the mothers’ sense of self and, consequently, on their parenting style is believed to be a factor that increases their children’s likelihood of developing addiction. Specifically, these mothers with unprocessed trauma may be more likely to engage in codependent family roles that enable addiction.
Intergenerational Trauma, Addiction, and Indigenous People in Canada
The influence of historical intergenerational trauma can be seen in Canada’s indigenous population. Within the context of forced assimilation into residential schools, repeated physical and emotional abuse, and the transmission of these traumas from one generation to the next, Canada’s indigenous population represents a strong example of intergenerational trauma.
Among indigenous people, drug and alcohol addiction has historically been observed as a common response to intergenerational trauma. Individuals are also more likely to experience difficulty in family communication and mental health disorders such as anxiety and depression.
Not all members of these communities agree, however. Cadrin Larocque, a 26-year-old indigenous member of Alberta’s Cree nation and 8-year alcoholic, does not believe that intergenerational trauma had a specific influence on his substance use and family relationships.
“Sometimes you get angry,” he said when asked about his thoughts on racial oppression and related trauma, “but there’s not much that you can do.” While he drinks regularly, he is a prolific guitarist and considers music to be his primary method of coping with the discrimination and violence that indigenous people in Canada continue to suffer. “I have a healthy outlet,” he says, “that being music.”
Parents’ Addictions Harm Their Children’s Mental Health
While not all children raised by parents who struggle with drug or alcohol addiction will experience neglect or abuse, their risk is greater. This may increase the prevalence of emotional instability, anxiety, and depression in children.
One study, published by researchers at the University of Toronto, evaluated a sample of 6,268 adults. They found that the offspring of parents who struggled with drug addiction were twice as likely to experience depression as an adult, after adjusting for parents’ age, sex, and race.
Children raised by unstable or neglectful parents often experience developmental problems.
Repeated experiences of neglect or abuse cause the developing brains of children undergo adaptive changes in their emotional, behavioural, and cognitive function that would improve their chances of survival—from an evolutionary perspective. Unfortunately, in practical terms, repeated activation of a child’s brain in response to perceived threats results in harmful consequences for children’s mental health by increasing hypervigilance, impulsivity, and anxiety.
How Addiction Harms Marriages and Domestic Partnerships
Addiction and family roles can negatively affect marriages and domestic partnerships in a variety of ways. For example, a spouse who drinks excessively may present financial difficulties, childcare problems, and an increased likelihood of engaging in extramarital sex without their spouse’s consent compared to a spouse who does not drink. 
Alcohol Use Increases Risk of Domestic Abuse
Studies and reports have consistently drawn a link between intimate partner violence and substance use disorders. Alcohol, in particular, is known to increase the frequency and severity of domestic abuse. In the United States, as many as 55% of domestic abuse victims believe that their partner was under the influence of alcohol when the abuse took place.
In addition to the perpetrators of domestic violence being more likely to be intoxicated with alcohol themselves, sometimes victims themselves are also under the influence. A Swiss study found that 33% of the perpetrators, and 9% of victims, were under the influence of alcohol during incidents of intimate partner violence.
Aggression and domestic abuse may drive the victim to develop an alcohol use disorder themselves. Research shows that women exposed to domestic violence are more likely to turn to alcohol as a mechanism for coping with the pain and distress. In Iceland, up to 20% of the women who suffered domestic violence turned to alcohol as a coping mechanism.
Unfortunately, turning to alcohol to cope with abuse can further increase the occurrence of domestic violence. If the victim develops a drinking problem, this will most likely impair their interpersonal effectiveness, which will increase their risk of experiencing domestic violence.
Addiction Leads to Intimacy Problems
Spouses who are addicted to opiates may have problems in their relationships due to dwindling sex drive, frequent mood swings, and periods of depression. This can further increase the risk of violence. According to research published in the American Journal of Orthopsychiatry, these factors are responsible for the increased domestic aggression of opioid-dependent spouses.
Addiction may also lead to lower trust between spouses. Spouses with drug or alcohol addiction will often lie about the severity of their addiction or the amount of money that they’re spending on it. Individuals who struggle with sex addiction (problematic compulsive sexual behaviour) may also erode their partners’ trust through deceptive sexual activity or by not respecting their partners’ boundaries.
Addiction Harms Spouses’ Mental Health
Spouses married to abusive, addicted partners often experience negative mental health consequences. According to a Birmingham University study, women who are victims of domestic abuse are up to three times more likely to have a serious mental health disorder.
However, as many as half of these women had been diagnosed with mental health disorders before the date of their first reported incident of abuse.
A number of different possible mechanisms could contribute to this observed behaviour. One is that women with mental health disorders may be more likely to enter relationships with potentially abusive partners. Another is that potentially abusive individuals may be more likely to maintain relationships with women who have mental health disorders. A third one is that women with mental health disorders may have experienced incidents of abuse (e.g. during their childhood) that precede the diagnosis of their mental health disorders, but that they do not consciously remember.
Addiction Increases Financial and Legal Problems in the Family
Individuals who are married to an addicted spouse may also face an increased risk of legal problems. Legal difficulties surrounding child custody, drunk driving, and drug use are more prevalent among couples who are affected by substance use disorders.
Being married to an alcoholic can also create financial instability in the home. In a 2011 paper, the European Alcohol and Health Forum revealed that binge drinkers are more prone to financial difficulties. Binge drinking can negatively affect a person’s educational achievement, which has consequences on their ability to get a job and how much money they will earn. Furthermore, it may limit the number of years they can work during their lifetime, due to related health problems that may present as they grow older.
This further increases the financial risk for individuals married to spouses with addiction. In addition to the direct financial consequences of unpredictable behaviour and spending money to support an addiction, health problems that result from drug and alcohol use can also add to financial uncertainty for the spouse and family.
Spouses Often Enable Addiction
Further difficulties are presented by the potential for enabling. It’s natural for people to want their spouse or partner who has an addiction to be comfortable, safe, and healthy. However, the resulting actions that people take often enable the addiction to continue. Despite being motivated by good intentions, enabling behaviours support a spouse’s or partner’s addiction.
Wittingly or unwittingly, by supporting their spouse’s or partner’s addiction, enablers allow their own abuse to continue.
How Young Adults’ Addictions Hurt Their Families
In Canada, young people between the ages of 15 and 24 are more likely to experience mental health problems and addiction than any other age group. Young adults who struggle with addiction can negatively affect the lives of their family members.
Individuals with substance use disorders are up to 15% more likely to struggle with concurrent mental health disorders. The resulting emotional and mental instability can result in problematic family dynamics.
One issue presented by the complex interactions of addiction and family is the potential need for a caretaker. The “caretaker” is one of the family roles in addiction. A young adult struggling with addiction may require additional attention and resources compared to a young adult without addiction. Family members willing to accommodate these extra needs will often have to sacrifice some of their own needs to do so.
This can create an enabling relationship, which we will discuss in greater detail in the next section. An enabler is an individual, often a family member or spouse, who knowingly or unknowingly helps sustain another person’s addiction.
Parents of a young adult who has an addiction may develop an dysfunctionally dependent relationship with them. This codependence can impede the maturation and independence of both the young adult and their parents.
Earlier, we discussed parental family roles in addiction and the effects that parents with addiction may have on their children. According to Kyren Teufel, age 28, sometimes, a young adult can influence their parents to use more drugs. Kyren believes that his parents only played a small role in influencing his own substance use behaviour, but that later in his life, he likely had a much greater influence on them.
“They did smoke weed, eat mush[rooms], and drink booze,” he says of his parents. “But by the time I was getting into those things, I was already into plenty of things that they had never tried. In fact, later in their lives, I influenced them to do more drugs.”
Family Roles in Addiction
There are a number of family roles in addiction. Family members tend to take on these roles unconsciously as the result of interactions with other family members, their own emotional responses, and dealing with the consequences of the addiction process. In her book Another Chance, addiction and codependency expert Sharon Wegscheider-Cruse identifies six common dysfunctional family roles in addiction.
- The addict: the family member with addiction is at the centre of the turmoil.
- The hero: the hero is the one who takes it upon themselves to heal the family.
- The mascot: the mascot functions as a jester and attempts to use humour to defuse the seriousness of the addiction and family involvement.
- The lost child: this younger family member is often withdrawn, avoids conflict, and tends to go to extremes to avoid confrontation and acknowledging the addiction and family roles.
- The scapegoat: the scapegoat often acts out and diverts attention from the addicted family member onto themselves.
- The caretaker (or enabler): this role is necessary for the other roles to exist. Family members in this role dedicate themselves to maintaining stability. Unfortunately, this allows all the family members to continue their lives without seriously addressing the addiction.
These family roles in addiction are driven by underlying feelings related to the individual with addiction and the family situation. The lost child, for example, feels guilt, loneliness, neglect, and anger towards the addiction and other family members. Feeling isolated and powerless, they recede from the problem in hopes that it will disappear.
The mascot, on the other hand, feels shame, embarrassment, and anger. Rather than taking on a more constructive role and acknowledging the addiction, they attempt to discredit or invalidate the addiction and family involvement using humour and sarcasm.
Enabling Allows Addiction to Continue Harming Families
Enabling is any behaviour that helps a person sustain their addiction and avoid addressing it. Because of their innate desire to support their loved ones, many family members become enablers of family members with addiction. Providing food, shelter, and financial support often seem like responsible choices for family members, and it’s easy to ignore how these behaviours perpetuate the addiction. Also, in many cases, it’s easier to continue enabling than it is to stop. In order to stop enabling behaviours, an enabling family member will almost always need to have a difficult confrontation with the addicted family member.
Enabling and Codependency Often Happen Together
Living in a family with an addicted family member may contribute to codependency. Codependency is a dynamic in which an individual is more concerned about someone else’s needs than their own needs.
When addiction is involved, codependency often leads to aversion and a lack of self-orientation. All of the family roles discussed above may lead to codependency. However, the caretaker role is most likely to present symptoms of codependency.
Siblings, parents, and other relatives of addicted family members often show codependent behaviours and attitudes such as low self-esteem, decreased focus on meeting their own needs, inappropriate prioritization of others’ needs, extreme caretaking behaviours, obsessive involvement in the lives of others, and difficulty with intimate relationships.
Addiction is a family disease that affects family members in a number of ways. Family members exposed to addiction are more likely to experience mental health disorders, domestic abuse, and financial difficulties. Depression and anxiety in children is more common among those raised by parents with addiction. Children’s mental health disorders increase their risk of developing addictions.
Family members tend to adopt roles in the presence of addiction. In an effort to maintain the well-being of their addicted loved ones, many family members become codependent enablers through their attempts to keep the addicted individual safe and protected.
If you or a loved one are struggling with addiction, the sooner you reach out for help, the sooner your family can start healing. Drug and alcohol addiction treatment programs provide the necessary skills, support, and education for individuals to overcome their addictions and live healthy and satisfying lives. The first step often feels like the most difficult one—but it’s necessary to achieve the positive changes that will restore the health and happiness of your family.
We Can Help You
Ledgehill’s two facilities in Annapolis County, Nova Scotia, provide gender-specific treatment for men and women who need to heal in a peaceful, supportive environment free from fear or distraction. If you’d like to learn more about the addiction and mental health treatment programs provided by Ledgehill, enrol yourself in one of our programs, or refer someone else, please call us at 1-866-624-0918.
(More information and the referenced links on this column can be found at: https://www.edgewoodhealthnetwork.com/resources/blog/family-roles-in-addiction-and-how-everyone-gets-hurt/ )