Is Addiction A Family Disease?

You may have heard others refer to addiction as a “family disease”, but it may not be clear what exactly they mean when they say this. Do they mean that when someone is addicted to a substance or a behavior, it’s the fault of the family? Are they saying that addiction is purely genetic? Or could they be implying that it’s the family’s responsibility to cure their addicted loved one? Perhaps they mean something else entirely. Here, I plan to unpack several different interpretations of addiction as a family disease, none of which are mutually exclusive.

1. The entire family is affected by addiction.

One common understanding of addiction as a family disease is that the presence of addiction affects everyone within a family system, not just the addicted individual. Family systems depend on various elements, such as values, methods of communication, boundaries, rules, etc., functioning effectively to maintain balance and equilibrium. Addiction inherently introduces dysfunction to the system, which leads to a sense of imbalance and disequilibrium. When a system is unbalanced, all members of the system can find themselves shifting and compensating to either keep up the perception that everything is “business as usual” or to redirect energy to care for the struggling member of the group.

2. The entire family maintains the addiction.

Another way to interpret addiction as a family disease is that different members of the system can play their own unique roles in maintaining the addictive behaviors. For instance, one member of the family system may take on a sort of “hero” role, where they feel responsible for the family’s sense of self-worth and strive for achievement to distract from the issues at hand. Another typical role is that of the enabler, often someone who makes excuses for the individual dealing with addiction or even denies the existence of the addiction itself to protect the family. These roles and more can serve to perpetuate the cycle of addiction through avoidance and blame-shifting, despite their intended function of maintaining balance within the system.

3. The entire family needs healing from the addiction.

One could also describe addiction as a family disease to communicate the necessity of involving the family in the treatment and recovery process. If an individual receives treatment, develops an understanding of their addiction, learns coping skills, and then returns to an environment where all other members of the family are prepared to carry out the exact same roles as before, long-lasting change is highly unlikely. However, if the entire family accepts that their historical approach to dealing with the issue of addiction is ineffective and collectively commits to holding consistent boundaries, they can create an environment that is conducive to change. This is not to say that it is the family’s job to manage their loved one’s recovery—that is solely the responsibility of the individual themselves. They can create the appropriate environment, and the rest is up to the individual.

As previously mentioned, none of these definitions are mutually exclusive. A family is involved in the consequences, maintenance, and treatment of addiction. Because of this, it’s not only helpful for the family as a whole to participate in the therapy process, but each member of the family can often benefit from individual therapy as well. Each person is a unique individual with specific needs, and there may be needs that cannot be fully addressed in family work. If you are an individual dealing with addiction or the family member of someone dealing with addiction, I would encourage you to reach out to a therapist today.