The effects of a loved one’s addiction increase over time as the addicted individual goes through the addiction cycle. Where before each member of a family had defined roles in the family ecosystem, with individuated and distinct relationships with each other; addiction changes the ecosystem.

The addicted individual is unable to function in the family ecosystem and the whole network may fray and eventually collapse without intervention. The strain of the addiction affects all members of the family, erasing harmony in the household, and infecting every member of the household with negative emotions ranging from anger and depression to shame and guilt.

Parents may harangue, nag, shame, or threaten the addicted loved one to give up the addiction. Fathers and mothers may fight with each other over the addicted child, blaming each other. Parents may question their own parenting and blame themselves for their child’s addiction. Siblings of the addicted will also suffer from their loved one’s addiction, experiencing stress, fear, and trauma. A teen suffering from opioid addiction may frighten their siblings during drug-induced episodes of rage and mania. An addicted sibling may show a physical decline and mental illness, or disappear or run away. In worst cases, a sibling may have a life-threatening drug episode, or die from an overdose.

All these events have an adverse effect on the whole family. The drama of pronounced changes—high highs, low lows, high lows, and low highs—can destabilize the family as a whole, harm them individually, wreck their relationships with each other, and damage their collective and individual relationship with the addicted family member. It is no surprise then that families of addicted loved ones are vulnerable to a host of trauma-related maladies including PTSD, complex PTSD, anxiety, guilt, and depression. They are also vulnerable to a condition called chronic sorrow, also known as living loss. This affliction is unique to parents caring for children with chronic illnesses and disabilities. The deep ties and bonds that hold a family together can be severed if things continue as they are.

In one Gallup survey of fathers, mothers, brothers, sisters, sons, daughters, and spouses of those suffering from addiction, a majority admitted that their loved one’s addiction had a negative effect on their own mental and emotional health. Fifty percent of those polled said the addiction affected their relationship with other members of the family. Spouses and parents of addicted loved ones were the most affected by a loved one’s addiction, with more than half admitting to adverse effects on their emotional health. A majority of spouses, children, and parents of addicted loved ones were emotionally affected by the addiction. In addition, they were affected financially due to medical, legal, and other expenses related to their loved one’s addiction.

The number of parents suffering from drug and alcohol addiction continues to increase. An estimated 20% of American children are growing up in households where a parent suffers from an alcohol or substance abuse disorder. Such children suffer from adverse childhood experiences including witnessing domestic violence. They frequently suffer from physical or emotional abuse and neglect. Instances of sexual abuse are also reported in such households. The prognosis for these children is troubling. Many are at risk of developing substance use disorders themselves, and all are vulnerable to the stress and trauma of domestic violence that affects learning and childhood development.