Addiction is a family disease. People wonder about addicts. “Why did they start?” “Why can’t they just stop?” “Can’t they see what they are doing to themselves?” The focus is on the disease and the victim, without much thought to those suffering behind the scenes, namely, the family.
Whenever there’s an addict in the immediate family, whether it’s a parent or sibling, the home atmosphere changes. Suddenly there are doctors’ numbers on auto-call, confused search history on a child’s browser, rehab pamphlets on the kitchen table which everyone besides the addict has read, stray bottles and needles under the bathroom sink, and a 3 a.m. perch by the window, waiting for the addict to come home.
“My sweet baby, my firstborn son, is homeless, mentally ill and addicted to heroin,” writes Cara Wykowski on Love What Matters.
“I doubt you can imagine the emotions I hold in my heart, let alone comprehend what I’ve witnessed over the last 10 years… Frankly, there are no words to describe the depth and darkness of my nightmare.”
Addiction is a Disease, Not a Choice
Because, honestly, who would choose it?
Addiction is a term thrown around to describe an obsession or impulse within healthy means. “I’m addicted to these brownies,” or “I have a reading addiction.” While these statements are said in innocence, they can cause misunderstandings of this illness.
Clinically diagnosed addiction—now known as a substance use disorder (SUD)—is defined as a strong compulsion to use substances, even though undesirable and dangerous consequences might occur.
Like other diseases, addiction disrupts the regular function of an organ, in this case, the brain. It shifts the brain’s ability to respond to circumstances that involve rewards, stress, and self-control.
Similar to something like hypertension or diabetes, the effects of this disease require continuous efforts to manage, and negative symptoms may return when the treatments slide.
It’s hard for a healthy person to comprehend why someone would willingly ruin their health, relationships, and overall quality of life. However, over 20 million Americans over the age of 12 suffer from this illness. If overcoming addiction was about locking up the drugs and throwing away the key, that statistic would decrease dramatically.  
The Social Impact on an Addict’s Family
“I dread holiday celebrations, graduations, and family gatherings,” writes Wykowski.“I listen politely to the Norman Rockwell-esque proclamations of your children’s achievements, and I’m just hoping my son is still alive.”
She mentions the comments she overhears at social gatherings about worthless junkies, overcoming the disease is just about willpower, and how addiction is the result of poor parenting.
Since addiction has such a negative connotation, the family suffering from it may feel uncomfortable talking about it or reaching out for help. Some choose to hide the disease from their friends and community to avoid the stigma and social outcome.
Some family members might wish the addict had some sort of physical illness instead of a mental one. People tend to understand heart disease and cancer. There are cards from well-wishers, fundraisers, and friends offering help in any way they could. With addiction, there is an awkward silence
“People say they don’t want to bring up anything sad or negative so they don’t ask me about my son,” says Wykowski. “Here’s my perspective. If you don’t ask, you don’t care, and you perpetuate the insidious shame cycle.”
The Dynamic of a Family with an Addict
In a regular family unit, the dynamic is centered around keeping the home balanced and functional. With a substance abuser, the roles of the family shift to adjust to the behaviors associated with addiction to continue maintaining that balance.
There are six identifiable roles:
1. The Enabler
The enabler covers for the addict by taking care of finances, social commitments, or other matters the addict has abandoned. This person is often in denial about the severity of the addiction and makes excuses for it.
2. The Mascot
Some individuals turn to humor as a coping mechanism and use it to bring moments of a little relief to the home.
3. The Hero
The hero is generally an overachieving child who takes on home responsibilities that exceed their development stage, sometimes even parental roles. He or she is obsessed with perfectionism, which becomes challenging to maintain as the addiction progresses.
This is a child who misbehaves and is often in trouble at school and at home. Their behavior reflects the chaotic and toxic atmosphere in the house.
5. The Lost Child
This person becomes isolated from other family members and has difficulty in social situations. They often engage in fantasy play to distract themselves from the negative environment.
6. The Addict
Many substance abusers feel shameful and guilty about the pain they’ve brought onto their families, while others hold anger and resentment toward them.
The family members themselves, especially parents, can blame themselves for progression of the addiction, while siblings can hold resentment against the addict for embittering their home life. 
Wykowski works to overcome the hardship of her position. “I’m becoming a mom who won’t let her son’s disease take her life too,” she writes. “I will weather these storms because shame, blame, and guilt are not as powerful as my conviction for living with fierce grace.”
Reaching Out to Families Impacted by Addiction
When reaching out to the family, addiction should be viewed with the same lens as any other disease. They don’t want pity, recommendations, or answers. Ask about the addict and the family member’s wellbeing. Addiction is a lonely disease, for the family as well. Above all, they want compassion and hope.
“There’s been a revolving door of hospitalizations, incarcerations, and homelessness,” concludes Wykowski in her essay. “Let’s stop the stigma. It’s powerfully healing if we can be in conversation together.” 
- Is Drug Addiction a Disease or a Choice? https://americanaddictioncenters.org/rehab-guide/is-drug-addiction-a-disease
- The Impact of Substance Abuse and Addiction on Families https://www.bhpalmbeach.com/recovery-articles/impact-substance-abuse-and-addiction-families/
- Addiction Statistics https://www.addictioncenter.com/addiction/addiction-statistics/
- ‘My sweet baby, my firstborn son, is homeless, mentally ill and addicted to heroin.’ https://www.lovewhatmatters.com/my-sweet-baby-my-firstborn-son-is-homeless-mentally-ill-and-addicted-to-heroin/