When Someone at Home Uses Drugs: How to Look After Yourself Before You Burn Out

Why family members become exhausted

Living with someone who uses drugs means chronic stress: worry about what might happen to them, anger at being lied to, shame that stops you from telling anyone, and guilt that you somehow did not raise them well enough. Many households also face money problems and frequent arguments.

A U.S. health-system study by Ray and colleagues (2014) found that children living with an adult who had an alcohol or drug dependence were more likely to be diagnosed with depression and substance use problems than children of adults with other chronic conditions such as asthma or diabetes, and had higher emergency and outpatient psychiatry costs. The impact does not stop with the patient; it reaches everyone at home.

Signs that you are burning out

Notice whether any of these apply to you: you cannot sleep because your thoughts keep circling back to them; you snap at everyone at home; you check their phone or bag again and again; you stop seeing friends or doing things you used to enjoy; you skip your own medical care; or your happiness depends on whether they used today.

If you have felt sad, hopeless or lost interest in almost everything nearly every day for more than two weeks, that is more than ordinary tiredness. Talk to a doctor or call Thailand's 1323 mental health hotline, available 24 hours. Asking for help for yourself is not a sign of weakness.

Looking after yourself is not selfish

Many people feel guilty about resting or doing something for themselves while a family member is still using. The evidence points the other way. Studies of CRAFT, a training programme for families of people who are not yet willing to enter treatment, found that once family members received support, their depression, anger and family conflict improved within six months.

A 2017 summary by Canada's CCSA also reports that in a comparison study, families trained in CRAFT got their loved one into treatment about 67% of the time, compared with 18% for families who used a self-help group alone and 30% for families who used a confrontational intervention. A family that has energy and skills is both the one most likely to cope and the best helper.

Setting boundaries that are firm but kind

A boundary is a clear statement of what you will and will not do, so that you protect yourself and do not accidentally make drug use easier. Examples include not handing over cash that could buy drugs, not lying or making excuses to their employer for them, not allowing drug use at home, and not discussing important matters while they are intoxicated.

Speak calmly and start from your own feelings, for example: "I'm worried and very tired. I won't give you cash any more, but if you're ready for treatment, I'll go with you." Then follow through consistently. SAMHSA's TIP 39 notes that serious family conflict is linked to a higher risk of returning to drug use, so calm boundaries work better than shouting or sarcasm.

Everyday ways to care for your mind

Start with the basics that are easy to neglect: enough sleep, regular meals, a little movement every day, and a short block of time each day for yourself, even 15 minutes in which you do not think about drugs.

Find at least one person you can talk to safely: a close friend, a trusted relative, a counsellor or a self-help group for families of people who use substances. SAMHSA recommends connecting families with community supports such as Al-Anon. Hearing from people who have been through the same thing greatly reduces isolation and shame.

Share the load at home so that one person does not carry everything, and accept that you cannot control all of their decisions. What you can control is your own actions.

When to get help right away

If there is physical violence or threats, or if you or children at home are not safe, get to a safe place first and call 191. Your safety matters more than trying to make them understand. If they are paranoid or out of control on drugs, see our article on methamphetamine psychosis for how to respond safely.

If you begin to have thoughts of disappearing or harming yourself, call the 1323 mental health hotline immediately. For advice on getting a family member into treatment, call the 1165 drug treatment hotline.

How Petch Nava Hope Care supports families

Families can call the Petch Nava Hope Care team even if their loved one is not yet ready for treatment, or complete the family assessment form in advance so the team can prepare suitable options before calling back. All information is kept confidential.

Once the patient enters treatment, family therapy is part of the Petch Nava Hope Care programme, so that everyone at home can recover together, not only the patient.