Loving a Child with Addictions
As parents, one of our primary instincts is to keep our children safe. It is built into our DNA. We are not a species who watches our young swim off into the ocean, never to be seen again, feeling we have done our duty, thank you very much. We are hardwired for birth, protection, rearing and attachment. We are social all the way to our core. We are devastated when faced with the potential loss of a child. And there is nothing more devastating than the unrelenting threat of overdose or accidental suicide in our children who are using drugs. Addiction, is a disease that can be completely prevented by not using; a disease which causes more deaths each year than any other single disorder of childhood; and which changes the addict profoundly. No wonder parents say: “I don’t even know who this is; this is not my child.”
We have only to read the memoirs of writers like David Sheff, David Magee, D’Anne Burwell, or Libby Cataldi to feel the terror of a parent who does not know if their son or daughter will survive the next day because of an addiction. Many alcoholics and addicts never choose recovery and die needlessly of a disorder that can be treated. Magee begins his book with the accidental overdose of his college aged son. Some of our children never recover. But some do.
The Institute on Alcohol and Alcohol Abuse[1] reports that there are 178,000 deaths annually (120,000 males; 28,000 females) attributable to excessive alcohol use, making alcohol one of the leading preventable causes of death in the United States. The fact that it is preventable is yet another heartbreak. In 2022 alone, alcohol impaired driving fatalities accounted for 13,524 deaths, or 32% of all driving fatalities in the United States. And the problem is becoming more severe by the year.
The rise in young adult alcohol abuse is alarming. According to a 2023 national survey (NSDUH)[2], 4.8 million males (28%) and 5.0 million females (29.4%) of the 16.9 million young adults ages 18 to 25 in the U.S reported binge drinking in the past month. Approximately 6.9% of young adults ages 18 to 25 in the United States reported heavy alcohol use in the last month, with females slightly more represented than males, and with white young adults leading the pack as compared to American Indian/Alaska Natives, Asian Americans, Black Americans, Hispanic/Latino and biracial young adults.
And, finally, the Monitoring the Future Panel Study (2023) reports that 5.1% of college students and 8.4% of non-college students one to four years past high school admit to high intensity drinking, defined as ten plus drinks in a row within the past two weeks.
Many of our children do not survive their addiction. And there is probably no other area in which parents receive such bad advice – if any at all – about what to do to help their child before it is too late. Family members develop secondary trauma, we are told to Tough Love it out (try that with an addict who is unable to access reason and logic!), and if we are fortunate enough to find a facility willing to accept our adult child for treatment, we are sometimes told thank you for getting them here and are promptly dismissed without a plan or support.
Here is what I wish parents knew.
Addiction is not, as Sheff repeatedly reminds us, a problem stemming from poor morals or bad homes. The vast majority of alcoholics and addicts begin to experiment in middle school or high school. Most come from good homes and most are not suffering from trauma – though some certainly are. For some, experimentation becomes regular use, which becomes dependence, which becomes addiction. Genetics plays a part. Environment plants a part. Family history plays a part. But the real issue is that once dependence has set in, the brain is changed, and it feels to the addict like there is no choice but to feed it. Any individual who uses enough eventually becomes addicted because that is simply how the brain works.
Poor advice includes: Shut the door on them, tell them to pull themselves up by the bootstraps, let them live on the streets, try the least restrictive treatment first - if the addict is even open to treatment. None of this advice works. Some people do in fact stop cold turkey, which, depending on their level of use could be deadly if done without medical supervision and oversight. But the best advice would be inpatient treatment first. Sheff recommends starting there so you do not waste years going through every other level of treatment and risking the worst possible outcome – death. Otherwise, you are waiting for the disease to advance, for the brain to become more addicted, and for the addicted person to feel less choice about recovery and less agency to choose any treatment.
Insurance will scream and holler. They want you to try every less restrictive treatment - meaning less costly to the insurance company – possible before inpatient care, even though inpatient is likely to be the most effective, due to the length and depth of treatment. Your insurance company is likely to tell you inpatient treatment is not covered. Find a treatment facility first and have them talk to your insurance company. You will likely find that it is covered – sometimes completely. Hospitals and inpatient facilities know the game, they know what to say, and they know how to fight back if insurance says no.
Let’s talk about the age of your addicted child. Parents can authorize care for minor children. But for our adult children, or our spouses, we cannot. The law typically allows an individual to be admitted for 72 hours if they meet criteria, which typically means they are determined by a mental health professional to be a danger to themselves or others. But a second review after that time period has lapsed is required by law, and often the addict is released and is furious at family. It is not against the law to drink or drug yourself to death in your own home. It should be!
One potential solution is to arrange for a family intervention. Most 12 step programs can refer you to someone who is capable of working with the family to provide this service. The family, including the addicted person, will sit down and talk about their concerns. The interventionist can describe to the addict how they can be of service – such as finding a program and transporting the person to the program. If your adult child is ready for inpatient treatment, that is wonderful. If not, you may have to play hard ball, including ending any funding you have been providing to them and watching for another opportunity down the road.
During this timeframe you will need to learn how to detach from the addicted person with love. You are not detaching from the person, but rather from the addiction (their part) and the pattern of enabling that you have very likely been engaged in (your part). There is no better place to learn how to detach with love than Al-Anon. Al-Anon teaches you to attend to your own needs – like putting on your own oxygen mask first before doing the same for your children. Parents become exhausted, emotionally drained, financially strapped, and hopeless in response to the addict’s turmoil and chaos. It is imperative that you have a life, take care of your own needs, support one another, and learn the basic 12-step refrain: You didn’t cause this; you can’t control it; and you can’t cure it. But you can detach with love, take good care of yourself, and continue to look for opportunities for the addict to get into treatment, if and when they are ready. You must learn to sit with your own discomfort. And you must remember to include younger children in the home into these discussions. Do not think for a minute they do not know something is going on. Explain the situation to them, encourage them to talk about their feelings and concerns, and do not let them experience this family crisis alone.
Having an adult child who is addicted is like being at war, waiting for the next bomb to drop and wondering if your family will survive. You become afraid to answer the phone, and afraid when there are no calls. If you are like most parents, you may have initially under-estimated the depth of the problem, thought it was a stage that would pass, financed what you thought was your child’s education, ignored your deeper intuition, or felt afraid to set firm boundaries. There is a lot of help out there if you will accept it.
The highlights are:
Do not underestimate your child’s substance. It may be common, but it is neither normal nor healthy.
Get educated about substance abuse, its effects, and potential treatment. Study all you can.
Take care of yourself. Go to Al-Anon. Find support. Keep family discussions open and positive.
If possible, look for inpatient treatment and maybe an interventionist.
[1] NIAAA.NIH.GOV
[2] National Survey on Drug Use and Health, updated January 2025.
3 American Addiction Centers (Alcohol.org) October 25, 2022