Living with the Disease

The last blog post was about defining addiction and alcoholism as a family disease.  The topic of this post will discuss the effects of living with the disease.

AA has described the disease of alcoholism as cunning, baffling and powerful.  Addiction affects those exposed physically, mentally and emotionally.  Some sources will add spiritually to the list as well.

Physical

The physical aspects of addiction occur in the short-term and long-term.  Some are temporary and others can be chronic.  Intoxication and withdrawal are the immediate, short-term effects.

Intoxication includes changes in heart rate, respiration, body temperature, appetite, alertness, paranoia, libido, redness of the eyes and pupil size, ability to maintain balance/mobility and speech.  Withdrawal can include changes in energy, sleep patterns, hunger, seizures, body temperature, GI symptoms (including vomiting and/or diarrhea) and pupil size to name a few.

The long-term physical effects include, but not limited to, scarring, sexually transmitted infections (hepatitis, HIV), heart condition, stroke, brain damage, broken bones, physical and mental disabilities, poor dental health, liver damage and/or disease, kidney damage, loss of reproductive abilities and/or miscarriage.  Family members may experience some of these due to being physically intimate with the person who is using, from stress or physical violence as the result of living with the disease.

Emotional

Some of the emotional effects of the disease are anger, aggression, depression, anxiety, guilt, fear, envy, jealousy, loneliness, resentment, humiliation, and shame.  The feelings of deprivation, helplessness, confusion, being overwhelmed, criticized, rejected, abandoned, unworthiness and unloved leads to increased isolation from healthy relationships and activities, fueling the cycle of further self-destruction.  These emotions can be experienced by the person suffering from the disease and the non-using family members.

Psychological

Those actively using may be trying to forget who they are or to avoid the painful emotions of hurting the ones they love and occurs impulsively as the drugs disrupt specific brain circuits.

SAMSHA’s chapter on the impact of substance abuse describes the following characteristics observed in families:

1. Negativism. Any communication that occurs among family members is negative, taking the form of complaints, criticism, and other expressions of displeasure. The overall mood of the household is decidedly downbeat, and positive behavior is ignored. In such families, the only way to get attention or enliven the situation is to create a crisis. This negativity may serve to reinforce the substance abuse.

2. Parental inconsistency. Rule setting is erratic, enforcement is inconsistent, and family structure is inadequate. Children are confused because they cannot figure out the boundaries of right and wrong. As a result, they may behave badly in the hope of getting their parents to set clearly defined boundaries. Without known limits, children cannot predict parental responses and adjust their behavior accordingly. These inconsistencies tend to be present regardless of whether the person abusing substances is a parent or child and they create a sense of confusion—a key factor—in the children.

3. Parental denial. Despite obvious warning signs, the parental stance is: (1) “What drug/alcohol problem? We don’t see any drug problem!” or (2) after authorities intervene: “You are wrong! My child does not have a drug problem!”
4. Miscarried expression of anger. Children or parents who resent their emotionally deprived home and are afraid to express their outrage use drug abuse as one way to manage their repressed anger.
5. Self‐medication. Either a parent or child will use drugs or alcohol to cope with intolerable thoughts or feelings, such as severe anxiety or depression.

6. Unrealistic parental expectations. If parental expectations are unrealistic, children can excuse themselves from all future expectations by saying, in essence, “You can’t expect anything of me—I’m just a pothead/speed freak/junkie.” Alternatively, they may work obsessively to overachieve, all the while feeling that no matter what they do it is never good enough, or they may joke and clown to deflect the pain or may withdraw to side‐step the pain. If expectations are too low, and children are told throughout youth that they will certainly fail, they tend to conform their behavior to their parents’ predictions, unless meaningful adults intervene with healthy, positive, and supportive messages.  https://www.ncbi.nlm.nih.gov/books/NBK64258/