As mental health care practitioners, and also more broadly as a society, we often discuss how it feels to experience addiction: the symptoms of substance use disorder, its effects, the challenges facing individuals who are in treatment and recovery, and the prevalence of these difficulties amongst the wider population. However, individuals with substance use disorder are not the only ones who face challenges; the loved ones of individuals who are struggling with addiction also undergo tremendous difficulty and pain. Yet, too often we overlook their experiences when talking about addiction.
No human being is an island, and addiction does not exist in a vacuum. In fact, substance abuse disorder reaches far beyond the individual as it begins to shape every interaction they have with other people in their lives. In this way, addiction also has direct effects on friends, family, colleagues, and community members. For close loved ones, these effects can be devastating and exhausting. For example, partners, family members, and close friends are all likely to experience intense pain, sadness, anger, and even guilt at one point or another. It is extremely important that we do not overlook this fact, because the emotional toll of loving someone with an addiction is significant and worthy of our attention.
Addiction and Emotional Volatility
Substance use disorder (SUD) is a term we use to refer to a range of mental health conditions where reliance on a substance (often but not always an intoxicant like alcohol or drugs) becomes an addiction. In other words, the individual using the substance finds it impossible to go without it. Thanks to years of dedicated scientific research, we know that substance use of this kind,, especially addiction to alcohol and drugs, is a medical disorder that affects the brain and therefore fundamentally changes behavior. Depending on the age and situation of the person who is experiencing addiction, these changes can be harmful and even dangerous to others. It is not uncommon for people who are experiencing substance use disorder to behave in unpredictable and volatile ways, experiencing changeable moods and memory loss and often neglecting or even abusing loved ones. [1]
Substance use disorder re-wires the brain, and research has shown that one of the key results of this rewiring is that it becomes harder and harder to emotionally regulate. [2] Pharmacological research (research on the make-up and effects of specific drugs) has also shown that drug addiction in particular elicits powerful and oppositional emotions. Euphoria is followed by despair and devastation, which is an important piece of the substance use disorder puzzle because it explains why drug users continue to seek out and take harmful drugs. That powerful feeling of euphoria can’t be achieved without them. [3]
Failure to emotionally regulate manifests in behavior as emotional volatility. In the same way that someone who is very tired, hungry, stressed, or physically uncomfortable may lash out in anger or burst into tears, someone who is emotionally dysregulated as a result of drug use will also display sudden, extreme, and often negative emotions. However, unlike someone who is tired or hungry, both of which are temporary and solvable states, a person who is addicted to drugs will be constantly emotionally dysregulated. This is how drug users become emotionally volatile and, thus, often difficult or even dangerous individuals.
What it Means to Love Someone With an Addiction
For loved ones of individuals who are struggling with substance use disorders, this emotional volatility has a direct and serious effect. Research has shown that individuals who care for loved ones with addiction report significantly higher levels of stress, anxiety, and loneliness than loved ones of individuals suffering from other chronic diseases. Similarly, caregivers of persons with addiction are far more likely to experience burnout, a high degree of stigmatization from others, and a lack of local support from friends or community members. There is still plenty of social shame associated with substance use and abuse, and the loved ones of those affected often feel it most acutely and are isolated as a result. [4]
A 2021 study conducted in Canada focused on the experiences of 21 individuals who had loved ones struggling with substance use disorders. [5] The type of relationship varied significantly across the study. For example, some people had children who were experiencing methamphetamine addiction, others had siblings who were addicted to alcohol, and yet others had parents who were addicted to cocaine. In one of the cases studied, a 72 year-old man was taking care of his daughter and grandson, both of whom were struggling with alcohol use disorder. Yet, even across all of their differences, the emotional experiences reported by these loved ones were remarkably similar and extremely painful. The authors of the study categorize these emotional experiences into four groups: grief and loss, dread and despair, perpetual crisis, and mitigation work.
Grief
One of the most significant responses that the researchers received from this group of loved ones was that they had, to some extent, lost someone to addiction. This created a deep feeling of grief and a hollow sadness for all the respondents. As one mother said to the researchers through tears, “I lost the son I had, now there is this new man with this illness.”
Dread and Despair
Most of the participants in this study also lived with the daily fear that their loved one would die from substance abuse, either directly from overdose or from complications from use. Many of these individuals talked about a devastating routine of checking on their sibling, parent, or child and wondering if they would find them dead. The researchers found that this was also linked to feelings of helplessness and despair.
Perpetual Crisis
Another shared emotional experience was the feeling of being constantly in crisis or of being unable to relax or find normal rhythm because of the chronic emotional volatility and often abusive behavior of loved ones with addiction. This was also reported in relation to the overwhelming demand for care they represented.
Mitigation Work
Finally, one major shared experience among all the loved ones of individuals with SUD interviewed was how much work it took to mitigate the negative effects of the addiction on daily life. One of the key ways this was felt was as lack of support. A sister to a woman with an alcohol addiction reported that, “[Other people] don’t understand the trigger points. They don’t understand, when she’s as bad as she is, it’s not a choice that she’s making; it’s her survival cause she’s so sick… There needs to be something for people who can do and they can learn about what their loved one is going through.”
If you or someone you know is supporting a loved one through their struggle with substance use disorder, know that you are not alone. Supporting those that you love through an illness is not shameful, and you deserve support and care as well. For resources and support, visit the “addictions” page of my website, or reach out via the “contact us” link. Our highly trained team of treatment professionals are here to help you and your loved ones navigate the complex and emotional journey of recovery.
[1] NIDA. 2020, July 6. Preface. Retrieved from https://nida.nih.gov/research-topics/addiction-science/drugs-brain-behavior-science-of-addiction on 2026, March 17
[2] Stellern, J., Xiao, K. B., Grennell, E., Sanches, M., Gowin, J. L., & Sloan, M. E. (2023). Emotion regulation in substance use disorders: a systematic review and meta-analysis. Addiction (Abingdon, England), 118(1), 30–47. https://doi.org/10.1111/add.16001
[3] Koob G. F. (2015). The dark side of emotion: the addiction perspective. European journal of pharmacology, 753, 73–87. https://doi.org/10.1016/j.ejphar.2014.11.044
[4] Mikulić, M., Ćavar, I., Jurišić, D., Jelinčić, I., & Degmečić, D. (2023). Burden and Psychological Distress in Caregivers of Persons with Addictions. Challenges, 14(2), 24. https://doi.org/10.3390/challe14020024
[5] Maina, G., Ogenchuk, M., Phaneuf, T., & Kwame, A. (2021). “I can’t live like that”: the experience of caregiver stress of caring for a relative with substance use disorder. Substance abuse treatment, prevention, and policy, 16(1), 11. https://doi.org/10.1186/s13011-021-00344-3
