This section was co-written with Dr Pauline Stewart (Family Drug Support Aotearoa New Zealand), Melissa Roberts (Community Alcohol and Other Drug Services Auckland), Erin Scarlett O’Neil (Brave Hearts), Sue Philipson (Families Overcoming Addiction), Marion Tizzard (Odyssey House Christchurch), and Kirsty McKenzie (Moana House) in 2023.
It was informed by a workshop with family support providers and conversations with family members of people who use substances.
Who a person views as their family can differ. This can include immediate family, extended family, other significant people, and chosen families. Allowing a person or family to define their whānau will result in centring their experience and allow for more meaningful engagement.
Each family member will have their own unique process and needs, regardless of whether a family member decides to access support or not. Like the continuum of care for addictions, which includes many different types of services that range in intensity, families need a range of different information and support options that match their situation. What a family member may need when someone in their family tries a substance for the first time is very different from what they may need when their family member has been using large amounts of substances for a long time and their use is impacting the family. Family support services provide space to talk and meet other people who are going through similar experiences. This can help both the person using substances and their family to make positive changes and access the information, tools, or support they need.
Key considerations
- There is a wide variation in what families experience when a family member uses substances. Some will have experienced fewer impacts or harm from it, while others will have experienced a lot of stress, worry, hurt, and fear. Sometimes the impact on family members is not related to the amount of use, or the way their family member uses substances. The stress and strain on family members can also include: worry about their family member’s health; finances; who their family member spends their time with; whether their family member is taking care of themselves; legal issues that may arise; and how they themselves are coping.
- Try to remove the extra barriers that many families experience to accessing support. These include: fear of being judged; wanting any support to go to their family member rather than themselves; not having access to safe childcare; feeling shame for asking for support for themselves; feeling like there are no services that will understand their specific situation; and reputational protection. Families should not feel ashamed about asking for information or support – they need to be seen as part of the core business of any service.
- Take time to consider what each family member needs. Each family member has their own hopes and support needs. Most family members who have experienced fear or stress, worry, and hurt want their family member to completely stop using substances. This can be the case for families who have been living with serious safety concerns because of the way that family member acts when under the influence of, or recovering from the use of, substances, or the prospect of serious physical harm because they obtained the substances from an illegal market. Understanding that their family member is receiving support from a harm reduction service can generate strong and conflicting emotions.
- Remind family members that it is ok for them to set their own expectations and boundaries with their family members. It is still ok to expect their house to be a place where people do not use substances, even if their family member is receiving support from a harm reduction service.
- Most families want there to be a wide range of information, tools, and support available to people to help them reduce potential harms from substance use. While some would prefer their family member engage with a service that will help them to stop all substance use, many still want there to be support if their family member does not want to stop or reduce their use. Very few families advocate for services refusing to provide information or support to people if they do not commit to reducing or stopping use.
“A parent’s natural response is to protect a child (abstinence), but when you look further out you can see the bigger picture.” – Family member
- Consider different experiences of substance use and the impact of that on different generations of families. Some families carry hurt from previous generations’ use of substances or how they were treated by the health, social, and legal systems at the time. This impacts how family members may engage with information and support. Trauma-informed approaches can also help.
- Provide a space for families to talk about the things they are doing to manage their situation and reduce potential health, social, and legal risks. Many families are already doing things to reduce potential risks every day. Providing a space to celebrate what they are doing, helping them to feel validated for their efforts, and listening for tips that could be helpful to share with other families can help.
- Many family members want both practical advice that they can apply straight away, and a safe space where they can talk about their own experience without being worried about how others around them may react. Sometimes people feel stuck in their roles, and feel they cannot do anything different or the family will fall apart. Being able to talk things through can help take the pressure off and help them to identify other ways of responding to the situation.
- Do not assume anything. This could include assuming that family members do not use substances themselves. While they may want to talk about the support they provide to another family member, remember that many family members may also have their own experiences of substance use and substance-related harm.
- Consider the impact on any children involved, including grandchildren, and their specific needs.