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Addiction is a disease that over 20 million American adults suffered from in 2014, according to the National Survey on Drug Use and Health (NSDUH). Addiction can affect relationships, work production, and physical and emotional health; it can also create possible criminal or legal problems. Addiction can be a constant source of strain on spouses and families.

A spouse often makes excuses for their partner’s erratic and unreliable behaviors caused by the disease of addiction, which only enables it. Calling work to tell a boss that their partner is sick when in reality they are hungover or high does more harm than good in the long run. This is an example of enabling behavior. Cleaning up a partner’s mess and not allowing them to fully experience the consequences of their actions also enables the addiction; it can therefore prolong it and delay recovery.

The SAMHSA (Substance Abuse and Mental Health Services Administration) Treatment Improvement Protocol (TIP) reports that enabling often leads to codependence, which can be a negative pattern of behavior for both partners. Instead of enabling, spouses of addicts should set clear and realistic boundaries and stick to them. Allow addiction to take a toll on the person’s life and have real consequences (while remaining safe, of course).

Having an honest and direct, albeit simple, conversation about the direct impact of addiction is a possible way to get things moving in a positive direction, Psych Central publishes. Remain calm, find empathy, avoid judgment and personal attacks, and have an open conversation about the addiction and the importance of getting help. It is important to have this talk when they are not high or drunk and will be most receptive. It may take several small conversations to get through to them that addiction is disrupting the relationship. Defensiveness and denial are common roadblocks that a spouse will encounter, and it can be helpful to tread lightly but firmly in some instances.

A professional can help with this process, either through a structured intervention or just with advice and direction on how to proceed. When there is a history of mental illness, violence, self-harm, or abuse of multiple substances, it’s always optimal to have a trained professional present. The main goal is to help the spouse battling addiction to agree to enter into a rehab program.

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Choosing a Rehab Program

There are over 14,000 facilities in the United States that specialize in addiction treatment, the National Institute on Drug Abuse (NIDA) reports. There are many different types of treatment programs to choose from, ranging from detox to outpatient care to inpatient rehab. Addiction is an individual disease, and the level of care will differ from person to person. Someone who is heavily dependent on drugs or alcohol will likely benefit most from a medical detox program followed by an inpatient rehab program, for instance, while someone who is less dependent on alcohol and/or drugs and has familial obligations to attend to may benefit from the flexibility of an outpatient rehab program. An intake specialist at a rehab facility, primary care provider, or mental health professional can help spouses determine what type of program will be best suited for their partner.

There are several available resources for finding a rehab program. For example, SAMHSA provides a behavioral health services locator tool on their website to help people find addiction and mental health treatment services in their local area. Primary care providers, community outreach programs, and mental health professionals can help with referrals as well.

Once the field has been narrowed, there are some things to look for when seeking rehab for a spouse, such as:

  • Type of services offered: Different facilities may offer variable treatment options, and it is essential to find out if they offer the types of services necessary for recovery.

  • Geographical location: It can be preferable to have a spouse in a rehab facility close by in order to make visiting more accessible. Also, if they are receiving outpatient services, it is important to be able to get to the facility easily.

  • Accreditation, certification, or licensing: Every state will have certain requirements for facilities to provide addiction treatment services, and it is vital to ensure that the center is compliant and up to date. There are also several certifications that rehab centers and trained professionals can apply for that indicate that they provide highly qualified care above and beyond what is required.

  • Amenities and complementary care options: Rehab facilities will vary in the types of amenities they offer. For instance, some may have private rooms, gym equipment, spa services, etc. Specialized therapies like yoga, nutrition planning, fitness programs, mindfulness meditation, and art therapy may be offered as well.

  • Payment options: Check with insurance to see what types of services and providers may be covered and then check with the rehab facility to see what insurance plans they accept. Most will also offer payment plans and possibly other options for payment as well.

  • Visiting policy: Find out what the policy on visiting is prior to admission. Many facilities have set hours in the evening or on the weekends for spouses and families to visit. Some may ask that spouses not visit in the initial days or weeks of treatment but offer time to talk on the phone or engage in written correspondence.

  • Aftercare programs: Services like relapse prevention programs, alumni support groups, peer support groups, education, medication support, transitional housing, and ongoing therapy sessions can be important aspects of recovery, and facilities often either offer these services or provide direct referrals to places that do.

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Involvement of Family in Treatment and Recovery

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Spouses and families play an important role during recovery. They make up a person’s initial support system and are often the first to recognize problematic behaviors and a potential relapse.

Partners and family members need to take care of themselves and even put themselves first for a change. The disease of addiction can be all encompassing, and a spouse may spend most of their time taking care of their addicted partner. Instead, spouses should make sure their individual needs are being met. Joining an exercise class, sticking to set family meal times, and keeping a structured schedule can help.

Family members and spouses can also benefit from joining a support group, such as Al-Anon (a subsidiary of Alcoholics Anonymous for family members) or CoDA (Co-Dependents Anonymous). Support groups provide families with connections to others who understand what it is like living with someone battling addiction and can offer support, empathy, encouragement, and hope. Educational programs can also help spouses and loved ones to better understand the disease of addiction and learn more about recovery and what to expect beyond treatment. Treatment centers will often have programs that allow spouses and families to be actively involved in the treatment plan.

Couples and family therapy can be highly beneficial to both the individual in treatment and their spouse. In therapy, a spouse can work through issues related to living with and loving someone who is struggling with addiction. Behavioral therapies, such as Cognitive Behavioral Therapy (CBT), serve to positivity change a person’s mindset and subsequent self-destructive actions.

Couples and family therapy works to improve communication within the familial relationships and therefore enhance and strengthen the family unit overall. Systemic Family Therapy, as published by the Association for Family Therapy (AFT), builds on strengths that already exist within the family and seeks to solidify these. Couples and family therapies can be very helpful in building trust, forming healthy coping mechanisms, and creating a strong foundation for sustained recovery.

Spouses can be a great source of encouragement and strength for their partner during addiction treatment and recovery. Those programs that involve spouses and other family members in clients’ treatment processes can be the best option for partners who are seeking out stability and healing in recovery.