What to Do When Your Partner Has a Substance Abuse Issue

Perhaps you are the partner of an individual whose drinking or drug use is affecting your relationship. You may find yourself feeling, at times, that you are in a complicated downward spiral – the more painful the couple dynamics, the more the substance abuser uses, and the more he or she uses, the more painful the couple dynamics.

Over the years, I have learned that there are a number of effective ways to stop the downward spiral. But before I discuss these, let me share a little bit about my experience working with couples who face these kinds of issues. Early on in my career I led groups with alcoholic couples at the Appleton Outpatient Clinic at McLean Hospital. During that time, and for many years since, I also have worked individually with couples where one or both had substance abuse issues, as well as worked with the partners of addicts who wanted to find ways of effectively intervening to help themselves and their addicted loved one to heal.

These important principles may be useful when you look for help for you and your partner:

Get substance abuse off the table

Drinking or drug use may be the cause of your problems as a couple, the result of your problems, some of each, or neither. But we cannot tell until it is out of the way.

When there is a substantial substance abuse problem, there is a serious risk that the couples work will be hijacked – the drinking or drugging becoming the ‘batboy’ with little else getting done. Until the substance abuse is off the table (which can be done only by bringing it under control with a program of supports), no issues that a substance abuser might want to raise, no matter how legitimate, are going to get a fair hearing. Thus, it is essential to address this problem in order to level the playing field enough for you and your partner to really engage in sorting out the issues between you.

At times, you may need to consult with an expert who understands not only the process of formal intervention but also less labor-intensive ways of maximizing your leverage to get your partner the help he or she needs.

Don’t try to determine the “cause” of the fire while the building is burning

The second principle is to avoid the very natural inclination early on to try to sort out the “causes” of the drinking or drug use. No matter how legitimate these explanations may seem to the substance abuser, the partner generally hears them as excuses, further stalemating the process.

Segregate the parts (separate support for each of the partners)

Frequently, the best way to proceed is to get specific substance abuse treatment for the addicted member of the couple and separate individual therapy (as well as Al-Anon) for your own support. Couples therapy might occur alongside of this or might be put on hold until the substance abuser has begun to achieve enough stability to provide confidence that this issue is being addressed and to begin to restore the partner’s trust.

Shoring up trust

Since substance abuse is often associated with behaviors that seriously erode trust (hiding use, not being upfront about it even when directly confronted, surreptitious spending to support drug or alcohol use), finding ways to restore trust is critical.

There are a number of structural ways to do this, and discussion between you and your partner, guided by a skilled couples therapist, can be useful in picking the one that may work best for you. For alcohol abusers, there are monitoring systems that can be easily accessed on the iPhone, such as sober link, that provides automatic updates that can be linked to your phone. There is also a cellphone breathalyzer that your partner in recovery may agree to use to reassure you when you are feeling anxious about his or her status with regard to alcohol use.

Your partner can also give other gifts of reassurance: for example, voluntarily taking Antabuse or Suboxone within view and if he or she is on other medications to deal with co-occurring depression or anxiety, letting you see that he or she is regularly taking those medications as well.

And of course, reassurance can also be buoyed by regular attendance at whatever ongoing supports he or she is using – individual therapy, group therapy, and/or AA.

Understanding the role and impact of substance abuse issues

Once the real couples work begins, in a climate of trust, you and your partner may benefit by coming to understand more about the role that substance use has played in your relationship, your past shared histories around it, and often, baggage from the past in terms of substance abuse issues in your families of origin.