Effects of Addiction On Siblings: Brothers & Sisters With Addiction

Addiction within a family can have a profound impact on all members, especially siblings. Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. While addiction primarily affects the individual struggling with substance use, its impact extends to the family system, and siblings often bear a significant burden.

Siblings of those with addiction may experience a range of emotional, social, and psychological consequences. They may feel burdened by the responsibility of supporting their addicted sibling, experience guilt and shame, struggle with feelings of isolation and resentment, and suffer from anxiety and depression. They may also experience difficulties in their own relationships and personal lives as a result of their sibling’s addiction.

Treatment options for siblings of addicts include individual therapy, support groups, and family therapy. These approaches aim to help siblings process their emotions, build coping skills, and develop healthy boundaries.

Strategies siblings can use to provide support and mend relationships with the addicted family member include open communication, education and awareness, and the establishment of healthy boundaries.

How Are Siblings of Addicts Affected by Substance Abuse?

Substance abuse within a family significantly strains sibling dynamics, leading to emotional neglect, trust issues, financial strain, and long-term impacts on mental health and personal development.

Here are 14 ways siblings can be affected by substance abuse:

1. Strained Sibling Dynamics: Families with substance abuse issues often experience increased conflict and communication breakdowns. Siblings may report higher levels of aggression and hostility, which can lead to long-lasting rifts in relationships.
   
2. Shifted Parental Attention: Parents may become preoccupied with the needs of the addicted child, leading to neglect of other siblings. This can result in abandonment and resentment, as siblings may feel they are competing for attention and support. According to Smith-Genthô, Logue, Low, and Hendrick’s 2017 book, siblings of individuals with substance use disorders often experience significant challenges due to the shifted focus of their parents.
   
3. Erosion of Trust: Addicted siblings may engage in theft or deceit to support their addiction, leading to a pervasive sense of mistrust that extends beyond family relationships. This behavior can create significant emotional and financial strain.
   
4. Emotional Turmoil: Living with an addicted sibling can create an environment characterized by unpredictability and fear. Siblings may experience heightened anxiety and emotional distress, feeling unsafe or threatened in their own homes.
   
5. Increased Caretaking Roles: Non-addicted siblings often take on caretaker roles. According to Kitzmüller, G., Wiklund Gustin, L., & Kalhovde, A. M. (2023), siblings of individuals with substance use disorders often experience high levels of stress, anxiety, and depression, which may contribute to their taking on a caretaker role. This premature assumption of adult responsibilities can hinder their emotional and social development.
   
6. Social Isolation: The stigma associated with addiction can lead siblings to withdraw from peers and social activities. This isolation can exacerbate feelings of loneliness and depression, making it difficult to form supportive friendships.
   
7. Mental Health Consequences: Siblings of individuals with substance use disorders are at a higher risk for developing mental health issues, including anxiety and depression, due to the chronic stress associated with living in a chaotic environment. According to Monari, Esther N. et al.’s 2024 study, family members living with individuals suffering from Substance Use Disorders (SUDs) are at increased risk of developing mental health issues compared to the general population.
   
8. Disrupted Personal Development: The focus on an addicted sibling can hinder the personal aspirations of non-addicted siblings, leading them to delay or abandon their own goals to support the family dynamic.
   
9. Altered Family Roles: Siblings may adopt roles such as the “hero,” “scapegoat,” or “lost child” in response to addiction. These roles can lead to dysfunctional family dynamics that persist into adulthood, affecting relationships and personal identity.
   
10. Feelings of Guilt and Responsibility: Siblings often feel a sense of guilt for not being able to prevent their sibling’s addiction. This burden of responsibility can impact their self-esteem and mental health.
    
11. Increased Risk of Substance Use: Siblings of individuals with substance use disorders are at a higher risk of developing their substance use problems. Familial patterns of addiction can influence behavior and increase vulnerability.
    
12. Compromised Family Resources: Addiction can strain family finances, limiting resources available for education and extracurricular activities for non-addicted siblings. This financial strain can hinder their opportunities for personal growth. According to Tambling, Rachel R. et al.’s 2019 study, financial anxiety is a common experience among caregivers of adult children with substance addiction.
    
13. Challenges in External Relationships: Trust issues stemming from familial addiction can hinder the ability to form healthy relationships outside the family. Individuals with a history of familial addiction may struggle with intimacy and trust in romantic relationships.
    
14. Impact on Future Parenting: Siblings of addicts may carry forward learned behaviors and attitudes towards substance use into their parenting, potentially perpetuating cycles of addiction and dysfunction in future generations.

Why might one sibling abuse or get addicted to substances?

One sibling might be an addict while another is not due to several factors. A combination of genetics, environmental influences, and personal experiences can contribute to an individual’s susceptibility to addiction. 

Here are the top 5 reasons for sibling addiction:

1. Genetic Factors

Genetic predisposition plays a significant role in the development of substance use disorders in a sibling. A family history of addiction can increase an individual’s risk, as certain biological vulnerabilities may affect how they respond to drugs or alcohol. According to Prescott, Carol A. et al.’s 2016 article ” It is estimated that genetic factors account for 50–60% of the variation in risk for alcoholism. The study also indicates that genetic variation contributes to the risk of developing addiction to alcohol, tobacco, and other illicit drug addictions as well.

Understanding these hereditary factors can help families recognize that addiction is not merely a choice but often a complex interplay of genetics and environment.

2. Environmental Influences

The environment in which a sibling grows up can greatly impact their likelihood of developing an addiction. Dysfunctional family dynamics, such as conflict or lack of support, can create stress that drives individuals toward substance use.

According to Kendler, Kenneth S. et al.’s 2013 study published in JAMA Psychiatry, a sibling with a history of drug abuse increases the likelihood of their sibling also having a history of drug abuse by 1.42 times.

Additionally, socioeconomic factors, like financial instability, can contribute to feelings of hopelessness. Peer pressure and social circles also play a crucial role, as friends can influence the initiation and continuation of drug use.

3. Psychological Issues

Many individuals turn to substances as a coping mechanism for underlying psychological issues. Mental health disorders, such as depression, anxiety, or PTSD, can lead to self-medication through drugs or alcohol. For some, substance use becomes a way to escape emotional pain or trauma, highlighting the importance of addressing mental health alongside addiction treatment.

According to a study done by Conway, K. P., Swendsen, J., Husky, M. M., He, J. P., & Merikangas, K. R. (2016), Adolescents with a history of mental disorders showed high rates of alcohol (10.3%) and illicit drug (14.9%) abuse, regardless of dependence. Abuse rates were highest among those with anxiety disorders (17.3% for alcohol and 20% for drugs) and behavior disorders (15.6% for alcohol and 24% for drugs). Having any prior disorder significantly increases the risk of moving from not using substances to first use, and from use to problematic use of alcohol or drugs

4. Social Environment

The social environment can significantly affect a sibling’s relationship with substances. Easy access to drugs or alcohol increases the likelihood of use. According to Maiya, Sahitya et al.’s 2023 study, older siblings’ cannabis and e-cigarette use were indirectly related to younger siblings’ later intentions to use these substances through their positive expectations about substances.

Cultural acceptance of substance use can also normalize experimentation.  Understanding these social dynamics can help families identify external pressures that may contribute to their sibling’s addiction.

These environmental sibling effects were significant after controlling for parent and peer smoking, indicating that the social dynamics within sibling relationships have a direct impact on smoking behavior beyond genetic predispositions or influences from other social groups.

5. Impact of Family Dynamics

Family dynamics can have a profound effect on a sibling’s mental health and potential for substance abuse. Feelings of inadequacy may arise if one sibling feels overshadowed by the achievements of another, leading to low self-esteem and a desire to escape through substance use. Strained relationships can create a sense of responsibility and guilt, further exacerbating mental health issues. Additionally, perceived neglect or favoritism can drive a sibling to seek solace in substances, making it essential for families to foster open communication and support.

A family history of substance use disorder (SUD) in parents or older siblings increases the risk of SUD in adolescents. Hamad, Amani F. et al. (2022) study found that adolescents with a history of SUD in their mothers, fathers, both parents or an older sibling had a significantly increased risk of developing SUD. These results highlight the importance of considering familial factors when assessing adolescent SUD risk.

Recognizing the multifaceted reasons behind a sibling’s substance abuse is crucial for family members. By understanding genetic, environmental, psychological, and social factors, families can approach the situation with empathy rather than judgment. This awareness not only helps in providing meaningful support but also encourages siblings to seek the treatment they need. Ultimately, fostering a supportive environment can pave the way for recovery and healthier coping strategies.

What treatment options are available for addressing addiction in siblings?

Treatment options for addiction in siblings include inpatient, outpatient treatments, medication-assisted treatment, therapy, support groups, and more!

Here are the key treatment options to address addiction in siblings:

Inpatient and Residential Treatment

This involves staying at a treatment facility where individuals receive medical care, therapy, and support in a structured environment. Inpatient programs can last from a few weeks to several months and often include a range of therapies, including group therapy, psychotherapy, and medication management for withdrawal symptoms and cravings.

Outpatient Treatment

For those who may not require the intensive care of an inpatient program, outpatient treatment allows individuals to receive care while continuing to live at home. This option provides flexibility and often involves therapy sessions and support groups a few times a week.

Medication-Assisted Treatment (MAT)

This approach combines medications with counseling and behavioral therapies to treat substance use disorders. MAT can be particularly effective in managing withdrawal symptoms and reducing cravings, aiding individuals in their recovery process.

Detoxification Services 

Before entering a treatment program, individuals who are actively using substances may need to undergo detox. This medically supervised process helps safely manage withdrawal symptoms as the body clears substances from its system.

Therapy and Counseling 

Individual and family therapy can be crucial for both the individual with the addiction and their siblings. Therapy can help address underlying mental health issues and improve communication within the family system.

Support Groups for Siblings 

Organizations such as Al-Anon or NAMI offer support groups for siblings of addicts. These groups provide a safe space to share experiences and gain insights from others facing similar 

challenges, helping siblings cope with the emotional toll of addiction.

Family Therapy 

Involving the entire family in the treatment process can facilitate healing and improve relationships. This type of therapy focuses on communication dynamics and aims to create a supportive family environment conducive to recovery.

What Emotions Do Siblings of Addicts Experience?

Siblings of addicts often experience a mix of emotions, including anger, sadness, frustration, and guilt. They may feel helpless watching their sibling struggle and often face isolation, as it can be hard to find others who understand their situation. Guilt can lead them to question their actions and may result in enabling behaviors. They need to acknowledge these feelings and seek support through therapy or support groups to cope and create a healthier environment for healing.

How to help an addicted Sibling Without Enabling Further Substance Abuse?

Siblings of addicts can help by encouraging their siblings to seek treatment while avoiding enabling behaviors. They should express concern and love without judgment and discuss how the addiction affects the family. Encouraging treatment participation is key.

To avoid enabling, siblings should set boundaries, such as not providing financial support for substances and avoiding situations that promote substance use. Instead, they can strengthen their relationship by engaging in positive activities like family therapy or support groups. This approach helps support the sibling’s recovery while protecting their well-being.

The table below explains more strategies to help addicted siblings:

Strategy	Description	How It Helps/Supports Addiction Recovery
Direct Assistance for Basic Needs	Provide direct help for essentials like groceries, rent, or utilities instead of giving cash, ensuring support aids well-being and not substance abuse.	Ensures basic living needs are met without enabling drug purchases.
Gift Cards for Necessities	Offer gift cards for essential services, supporting basic needs without enabling access to cash.	Limits the use of funds to necessities, reducing the risk of funding substance abuse.
Direct Payment to Service Providers	Pay landlords or utility companies directly to ensure funds are used for necessary expenses.	Guarantees that essential bills are paid, maintaining stability during recovery.
Offering Non-Monetary Support	Provide non-financial assistance such as job search help, resume building, or emotional support during recovery.	Enhances self-sufficiency and emotional well-being, critical for recovery.
Connect with Treatment Resources	Encourage and assist in finding treatment programs, support groups, or counseling to address addiction’s root causes.	Facilitates access to professional help, addressing underlying issues of addiction.
Set Boundaries	Communicate support for recovery with clear financial boundaries, contingent on their commitment to sobriety.	Reinforces the importance of responsibility and accountability in recovery.
Involve a Trusted Third Party	Involve professionals like counselors to manage financial support, ensuring alignment with the recovery plan.	Adds a layer of accountability and ensures financial support is used appropriately.
Educate Yourself on Addiction	Gain knowledge on addiction and recovery to offer informed support and avoid enabling substance abuse.	Empowers you to provide more effective support and avoid enabling behaviors.
Encourage Responsibility	Support your sibling in taking responsibility for their actions and decisions, promoting personal growth and accountability.	Limits the use of funds for necessities, reducing the risk of funding substance abuse.
Join a Family Support Group	Engage in groups for families facing similar issues for shared experiences and insights on non-enabling support.	Offers emotional support and practical advice, helping families navigate recovery together.

How Do I Set Boundaries With My Addicted Sibling?

Boundaries for siblings of an addict refer to the clear lines or rules established to maintain a healthy relationship and personal well-being while supporting the sibling’s journey to recovery. These boundaries are crucial for defining acceptable behaviors, responsibilities, and limits on the assistance provided, ensuring that support does not enable addiction. They help protect the sibling from emotional or financial harm and encourage the addicted sibling to take responsibility for their actions and recovery process.

Setting boundaries with your addicted sibling is essential for both their well-being and your own, but it can be emotionally challenging. Start by clearly communicating your limits with empathy and love. Let them know that your decision is motivated by a desire for their recovery and your mental health.

Understand that saying “no” doesn’t make you unsupportive; it establishes a necessary framework for accountability and peace of mind. Seek guidance from support groups or a therapist to reinforce your conviction in maintaining healthy boundaries, ultimately contributing to a more stable and supportive environment for your sibling’s recovery.

How does substance abuse affect the family?

Substance abuse significantly impacts families, creating rifts and feelings of resentment and mistrust. Siblings may feel torn between loyalty to the addicted sibling and their own needs, leading to communication breakdowns. Parents might unintentionally prioritize the addicted sibling’s needs, affecting family dynamics.

The stress of addiction can also cause mental health issues, like anxiety and depression, in siblings. Families need to seek support through therapy or counseling, which can help siblings express their feelings and learn coping strategies, promoting a healthier family environment and aiding recovery.