Who are the hidden victims of drug dependence? Parents

One of my patients – let’s call her Amanda – has been a long-term patient of our practice. A single mum, she’s worked hard to provide for her three kids.
 
I’ve had the pleasure of seeing them all in the surgery over the years, watching the kids grow up and treating their childhood rashes and upper respiratory tract infections. I was there while Amanda fought off breast cancer. She’s an outstanding mum and amazing woman.
 
Sadly, last year her 20-year-old son started using crystal methamphetamine (ice). Soon after that, he dropped out of university and started turning up at home in crisis. He would demand money, and if denied, simply steal from the family.
 
She encouraged her son to see me for support and information but he failed to attend any of the appointments she made for him.
 
And while I am able to provide this support and information to him, I can’t do this without him engaging with me.
 
Instead, Amanda would come. She would apologise for wasting my time. It was difficult to reassure her, but I told her that this was ok, that she was my patient and that my role would instead be to support her to manage her son’s now-chronic illness – a dependency on stimulants.  
 
Supporting her through this crushingly difficult period has made me think deeply about the toll that drugs takes on families.

Too often, there is a tendency to blame the family. We might think that this only occurred because of family dysfunction. Some might even think mothers are particularly to blame.
 
But having seen this family over the decades, I know this to be patently untrue and wholly unhelpful for Amanda and her family, and the many other families in similar situations I’ve seen over the years. I know them to be a loving and functional family.
 
The pain Amanda is experiencing is immense. She wonders what she did to her son, whether this is her fault and feels so deeply shameful. She says it feels like she has lost her son, and not just temporarily. It feels, to her, like her beloved son is already dead.
 
Many GPs will be in the same boat. We do our best to support distressed parents, siblings, or children as they struggle with their new role of carers for their loved ones who are in the grip of an addiction.
 
The view of dependency and addiction as a chronic relapsing medical condition can be helpful for families to understand this complex issue. But it does not help them with the real life challenges of maintaining boundaries between them and their addicted loved one. So often, families, too, get entangled in the emotional rollercoaster of crisis and obsession that is addiction.
 
When it was clear that Amanda was struggling, I encouraged her to contact a support group for families whose loved ones are dependent on drugs. It was a huge step for her, to be able to push past the shame she felt. But when she finally contacted the group and spoke to another parent, she realised for the first time that she wasn’t alone. Amanda told me there was a huge relief in having others who understood the journey that she and her family were on.
 
Eventually, her son realised that he was in trouble. He sought help and is currently in an inpatient rehabilitation service.
 
I am holding my breath, hoping that he’ll be able to maintain the changes he’s made as an inpatient.
 
Now, my job is to help Amanda and her other children understand that it may still be a long road after he leaves treatment. When I see her next, I will work with her to set boundaries and get support for her son – and for her – as both continue down the road to recovery.

Note: The Family Drug Support (FDS) organisation offers tremendous peer support to many of the families I see who are struggling to support their loved ones with addiction. It was set up by Tony Trimingham, who lost his son to a heroin overdose. FDS has a 24-hour support line, and regularly holds meetings around Australia.

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