The Opioid Crisis Changing Families in the 21st Century    

What is the Opioid Crisis?

The “opioid crisis”, also called the “opioid epidemic”, refers to the rapid increase in the use of prescription and non-prescription opioids in the United States.  On Oct 26, 2017, the president actually declared the opioid crisis a national public health emergency, freeing up federal funding for treatment and other resources.  Many federal agencies have joined to combat this crisis that is taking American lives at unprecedented rates.  It is devastating families and even entire communities.  While the causes of opioid misuse are highly complex and multifactorial, the goals of prevention and recovery focus on reducing risk and promoting resiliency.  The government is addressing the opioid crisis by helping to educate families, educators, and others about the dangers of opioid misuse and ways to prevent and overcome opioid addiction, along with supporting state and local agency efforts.

“Opiate” is a pharmacological term referring to a drug derived from the opium plant.  “Opioid”, a more modern term, is used to describe both natural and synthetic narcotic pain relievers.  They work via the central nervous system by reducing the number of pain signals sent to the brain.  Common types of opioids include prescription drugs such as codeine, OxyContin®, Vicodin®, fentanyl, and morphine.  Heroin is an illegal opioid.

Risk of Addiction

The risk of addiction is high with opioids.  With addiction, the drug use alters the brain and causes the person to crave its euphoric feelings, disregarding any consequences.  When people use opioids that have not been prescribed specifically for them or they begin to use more than what is prescribed, they are more likely to become addicted.  A person may also begin to build a tolerance where more of the drug is needed in order to have the same effect, as well as withdrawal symptoms upon stopping the drug, which all can be referred to as chemical dependency.  Opioid addiction can cause serious issues with family responsibilities, relationships, health and well being, finances, the law, employment, and education.  Overdose is a severe problem, especially for people who illegally use opioids, and it can lead to death.

As this nationwide epidemic continues, with devastating effects on individuals, families, and communities, few are left untouched.  In addition to deep psychological and physical impacts addiction has on a person, it also has profound effects on his or her family.  Research on the consequences of opioid addiction on families is abundant and seems to point to the same conclusions.  Opioid addiction profoundly affects the emotional, physical, and financial health of family members and the family as a whole.  These addictions drastically change family roles, rules, rituals, and both internal and external relationships.  The effects are seen across all family subsystems as well (relationships including adult intimacy, parent-child, sibling, the nuclear family, extended family, and social networks).


Almost all addiction cases contain multiple family stories.  Opioid-affected family life is unfortunately rampant with shame, humiliation, anger, verbal confrontations, frustration, fear, anticipatory grief, guilt, helplessness, shock, confusion, denial, brief glimmers of hope, and social isolation.  These are amplified when there is threatening behavior, violence, lying, manipulation, failed promises, money requests, theft, or property damage involved.  There is often generational role disruption (for example, grandparents raising a child of an addicted parent), declining social life, financial stress (from the effects of opioid addiction, repeated treatments, and legal expenses), and actually a stress-related increase in their own substance use.  Also, each opioid overdose death affects numerous people and the loss of a loved one through death, incarceration, or incapacitation creates immense suffering for family members and others involved, causing pain that can persist for years.

Research and clinical experience on the psychological effects of opioid addiction on children and parental opioid addiction on parent-child relationships seem to all point the same directions as well.  Children of opioid-addicted parents are at increased risk of attachment issues, mood disorders (including depression, anxiety, and suicide), conduct and substance use disorders, as well as problems with school adjustment and performance.  Interestingly, these tend to be gender related with female children suffering greater mood disorders and male children experiencing more conduct and substance use disorders.  These are amplified when the parental intimate relationship is conflictual, violent, or there are cycles of engagement, abandonment, and re-engagement.  Studies on the effects of parental opioid addiction on parental effectiveness and parent-child relationships show patterns of disengagement, abandonment, and guilt-induced over-protection and over-discipline.  This is a recipe that frequently leaves children confused and defiant.

There seems to be a need for family-oriented work and research specifically regarding treatment, recovery, support, policy, and prevention.  Along these lines, support group organizations are key in addressing the shame and social isolation that plague addiction-afflicted families, and provide much needed education as well as referrals/linkage.  Al-Anon (which includes Alateen) offers hope and help to families and friends of those addicted to alcohol or drugs.  Also, “Learn to Cope” is a non-profit support network that provides education, resources, and peer support for parents and family members coping with loved ones addicted to opiates or other drugs.  In addition, with individual and family psychotherapy, confidential professional assistance can be obtained, treating the effects that addiction has on family members.  It is important to note that family counseling can be with or without the addicted family member present.

Hopefully, alternative, more natural ways to relieve physical pain, with reduced risk of addiction, can all continue to come to the forefront.  Along with the increased funding for education and treatment programs, it looks promising.  We can all work together to mitigate the devastating effects opioid misuse has on our families and communities, decreasing the overall amount of lives affected in the future.