Takeaway
A family member’s substance use can impact a patient’s health and ability to engage in their own care. Healthcare professionals can offer support by listening, validating, and sharing resources.
Lifelong Learning in Clinical Excellence | July 30, 2025 | 2 min read
By Jessica Ratner, MD, Johns Hopkins Medicine
It often first pops up as an aside while talking with my adult primary care patients about the ways that stress affects their health—whether it’s a recent increase in blood pressure, the difficulty of smoking cessation, a downturn in mood, or missed appointments.
“My husband came home from rehab last week and has already started to drink again. So, I couldn’t make it to that MRI even though I’ve been waiting for it for weeks.”
“I just can’t focus on quitting smoking right now. My daughter dropped my grandson off and left . . . he’s been using.”
Substance use disorders (SUD) can have a broad circle of impact, often including the loved ones of those affected. This impact may be felt in many ways. Substance use can cause conflict and stress within family relationships. Money spent on substances or job loss can create financial strain. Sometimes substance use can lead to an unpredictable, chaotic, or even unsafe home environment. Family members may experience a wide range of emotions about their loved one and their substance use disorder—worry, fear, frustration, anger, hopelessness, embarrassment, and/or guilt. These stressors can impact a patient’s physical and mental health and well-being, as well as their ability to attend to their own needs.
When a patient discloses substance use in a loved one, they provide a window into the ways that their family life impacts their health and offer an opportunity to provide support. Here are some approaches that healthcare professionals can take:
1. Ask and listen.
Ask the patient about how their family member’s substance use affects them.
2. Validate.
Acknowledge that coping with substance use in a loved one is hard—it’s normal to have complex feelings.
3. Advocate.
Let the patient know that it’s ok (and important) to prioritize their own health and set boundaries when needed. Assess for safety, if relevant. There are resources to help family members cope with a loved one’s SUD—for example, individual or family therapy, or local or online family-focused support groups such as Al-Anon, Nar-Anon, or Smart Recovery.
4. Educate.
If the patient is interested, educate about resources that support family members in encouraging their loved one to seek treatment—for example, in the U.S. via the Substance Abuse and Mental Health Services Administration (SAMHSA).
5. Offer naloxone.
Ask if they need naloxone for opioid overdose prevention. If yes, consider prescribing it to them or offer information about where to get it—in the U.S., check out Next Distro for state-specific information on how to obtain this life-saving medication or direct patients to their local/state health department.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.