"We Are Also Struggling": The Challenges Family Members of Individuals Who Misuse Substances Face in Seeking Help for Their Loved Ones

Background and Purpose: Substance misuse in the United States has been deemed an epidemic. Although substance misuse treatment programs provide services to over 3.8 million Americans aged 12 or older each year, individuals misusing substances are still struggling to get help. Previous research has examined the perceptions of challenges to seeking treatment from the perspectives of directors and staff associated with treatment facilities. However, little research has been conducted to assess family members' perceptions of the challenges encountered in seeking help for their loved ones. Family members play an essential role in the recovery process of their loved ones, and individuals misusing substances are more likely to enter and persist in treatment with support from family members. Understanding the challenges encountered by family members seeking treatment for their loved ones’ substance misuse is of great importance. The purpose of this study was to determine the challenges family members encounter in seeking treatment for these individuals and determine how these challenges affect them and their loved ones.

Methods: Data were derived from 97 family members of individuals misusing substances who received services from family support programs located in a northeastern state. Participants filled out a survey, which consisted of several closed and opened ended questions. For the purpose of this study, we analyzed the data from two opened questions. One question asked the family member to describe what challenges they encountered seeking services for their loved ones and how these challenges affected them. The other asked the family member to describe how the challenges affected their loved ones.

Data were organized using NVivo 12 and analyzed thematically. Research rigor was ensured through multiple triangulation techniques, such as the recruitment of a large sample and the use of two coders to analyze and interpret the data. The coders compared and discussed the themes after separately coding, interpreting, and recoding the data until reaching 100% agreement on themes.

Results: We identified three categories of challenges: (1) lack of bed availability, the most frequently cited challenge, (2) health insurance issues, including not having insurance or their insurance not being accepted by the treatment provider, and (3) mistrust of treatment facilities, which was the result of these facilities not meeting the family members’ expectations or being told about aspects of services that was not fulfilled in the end. These challenges affected both the family member and their loved one. For example, family members reported experiencing much emotional stress and many experienced financial burdens due to unanticipated treatment costs. While waiting for a bed to become available, family members commonly reported that their loved ones experienced relapse or job loss.

Conclusions and Implications: Findings suggest that the challenges encountered by family members seeking treatment for their loved one who is misusing substances not only affected them but their loved one as well. Therefore, social workers need to advocate for more treatment facilities and the appropriate training for those running such facilities. Policymakers should address the phenomenon of predatory practices in the substance treatment industry.