Journal of Community & Applied Social Psychology, Vol. 3 , 6 7 6 9 (1993)

Commentary

‘Ways of Coping with Excessive Drug Use in the Family: A Provisional Typology Based on the Accounts of Fifty Close Relatives’ by Orford, Rigby, Miller, Todd, Bennett and Velleman

ANNE MARSHALL Director, ADFAM National, 1st Floor, Chapel House, Hatton Place, London, ECl N 8ND

ADFAM National, a registered charity, is the national organisation for the families and friends of drug users in the UK. We run the national Helpline for families, provide training for professionals and volunteers to work with families and offer information, support and advice to drug-related family support services around the country.

Our direct and indirect contact with relativeslfriends coping with a drug user mirrors one of the main findings of this study, in that families often employ a combi- nation of coping strategies and that there is usually no neat and tidy method of categorising responses. Just as families use a variety of different methods to help their user-and themselves-families also need access to a range of helping options. It is very much evident in this study that what works for one relative in terms of coping may not work for another. Similarly, the kind of support that helps one family member may not be appropriate for another. An illustration of the latter: to some professionals, support for families of drug users is seen only in terms of a self help group. For some, joining a self help group can be tremendously beneficial:

- it can be empowering to be part of a group that depends on peer co-operation,

- by being in a self help group people are involved in running it and can develop

- reassurance can be gained and isolation reduced by hearing that other people

-some people are very nervous of institutions or ‘professionals’, so that self help

rather than any institutions or ‘professionals’

their skills and abilities, discovering skills they were unaware of

are experiencing similar problems

groups provide an invaluable alternative.

However, in some cases and for some people, self help groups can be inappropriate:

1052-928419310 10067-03$06.50 0 1993 by John Wiley & Sons, Ltd.

68 Anne Marshall

- it can heighten anxiety to hear of drug problems that are worse than those in

- if too much time is spent sharing negative experiences the group members can one’s own family

become even more anxious or depressed than they were individually.

Consequently, a group may be an effective means of support to some, whereas others may prefer the complete anonymity of a Helpline, the individual focus of one-to-one counselling or the informality of a befriending network. A number of repeat callers to the ADFAM Helpline combine various helping options, eg: the family support group they attend may meet only once every two weeks so, in between and as the need arises, they also ring the Helpline.

As the authors in the study expected, their female relative interviewees outnum- bered men. Our national Helpline statistics show that approximately 70% of our callers are female. A higher percentage of partners who call for help are male so this may (we hope) signify a greater degree of openness and willingness to talk about feelings among younger men who seek support.

The eight coping categories analysed in the study-Emotional Coping, Inaction, Avoidance, Tolerance, Control, Support for the User, Confrontation and Indepen- dence-are useful in focusing on specific types of responses but, as the authors recog- nize, they also illustrate the limitations of any such typology. As noted previously, many relatives calling our Helpline have used a combination of coping strategies and are experientially learning what does and does not work for them. A particular illustration of this occurred after a recent TV screening of a dramatized scene between a father and son about drugs, which fell into the ‘Confrontation’ category. The ADFAM National Helpline telephone number was broadcast directly afterwards and we received a high number of calls, specifically-and unusually-from fathers who recognized that they had used the confrontational technique as per the TV scene, had been extremely unsuccessful and wanted to discuss alternative ways of coping/helping. By the time many family members seek help, they are usually aware that any rigid coping stance they may have previously employed has been ineffective and, as desperation grows, they become more flexible in trying different ways of coping.

A proportion of family members who ring the ADFAM Helpline, or who contact local agencies, cope alone for a considerable period of time before seeking help for themselves: ‘The family’s always coped before with other problems. It feels like a failure to ask for help.’ ‘I feel so helpless/angry/guilty/frightened/betrayed.’ ‘I’ve reached the end of my tether.’ ‘I don’t know how much longer I can go on like this.’ We know from experience how the extent to which people will cope differs: one parent will throw out a soddaughter who’s been using or experimenting with cannabis but whose behaviour is not particularly problematical, while another parent will have tried many different ways of coping with and helping their long term drug dependent child for many years-sometimes even keeping a ‘sharp safe’ container for used needles in the home in order to reduce harm.

Those caring for drug users are an especially hidden set of carers and usually experiencing a great deal of isolation. This sense of isolation can be evident within the family itself-many carers, particularly mothers, are carrying the whole burden of coping themselves. ‘I can’t tell my husband as he’d go mad.’ ‘My husband would throw our son out if he knew.’ ‘My partner’s got enough to cope with-I don’t

Ways of coping with excessive drug use in the family 69

want to burden him with this.’ We often hear from siblings who are supporting their user brother or sister-and this can involve protecting the user from their parents: ‘they wouldn’t be able to cope;’ ‘they’d overreact and make things worse.’

The reduction of isolation is a vital factor in enabling family members to cope: ‘I know there’s nothing more that I can do to make my daughter stop-but it helps so much to talk to someone about it all. Someone who’s concerned about me.’ ‘I knew there was a lot of help available for drug users but I didn’t know there was any help for me.’ As we know, the kind of stress associated with this type of situation can and does lead to family members experiencing health problems (e.g. having to take time off work), money worries, legal concerns and, for some, using avoidance tactics such as increased drinking or tranquillizer use. (We hear of an unfortunate number of callers, primarily women who attend their GP-so often the first port of call in a drug problem-for help in coping, are prescribed tranquillizers and have consequently developed dependency problems of their own.)

ADFAM National welcomes this and other research currently being conducted on families and drug use. The findings aren’t new to us as practitioners and the national organisation in the field but the presentation of analysis is most valuable in reaffirming the necessity of non-judgemental support and a choice of helping options for the carers of drug users. We know from our experience that no one style of coping is universally the best. Support for families and friends of drug users at both local and national level should encompass the findings of this study.