Substance misuse is a serious issue when it affects just 1 member of the family, but it can be even more problematic when it affects 2 people who are in a relationship, live together, or are married. Drug and alcohol rehab for couples is crucial for recovery, the well-being and health of both individuals, and the future success of the relationship. Many treatment centers offer couples’ addiction treatment to help you and your loved one start on the path to recovery and begin leading sober, happier lives.
Couples and Substance Abuse
Substance misuse occurs when an individual uses substances—including alcohol, illicit drugs, and/or prescription medications—in a way that is detrimental to their health and well-being and the health and well-being of those around them. Addiction is a chronic disease, with a potential for relapse, that involves compulsive use of substances and uncontrollable drug or alcohol-seeking behaviors despite the negative consequences to a person’s mental and physical health.1
Codependency is a learned behavior that can be common in couples who have a drug or alcohol addiction problem. Often, those who are co-dependent learned the behavior by watching another family member exhibit codependency. It is a psychological problem where a person is “controlled or manipulated by another who suffers from a pathological condition,” such as alcohol or drug addiction.2
Codependency does not only affect couples and spouses. It can also affect parents, brothers, sisters, friends, and colleagues in the workplace. Codependency is sometimes referred to as relationship addiction and involves caretaking, rescuing and enabling behaviors that keep each partner dependent on the other.
Couples who are addicted to drugs or alcohol may be codependent due to underlying, unconscious issues and unhealthy dynamics that play out in the relationship. Codependency involves compulsive caretaking behaviors that help an individual feel as though they are needed or wanted by the other person. For example, a codependent person may make excuses for their partner, such as calling in sick for them when they are hungover. These behaviors only serve to perpetuate the addiction because each partner continuously rescues or makes excuses for the other.3
Warning Signs of Codependency and Substance Abuse in Couples
People aren’t often aware that they are codependent until they learn about what codependency is. They may think they are acting in ways that are helpful to their partner without realizing that what they are doing is harmful to them both.
Signs of codependency include:2,3
- Caretaking behaviors.
- Taking too much responsibility for others.
- Feeling that you always have to do more than your share.
- Feeling hurt when your partner doesn’t recognize your attempts to “help.”
- Being dependent on the relationship or feeling that you can’t do things on your own.
- Feeling an extreme need for recognition or approval.
- Poor self-esteem.
- Repressing emotions.
- Obsessive behaviors or thoughts.
- Attempts to control your partner.
- An intense fear of abandonment.
- Denying the existence of a problem.
- Poor communication.
- A lack of trust.
- Lying or being dishonest.
- Sexual problems or issues with intimacy.
- Poor boundaries.
Signs of substance abuse in couples include:4
- Using higher amounts of or more frequent doses of the substance than originally intended.
- Failing to meet obligations at work, home or school because of substance use.
- Giving up activities you once enjoyed to use drugs or drink alcohol.
- Using substances in situations where it’s unsafe to do so (such as while driving or while taking care of children).
- Frequent arguments about drinking or drug abuse, or things that can be related to substance use, such as financial problems, not meeting responsibilities at home, staying out late or not coming home at all.
- Feeling the need to use drugs or drink to alleviate the distress you feel from fighting with your partner.
- Feeling that drinking or using drugs are the only activities you and your partner enjoy doing together.
- Experiencing episodes of domestic violence (which can include pushing, shoving or threatening the other with physical harm) while under the influence of drugs and/or alcohol.
- Feeling that you or your partner need to be drunk or high to be affectionate or feel comfortable talking about the problems you’re experiencing in the relationship.
- Feeling as though you’ve had to isolate yourself from others to hide the addiction and its effects.
Couples’ Drug and Alcohol Addiction Treatment
Couples can seek rehab treatment together to not only help eliminate substance abuse but also to begin the process of repairing the relationship. Many recovery centers offer treatment that is specifically geared toward couples and addressing the unique issues that are encountered when both partners are addicted to drugs or alcohol. Depending on the couple’s circumstances and the particular approach of the treatment center, couples may engage in different types of treatment both as individuals and together. For example, a couple that enters a rehab program together may be encouraged to attend both individual counseling and couples’ therapy to address their relationship issues.
Behavioral therapy can be very effective in helping those affected by codependency break away from the unhealthy cycle of behavior that causes it. Co-Dependents Anonymous (CoDA) is a program of recovery from codependence.5 CoDA helps participants find freedom and peace in relationships and believes in applying the CoDA Twelve Steps and principles to grow and improve both past and present relationships.
The couple must have a strong, safe and committed relationship for treatment to be successful. People who are in relationships that are abusive or deemed to be dangerous may not be allowed to enter treatment.7
Interventions used to treat addiction in couples include:4,8
- Individual counseling.
- Group therapy.
- Self-help meetings like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).
- Couples’ counseling, particularly in the form of behavioral couples’ therapy (BCT).
Behavioral Couples Therapy (BCT)
Behavioral couples’ therapy (BCT) is an effective form of treatment that focuses on changing dysfunctional behaviors and is specifically designed to treat couples suffering from addiction. The goal of BCT is to reduce substance use in couples through “restructuring the dysfunctional couple interactions that frequently help sustain [the addiction].” Couples who receive this form of treatment have reported significant benefits, such as higher rates of relationship satisfaction and reduced substance use and improvement in other areas of functioning, such as reduced partner violence and improved family life.8
BCT involves a set of interventions that may include:9
- Agreeing to a recovery contract, in which both partners commit to their intention to stay sober that day, thank each other for staying abstinent, and agree not to argue about substance abuse.
- Medication to help recovery, if applicable. If either partner is taking medication, then the other partner witnesses the ingestion of the medication and expresses support for doing so.
- Becoming involved in self-help groups, like AA or NA.
- Agreeing to weekly urine tests.
- Keeping a progress record on a calendar.
- Crisis intervention by the therapist if a relapse occurs.
- Increasing positive activities within the relationship (such as sharing rewarding activities or increasing caring behaviors).
- Learning improved communication skills.
- Maintenance and relapse prevention planning once treatment has ended.
Pros and Cons of Couples’ Treatment
Some of the benefits of couples’ treatment include recovering from addiction, better overall relationship functioning, reduced domestic violence, improved compliance with medications and fewer separations/reduced risk of a family breakup than with individual treatment alone.9
However, there may also be potential risks of couples’ treatment, such as if one partner is more motivated and the other partner isn’t as willing to engage in treatment. This can make it more difficult for either partner to remain abstinent and complete the treatment process.10
Couples Recovery after Treatment
Recovery is a lifelong process that doesn’t end once treatment has been completed. A couple will need to continue to work on their recovery for the rest of their lives, which means that you’ll need to have an aftercare plan in place to help prevent relapse and ensure your ongoing sobriety together. An aftercare plan is designed to guide you in early recovery by helping you abstain from substance use and supporting you in your other life goals.10
Aftercare can include support groups like AA, NA, or Recovering Couples Anonymous, individual and couples’ therapy, and sober living homes if living in the home environment is not an option or the couple needs a supportive structure as they transition back to regular life.
Seeking couples’ addiction treatment may be one of the best choices you can make to heal your relationship, recover from substance abuse, and ensure the stability and integrity of your home and family life. Engaging in treatment can help you take back control of your life and save your relationship.
You may be looking for inpatient or outpatient treatment, with or without insurance. The form below is free and 100% confidential. It allows you to run your insurance against all treatment centers in the American Addiction Centers network to see if you are covered for treatment. Don’t hesitate to take the first step today.
Additional Resources on Health Insurance Providers and Coverage Levels
Visit the links below to find out more about your health insurance coverage levels, how to get your insurance company to pay for drug and alcohol rehab and also how to pay if you don’t have insurance.
- Blue Cross Blue Shield
- Kaiser Permanente
- Rehab Without Insurance
Additional Resources on Drug and Alcohol Rehabilitation
Whether you’re looking for a specific type of rehab treatment, substance-related information or additional guides, here are some recommended resources.
- Faith-Based Rehab Centers
- Holistic Rehab Centers
- LGBTQ+ Rehab Centers
- Women’s Rehab Centers
- How to Help a Drug Addict
- Detox Centers Near Me
- Free Drug Rehab Centers
- State-Funded Rehab Centers
- Drug Addiction Hotline Numbers
- Alcohol Addiction Hotline Numbers