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Families in Addiction


Oftentimes a substance use disorder is also co-occurring with a mental illness, such as codependency. 

Do you often get involved in relationships that are dysfunctional, one-sided; where one partner is always reliant on the other for emotional and self-esteem support?  You may even notice that your relationship enables the other person to be irresponsible, addictive, and exhibit low achieving behavior.  If these characterizations describe your situation, then you may be involved in a codependent relationship. 

People in codependent relationships can often feel that all their energy goes to meeting their partner’s needs.  They also feel trapped or find that they are always the ones making sacrifices in the relationship.  Codependency can also be linked to substance abuse. 

The term “codependency” has been used for decades and was first used to apply to “co-alcoholics,” or alcoholics of spouses, as well as drug addicts.  Here at the Sana Lake Recovery Center, our healthcare professionals have the resources and methods to help treat your struggles with codependency disorder and substance abuse. 

Some things to ask yourself if you think you may be in a codependent relationship are:

  • Does your sense of purpose involve making extreme sacrifices to satisfy your partner’s needs? 
  • Is it hard for you to say no to your partner when he or she demands your time and energy? 
  • Do you cover illegal or dangerous problems that your partner exhibits with drugs, alcohol, or the law? 
  • Are you constantly worrying about your partner’s opinions of you? 
  • Do you feel trapped? 
  • During arguments, do you keep quiet to avoid confrontation? 

Researchers have found that characteristics of codependents were more prevalent in the general population than what was previously realized. 

They also discovered that individuals who were raised in a dysfunctional family or had an ill parent could also be codependent. Having codependency disorder and a substance abuse issue is known as a dual diagnosis or co-occurring disorder. 

Codependency and Substance Abuse

Statistic on codependency and substance use

Some theories on codependency say that people who grow up in households ruled by alcoholics are forced into adulthood early on in life.  As a result, they may even struggle with intimacy and control. Some experts believe that codependency issues are a response to life with a person who is currently struggling with a substance problem with alcohol or drugs. 

When under the influence of one or more of these substances, the individual will make poor decisions that could impact their household. Individuals that are not battling addiction will naturally want to take over the addicted person’s life to help or solve the problem. 

Much of the information about codependency is based on studies that involve alcohol.  There is a connection between alcoholic parents and adult children who exhibit codependent behaviors.  The children of alcoholic parents will often grow up to marry partners who abuse alcohol or drugs. Alcohol is the primary substance associated with codependency, but other substances can be a factor in this co-occurring disorder. 

Signs of Codependency

Codependent personalities typically follow a pattern of behaviors that are consistent, problematic, and directly interfere with the individual’s emotional well-being and ability to find a fulfilling relationship. People often use the word “codependency” loosely.  There are different types of codependents; such as codependent couples, codependent companions, and codependent caretakers. 

You don’t have to have all of the following symptoms to be deemed codependent, but here are some signs to look for in yourself or a loved one that may have this disorder: 

Low self-esteem – You may always compare yourself to others and feel that you are never good enough. 

People-pleasing – Codependents have anxiety at the thought of saying “no.” They often go out of their way to please other people. 

Poor boundaries – There are blurry or weak boundaries when it comes to your body, money, belongings, feelings, thoughts, and needs.  You may feel responsible for other people’s feelings and problems or blame your own on someone else. 

Reactivity – Codependents will often react to everyone’s thoughts and feelings. 

Care-taking – You want to help others with a problem, but you help them to the point that you give up on yourself. 

Control – Having control helps those with codependency feel safe and secure/ 

Dysfunctional Communication – There is an evident struggle when it comes to communicating thoughts, feelings, and needs. 

Obsessions – The tendency to spend time thinking about other people or relationships.  This is a result of their dependency and anxieties and fears. Codependents may even become obsessed with making a mistake, or lapse into fantasies about how they would like things to be or about someone you love as a way to avoid present pain. 

Dependency – They need to have other people like them to feel okay about themselves.  There is a fear of rejection or abandonment, even if they can function on their own. 

Denial – They are often in denial about having a problem and think that the problem is someone else or the situation. 

Intimacy Issues – Codependents may have problems being open or close with someone in an intimate relationship. 

Painful Emotions – Codependency creates stress, which can lead to unpleasant emotions.  Shame and low self-esteem can cause anxiety or fear about things like being judged, rejected, being a failure, or feeling trapped.  Other symptoms can lead to anger, resentment, and depression. When these feelings are too much, the individual can become numb. 


When codependency behaviors are present in your daily life or the behavior of a loved one, it should not go untreated.  Untreated symptoms of codependency can become more severe over time and lead to other mental health issues like major depression or an anxiety disorder.  In some cases, the person may develop a condition that involves self-harm. 

Codependency is an underlying factor of addiction because its core symptom of “dependency” is the reliance on a person, substance, or process.  When you are in a codependent relationship, you don’t focus on having a healthy relationship with yourself, but you make something or someone else more important.  Successful recovery will involve a complete reversal of this type of thought pattern so that the codependent individual can reconnect with, honor, and act from their core self. 

Change for a person dealing with a codependency and substance abuse issue can be complicated.  Steps to recovery may include abstinence, awareness, acceptance, and action. Each case is unique and depends on the individual, their type of codependency, and substance abuse issue.  Treatment should be tailored for each individual and the methods used based on the severity of the codependency and the severity of substance abuse. 

Sana Lake Recovery serves the greater St. Louis area, including St. Louis, Maryland Heights, O’Fallon, Affton, and Dittmer, Missouri.

If you or your loved one would like to seek treatment for codependency and substance abuse, take the first step today by speaking with one of our representatives. You can also read more about our treatment options for co-occurring disorders and learn about our rehabilitation center on our website. 

Lyon, D., & Greenberg, J. (1991). Evidence of codependency in women with an alcoholic parent: Helping out Mr. Wrong. Journal of Personality and Social Psychology, 61(3), 435–439. 

Bacon, I., McKay, E., Reynolds, F. et al. The Lived Experience of Codependency: an Interpretative Phenomenological Analysis. Int J Ment Health Addiction 18, 754–771 (2020). 

Asher, R., & Brissett, D. (1988). Codependency: A View from Women Married to Alcoholics. International Journal of the Addictions, 23(4), 331–350. 

Hughes-Hammer, C., Martsolf, D. S., & Zeller, R. A. (1998). Depression and codependency in women. Archives of psychiatric nursing, 12(6), 326–334. 

(Photo) Bortolon, Cassandra Borges et al. Family functioning and health issues associated with codependency in families of drug users. Ciência & Saúde Coletiva [online]. 2016, v. 21, n. 1 [Accessed 20 May 2024] , pp. 101-107. Available from: <>. Epub Jan 2016. ISSN 1678-4561. 

Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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