Martin and Katarina have been married for 5 years. For the last 9 months, Martin has become increasingly difficult to live with due to his opioid addiction. After being prescribed OxyContin for chronic back pain, Martin became dependent on the medication because it also numbed his anxiety and work-related stress.

Over time, Martin began taking more than the prescribed dose which meant he was often high, distant, and unavailable. When his prescription ran out, he resorted to more drastic measures, such as seeing multiple doctors and faking symptoms to get a new prescription. It wasn’t long before Katarina noticed that their savings were dwindling, and that Martin was using all their money for his drug habit. Their arguments have become increasingly more volatile, and Katarina has become fearful of Martin’s erratic mood swings.

The above story, while fictional, is illustrative of what some couples go through if one of them has a substance abuse problem. If the issue isn’t addressed or dealt with, it can put a huge strain on the relationship and lead to dangerous consequences. However, hope is not lost, as help is available.

Prevalence of Drug and Alcohol Addiction in America

Substance abuse is a widespread problem in the U.S. Below are the results from the 2019 National Survey on Drug Use and Health:

  • 4 million people aged 12 and older had a substance use disorder in 2019. Of those, 71.1% had an alcohol use disorder, while 40.7% had an illicit drug use disorder (including prescription drugs).
  • In 2019, over 165.4 million people aged 12 and older used a substance of some kind.
  • In the past month, 139.7 million people drank alcohol, 58.1 million used tobacco, and 35.8 million used an illicit drug.
  • Among the 139.7 million people who drank alcohol, 47% of those were binge drinkers.
  • While substance use is high, rates are declining. Among people aged 12 and over, prescription opioid use declined from 4.7% in 2015 to 3.5% in 2019; prescription benzodiazepine use declined from 2.1% to 1.8%, and past-year cocaine use declined from 2.5% to 2.0%. However, cannabis use increased from 11.0% to 17.5%. This could be due to the legalization of cannabis in recent years.
  • In terms of drug overdose deaths, data from the Centers for Disease Control and Prevention (CDC) show that rates were at 67,367 in 2018 compared with 70,237 in 2017.

How to Know if Your Parent Has a Problem

Substance abuse in a relationship often results in unhappiness for the other partner. While things may seem manageable in the early stages, over time, substance abuse can crack the foundation of your partnership. Once your partner’s drinking or drug use worsens, it can create more distance between you, as the substance becomes their primary focus.

Most couples who deal with substance addiction often have progressively more arguments, and this can put an immense strain on the relationship. As the arguing begins to escalate, this can also prompt your partner to cope with these episodes by increasing their substance use. This leads to a vicious cycle and a downward spiral for both parties. Substance use can also trigger abuse situations (or worsen them if they were already occurring) and leave you in a dangerous situation.

The American Association for Marriage and Family Therapy describes these escalating arguments as a cycle of conflict (whether verbal or physical) that occurs in partnerships where substance abuse is the main cause. If left unaddressed, the cycle will continue as the couple has more and more disagreements about the substance abuse problem.

Some of the key issues that can arise from substance abuse in a partnership include:

  • Financial difficulties.
  • Legal battles over child custody, drunk driving, or illicit drug use.
  • Verbal, sexual, psychological, emotional, or physical abuse.
  • Mental health issues.

If your partner or spouse is struggling with substance abuse, remember that you should seek help as soon as possible. Waiting for things to get better or delaying help may only worsen your (and your partner’s) mental health and well-being. It’s important to remember that help is available, no matter how powerless you might feel.

How to Talk to Your Partner

Talking about your partner’s substance abuse issues can be challenging, especially if they are defensive and unwilling to change their behavior. However, it’s important to remember that waiting or avoiding the topic will only make things worse.

Try where possible to have an open, empathetic, and honest conversation about their substance use. Find a way to let them know that you’re not there to judge them or tell them what to do. If this is the first time that you’re having a conversation about this, it can be a good opportunity to create a positive environment before things have a chance to turn sour.

Most people who are addicted to drugs and alcohol also feel deep shame about their substance use. If you go into the conversation with all guns blazing, this can trigger that sense of shame and it may lead them to lash out, argue, or clam up and withdraw. Even though you may be frustrated, fed up, and worried, the best way to start talking about it is with love and compassion.

However, if after trying multiple times to have an open conversation your partner continues to refuse to listen or seek help, you’ll need to set boundaries for yourself. As well as trying to help your loved one, you also need to protect yourself. Whether this involves taking the next step and attempting an intervention with family/friends or leaving your partner (even if temporarily), you need to let them know that you’re drawing a line in the sand. This is especially the case if your partner is mistreating you or has become abusive.

Protecting Yourself and Getting Help

If your loved one is willing to seek help and you are planning to stay together, there are ways to support them through this process. This requires a balance between backing them up and taking care of you, especially if you’re juggling your own demands when it comes to work and children.

Also, while you support your partner during rehab, it’s important to be mindful that you’re not enabling them by:

  • Giving them money or providing the means that might enable them to buy or use substances.
  • Allowing your partner to neglect their responsibilities.
  • Letting your partner mistreat and/or abuse you or someone else.
  • Making excuses for them.
  • Neglecting your own needs to help them.

When to Leave

There may come a point during this process when you need to decide whether to leave your loved one. Whether it’s because they’re refusing treatment or because your relationship has broken down beyond all repair, knowing when to leave can be tricky. However, the decision is always yours to make, and it will depend on what feels right.

When it comes to married couples, it’s worth considering the legal ramifications before you initiate anything. For example, you’ll likely be responsible for shared debts, so this could have a big effect on you if your partner has maxed out credit cards or taken out loans to fund their substance use. If you’re more likely to stay with your partner, counseling or couples therapy can help.

Other situations which may necessitate you leaving your partner include:

  • Violence or threatening behavior: this is not acceptable, and you should make sure that you and your kids are safe.
  • Emotional abuse: this can be harder to spot, but it is equally important to remove yourself from a situation where you and your kids are being verbally or psychologically abused.
  • Open drug use at home: if your partner is openly using illicit drugs at home (and in front of your kids), this can be a dangerous situation that is not tolerable, especially around children.
  • Strangers in your home: if you find that your partner is bringing strangers home to party with or use substances, this can also be a perilous situation.

Finding Treatment Options

Dealing with substance abuse in a relationship or marriage is never easy, but it is possible to turn things around. It may require multiple stages of therapy, but there are plenty of resources out there for people with addiction and their spouses/partners.

If your partner has agreed to go to rehab, they will likely need to go to a detox center first. Some centers integrate detox into their treatment programs, so it’s worth doing some research first. Depending on the severity of your partner’s addiction, they have numerous rehab options:

  • Medical detox
  • Residential/inpatient program
  • Partial hospitalization program (PHP)
  • Intensive outpatient program (IOP)
  • Standard outpatient program
  • Sober living

Other resources that couples can use to find treatment options are support groups include:

  • Alcoholics Anonymous (AA): 12-Step groups/program for alcohol abuse.
  • Narcotics Anonymous (NA): 12-Step groups/program for narcotic abuse.
  • Couple Recovery from Addiction: this is a support organization that provides a holistic model for couples trying to heal from substance addiction.
  • Recovering Couples Anonymous: while not affiliated with Alcoholics Anonymous, this program is based on the 12-Step recovery model. The goal is to help couples create committed and lasting relationships through their shared recovery experience.

Couples Therapy and Support Groups

Research has shown that when couples work together, it can boost the success rates for recovery. One type of therapy known as behavioral couples therapy (BCT), is showing positive outcomes and may lower the risk of relapse.

BCT helps couples address the dysfunctional patterns within their relationship that can encourage or sustain substance abuse. It is designed for couples with a strong emotional investment in their relationship and who are willing to make behavioral changes to aid sobriety.

Some of the therapeutic goals of BCT include:

  • Improving problem-solving skills
  • Improving communication skills
  • Increasing caring behaviors
  • Developing a program for treatment and recovery
  • Creating a recovery contract
  • Supporting self-help in both partners

The great thing about BCT is it can be applied alongside other rehab programs that your partner is going through. It is also delivered as an inpatient or outpatient program.


If you or a loved one are struggling with substance abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

American Association for Marriage and Family Therapy. (n.d.). Substance Abuse and Intimate Relationships.

Centers for Disease Control and Prevention (CDC). (2020). Drug Overdose Deaths in the United States, 1999–2018.

Lesser, B. (2021). How Does Addiction and Relationship Connect?.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.

Medical Disclaimer

At, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on