Allison came to a support group meeting desperately seeking insight into how to save her marriage. Her husband of 10 years had developed a drug addiction after extended use of opioid pain medicine. She knew his behavior had changed, but she was in denial for many months. Her husband was becoming more moody and withdrawn, and he started missing the kids\u2019 school events and family functions. It wasn\u2019t until he got into a car accident that she realized the seriousness of his addiction. She needed help but wondered, \u201cCan a marriage survive drug addiction?\u201d Addiction is a family disease. It affects everybody in the family system. But spouses, who are left to pick up the pieces, often struggle with how to help their spouse without enabling them. Like Allison, spouses of substance abusers often feel helpless, lost, alone, confused, frightened and desperate. \u201cYou may see acting out behavior in a variety of forms, or you can just see someone who is not present,\u201d says Jack Gilbert, LCSW, clinical director at The Ranch PA. \u201cThey might be in the home, but they're not really present because they're down in the basement drinking or using. They're just not available to their spouse.\u201d The addicted spouse cannot be available because, physiologically and physically, their primary relationship is with substances. \u201cWhen they're in active addiction, they're thinking about getting drugs or drinking, where they can get it next, how they can hide it,\u201d says Robert Matylewicz, DO, FASAM, medical director at The Ranch PA. \u201cThey're consumed. They're obsessed with drugs and alcohol \u2015 and that's when it becomes an addiction. They've disengaged from their social responsibilities, their family responsibilities and even their work responsibilities. They're just there in body. And while they probably see what's happening to their families, they're in denial and minimizing it.\u201d Can This Marriage Be Saved? The best course of action to help a marriage survive drug addiction is to make sure that both spouses, and the whole family, receive treatment. It can also help to learn about the bumps in the road to addiction recovery and how they will affect the marriage. When a person is actively using, it's very hard for the relationship to survive,\u201d says Gilbert. \u201cAnd if it does survive, it\u2019s not really going to be a healthy, fulfilling relationship unless both people engage in treatment to change the problematic behaviors within their relationship.\u201d Once the addicted spouse is in drug or alcohol treatment, there may be other hurdles to anticipate. When lost to addiction, your spouse is no longer the person you married. They still may not be the person you want them to be while they are healing. \u201cHaving a substance use disorder severe enough to get them into treatment is not like a head cold that will just clear up,\u201d Gilbert adds. \u201cEven when sober, there will be times when some of the substance user\u2019s old behaviors are going to crop back up, and the spouse will again go through stages of feeling helpless and probably hopeless, and very much alone.\u201d This is why it is so important for spouses to also find healing. \u201cEarly on, there's a sense of relief that they're not the caregiver anymore,\u201d says Matylewicz. \u201cThey don't have to pick the drugged or drunk spouse up off the floor because they're safe in drug or alcohol treatment. Later, as the addict goes through treatment and gets better, the relationship dynamic once again changes. All of a sudden they're starting to identify their problems. They're starting to make action plans to get better. They're on medications to help.\u201d Things will seem out of balance if the spouse of the person in addiction recovery hasn't gotten any type of treatment. As recovery progresses, the spouse may feel bitter or left behind. \u201cThey see that the addict is now getting healthier, playing basketball, laying by the pool, or laughing with people,\u201d says Matylewicz. \u201cAnd the sober spouse is still sick because they haven't had a chance to heal. They lag behind in terms of healing and getting better.\u201d Getting Help for Yourself Even though the spouse with the addiction may have caused the problems in the marriage, the other spouse must catch up in treatment and dealing with their own trauma and pain. \u201cSpouses need to be educated about how addiction in the family has impacted them. They need support in finding their own healing,\u201d says Gilbert. \u201cThey need to develop their own coping skills and ensure that, in their pain, they do not engage in any unhealthy behaviors.\u201d A spouse will be impacted in different ways depending on where their addicted loved one is in the journey: still using, in recovery or coming back home. Help for people with spouses in active addiction: \tEducate yourself on the disease of addiction \tFind 12-step programs or 12-step alternative support groups \tStart individual therapy \tRemove yourself and children from dangerous situations \tDevelop new coping behaviors such as mindfulness meditation \tLearn how to\u00a0stop enabling\u00a0the addicted spouse \tLearn about addiction treatment and do your best to help them find help Help for people with spouses in drug or alcohol treatment: \tMake your own treatment as urgent as your spouse\u2019s \tHave a full emotional and medical assessment done \tRecognize the anxiety that has ruled your life and begin to heal it \tGo to therapy while your spouse is in treatment \tTake advantage of professional family support systems during drug or alcohol treatment \tWork on issues of anger, fear, abandonment and betrayal Help for people with spouses who are settling back home after drug or alcohol treatment: \tBe aware of possible disruptions when your spouse comes home \tFind support as you readjust to life at home \tConsider family therapy \tLearn healthy communication skills, together \tGet ongoing help from support groups, 12-step groups and\/or outpatient programs Often, the person who has been in drug or alcohol treatment comes home after making a lot of progress, and they\u2019re anxious to return to their life, says Gilbert. However, their spouse has been the sole parent, adult, caregiver and perhaps breadwinner and they are no longer used to sharing responsibilities. \u201cYour spouse hasn't been involved and all of a sudden he or she wants to start making financial decisions,\u201d he says, \u201cor decide where you\u2019re going on vacation, or suddenly doesn\u2019t like the chairs in the living room.\u201d This may be upsetting to the spouse who was left to manage it all and has struggled to understand if their marriage can survive drug addiction. The Key to Helping a Marriage Survive Drug Addiction Can a marriage survive drug addiction? Yes, but it takes time, patience and understanding. You must invest in your own well-being as much as you invest in your spouse and family\u2019s. Ultimately, it is up to each partner to decide if the marriage can survive drug addiction. \u201cIt's a delicate process and sometimes too much damage has been done,\u201d says Gilbert. \u201cSome people can't let go of the past. They may not be able to tolerate anymore. Or it's gotten to the point where a spouse says, \u2018You need to go get sober, and if you don't stay sober it's over.\u2019\u201d But there is always hope. Sobriety can sometimes open the doors to an even better relationship. \u201cFirst, people have to know how to define what a healthy relationship is and take into consideration their own family history,\u201d says Gilbert. \u201cThey have to acknowledge that a healthy relationship involves give and take, compromise, sacrifice and communication, plus physical and emotional energy. It also involves having boundaries and appropriate expectations.\u201d If a couple can get at those core issues in inpatient drug or alcohol treatment, outpatient rehab or private therapy, the marriage can survive drug addiction and thrive.