Moms, SUDs, & “emotional disintegration within the family”

Addiction Research & Theory recently published an interesting article entitled “The unseen burden: exploring the lived experiences of mothers caring for individuals with substance use disorder.” It focuses on the lived experiences of Indian mothers caring for sons with severe Substance Use Disorders.

The authors set the focus of the paper as follows:

This growing crisis is not merely an individual problem, it impacts whole family system. While each family member faces unique challenges in coping with a loved one’s substance use, parents in particular face the immense challenges as they are often considered as primary caregivers. This paper specifically focuses on the experiences of mothers who often bear the emotional, psychological, and caregiving burden. In Indian society, where caregiving is often seen as the primary responsibility of women, mothers of individuals with SUDs experience a disproportionate share of psychological, social, and economic stress.

Farooq, F., & Farhad, S. (2026). The unseen burden: exploring the lived experiences of mothers caring for individuals with substance use disorder. Addiction Research & Theory, 34(2), 162–174. https://doi.org/10.1080/16066359.2025.2542779

The authors interviewed 8 mothers with sons whose ages ranged 16-25 years old and were currently in addiction treatment. The mothers were all low-income, 2 of them were literate, and 5 were from rural communities.

9 Themes

The authors identified 9 themes from the interviews with these mothers:

1. Prolonged discovery of SUD – The mothers did not recognize the SUD until the problem had become severe and biopsychosocial harms had already occurred.
2. Religion as coping mechanism (faith as solace) – Religion was a primary source of support and sense-making for the mothers. This was an important source of support but also delayed professional help-seeking.
3. The burden of maintaining family harmony – “These mothers shared… How difficult it is to motivate each and every member to stay connected, and cooperative. Managing everyone’s needs and demands becomes challenging. Managing anger of husbands, demands of children, needs of family, expectations of relatives, and more importantly managing a child with SUD, their requirements, motivating them to start treatment, their tantrums, all these things together make it so difficult for these mothers to maintain peace and harmony in their families, which left them helpless and more often brings frustration and extra burden on them.”
4. Social isolation and self-neglect – The mothers withdrew from family and community involvement, leading to disconnection, loneliness, and feelings of helplessness.
5. Emotional and physical drain – The mothers reported a physical toll to caretaking that sometimes required pain medication, but the emotional toll was greater. Both infringed on their capacities for their other roles.
6. Self-doubt in maternal caregiving – The mothers carried questions about their role in their sons’ problems — Did they fail as a parent? What could they have done differently?
7. Negligence of other children – The mothers described feeling consumed and overwhelmed at the responsibilities of caring for their sons with SUDs and believing they were not giving their other children adequate time and attention.
8. Shattered expectations – The mothers had dreams of great pride in their sons as esteemed community members who financially support their family and serve as role models and caretakers. The realities of their SUDs shattered their assumptions about life and their futures.
9. Making difficult choices: from hope to hopelessness – “These mothers find themselves at a crossroads, where they are compelled to make difficult decisions—whether to continue enduring the turmoil of SUD or to prioritize the well-being of their family, other children, and themselves. Despite their tireless efforts to support their children through hospital visits, rehabilitation programs, and medications, they have come to the painful realization that the road to recovery is often cyclic, with relapses returning them to square one. This ongoing struggle has pushed them to make bold, and at times heart-wrenching decisions that are far from easy but are driven by the necessity of safeguarding their own mental health and the stability of their families.”

A Family Crisis

The authors note that, while SUD is often discussed as an individual experience, it’s actually a family crisis.

This study disrupts the dominant narrative which is centered around the individual with SUD and excludes the broader systemic effects it has on families, particularly on mothers. The narratives presented underscore that SUD is relational in nature, not just an individual problem, it reverberates through family system, eroding relational bonds, disrupting routines, and shattering expectations. An elaborate idea, which is much deeper within the lens of Family Systems Theory (Kerr and Bowen 1988). The theory suggests that families operate as interconnected emotional contagion, where one member’s disorder destabilizes relationships, roles, patterns and overall well-being of the family. This was mirrored by the mothers participated in this study who talked about getting involved in cycles of emotional fusion (absorbing their child’s distress), Triangulation (mediating conflicts between family members), and boundary dissolution (shifting from parent to caregiver or therapist roles).

Farooq, F., & Farhad, S. (2026). The unseen burden: exploring the lived experiences of mothers caring for individuals with substance use disorder. Addiction Research & Theory, 34(2), 162–174. https://doi.org/10.1080/16066359.2025.2542779

While there’s no question that culture and socioeconomic status influence the experience of these women, but it’s striking how those nine themes could parallel the experience of moms anywhere in the US. It would be really interesting to repeat the study with moms from other cultures.

While there’s little doubt that moms shoulder a disproportionate share of the burden, it would also be interesting to look at other members of the family, particularly children sharing a home with a family member with a severe SUD. I also wonder to what extent the gender of the child with the SUD might change the family dynamics, particularly with fathers. We could also take it further and complete similar interviews with moms and families experiencing recovery.

Finally, so much of the discussion about the burdens associated with SUDs focuses on policy and public health failures. While policy and public health responses (even ambitious cultural change) might help ameliorate some of these experiences, it would appear that much of this burden is relational and touches essential family dynamics that are beyond the reach of policy and public health. It would require recovery. (Though even that can bring its own form of trauma.)