Alcohol, drugs and gambling in a relationship

Heavy or problem use tends to put a relationship under strain, and it is linked with a higher chance that the relationship ends¹. Among couples where a partner has had an alcohol use disorder, marriages ended more often (48% versus 30%), and alcohol or drug misuse was linked with a 1.62 times higher risk of later divorce¹. This is about heavy or problem use, not an occasional drink.

These figures are links, not proof that substance use alone ends a relationship. People describing their own lives say there can be other reasons, and one person found the problems were still there after they stopped using².

Day to day, partners describe effects that are emotional, practical and social. One is slowly losing confidence in their partner's ability and willingness to be a partner and, where there are children, a parent³. Shame and stigma can change how partners see themselves and their relationship, and can lead to pulling back from friends³. When one partner uses regularly and the other doesn't, the relationship can suffer. Some people, looking back, felt that when they were high they couldn't relate to their partner or pay attention to their feelings².

The partner often pays a personal price: stress, depression and anxiety, and a lower quality of life, especially when the misuse is severe^3,1.

If you want to raise it, start with the concrete effects on the two of you, such as lost time together or missed plans, rather than judging the person.

Support them calmly as a partner, without pressuring them, and look after yourself too. Family-training programmes that support the concerned partner, rather than pressuring the person with the addiction, are about twice as effective as comparison groups at getting that person into treatment⁴. Entry rates were highest where the partner got both individual and group sessions⁴. With gambling, family-led routes into treatment have had low success rates (12.5–23%), so don't be discouraged if progress is slow⁴. Involving family in gambling treatment is linked with better outcomes and better family functioning⁵.

When you talk:

• Choose your moment. Pick a time when your partner isn't intoxicated or "coming down"⁶.
• Ask about feelings. Ask how they are feeling rather than focusing on what they are doing, and use "I" statements to say how their use affects you⁶.
• Keep it positive. Try "How about a few alcohol-free nights each week?" in place of "I wish you wouldn't drink every night"⁷.
• Notice small steps. Acknowledge small positive changes, and keep your own boundaries.

If your partner drinks heavily and wants to stop, they should talk to a doctor or alcohol service first rather than going it alone. Detox on its own can be hard to sustain, and it tends to work better with counselling before, during and afterwards^6,8. Severe withdrawal symptoms need urgent medical help: unusual restlessness, irritability or upset, confusion, seeing, hearing or feeling things that aren't there, and seizures. Call your local emergency number or go to emergency care, and ask someone else to drive them or call for an ambulance⁸.

There are several routes, and you can take them whether or not your partner changes. One is a peer mutual-help group for relatives and friends of people who misuse alcohol or other substances⁹. Newcomers who kept attending over the first six months were more likely to report gains: learning how to handle problems caused by the drinker, and better well-being and functioning¹⁰. More intensive, sustained attendance seemed more helpful than dropping out early¹⁰.

Structured family programmes can help too. Partners and family members showed marked psychological and physical improvements within six months, whichever of three programmes they joined¹¹.

For a starting point, ask a doctor or a local alcohol or drug service what is available for partners and families where you live. Help with drinking concerns comes from doctors, counselling and alcohol support services¹², and a doctor or alcohol support service is a sensible first stop if you're worried about someone else's drinking⁸.

Treat your own support as worthwhile in its own right, not only as a way to help your partner. Living with a partner's substance use can bring its own stress, low mood and anxiety³.