Should Couples Go to Drug Treatment Together? | Ambrosia
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Treatment Should Couples Go Together?

The happiest couples do most things together. They eat, work, exercise, and sleep together — preferably while sharing sweet snaps on social media to prove their love to the outside world.

But behind those pretty pictures lies a darker reality. Many couples also drink or do drugs together. When they do, they can enable and strengthen addiction.

The National Institute on Drug Abuse says close to 7 percent of the population is addicted to drugs and alcohol. Every single one of these people should get help to recover.

But just as every person is an individual, so is every marriage. For some, getting care together is the best route to wellness. But for others, it’s best to tackle rehab alone.

sad couple

How Couples Prop Up Addiction

Addiction is often a solo enterprise, but it can appear within a couple. When it does, the consequences can be dire.

The University of Buffalo found that 79 percent of couples include one partner who drinks heavily and one who does not. Just 4 percent of couples involve two partners who drink to excess.

When one partner remains sober, that person can:

  • Be a role model. The sober partner can demonstrate the benefits of an unimpaired life.
  • Persuade. A sober partner can provide gentle pushes toward rehab that could lead to recovery.
  • Demand. A sober partner could require treatment before allowing visits from children, access to bank accounts, and more.
  • Support. Recovery can be difficult, and a healthy partner can provide strength during tough times.

In a crisis situation caused by addiction, the sober partner steps up to make the entire family feel better.

But when both partners are impaired, there is no guiding force. The two often work together to protect their substance use.

In an important 2006 study, researchers found that couples with addictions to heroin and cocaine engaged in both collusion and care. They worked together to keep up the household drug supply, and they were nursemaids when a dose went wrong.

Caring and collusion serve to make life with an addiction easier. Fewer negative consequences take hold, and it’s harder to hit rock bottom. 

Couples like this need to change almost everything about their relationship. Therapy helps, and there is a specific form of treatment made just for pairs.

join hands

Traditional Treatment Approaches

Therapists considered drug use a solitary behavior, and early interventions isolated a user from the pack. In private, tailored sessions, people learned how to change the way they felt about drugs, and they learned to stop using. Couples therapy was born of the need to expand the conversation to the family.

For someone with addiction, loving support is critical. Temptations persist, and they can be very hard to resist. A family can surround the person with respect and care, so there is always someone to help during a dark time.

Couples therapy, researchers say, typically lasts 12 to 20 weeks. In treatment sessions, couples work on:

  • Staying connected.
  • Supporting sobriety.
  • Improving their relationship.
  • Sustaining recovery.

This form of therapy is often provided in concert with other treatments, such as 12-step involvement and private counseling. And typically, it involves one person who uses and one who does not.

When both people use, the treatment sessions are slightly different, but the underlying goal is the same. Couples damage their relationship during a period of drug use, and they harbor lingering resentment that keeps them apart. Therapy aims to repair that damage so the couple can work together on a shared goal.

Researchers say this therapy is effective. In a study published in Clinical Psychology Review, people who participated in this kind of treatment had higher scores of relationship adjustment than those who did not. In other words, they had healthier relationships due to the work they did with a therapist.

But these scores might hold whether people went to therapy or not. To understand whether or not it’s really worthwhile, we need to dig deeper.

friends helping each other

Is Togetherness Always Better?

Programs made for couples enforce togetherness. The pair lives together, goes to therapy together, and spends free time together. They may set aside time for private recovery work, but the majority of their time is spent with the person they love.

Research suggests that blending couples work with private work might be slightly better, especially for women. But the researchers say that this result depends deeply on a woman’s personal preferences.

You might consider your partnership:

  • Critical to recovery. For some people, a partner provides support during the darkest part of life. They recover quicker because they have someone right beside them, going through all of the same difficulties they’re enduring. They have a small, built-in support group. For them, that’s the difference between sticking with recovery and relapsing.
  • A risk to sobriety. For others, emerging abstinence leads to irritation and unexpected emotions. Without the addiction to blame, they’re forced to look at the relationship clearly, and they may not like what they see. This causes even more pain than recovery alone, and it leads to relapse.
  • A deterrent to your progress. People heal at different speeds. If you achieve sobriety quicker than a partner, you could have different expectations and different needs as you recover That could also lead to resentment and anger.

There is no right or wrong answer here because all couples are different and all relationships are unique.

What’s the Alternative?

Of the 23 million Americans who need addiction care, only 2.6 million get it, says CNN. If you know you need help, you should do whatever you can to make it happen. That might mean moving away from your partner for a short time as you focus on your healing.

Private addiction care facilities will home in on you and your needs, history, and future. Your partner might play a role in your recovery by attending a few sessions with you when you’re farther along in your healing process, but you won’t be together around the clock.

This could be a better choice for you if your partnership is difficult or you simply want to take this step on your own.

You can also move back and forth between couples care and individual care. As the surgeon general points out, recovery typically takes multiple years and many sessions of treatment. If you’ve been to individual therapy in the past and relapsed, perhaps couples therapy is the best option for additional care. If you went as a couple and then relapsed, maybe the reverse is true.

Talk to your partner. Listen to your counselor. And then, listen to your inner voice. You’ll make the decision that’s right for you and your sobriety. And when you do, you’ll emerge as a stronger partner who is ready to participate fully in your relationship.


Nationwide Trends. (June 2015). National Institute on Drug Abuse.

RIA Reaching Others: Does Drinking Affect Marriage? (October 2014). University at Buffalo, Clinical and Research Institute on Addictions.

I Love You and Heroin: Care and Collusion Among Drug-Using Couples. (March 2006). Substance Abuse Treatment, Prevention, and Policy.

Substance Abuse and Intimate Relationships. American Association for Marriage and Family Therapy.

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