Why People Turn Their Backs on Addicts – Understanding the Psychology of Abandonment
- Jan 23
- 10 min read
Written by Sam Mishra, The Medical Massage Lady
Sam Mishra (The Medical Massage Lady) is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach, and hypnotherapist.
I recently spent some time trying to support someone who, as the result of severe trauma, became addicted to alcohol. This period of time has been probably the second most difficult time in my life, next to losing my children. I didn't have much experience with addiction and I still have much to learn. As much as I wish, at times, that I could have just walked away, it's not really in me to abandon someone who is vulnerable, particularly when I care so much about them as a person. Actually, despite having felt intense pain at being witness to his destruction, this time was also one of the most rewarding stages in my life, that has taught me so much more about myself, my boundaries, and about love and what it really means for me. But it also got me thinking about why so many people do turn their back on those they love who are suffering with addiction.
Addiction is often called a family disease, not because it's hereditary, but because its effects ripple outward, touching everyone in an addict's orbit. Yet despite growing awareness that addiction is a medical condition rather than a moral failing, people frequently distance themselves from addicted loved ones. This withdrawal, emotional, physical, or both, occurs across all relationships, parents step back from children, siblings stop answering calls, friends fade away, and romantic partners leave. Understanding why people turn their backs on addicts requires examining a complex interplay of psychological defence mechanisms, societal stigma, emotional exhaustion, and the deeply human need for self-preservation.
The persistence of moral stigma
Despite decades of research establishing addiction as a chronic brain disease, public perception remains stubbornly rooted in moral judgment.[12] The National Institute on Drug Abuse has repeatedly emphasized that addiction involves changes to brain circuits involved in reward, stress, and self-control, yet surveys consistently show that many people still view addiction primarily as a character flaw or lack of willpower.[1]
This moral framing creates a psychological permission structure for abandonment. When we view addiction through a moral lens, the addict becomes someone who is "choosing" their behaviour, repeatedly making the "wrong" choice despite consequences. This framework allows friends and family members to recast their withdrawal not as abandonment of someone who is suffering, but as a reasonable response to someone who refuses to help themselves. The language people use reveals this mindset, "I've done everything I can, but they just won't change" or "They need to hit rock bottom before they'll get help."
Research by Corrigan et al. (2009) on mental health stigma demonstrates that when conditions are perceived as controllable, public attitudes harden significantly.[5] Their work shows that unlike diseases viewed as purely biological, conditions attributed to personal choice trigger anger rather than sympathy, and blame rather than offers of help. This stigma operates even among healthcare professionals, with studies showing that medical staff often provide lower quality care to patients with substance use disorders compared to those with other chronic conditions.[11]
The trauma of loving an addict
Beyond societal stigma lies the raw, personal trauma experienced by those close to addicts. Living with or loving someone with active addiction often means enduring cycles of hope and disappointment, truth and deception, promises and betrayals. Each cycle inflicts fresh wounds, and over time, many people find themselves suffering from symptoms that mirror post-traumatic stress disorder.
Family members and close friends of addicts frequently experience what researchers call "secondary traumatic stress" or "compassion fatigue".[4] They remain hypervigilant, constantly scanning for signs of intoxication, relapse, or danger. They experience intrusive thoughts about worst-case scenarios, imagining their loved one overdosing, being arrested, or dying. Sleep becomes difficult. Anxiety becomes chronic. The emotional toll is measurable and significant.
Financial betrayal compounds this trauma. Stories of stolen jewellery, emptied bank accounts, forged checks, and maxed-out credit cards are common in addiction narratives. When trust is violated at this fundamental level, when someone steals from their own mother or raids their child's college fund, the relationship sustains damage that can be irreparable. The betrayal isn't just about money, it's about the revelation that the addiction has become more important than the relationship itself.
Moreover, many people close to addicts find themselves drawn into enabling behaviours that conflict with their own values and judgment. They lie to employers to cover absences, pay rent to prevent homelessness, or bail their loved one out of jail repeatedly. Each enabling action creates cognitive dissonance, a disconnect between what they believe they should do and what they're actually doing. Over time, this dissonance becomes unbearable, and distancing becomes a way to escape the impossible situation.[9]
The unpredictability and chaos
Addiction thrives on chaos, and chaos is exhausting. One of the most draining aspects of loving an addict is the fundamental unpredictability. Plans are cancelled. Crises erupt without warning. Behaviour swings from apologetic to aggressive. This unpredictability makes it nearly impossible to maintain normal life rhythms.
For family members, especially those with children or demanding careers, this chaos becomes unsustainable. A parent cannot simultaneously manage their own children's needs and continually respond to an addicted adult child's emergencies. A spouse cannot maintain employment while managing constant crises at home. At some point, the arithmetic of life demands a choice, and many people choose stability for themselves and their dependents over continued engagement with the addicted person.
Research on caregiver burden in other chronic conditions provides insight here. Studies of family members caring for loved ones with dementia, schizophrenia, or severe physical illness show that unpredictability and behavioural symptoms predict caregiver burnout more strongly than the severity of the condition itself.[10] The same principle applies to addiction, it's not just the severity of the substance use, but the chaos it generates that drives people away.
The illusion of control and the fantasy of "Tough love"
Many people distance themselves from addicts while believing they're employing "tough love", a concept suggesting that withdrawal of support will motivate change. This idea has deep roots in American culture and in certain addiction treatment philosophies, particularly those emphasizing the need for addicts to "hit rock bottom" before recovery becomes possible.
The tough love framework provides psychological comfort to those stepping back. It reframes abandonment as intervention, withdrawal as strategy. "I'm not giving up on them," the thinking goes, "I'm giving them the space to face consequences and choose recovery." This narrative allows people to maintain a positive self-image as caring individuals while simultaneously protecting themselves from further pain.
However, research on addiction treatment increasingly challenges the rock bottom myth. Studies show that people can and do recover at various stages of addiction severity, and that earlier intervention generally predicts better outcomes.[13] The notion that addicts must lose everything before they can recover lacks empirical support and may actually increase mortality risk by delaying treatment.
Moreover, the tough love approach often reflects a desire for control in an uncontrollable situation. People cannot force someone else into sustained recovery, but they can control their own behaviour, including the decision to step back. This creates an illusion of agency in a situation characterized by powerlessness, which provides psychological relief even if it doesn't actually help the addicted person.
Grief for the person who was
Another powerful factor in turning away from addicts involves grief. Family members and friends often describe feeling that the person they loved has "disappeared" or been "replaced" by the addiction. They mourn the loss of personality traits, shared interests, inside jokes, and the essential qualities that made their relationship meaningful.
This phenomenon resembles "ambiguous loss," a term coined by psychologist Pauline Boss (1999) to describe situations where a loved one is physically present but psychologically absent, or vice versa.[3] With addiction, the person is often still alive and occasionally present, but fundamentally changed. This type of loss is particularly difficult to process because it lacks the closure and social recognition that comes with death.
The grief can be profound. Parents mourn the child who was curious and affectionate. Siblings mourn the brother or sister who was their closest ally. Spouses mourn the partner with whom they built dreams. Over time, this grief can calcify into a protective detachment. People create emotional distance to stop the continuous reopening of the wound each time they see what their loved one has become.
Doka (2002) discusses "disenfranchised grief", grief that isn't socially recognized or validated.[6] Grieving someone who is still alive but changed by addiction often falls into this category, leaving people feeling isolated in their loss and less likely to seek support. This isolation can accelerate the process of turning away, as people lack the community scaffolding that might help them maintain connection despite the pain.
Self-preservation and boundary setting
At its core, the decision to distance from an addict often represents self-preservation. Mental health professionals working with families of addicts frequently emphasize the importance of boundaries, recognizing what you can and cannot control, protecting your own wellbeing, and detaching with love when necessary.[2]
These boundaries aren't inherently about abandonment, they're about survival. When someone's mental health deteriorates from the stress of the relationship, when their own substance use increases as a coping mechanism, when their physical safety is threatened, or when their other relationships suffer, stepping back becomes necessary for health.
Research on co-dependency and family dynamics in addiction shows that enmeshment with an addicted person can be genuinely dangerous to one's wellbeing. Studies document elevated rates of depression, anxiety, and stress-related physical illness among family members of people with substance use disorders.[8] The decision to create distance, while painful, can represent appropriate self-care rather than callousness.
However, the line between healthy boundaries and harmful abandonment isn't always clear. One person's necessary self-protection might be experienced by the addict as rejection at their most vulnerable moment. This ambiguity creates moral complexity that haunts many people who step back, leaving them with guilt that persists even when their decision was justified.
The role of exhaustion and burnout
Perhaps the simplest explanation for why people turn their backs on addicts is sheer exhaustion. Addiction is a chronic, relapsing condition. Watching someone cycle through treatment, relapse, recovery, and relapse again, sometimes over decades, depletes emotional reserves.
Each relapse after a period of sobriety brings crushing disappointment. Each broken promise erodes hope a little more. Each crisis demands resources, emotional, financial, temporal, that people have in finite supply. Eventually, for many, there's simply nothing left to give.
Research on compassion fatigue among professional caregivers shows that even trained, compensated professionals experience burnout when repeatedly exposed to others' suffering without adequate recovery time.[7] For family members and friends who lack professional training, support systems, or time off from the relationship, burnout arrives even faster.
This exhaustion isn't weakness, it's biology. The human stress response system wasn't designed for chronic, unrelenting activation. When someone spends years in a state of heightened anxiety about a loved one's wellbeing, their capacity for empathy and engagement genuinely diminishes. The turning away that results isn't always a choice as much as a collapse, the organism protecting itself from further damage.
Conclusion
Understanding why people turn their backs on addicts requires holding space for multiple truths simultaneously. Addiction is a disease that deserves compassion, and yet loving someone with addiction can be traumatic and unsustainable. Society's moral stigma toward addiction is unjust and unscientific, and yet individual people's need to protect themselves from chaos and harm is valid. Recovery is always possible and worth supporting, and yet not everyone has the resources to stand by someone through repeated relapses.
The people who distance themselves from addicts are not uniformly callous or lacking in love. Many are themselves traumatized, exhausted, and grieving. They've often spent years trying to help, sacrificing their own wellbeing in the process, before finally stepping back. Their withdrawal frequently represents the culmination of a long process of erosion rather than a single moment of abandonment.
What remains crucial is to recognize that both the person with addiction and those around them are suffering, and both deserve compassion. Creating systems that provide better support for families, reducing stigma that makes it harder to seek help, and developing more effective treatments might reduce the impossible choices people currently face between their own wellbeing and their love for someone in the grip of addiction.
Read more from Sam Mishra
Sam Mishra, The Medical Massage Lady
Sam Mishra (The Medical Massage Lady), is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology and lymphatic practitioner, trauma practitioner, breathwork facilitator, reiki and intuitive energy healer, transformational and spiritual coach and hypnotherapist. Her medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service, but she is mostly known for her trauma work. She is motivated by the adversity she has faced, using it as a driving force in her charity work and in offering the vulnerable a means of support. Her aim is to educate about medical conditions using easily understood language, to avoid inappropriate treatments being carried out, and for health promotion purposes in the general public. She is also becoming known for challenging the stigmas in our society and pushing through the boundaries that have been set by such stigmas within the massage industry.
References:
[1] Barry, C. L., McGinty, E. E., Pescosolido, B. A., & Goldman, H. H. (2014). Stigma, discrimination, treatment effectiveness, and policy: Public views about drug addiction and mental illness. Psychiatric Services, 65(10), 1269-1272.
[2] Beattie, M. (1986). Codependent no more: How to stop controlling others and start caring for yourself. Hazelden.
[3] Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Harvard University Press.
[4] Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63-70.
[5] Corrigan, P. W., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A. (2009). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162-179.
[6] Doka, K. J. (2002). Disenfranchised grief: New directions, challenges, and strategies for practice. Research Press.
[7] Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1-20). Brunner/Mazel.
[8] Orford, J., Velleman, R., Natera, G., Templeton, L., & Copello, A. (2013). Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science & Medicine, 78, 70-77.
[9] Rotunda, R. J., Doman, K., & Tugrul, K. C. (2004). Enabling behavior in a clinical sample of alcohol-dependent clients and their partners. Journal of Substance Abuse Treatment, 26(4), 269-276.
[10] Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. The American Journal of Nursing, 108(9), 23-27.
[11] van Boekel, L. C., Brouwers, E. P., van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 131(1-2), 23-35.
[12] Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363-371.
[13] White, W. L., & Kelly, J. F. (2011). Recovery management: What if we really believed that addiction was a chronic disorder? In J. F. Kelly & W. L. White (Eds.), Addiction recovery management: Theory, research and practice (pp. 67-84). Humana Press.
