When addiction settles into a couple
An addiction is never about just one person. When alcohol, a drug, gambling or a screen takes first place, the couple starts to organise itself around it: one partner hides things, the other keeps watch, people apologise, certain subjects are avoided, and trust wears away. The partner often ends up dealing alone with the money, the children and the lies, swinging between anger, shame and hope.
This page does not replace a doctor, an addiction specialist or a lawyer. It brings together what research and public health bodies say about what really helps a couple, what makes things worse, and which numbers to call. One idea to keep in mind from the start: a partner is neither responsible for the other person's addiction, nor condemned to stand by and watch.
Recognising the problem without making a diagnosis
There is no number of drinks or hours of screen time that separates “normal” from “addiction” for every couple. What matters is the consequences and the loss of control. A few concrete signs come up often:
- promises to cut down or stop, repeated and not kept;
- time, money or energy that disappear, with explanations that keep changing;
- activities, meals, evenings out or shared plans that are abandoned;
- unusual irritability, sadness or tiredness when the substance or the screen is not available;
- the behaviour continuing despite arguments, health problems, or money or work troubles.
For video games, the World Health Organization describes the disorder in the International Classification of Diseases (ICD-11) by three features: a loss of control over gaming, a growing priority given to gaming to the point that it takes precedence over other interests and daily activities, and continuing to play despite harmful consequences. The diagnosis requires a significant impairment of personal, family or occupational life, normally lasting at least 12 months (World Health Organization). In other words, the number of hours is not enough: what counts is the place the behaviour takes up, and what it costs the couple. Only a professional can make a diagnosis.
What helps most: learning to respond differently (the CRAFT method)
Many partners have tried to persuade, threaten, hide the bottles or control everything, without success. A structured approach called CRAFT (Community Reinforcement and Family Training) offers something else: over a few sessions with a therapist, it trains the loved one to communicate positively, to encourage the moments without use, to avoid cushioning every consequence in the other person's place (without ever putting themselves at risk), and to suggest help at the right moment. The aim is twofold: to bring the person to accept care, and to protect the health of the loved one.
The results are solid for alcohol. In a randomised trial of 130 relatives of drinkers who refused any treatment, 64% of the drinkers entered treatment with CRAFT, compared with 30% with a family confrontation intervention and 13% with an approach centred on Al-Anon-type self-help; entry into treatment took place on average after 4 to 6 sessions (Miller, Meyers and Tonigan, 1999). In that trial, 70% of the families invited to organise a confrontation dropped the idea, and all three approaches were associated with a comparable improvement in the relative's own functioning (Miller, Meyers and Tonigan, 1999). A systematic review of four trials (264 relatives) concludes that CRAFT brings about two thirds of the people reluctant to seek care into treatment, with three times as many treatment entries as Al-Anon/Nar-Anon and twice as many as confrontation (Roozen, de Waart and van der Kroft, 2010).
Results do vary, however, with the form of the programme and the type of addiction. In a more recent review of 14 studies, entry into treatment reached 77% and 86% with combined individual and group sessions, but only 12.5% to 23% in the five studies on gambling (Archer et al., 2020). So this is neither a guarantee nor a recipe to apply alone: support from a trained professional is part of the method. These trials mostly concern alcohol and drugs; for screens, pornography or gambling, the data are thinner.
When the person agrees to seek treatment: treating the couple too
Once the person is engaged in treatment, behavioural couples therapy (Behavioral Couples Therapy, BCT) involves both partners. It combines a daily commitment by the person not to use that day, which the partner welcomes without reproach about the past, with communication exercises and shared pleasant activities. A meta-analysis of 12 randomised trials (754 participants) showed an advantage of this approach over individual treatments; some time after the end of treatment, it was superior on frequency of use, on its consequences and on relationship satisfaction. The authors note that its value has been little studied in people whose problem is of low severity (Powers, Vedel and Emmelkamp, 2008). These trials involve married or cohabiting couples who seek help for an alcohol or drug problem. Ask an addiction treatment centre whether it offers work with the partner: it is common.
A relapse does not erase the progress made. It is better to agree in advance, at a calm moment, on what each person will do if it happens: talk about it quickly rather than hide it, contact the care team, and avoid both catastrophe (“it's all over”) and denial (“it's nothing”).
Alcohol: do not force a sudden stop
Throwing out every bottle and demanding a stop overnight may seem like a good idea. In someone who drinks heavily and every day, it is dangerous: in France, the Haute Autorité de santé (National Authority for Health) points out that alcohol is a substance whose withdrawal can cause neurological toxicity, even death, and lists an unsupervised sudden stop among the at-risk situations (Haute Autorité de santé (French National Authority for Health), 2023). Stopping should be prepared with a doctor (a family doctor, an addiction treatment centre or a hospital). Severe tremors, sweating, confusion, hallucinations or a seizure after stopping mean you must call 15 or 112 (in France).
To put a level of drinking in context, Santé publique France (the French public health agency) uses the benchmarks from a 2017 expert opinion: no more than 10 standard drinks per week, no more than 2 drinks per day, and alcohol-free days during the week (Santé publique France (French public health agency)). These benchmarks describe a level of risk judged acceptable, not an absence of risk; they do not apply to someone who is already dependent, for whom a professional's opinion is necessary.
Violence: an addiction excuses nothing
Alcohol and drugs are often present in violence within couples, but they are neither its sole cause nor an excuse. The French interministerial strategy against addictive behaviours points out that alcohol and drug use increases the risk of violence, and that it is not a mitigating circumstance but an aggravating factor. It states that in France alcohol is present in 30% of convictions for violence and in 40% of family violence, and that in 2021, among 143 people killed by their partner or ex-partner, a substance liable to impair judgement was recorded in 34% of cases (52% in 2020) (MILDECA (French inter-ministerial mission on drugs and addictive behaviours), 2023-2027 strategy). The same document stresses that the link also runs the other way: an addictive behaviour can be a consequence of the violence suffered.
In practical terms: if you are afraid, or if you have been hit, threatened or coerced, your safety comes before any plan for couples therapy or for helping the other person. In France, call 17 or 112 if you are in immediate danger (114 by text message if you cannot speak), or 3919, the national helpline for listening and referral for women victims of violence (Arrêtons les violences (French government)). Working on the relationship as a couple is only an option if a professional judges that the situation allows it.
Screens, gambling, pornography: less visible addictions
When there is no substance and no smell, those around the person sometimes take a long time to understand. With gambling, the signs are often financial: unexplained withdrawals, overdrafts, hidden loans, items sold. Talk about joint accounts without delay, and ask a specialist service for advice before making any major financial decision. With screens, think about your own use too: a phone put down at the table or in bed, shared with the other person, settles nothing if one of you keeps it in hand all evening.
With the partner concerned, a few rules help: choose a calm moment rather than the conflict of the moment, describe facts (“over the last three weeks, we haven't had dinner together”) rather than judgements, suggest concrete solutions (a screen-free hour, accounts needing two signatures, an appointment with the doctor) and accept that the person may not respond straight away. If screens also take up the children's time, a single adult setting the rules alone will not hold for long: the couple needs a common framework.
Taking care of yourself
Living with someone who is dependent is wearing. The loved one has their own needs: sleeping, talking, not becoming isolated, keeping friends and activities of their own. Several doors exist, even if the person concerned refuses to see anyone:
- in France, addiction treatment, support and prevention centres also see relatives on their own when the person concerned does not want to come; the consultations for young users are open to parents (Drogues Info Service (French drug information service));
- self-help groups for relatives (Al-Anon, Nar-Anon, Vie Libre and others) let you talk to people who are going through the same thing, whether or not the other person is treating their problem;
- a doctor or a psychologist for yourself, if anxiety, sleep problems or sadness set in.
Phone numbers and resources (France)
- Alcool Info Service: 0 980 980 930, an anonymous call at no premium rate, for the person and for those around them (Santé publique France (French public health agency)).
- Drogues Info Service: 0 800 23 13 13, an anonymous and free call (Santé publique France (French public health agency)).
- Joueurs Info Service: 09 74 75 13 13, an anonymous call at no premium rate (Santé publique France (French public health agency)).
- 3919 (violence against women), 17 or 112 in case of danger, 15 for a medical emergency. All of these are French numbers.
The opening hours of these lines were changed from 1 October; they are shown on each website, so check them before calling. To go further, see Spotting substance use and Getting out of dependence: who to turn to. See also: alcohol, sleep, drugs and addiction.
Key points
- Addiction is an illness, not a lack of willpower nor proof of a lack of love.
- Approaches that teach the loved one to respond differently give better results than confrontation.
- For alcohol, no sudden stop without medical advice if the drinking is heavy and daily.
- In the case of violence, safety comes before everything else.
- The loved one can, and should, also ask for help for themselves.