Treatment for alcohol and drug problems is far more accessible these days.  Most GPs and healthcare providers have both the training and resources to spot problem drinking and drug abuse, and to offer helpful interventions.  The NHS provides counselling, support services, even detox programmes and rehab services.

Addiction of all sorts – alcohol, prescription drugs, food, gambling, on-line addictions, is thought to affect one-in-three of the UK population.  Thanks to a destigmatisation of addiction, many of us have a friend or family member “in recovery”.

What happens, though, when a partner is affected by addiction?  What happens to a relationship when one partner is using drugs, alcohol or other behaviours addictively?  At LoveRelations, the specialist relationship psychotherapy practice, we see a large number of couples whose relationship is adversely affected by alcohol or drugs.

It can be hard to approach, in the therapeutic process, when the drinking or using partner maintains that “they are fine”, that the only harm done is to themselves.  In many cases, the alcoholic or addict seems to function well on the outside.  Often he or she holds down a job, pays the household bills, is sociable up to a point.

Dr David Perl, founder of LoveRelations, and specialist relationship psychotherapist, maintains that “functioning well at work” is a dangerous smokescreen when it comes to relationships and prevents many partners looking at their drinking or other addictions and the damage it causes to their personal lives.

Recent figures from NHS England and the Office of National Statistics (ONS Opinions and Lifestyle Survey, 2018) show that drinking rises steadily with socioeconomic status.  High earners in professional jobs such as doctors, lawyers and teachers are much more likely to be regular and heavier alcohol users than those on average incomes.

There is less statistical information on drug abuse – whether recreational drugs or prescription drugs – among professional people, but the British Medical Association estimates that one in fifteen medical professionals has a “substance abuse” problem.

In 2017, the Westminster Drug Project set up Square Mile Health, a charitable initiative to provide alcohol and drugs support services to the estimated 200,000 City of London workers thought to be affected by addiction.

“This is just the tip of the iceberg,” says Dr Perl.  “We see more and more couples at LoveRelations, who are seriously affected by one partner’s alcohol or substance abuse .”  He goes on: “And it’s not unusual for this partner to still be functioning apparently well at work, often earning a high salary.”

What are the consequences of untreated alcoholism or addiction on a relationship?  Ruth Perl, a relationship psychotherapist says: “The effects of addiction can be subtle as well as obvious, but they are always extremely damaging.”

“Often the using partner tells a string of lies to cover his or her addiction.  Trust within the relationship breaks down and partners – quite understandably – maintain they can’t believe anything anymore.”

“There are  also the pernicious effects of unpredictable behaviour,” says Ruth.  “We often hear partners at LoveRelations, talking about “walking on eggshells.”  One partner is constantly defending against the possibility of an outburst.  All real communication and intimacy is sacrificed to keep the fragile peace.”

She continues: “Of course, there are also the overt and very damaging behaviours that go hand-in-hand with alcohol abuse and substance addiction – domestic violence, infidelity, financial mis-management.  Whatever the behaviour, the effects on the relationship are devastating.”

Is it possible to heal a relationship damaged by addiction?  At LoveRelations, we see couples committed to making a real change to their relationship.  The process is a tough one, and often it requires the using partner to make some sort of commitment to sobriety and abstinence.

David Perl says: “If alcohol or drugs are damaging a relationship, then removing the alcohol or drugs might need to be the first step to repair.  At LoveRelations, we work with individuals to help them achieve sobriety, whether through one-to-one psychotherapy, a 12-step support group or combination of these things.”

David also encourages the other partner to find a support group:  “the family support groups such as Al-Anon or Adfam can be an invaluable resource for partners struggling with the effects of addiction in their relationship.”

“In the relationship therapy, we work with couples in active addiction, with those struggling with sobriety or abstinence, and with those now free from the substance itself, trying to heal from the consequences of addiction.  It’s a tough process.”

Couples therapy with addiction requires specialist psychotherapy.  David and Ruth, who have been married for over thirty years, both agree that a relationship in recovery can be a fragile one.

Ruth says: “Trust has been broken time and time again.  The newly recovering alcoholic or addict must prove to his or her partner that they are working hard on their addiction and that they understand the damage done to the relationship.”

She says: “At LoveRelations, we encourage couples who are newly sober or abstinent to not just look at the damage addictions has done, but how they would like their relationship to look from now on.”

“Destructive though addiction can be, recovery and entering relationship therapy can mark the start of a new beginning.  If all the resentment, mis-trust and anger can be worked through, a relationship in recovery can become stronger and far happier than one clouded by alcohol or substance abuse.


David qualified as a Medical Doctor (GMC number 2941565) in 1984 from St. Thomas’ hospital, London. He obtained his GP and family planning certification. In 1999 he left medicine to set up docleaf, a leading Crisis Management and Trauma Psychology Consultancy. He has experience as a hypnotherapist and holds a postgraduate diploma in psychotherapy and counselling from the Centre of Counselling and Psychotherapy Education in London and is currently studying for an advance diploma in executive coaching.

David spends part of his time as an executive coach and running docleaf leadership which works with CEO’s and other C suite leaders in helping them develop and grow.

David has written extensively about limerence, sex and love addiction as well as trauma and PTSD. His interest in romantic relationships led him to set up, a support forum to help those impacted by this debilitating condition.

David is passionate about men’s work and his mission in life is to help people become more conscious by teaching and helping others and continuing his own self-development. He is actively involved in volunteering with the ManKind Project charity which helps men live their lives with more integrity, honesty and taking more personal responsibility.

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