The grandfather, a man in his early 50s, had tears in his eyes in one of our group sessions as he spoke of his five-year-old grandson. He was distressed because his son and daughter-in-law were using heroin and other drugs. The grandfather wasn't sure his grandson was receiving proper care. He feared for him living in that environment.

As the different group members commented on the grandfather's dilemma it became clear that there were no easy options. One of the choices proposed was that the grandfather call child protective services. Obviously, this would alienate his son and daughter-in-law. Another option proposed was that the grandfather might assume care of the child with the permission of his son and daughter-in-law. But that wasn't a good choice either because the grandfather had no one to help care for the child while he worked.

Some group members supported the idea that others could help care for the child while he worked. Other group members brought up the idea of employing a day care service. But that turned out to be a bad idea because day care is expensive and the grandfather didn't make a lot of money.

As the group continued it became clear that this was a real world dilemma with no easy solution. The grandfather could risk alienating his son by reporting the drug use to child protective services. He could also do nothing, letting his grandson stay in that environment. At the very least, the grandson would continue living where he would witness drug use and the other behaviors associated with it.

Substance abusers in the midst of their addictions sometimes don't realize how their abuse affects those around them.