Substance use disorders (SUDs) have major impacts on people with substance use, their families, and society at large. Families affected by SUDs encounter significant emotional, psychological, and social difficulties, frequently undergoing alterations in daily routines, roles, and relationships while trying to help their family members who are struggling with addiction. This review paper is a narrative literature review that seeks to explore the various impacts of SUDs on familial dynamics, focusing on topics such as initial shock and confusion, evolving family attitudes and beliefs, dysfunctional relationships, and coping and enabling behaviours. Cultural, societal, and familial factors significantly influence family responses, which may be exacerbated by stigma, denial, and insufficient resources or comprehension regarding SUDs. The review highlights gaps in family-centred support, particularly in under-resourced areas, where families may be deprived of adequate educational and intervention resources. The findings emphasise the necessity of including family education and support in SUD treatment programmes to strengthen family resilience, diminish enabling behaviours, and foster appropriate coping skills.