COLUMBUS, Ohio (AP) — Joe Smith did not picture raising his granddaughter at age 66, but when his daughter’s substance use disorder meant she couldn’t care for her child, that’s where Smith and his wife found themselves nineteen years ago.

That brought all the costs that come with a new baby in the house, like clothes, a crib, a third mouth to feed — and sometimes a fourth, when Smith’s daughter lived with them on and off. His granddaughter’s father provided no child support. When Smith and his wife finally gained legal custody of their granddaughter, Olivia, Smith had missed countless hours of work as a construction electrician to attend court hearings and attorney meetings.

“You don’t get paid sick days... They expect you to be there every day. They don’t care what goes on in your personal life. I mean, at least the companies I was working for,” said Smith, who runs a weekly peer support group for parents of those struggling with addiction in Columbus, Ohio.

Smith’s story isn’t unique. Family members across the country are facing new financial burdens as children, parents or other relatives struggle with the disease of addiction, whether it’s missing work, blowing through their savings or becoming parents again well into their 60s and 70s. The costs can add up to hundreds of thousands of dollars in medical bills, treatment stays, damaged property and countless other unforeseen expenses.

The opioid crisis alone cost the U.S. economy $631 billion from 2015 through 2018, according to a study from the Society of Actuaries. That amount has almost certainly increased as there has been little relief in the opioid crisis during the last five years. Overdose deaths increased in 2022, though only slightly, after a massive spike during the first years of the pandemic.

The study also found that just one-third of those billions is borne by the government, with the remainder falling on the shoulders of individuals and the private sector.

In Ohio, an epicenter of the opioid crisis, the state’s Department of Commerce is taking a one-of-its-kind approach to aiding families financially impacted by addiction, by making sure the people handling their money are educated about it.

This summer, the department launched the first trainings in its “Recovery Within Reach” program for financial advisers, teaching them how to spot the signs of addiction in their clients’ families and direct them to state and private resources that can help relieve the heavy monetary burden.

When surveyed by the department, 45% of Ohio’s financial advisers said they were aware of a client of theirs, or a client’s family member, that was struggling with addiction.

But that number is likely much higher, according to Ohio Securities Commissioner Andrea Seidt, as one in 13 Ohioans have a substance use disorder. The stigma of addiction, especially coupled with a conversation about money, could be keeping people from disclosing their struggles, even to someone they trust.

“The more we talk about it and every industry starts talking about it, the more successful we will be in combating the stigma and the more comfortable people will be reaching out and getting the treatment they need,” Seidt said.

In the program, financial advisers are taught to look for certain signs. These include large, unexpected withdrawals from their clients’ accounts, late or missing payments on important bills, recurring accidents or injuries, skyrocketing insurance rates or sudden custody of a minor family member.

Recovery Within Reach also has an information hub on its website. Those seeking help can input their insurance status and treatment needs to be connected programs they can more easily afford or receive financial help with.

Carl Hollister, president of the Cincinnati-based investment advisory firm L.M. Kohn since 1994, took the training earlier this summer. In September, he brought in employees from his company’s branches around the country to take it, too.

Financial advisers have had to come up with ways to combat a multitude of financial crises, like increasing cybersecurity breaches or investment fraud targeting the elderly. Hollister said he sees addiction as the next crisis the country will need to set protocol for in the financial world, and he believes Ohio is a leading example for what other states should adopt.

Ohio’s program also encourages financial professionals to break through the stigma and start the conversation themselves, ensuring confidentiality and approaching clients with empathy.

Lori Eisel, a financial adviser and owner of Arcadia Financial Partners, knows both sides of the struggle. But for a long time, she hid that her son has been in and out of treatment at least six times for substance use disorder since he was a high school freshman.

“It was sort of like a doctor trying to treat themselves,” Eisel said, noting that even as a financial planner, she didn’t make the best financial decisions throughout her son’s ordeal. “You’re looking at this first as a mother, and this is what my child needs.”

His first round of treatment cost $10,000 out of pocket, even partially covered by private insurance. The second round was in a treatment facility in another state. Travel costs added up — plane tickets, hotel stays and food. Later, an intensive outpatient treatment cost another $5,000. When he was 18, she transferred him to Medicaid after a recommendation from another treatment facility, which helped ease some of the financial burden.

But treatment was not the only cost. Her son totaled a car while driving under the influence. He had to have special medical care for symptoms and injuries related to his disease. Eisel at times was forced to miss work.

Looking back, what Eisel needed most was someone to be compassionate. But she also needed someone to look objectively at resources and programs that would help her son without jeopardizing her or her other children’s financial stability.

“This is a journey that takes years and years to get through,” Eisel said, and that journey often turns into a cycle of enabling the addicted loved one rather than helping them.

Eisel, like Joe Smith, helps run a group for family members affected by addiction in Ohio, and tries to give others the help she could have used. “We have people that’ll never be able to retire because they spent all of their retirement funds on treatment,” she said. “It does not have to be that way.”

Smith is practiced in navigating the courts, Medicare and other state resources after having to do so for Olivia, her mother and his three other daughters, who also suffer from substance use disorder, for decades.

But that practice, like much of his situation, has come at a price: time, money and stress. If the resources he had to find on his own were common knowledge to more people, financial advisers or otherwise, Smith sees that as “the greatest thing” for those financially burdened by addiction.

Nineteen years after first taking Olivia in, Smith is finally considering retirement next year, though it likely won’t be what he imagined. His beloved wife passed away last December. He’s seeking independent housing for his granddaughter, who still lives with him. He’s managed to stow away some money but had to dip into his savings to fix the roof on his house.

“For 19 years, our life was on hold,” Smith said. “Now my wife’s gone. I don’t have that many years left. I just want to try to enjoy life.”

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Samantha Hendrickson is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.