Substance use disorders (SUDs) significantly impact family systems, yet have often been treated as an individual problem. Nevertheless, family inclusion has become a treatment priority although limited research exists regarding family members. Specifically, research has yet to examine neuropsychological processes associated with family members. This study examined prefrontal cortex (PFC) activation of family members using functional near-infrared spectroscopy as they viewed images of a loved-one with a SUD. Activation patterns of an experimental group were compared against those of a control group and showed significant differences in PFC responses. Implications are discussed and demonstrate the importance of family member recovery.