Dear Alice,

I'm hoping that you can help!! My brother, who is 35 years old, is a heroin addict. He has taken his whole family for a roller coaster ride with this drug. WE all want off the ride - he uses the family when he needs us, just to return to this disgusting drug.

The type of heroin that he is addicted to is called Black Tar heroin. I am not sure how he takes it but I think he smokes this stuff. My family (including myself) has given up on him. Last year my sister let him live with her for a whole year while he went through a rehab (methadone) program. It was probably the hardest thing she ever did, to see him go through all the pain and withdrawals, etc. But she stuck by him through it all. The whole family at one time or another has supported him financially, as well as mentally. Then we all watched him turn around and go right back to this disgusting drug.

As a family, is it best just to totally cut him out of the picture? Do we let him hit the bottom with nowhere to turn? It seems we have tried everything else! The drug always turns out to be the important thing! I almost wish he would get busted and sent to jail, I bet that might work.

Any suggestions would be helpful and very much appreciated.

Thank you,
Heroin Hater

Dear Heroin Hater,

Living with an addict in the family can be difficult and stressful, regardless of whether or not you live under the same roof with that person. You may not be able to help your brother get off heroin, but you can come to terms with what his addiction means for the rest of you. The next step involves figuring out changes that can help you and your family better cope with this tough and painful situation.

Sometimes family members of a person with an addiction can become caught in a cycle of co-dependency. Essentially, family members "help" the addicted brother/daughter/mother/uncle (or other relative), but in ways which enable her or him to return to, or maintain, the addiction. For example, a family member might have loaned money in the past, thinking "this time, s/he's really telling the truth; s/he's going to kick the heroin habit and won't use the money to buy more drugs." It's easy to maintain this compassionate line of thought, even knowing in the back of your mind that this outcome is unlikely. While it may not be necessary to entirely cut your brother out of the picture, your family could think about the idea of co-dependency and how it does (or doesn't) fit into the story of his addiction.

Breaking out of this cycle depends on the way you and your family decide to handle future interactions with your brother. Your concern is to take care of yourself and get off the "roller coaster ride" that you have been on for far too long. Naturally, all of this is easier said than done. Just as the road to recovery for your brother is extremely difficult, so too is making the decision to put your own needs and mental health ahead of concerns you have for your brother.

The best suggestion may be to spend some time with a counselor, who will help you identify options that you and your family can consider taking in your relationship with your brother. Counselors provide an objective point of view, as well as lots of support and encouragement — things you may not get from other family members who are as entrenched in the situation as you. You can check out Mental Health America for counseling and other resources. If therapy isn't an option, you can attend Nar-Anon meetings, which are geared toward family members of those suffering from an addiction. For more information on addiction in general, visit the Substance Abuse and Mental Health Services Administration or the National Institute on Drug Abuse.

As a final note, do try to keep your brother's addiction in perspective. His addiction to heroin is an illness. He uses and manipulates you and your family because of this illness, not because he wants to hurt all of you. On the one hand, the fact that he has an illness doesn't mean you have to give him money or shelter every time he asks. On the other hand, you might not need to cut him out of your life completely. Finding a balance between these two extremes could be your goal. While it will be a difficult goal to reach, it is not impossible. Above all, remember that you and your other family members also deserve support as you decide how to best help your brother.


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