Supporting a brother struggling with an addiction to heroin

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, 

Seeing a loved one struggle with addiction can be difficult and stressful, whether or not you live under the same roof. 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. As challenging as it may be, it’s key to try to keep your brother's addiction in perspective. His addiction to heroin is an illness and could be altering the way his brain operates. When an individual chronically abuses alcohol or drugs, their brain chemistry and signaling pathways begin to change. Thus, it’s likely his actions are influenced more by his addiction and not out of a desire to intentionally hurt you or other family members. While this doesn't mean you have to give him money or shelter every time he asks, you might not need to cut him out of your life completely. Finding a balance between these two extremes could be your goal. Above all, you and your other family members also deserve support as you decide how to best help your brother. 

The next steps for your family may involve figuring out changes that can help you all better cope with this tough and painful situation. Some possible next steps could include: 

  • Learning everything you can about addiction. The more you understand about addiction, the more you’ll be able to help your brother and understand the struggles he is experiencing. 
  • Managing expectations about the healing process. Those who struggle with addiction usually only get better with help. Having support, treatment, and coping skills are all crucial in recovering from addiction. You can continue to offer your support in his getting treatment, though only he can make that decision to seek it. 
  • Recognizing that recovery is an ongoing process. Recovery isn’t a quick process and relapses can occur. Maintaining a commitment to getting help for your brother and your family will help show that you’re invested in his long-term health. 
  • Setting boundaries. Only he can be responsible for his actions, and one way your family can support him is to not make excuses for him and enable his behavior. Holding him accountable for his actions and not shielding him from the consequences of his actions (such as lending him money) may be a way to help him realize that his behaviors aren’t sustainable.  
  • Being thoughtful about when to speak with your brother. Having a conversation or argument while he is high may not be conducive to healing, recovery, or setting boundaries. You may find it helpful to wait until he’s no longer high in order to try having a conversation. 
  • Understanding what is and isn’t in your control. Your brother is responsible for his actions, and while it’s common for families to feel guilt when their family members struggle with substance abuse, it isn’t your fault. All that you and your family and can control are your own actions and how you respond to the actions of others.  

Even with these tips, your family might also need additional support. You could try talking with a mental health professional who can help you identify options that your family can take when navigating your relationship with your brother. They can also provide an objective point of view, as well as support and encouragement — help you may not get from other family members who are as entrenched in the situation as you. You could also think about attending Nar-Anon meetings, which are geared toward providing support and resources for family members of those suffering from an addiction. At the end of the day, you may not have control over your brother’s behavior, but you do have control over your response. If you need it, practicing self-care and seeking additional support for yourself may help during this difficult time.  

Good luck! 

Last updated Aug 13, 2021
Originally published Apr 24, 1998

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