My sister's addicted to heroin

Is there anything I can do to help her? Pay her rent? Get her into rehab? Tell her new husband?

Published January 20, 2005 8:00PM (EST)

Dear Cary,

I have a sister who's been abusing drugs for years. The current situation is she is addicted to heroin, alcohol and any prescription drugs she can get her hands on. She has lost her job (no unemployment checks are coming), divorced a husband, sold her home (spent all the proceeds), and is remarried to a man who lives in another city who does not know of her addictions. Of course, finding a new job is impossible -- she is a professional in the healthcare industry and drug tests are required. She tried to sneak it by, buying someone else's urine, but that failed (good thing, really). How did all this happen? You must know the weaves and manipulations that junkies do.

My sisters and I have offered rehab, but she refuses. She says she's been there, done that and won't do it again. She is able to detox herself and has many, many times. But in the end, the addiction activities return.

Did I mention that all her troubles are due to my other siblings and me? We live in the East and she in the West, so of course that would follow (sarcasm intended). Also, she takes no responsibility for any of her actions or her situation. She was fired due to jealousy of her beauty, her ex-husband took advantage and now her dealer is her only friend, as he extended her credit when she was hungry. You'd think a Big Mac would be better for hunger than a hit of heroin, but these are words I hear and I continue to be surprised.

I know neither you nor I can solve the big problem. But maybe you can see a way where I can assist her financially or whether I should. My sisters and I have given her money to pay her bills and have paid bills for her directly. What we saw, however, was that this freed up money on her end for more drugs, so we stopped altogether. I would like to help with her rent so she should not be homeless. Would this only keep her with a roof but always high and closer to oblivion? Then again, maybe she should be homeless, that "hit rock bottom thing," you know? Should we tell the new husband? In some ways, I feel the guiltiest about him and what he walked into blindly.

Sister

Dear Sister,

I have heard many, many addicts and brothers and sisters of addicts tell stories of the lengths they went to deceive and manipulate, the extravagant machinations and contortions of logic designed to keep their malady secret, and the financial sleight of hand and elaborate hoaxes they perpetrate on hospitals, schools, families, friends and businesses. Again and again the same pattern holds true: Addicts will do most anything they feel they have to do to keep their addiction secret. Why? Because secrecy is the key to maintaining access to the drug. The general reaction of John Q public, upon learning that someone is an addict, is to immediately deprive him of his substance. So it's understandable that addicts must keep their addiction secret. Until he or she is ready to try to recover, secrecy is paramount.

And when an addict does decide to rend the cloak of secrecy and come clean, it's often impossible to understand what brought it on. The conversion experience is sometimes triggered by unimaginable personal suffering and degradation (the "hitting bottom" thing) and sometimes by an almost ethereal inner change, but it remains stubbornly impervious to our attempts to induce it from the outside. Until addicts make some personal decision to try to change, nothing the rest of us can do seems to have much effect.

That is not to say that people cannot intercede in the lives of junkies to keep them from killing themselves or becoming more ill from infection, malnutrition, blood clots, fluid in the lungs and so forth. Anything one can do to save the life of another human being is a good and humane act.

No one can say with certainty what effect your financial aid to prevent your sister's homelessness might have on the eventual course of her life. Nor would it be right to dismiss your very humane concern for her well-being by blithely suggesting you "cut her loose." I can only say that to those of us who have recovered from addiction, despite all the slogans we have committed to memory and all the narratives we have followed with a breathless sense of "Yes, that's my story too!" the essential nature of that recovery retains an air of profound, impenetrable mystery; most of us are certain that until we reached that unaccountable point of readiness, neither the awesome power of the state nor the accumulated wisdom of science nor the heartbreaking imprecations of our loved ones could have saved us. We were in the grip of something tragic, demonic and implacable.

I look forward to the day when science gets a clear grip on this thing. Perhaps in the not-too-distant future all the spiritual mumbo jumbo in which our cures are bathed will sound as ludicrous as the incantations of Druid sorcerers on remote hills and heaths. And there are increasing rumblings of a medical cure. But until that time, we know addiction as a disease over which not only the addict but his family, friends, co-workers and victims are powerless.

That is not to say that going to court-mandated rehab has not often resulted in just the kinds of behavioral and environmental changes needed to give a person a shot at lasting sobriety, or that other kinds of changes -- a family-sponsored visit to Betty Ford or the like -- do not often work. They do. And who's to say that one's first brush with organized recovery, though it might fail to induce longtime sobriety, does not indeed plant the seed for some later success? One often hears a recovered addict say of his early unsuccessful attempts, "I was not ready." But that does not mean that those early attempts were not in some way a preparation. So it cannot hurt to keep trying, to remain ready to underwrite another visit to a rehab.

Inasmuch as heroin addiction is a life-threatening medical condition, I do think the husband should know. If she should collapse on the job or in his arms, that knowledge could save her life. If the proper diagnosis of heroin addiction had to await blood test results from the lab, precious time to save her might be lost.

So what am I trying to say to you? I am trying to say that you may find some modest comfort in accepting the limits of your own efficacy in this matter. It might give you some respite to know that no matter what you do, it's to some degree out of your hands. But you may also want to know that, as far as I know (again, I'm no expert; I've just listened to a lot of stories), there's little harm in trying. You may meet people along the way who say that your attempts to save your sister are only "enabling" her addiction; you may also meet those who see your reasonable attempts to get on with your own life as nothing short of heartless abandonment. The truth probably lies somewhere in the middle. Your "heartless abandonment" may turn out to be life-saving; your "enabling" of her addiction might also enable her survival.

What we all hope is that eventually, somehow, you get your sister back. Nothing can guarantee that, but nothing can prevent it either if it is going to happen. If you know how to pray, you might consider taking up or increasing the practice; it does seem to help many people get through the day. And if you have not done so already, I would urge you to contact a support group for loved ones and family of addicts, such as Al-Anon or Nar-Anon.

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