In the late 1990s, prescribing practices for opioid painkillers, especially new medications made with oxycodone and hydrocodone, were relaxed. More people began receiving prescriptions for narcotic drugs to treat moderate or severe pain. While this has been advantageous for people suffering from extended pain after surgery or an injury, too many people have developed addictions to narcotic drugs.

Since 2010, when many states and the federal government tightened regulations on prescription opioid painkillers, people struggling with narcotics turned to cheaper, more available heroin. According to the United States Department of Health and Human Services (HHS), in 2016, approximately 948,000 people abused heroin, and 170,000 people abused it for the first time.

The U.S. Centers for Disease Control and Prevention (CDC) reports that between 2002 and 2013, the rate of heroin-involved overdoses almost quadrupled; more than 8,200 people died in 2013 alone. Around 45 percent of people who abused heroin also abused prescription painkillers, and according to the National Institute on Drug Abuse (NIDA), between 75 and 80 percent of people who abused heroin reported using a prescription painkiller prior to turning to heroin.

With so many people struggling with heroin abuse related to prescription opioid painkillers, it is likely that you may know someone who suffers from an addiction to opioid drugs. Maybe one of those loved ones is a brother or sister, making it a source of incredible worry and hardship for you and your family.

Although heroin is a potent and harmful drug, there are many evidence-based programs available to help your sibling detox safely and get appropriate therapy to overcome this addiction. There are also steps you can take to encourage and support your brother or sister to get the help they need.

Heroin Abuse and Addiction Hurts Families

Heroin is a potent, illegal opioid drug derived from morphine, which comes from the opium poppy. Drugs related to opium have been used by humans for thousands of years as medicine and recreational substances.

Currently, heroin is found as either a white powder or a sticky brownish or almost black powder, which is typically mixed with water or alcohol and injected. Some people may snort or smoke the white powder, and in very rare cases, some people may eat the drug.

Since heroin’s half-life is short, the drug binds very quickly to the brain, causing an intense, relaxing high that goes away almost as quickly. Injecting the drug makes it bioavailable within a minute, but the high goes away after about 15 minutes. Other forms of abuse last longer, but the high may not be as potent and come on as quickly.

The most noticeable effect of heroin abuse is “nodding,” or being “on the nod,” when the person passes out and wakes up a few seconds later in a cycle for several minutes. They may also just pass out, be extremely confused, and appear intoxicated. Their breathing and heart rate may be slower as well.

There are other signs of drug addiction, including addiction to heroin:

  • Stealing money or drugs from friends and family
  • Lying about or being in denial about the drug problem
  • Leaving paraphernalia like needles or pipes around the house
  • Changes in behaviors, especially in sleep schedules, hygiene, and personal responsibilities
  • Losing a job or suffering from financial instability because of addiction
  • Changes in social groups or spending more time alone abusing heroin
  • Making poor decisions, like driving while high

If you find yourself worrying that a sibling is abusing heroin, you may notice your own behavioral, emotional, and mental changes:

  • Worrying about your brother or sister’s safety and health
  • Experiencing persistent anxiety to complete fear or a panic attack
  • Other negative emotions like anger, sadness, or grief
  • Lying or making excuses for their behavior
  • Avoiding your sibling due to their behavior when they are intoxicated or in withdrawal
  • Thinking about calling a doctor, ambulance, or law enforcement because of your sibling’s behavior

Siblings have a unique relationship with each other in the larger family structure. Whether you’re related biologically, through adoption, or through marriage, siblings are closer in age than many family members, and they share an understanding of their family life that isn’t shared in other family relationships. Drug abuse, especially with a harmful substance like heroin, can strain this relationship and cause intense emotional and psychological pain for siblings. It is important to get help for your sibling, and for yourself, if you are worried that your brother or sister is struggling with addiction.

When Your Sibling Abuses Heroin, you Also Suffer

If you have a sibling struggling with heroin addiction, you may feel guilty that you are somehow “the lucky one” in the family or the “good child” to your parents. You may even struggle with survivor syndrome. You may want to protect yourself and set strong boundaries, but this may be very difficult because you also want to make sure your sibling is safe.

You may worry about your own potentially addictive behaviors because substance abuse is influenced by genetics, family history, and the environment, which you share with siblings more so than many other members of your family. Your guilt, worry, and attempts to control your sibling can result in codependency, so it is important to step back and take care of yourself. Once you do, you’ll be better able to care for your brother or sister.

Some ways you can take care of yourself, as you find better ways to take care of a sibling struggling with heroin addiction, include:

  • Educating yourself about addiction, the risks of heroin, and how medical professionals understand this issue
  • Not allowing yourself to be abused, emotionally, financially, physically, or in other ways
  • Not enabling addiction by excusing behaviors, trying to hide evidence, or paying bills
  • Getting help or going to therapy if you are having a hard time getting to work, taking care of your own family, or your mental health is suffering

“Taking care of your needs first is not selfish. Setting up these boundaries will help you and your sibling as you both work toward a healthier relationship in recovery.  ”

Siblings who are not adults are also impacted when one person struggles with addiction. Until recently, psychologists, addiction specialists, and most of society focused on the parents and their relationship to the child struggling with addiction, and less on the relationship between siblings. Now, many family therapists who work with those suffering from heroin addiction focus on the sibling relationship as well.

Interventions to Help Siblings Struggling With Addiction

Once you have ensured your own needs are being met and you feel emotionally stable, you may want to find a way to get your sibling into substance abuse treatment. You have probably spent a lot of time trying to encourage them, support them, or even force them into treatment; however, cajoling or arguing about it generally doesn’t work.

Planning an intervention, when done with consideration and care, can be very helpful. An intervention is a planned process in which the person struggling with heroin addiction meets in a safe location with family, friends, and possibly spiritual leaders, medical professionals, or a professional interventionist to discuss the individual’s addiction, loved ones’ worries, and options for detox and rehabilitation to end addiction to heroin.

Here are some recommendations for planning a family intervention:

  • Make a clear plan for a specific day, in a specific predetermined location, with a specific list of people.
  • Gather information on the best detox and rehabilitation options.
  • Form the core team, including one person who will lead the intervention and ensure everyone stays focused.
  • Make sure everyone decides what they will say ahead of time, that it does not focus on blame or get too emotional, and that everyone sticks to their statements.
  • Express worry for the sibling but offer specific ways to help.
  • After making clear offers to help that you will uphold, be clear about consequences if your sibling does not agree to treatment.
  • Stick to both offers and boundaries. If you offer to drive your sibling to appointments, do it, and if you refuse to give them money anymore, do it.
  • Understand that your sibling may say “no” to treatment at first. You did your best to encourage them, now take care of yourself.
  • Follow up with them when they say “yes” to treatment, and encourage them to stay in treatment as long as it is deemed necessary.

It is important to know that, since you are closely related to someone struggling with an intense addiction, you may be too close to the situation to lead or even participate in this intervention. There are interventionists who specialize in helping families create interventions for loved ones and who can lead the intervention to ensure it goes according to plan. Interventionists may also have therapy recommendations for you and your family members, so you can get the help you need to be supportive of your sibling.

Evidence-Based Treatment for Addiction

You want to get your sibling into treatment as soon as possible, which means contacting detox and rehabilitation programs to see which programs have available space. This way, you can get your sibling into detox and rehabilitation immediately after the intervention. Be sure to find out about visiting hours if your sibling is in inpatient rehabilitation, and what the communication policy is on phone calls, letters, or emails. Staying in contact to offer them encouragement and support can be a wonderful way to help your brother or sister during this tough time. If they have a spouse and children, you may offer to help your sibling’s family with rides to and from school, meals, and emotional support. See a therapist or find a religious or spiritual leader you can talk to because you also need emotional support and guidance during this time.

You want to do everything you can to help a sibling suffering from heroin addiction, but remember to take care of yourself first. Make sure you are in a stable emotional and mental place and work with professionals like therapists, physicians, and interventionists to encourage your sibling to get the treatment they need. There are many great options for evidence-based detox and rehabilitation, and you can use this information to provide positive support to your brother or sister.

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