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Cocaine Addiction: Treatment First for the Family

answered 10:06 PM EST, Tue February 07, 2012
My brother has hepatitis C, he is HIV positive and he is in a lot of pain from abscesses on his toes and legs from injection injuries. He can barely walk at this point and he is only 36 years old. He will not go to the hospital to get the treatment he needs because if he was laid up getting the IV antibiotics he couldn’t be on the street injecting cocaine.

My brother rarely makes contact with me other than to try to scam money out of me and since I have been burned by him so many times already he doesn’t succeed to often in doing that anymore. He did get some money out me this weekend though after he called me up and told me he had had his big toe amputated and asked to meet me for some money so he could get a room for a couple of weeks. I gave it to him. He was obviously in pain and having more trouble than normal getting around. I don’t know if he will really get that room or not but it is a shocking thing to see a person (my dear little brother!) who uses cocaine until he needs to have his toe amputated and then still doesn’t want to stop.

This is so tragic and insane. I know I can’t make him stop. I have given up on that. I just wish I could make things a little better for him so he wouldn’t be getting gangrene and wouldn’t be suffering such pain from all his abscesses. I know giving him money won’t help, but is there anything I could provide for him that would make his life a little easier and reduce some of the secondary infections and problems he gets from his IV drug use? Should I buy him needles? How many does a cocaine addict need in a week? I have no idea. What else does he need to be able to use without doing himself so much harm?

Delisted Expert Says...

First, I would like to express some empathy for your family, you and your brother. Your brother is suffering from three progressive diseases: HIV, Hepatitis C, and cocaine addiction. It is entirely understandable how confusing and conflicted it can be to deal with an immediate family member who suffers from one of these diseases; more or less three of them. Here is a good resource of cocaine addiction complicated by HIV and Hep-C: http://www.stopcocaineaddiction.com/Cocaine-hiv-aids.htm

It is important to understand that addicts cannot progress or make it on their own without the help of others who often enable them. For example, giving an addict “money” is not giving them money; it is giving them their next hit or high. If you have any hope to help your brother get medical treatment for his addiction, his friends and family must stop enabling him with things he wants or needs so he can hit bottom and ask for sincere help. Every addict must hit bottom to find recovery from addiction. The family can raise the bottom for their addict by not giving him resources, like money, and helping him to see how dependent he is and how much help he needs. Have you given up all hope for your brother’s recovery. There are other people with HIV, Hep C and cocaine addiction who are healing and in recovery. The most discouraging aspect of your brother’s health condition is hepatitis C. However, I do see some hope glimmering about Hep-C treatment. Pamela Anderson, the Hollywood star, is the poster child for Hep-C. For more information, go to these websites and see that it is an manageable disease: starpulse.com, people.com.

I think what you are asking is “what role do I play in my brother’s life, whether long or short?” First, you must decide if you want to help recover/heal or try to help him die in the most comfortable way…according to your brother’s addiction. To buy him needles is another way to enable him. Clean needles won’t change his status with HIV or Hep-C since he has already acquired these diseases. If he did not already have them, it might make some sense to arrange for him to have clean needles. By sharing needles with others, your brother could potentially infect others. If you make things easier for him, he many never make different choices…like doing whatever he needs to…to live. With cocaine addiction, hiv, and Hep-C, there is often accompanying depression. When people are depressed they often feel unmotivated and hopeless. Do you think depression could be what is keeping him stuck in a very destructive lifestyle and poor decision-making? My strongest recommendation for him is to have him obtain a professional evaluation by an addiction professional who knows what someone needs to do who does not know what to do with cocaine addiction, HIV, and Hep-C. The Choose Help website offers free assessment.

In my professional opinion, I think the best treatment option for your brother is residential treatment. Here is a link which discusses this: http://www.drugaddictiontreatment.com/addiction-in-the-news/addiction-news/hepatitis-c-drug-users/

As far as your question about how much cocaine your brother is using, I think the only way you might find out is by asking him how much his cocaine use is costing him daily. Then find out the local cost of cocaine by the gram and you will know. I am unclear how this information would be useful to anyone unless they are financing his use.

Finally, for many addicts to recover, the family often has to go into recovery first. There are support groups for family members of cocaine addicts. To find out how other families deal with the very difficult issues which you are presenting, you may want to attend several support groups until you find one that you like. Some websites which give this valuable information are:

My hope is that I have provided your brother and you with solid information and some hope for recovery which can be used to stop your brother’s disease process. If you need anything more from me, please do not hesitate to contact me.

All the best,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

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Page last updated Feb 08, 2012

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