What can I do? Please help 911!

[Belle27]

I am in desperate need for advice. My fiancé’s 18 year old brother, has undergone many years of depression, anger issues, as well as social anxiety. He’s the youngest out of three brothers, and is very self-loathing and destructive to himself and his parents. The family is a great bunch of people, though I can see how they may have enabled him to be at the point he is now. Dad is very self-serving and steps aside a lot, while mom is very overbearing and prodding with this brother, which virtually drives him further away.
He has dropped out of high school, has been very unmotivated to do anything, steals items and cash from the home, hangs out with a few really bad seeds around the block, smokes weed all day and spends all his work money on it, though just recently, his behavior changed for the worse.
I have been around heroin addicts before, and noticed that his behavior was off, though couldn’t quite pinpoint what it fully was. He rants and raves and is paranoid a lot, though his he hasn’t lost any weight. He has so many different behaviors that scream different drugs, I really didn’t know which he could be on, though I knew he was on something. I told the family, including my fiancé, though they wouldn’t believe me. They knew something was wrong, and I know it wasn’t my place to say anything, but I can’t help it. I KNOW what this drug can do to a person, and how it can end, all too well. Just recently, at a family event, the brother was locked in the bathroom ( a new behavior) though to make a long story short, everything went down.
We prodded him out of the bathroom and he flipped out to an extreme rage. His pupils were pinpoints, his speech was slurred, and he was crying and screaming uncontrollably. Family members and myself talked him down, though he didn’t come right out and say what he was on. He slurred pills, junk, dope, and told everyone a different aspect of what he was doing. While he was outside screaming in the beginning, his brothers found needles and a spoon with some junk melted onto it. It’s obvious to them now what he was on, and they agreed to get him to go talk to somebody, which they did that night, at a crisis center. The younger brother agreed to it, though does not want to go to rehab. He thinks he can do this on his own.
Is it possible that he can abstain from such a powerful drug without a legitimate detox in a controlled environment, because I really don’t think he can? Knowing how bad he hates himself and is very inconsistent with feeling and actions, and having been using this drug or derivative of, for many months, leads me to worry. They are also keeping it from the mother, and she knows something is going on, but not to such an extreme, which I also feel is wrong.
The brothers want to protect his dignity, but I have a very bad feeling about this. I know I can’t interfere anymore than I already have, but I feel he needs to be persuaded to go to rehab ASAP, before it really is too late. It’s still fresh. What the heck can I do as the outsider? I love the brother as one of my own, and I am marrying into this family. I CAN’T BEAR to see them fall apart if something worst happens. What advice can I give my fiancé that will seep in? I don’t want to see this kid fall, get hep, HIV, or OD. Please help!:confused:

[exjunky]

It's a great thing that you are looking out for your future brother-in-law. Unfortunately he has a disease which is not easily cured. The first step is that he honestly has to want to quit, not that he's being forced to quit against his will. Nobody ever quits because of outside pressures, remember that junkies use heroin as a coping mechanism, so the stronger you turn up the heat the more he will crave dope.

Your first goal is to figure out how bad his habit is. Does he shoot up several times each day or is it a once-in-a-while thing? People with bad habits can't go for 8 hours without a fix, much less a few days. But maybe he uses it on and off, maybe he goes for days at a time not using, and he doesn't really have a bad habit. Just because you found a spoon with heroin on it doesn't tell the entire story.

Is it possible that he can abstain from such a powerful drug without a legitimate detox in a controlled environment?

Depends how you define "controlled environment". Not everybody needs to be locked up in a rehab center to detox themselves, some people can visit a clinic once a day, receive suboxone or methadone, and then slowly kick their opiate addiction.

Suboxone is a new method that some people herald as a "miracle drug." You need to look into it.

If it was my brother I would say "Look bro, I know it's hell to quit this stuff, but if you don't quit you're going to DIE and destroy everything and everybody around you." Then I'd take him out and buy him an ounce of pot, and offer to pay for suboxone treatment under a doctor's care.

About the "ounce of pot" comment: I know that not everybody here believes in offering an addict alternate drugs as a lure to take them away from heroin, but the way I see it, it's vastly the lesser of two evils. (Don't get me wrong--if he doesn't smoke pot now I wouldn't encourage him to start--I'm just assuming that he probably already enjoys it.) Pot will help with the withdrawal symptoms, help him regain an appetite, help him sleep. I honestly think of it as a medicine.

What advice can I give my fiancé that will seep in?

Tell him that his brother will utterly destroy himself if you don't support him in an effort to quit. Junkies NEVER come to a good end, if it's not AIDS it's an overdose, or just total destruction of body and mind.