My brother is officially in his second week of rehab.  On Monday he was temporarily released for a court date.  After insisting that my brother waive all rights to any day passes at the rehab, the judge officially reinstated deferred adjudication.  Pending a successful three month rehab stint and a year of probation, my brother could still get out of this all without a felony.  One dares to hope.

Now that Joseph’s* rehab is in progress, he is being evaluated and reevaluated and receiving more counseling than ever before in his life.  The doctor’s first order of business was to put my brother on anti-depressants.  He certainly had seemed depressed to me when he was staying at my house.   Joseph’s depression mainly stems from the event that made him want to get clean again.

Earlier this year Joseph contacted me after months of not speaking to me and asked if he and his girlfriend Ashley* could rent a room at my house.  I was weary but I agreed provided that they would be willing to sign a lease.  They first arrived on a Saturday morning around 9 a.m. reeking of booze.  They had clearly been up all night drinking.  They slept most of the day and then left to work their night shifts waiting tables.  They came back home on Sunday around 3 a.m. and went to sleep shortly thereafter.  By 7 p.m. on Monday evening they still had not woken up.  Neither Joseph or Ashley had so much as gotten up to use the restroom, have a glass of water, or eat anything at all.  When they finally got up around 8 p.m. and headed out to their jobs, I did a quick search of their room.  The bloody cotton ball and the belt adjusted to arm’s width were all I needed to see.  I let my brother know that if he wanted to come back to stay then he would have to take a drug test.

He refused and a couple more months went by before I heard from him again.  “Will you please help me buy my prescription?” he asked by text referring to his suboxone.  I agreed to meet him at the pharmacy.  For a hug and chance to see his face, I spent $120 on his medication and another $20 buying him soda and some snacks.  “Ashley is sick so I’m going to share my medicine with her,” he told me.

Yet another couple of months later I was sitting at a bar having a sangria martini with my fiancé when I got the text message.  Joseph said that he was at the hospital and wanted to know if I would buy him some food.  I took him to dinner and he told my fiancé and I over dinner that Ashley had collapsed from pneumonia and was in the ICU.

It was another day before my brother texted me from the hospital and asked if he could come home with me.  “I’m done using,” he said, “and I just need to get out of here.”  Over the course of the next couple of weeks, while my brother suffered through his withdrawals, we occasionally went to the hospital to check on Ashley.  I always went because I could scarcely stand to let my brother out of my sight.

I learned what I think most people don’t realize about heroin. People die from heroin in other ways besides just acute overdose events.  Ashley had a heart infection caused by shooting up, most likely with a dirty and/or used needle.  She had not sought medical treatment when she started feeling ill and her lungs began swelling with liquid.  Joseph had finally taken her to the hospital when she started speaking gibberish and was too weak to walk on her own.  At the ICU, the medical staff put Ashley on a breathing tube and let us know that she may never be able to fully breathe on her own again.  A couple of weeks later, a nurse at the front desk told us that there was no longer anyone by Ashley’s name at the hospital.

My brother blamed himself for what had happened to Ashley.  Ashley had a long history of drug use.  She had even lost custody of her two children in another state.  Joseph claimed that Ashley had moved here to get clean and that he had gotten her using again.

Before Joseph was admitted to the rehab, we learned that Ashley had actually recovered (at least enough to breathe on her own) and was released from the hospital.  Contrary to what the doctors had told me, they did not attempt to detox Ashley and she was discharged with a heavy arsenal of pain killers.  Just like that, she was back in my brother’s life trying to see him.  Thankfully, Joseph got admitted to rehab without any major incidents, but I didn’t sleep for at least a week.

Joseph’s biggest challenge in rehab will be accepting that Ashley made her own decisions to use heroin.  He will also need to think long and hard about his relationship with her, and hopefully acknowledge that having her in his life is probably not the best decision for his recovery.  One of my worst fears is that he will finish rehab, go back to Ashley, and then we’ll never see him alive again.

*Names have been changed.