Living in the Shadow of Opioid Use: A Sibling’s Journey Through 15 Years of Struggle, Boundaries & Hope

I have countlessly journaled my thoughts, feelings, and concerns I wish I could say aloud regarding my sibling and their substance use… always privately, never publicly.

A Lengthy, Tumultuous Ride

I’ve had a lot of opportunities to do so over the last 15 years. The way I perceive this lengthy duration of a rollercoaster ride is a catch-22. On one hand, I’m tired of this unrest—utterly exhausted and emotionally depleted. On the other hand, I am grateful that the ride continues to operate even if tumultuously instead of closing permanently. Because if I weren’t exhausted, I’d be devastated.

This ride began while I was in college and my younger sibling was in high school. They’re five years younger than me, and I’ve always felt a maternal instinct to protect them (and all of my siblings) since I’m the eldest.

A Town Transformed by the Opioid Crisis

We grew up in one of those towns that are now widely recognized but weren’t back then. It was a city whose industrial reputation took a downward plight and became well known for its “pill mills,” alarming drugs per capita statistics, and local corruption that the opioid crisis caused our community. We were featured in the New York Times, Guardian, Rolling Stone, and many other outlets once the blind eye was opened and an eventual DEA raid would ensue—but the damage remains despite community efforts to reverse the city’s image.

Regardless of my hometown morphing into a depressing hellhole in my adolescence (The Wild and Wonderful Whites of West Virginia really resonated with me), I remember it being an ideal childhood for me and most of my siblings. At that time, we were a typical, middle-class family participating in Scout troops, piano lessons, gymnastics, and dance, most in which my sibling shined. They were graceful, talented, intelligent, and comical—all attributes they still hold today (when they’re not actively using).

Luckily for me, my grade was slightly ahead of the opioid crisis’s destruction. I wasn’t aware of anyone doing pills—let alone heroin—during my formative years. And I would’ve known because I love a “party.”

My sibling switched high schools due to some trouble they were beginning to get into. Our mom was a teacher at another high school, and she wanted to be able to keep an eye on them. In spite of my mom’s effort to monitor my sibling, this is when they fell victim to… falling in love.

In the beginning, the prospect was innocent with unfortunate circumstances—they were part of a locally infamous drug trafficking family. Everyone knew about their crimes and lifestyle, but no repercussions were ever delivered. And they despised their family until, unfortunately, they, too, fell into this family business. And this is where my sibling’s exposure to painkillers, benzodiazepines, and heroin first occurred.

My Sibling’s Struggle with Substance Use

As I was in college and moved far away after graduation, I had a distance that allowed me to be oblivious to what was occurring back home. I wasn’t there to witness the drastic change in behavior, personality, and priorities. I would catch glimpses when I’d come home for short stints to visit, but I wasn’t in the “trenches.” I wasn’t aware of the full extent of their use or what the future would entail.

The Emotional & Physical Toll

Once I had learned about my sibling’s first overdose, I was absolutely terrified. I just couldn’t understand. I was bewildered… “What had happened to make them this way? Who would ever think that heroin is a good idea? Why would someone with such a bright future throw it in the garbage? Why did they prefer to be surrounded by these drug dealers and addicts living in squalor?” Especially when they had us—their family.

There wasn’t any overt reason I or my family could fathom for this to be their life path. And we asked ourselves why—a lot.

I was so consumed with fear that it even began to manifest physically. I experienced canker sores for the first time from emotional distress, worrying throughout the night that maybe the next day they wouldn’t be here anymore. Bracing myself for every phone call I received from my mom that this would be it— the news I had been dreading. They had died before—and they could die again.

And they would, again and again.

This eventually presented my first experience with dyshidrotic eczema; small blisters formed on the palms of my hands. I can’t conclusively determine its cause since it’s medically unknown, but it’s been strongly linked to experiencing times of stress. And I definitely knew I was stressed.

Sidenote: I want to express my gratitude for the invention of Narcan and those who promote its use and awareness. Without it, I wouldn’t have the memories I cherish with my sibling. It’s provided them with breath and us with hope as we proceed to fight.

Living with Fear and Uncertainty

Over the last 15 years, we’ve observed highs and lows. I have experienced fear, anger, depression, hopefulness, pride, and optimism. With each relapse, I’ve attempted to change my approach to “fix” the situation, but now I know I simply can’t.

There have been encouraging moments followed by discouraging moments, and this volatile change in disposition wears on me the most. Slamming me down again and again.

I thought that drug court would be the end. I thought that getting away from that family when they headed to college would be the end. I thought that living in a sober living facility would be the end. I thought getting them out of our hometown would be the end. I thought me having children would be the end. I thought them making responsible moves to improve their future would be the end.

A Maddening Carousel

There is a distinct cycle to the lunacy.

Leading up to the next round, I know the red flags very well by this point. But it’s an internal struggle because you hope you’re wrong, so I’ll doubt myself. Or feel like I need to gather more evidence before I broach the subject—to be readily armed if there is dissenting backlash from my “accusation.”

Still, with the prolonged time this has occurred, it’s never been an easy topic to discuss. Substance use, addiction, and mental health issues are mostly a family tradition, as Hank Williams, Jr. would say. A lot of defensive finger-pointing can erupt paired with deflection—”You’re such a hypocrite. What about your own addictions? You’re just judgmental. You’re overly concerned about nothing.”

And then, the other shoe always drops. Here is where the dread and self-criticism kick in—”What if the next overdose is the final one? What would life be like without them? Why was I such a fool to think this was over? Why didn’t I intervene earlier when I knew suspicious behavior was happening?”

Coping with Boundaries and Support

I’ve learned skills to help me cope during the “dark times,” as I call them. I’ve mostly learned about boundaries and what support is versus enabling.

I’ll set my boundary. “I will not have any contact with you until you’re ready to get better. You cannot come to my home. You cannot be around my children.” Here comes the depression and grieving. Life goes on, but there’s a noticeable void. A precious piece of your family is gone. I miss them…

Despite my longing, I can’t cave. I can’t remove the boundary. I cannot allow myself to be consumed by these negative spirals and endless catastrophic worries. I have a life; I have children now—they need me. I must be present for them.

It’s a conflicting sentiment to convince yourself that distancing yourself from someone you love is correct because you desperately want them back and a sense of “normalcy.” I must remind myself that this version of my sibling differs from the one in my memories.

Other tools I’ve started utilizing are my therapist, a family recovery coach, and attending the virtual siblings’ support group that WakeUp Carolina offers. I can’t claim I look forward to these conversations, but I must cope.

A Story Still Unfolding

Honestly, I did it begrudgingly when I volunteered to submit this article. My story (does not yet) have the ending of “now they’re this many years sober.” I’m in the midst of it now today as I type with an eczema outbreak on my palms.

But that’s why I wanted to share—I figure others have stories similar to mine that have no resolution to this ongoing battle. Not every story has a happy or sad ending. Some of us linger in an uncertain limbo.

On the darkest days, holding on to hope is challenging, especially when you have 15 past years whispering to you that it may never be genuinely okay. But I’ll keep showing up for them every chance I get when the occasion arises. Within my boundaries.