Dear Family Advisor

I'm afraid my sister has become a pain-pill addict.

Last updated: Jun 21, 2011

Medicine Series

I'm scared for my sister. She was injured in a car accident last year, spent six months in a wheelchair, and has had extensive rehab to learn to walk again. She seems dull or drugged most of the time, her place is a pigsty, she keeps missing work, and her boyfriend broke up with her two months ago. I'm concerned that she's abusing prescription meds. Should I talk to her doctor or just confront her? I'm her closest friend and family member, and what I'm most afraid of is that if I confront her, she'll shove me out of her life and get worse.

Even if your sister hates you for it, it's time to take action. Without doing a bit of sleuthing, you won't know for sure if she's addicted to pain pills, but you can tell by her behavior that she's depressed. In fact, she may have depression, which is more than just being temporarily sad or bummed that life isn't going your way. Depression is a mental health disease, which means your sister needs your consistent help and compassion -- and perhaps supervised professional care.

While it might not sound nice, if it were my sister I'd get real nosy and stop by at all hours of the day and night and look through her place top to bottom for pain meds. I don't think she's going to be honest with you if you simply ask her if she's abusing meds. And I don't think you can wait -- abusing prescription drugs is a growing problem in our country, and it's downright dangerous. Playing by the rules -- being nice and not intrusive -- is unlikely to keep your sister safe. I know that my advice is a little unorthodox, but I think you'd rather have your sister mad at you than gone.

Take inventory. List every prescription bottle you find (mark it some way) and note how many pills are in each. Go through the entire place: purse, car, hiding places. List every doctor's name you find, every pharmacy name and number you find. Do a Google search and see if they have any charges against them. Look on her credit card or check registry to see if she's visiting a "pain-pill mill." Is she driving out of her county or out of the state to get these medications? If so, that's a huge indicator that she's in trouble.

The problem is that eventually she'll find a way around you. She'll find other doctors, other pharmacies -- and she'll become smarter at tricking you. The question is: What's driving her? Is it addiction or depression? Which is stronger at this point?

Don't focus on getting your sister to confess to you -- get her to talk to a professional. She needs a safe place to talk about her grief, her loneliness, and all the emotions that are spiraling out of control. Get her to see someone regularly. This isn't just about taking a pill for depression. Although the right depression medication can help, your sister needs to work through everything that's happened, and that's not a quick fix.

This isn't going to be easy. She might lie to you, turn on you, and push you away. You're going to have to show up when you don't feel like it, but it's the only way. Put your relationship aside. She's like an animal caught in a trap, and she'll lash out at anyone who gets close. So set your sister issues aside and just be there for her. You probably won't see real progress for at least six months to a year. (And if she really is battling an addiction, you may eventually need help from one of the support groups that are out there for family members).

Stop being afraid. Love isn't about someone liking you. Your sister might not like you for a long time. But she needs you, and that matters more. Find a photo of the two of you -- from when you were younger, when the two of you were silly, playful, connected -- and put that photo on your bathroom mirror or next to your computer. Hold onto that image and hold tight.