My brother ruined his psychiatric rehab visit

Hey

,My brother, 22, tried to abstain from substance use with the help of our family friend (Uncle G) and me at home but relapsed because, as he said, one of our family members said some mean things.

We caught him this time because: (1) A day before his best friend J—whom I had confided in about his drug use to get help—came to our house high as a kite, running from his family, and my brother was high too. (2) One of our relatives called us and asked if he's using (we never told them, but everyone was suspicious). We learned he had been taking a lot of money from friends and family by faking accidents, claiming J needed money, and lying about our cafe business installments (which my father and I pay for). We opened the cafe 2 months ago with him as the chef. (He even faked an accident with my relative that day to get money.)

He uses heroin (via chasing), tapentadol, tramadol, opium, pregabalin, weed, oral cannabis, cigarettes, and probably more. He reports consuming multiple substances a day.

This time, we got him into the psych ward for proper treatment to manage his withdrawals and start him on naltrexone (around February 3, 2026).

On his first day in the inpatient ward, he managed to get some cigarettes (the small ones he usually uses). I caught him once when I came to be his attendant on the second day. I walked off distressed and had a bad panic attack. He asked me not to tell anyone because the person he got the cigarettes from was a gangster in the ward. I don't believe him—Ava (name changed), one of his girlfriends, sneaked into the ward (I complained to the guards, but there was no concrete action). He got his usual thin cigarettes. While I was processing this, he called me about 10 times. I picked up, and he said he had given the cigarettes to the doctor. When I entered the ward, the psychiatrist told me that it happens.

On later days, he was in severe withdrawals, and I did my best as a brother, staying 24/7 to help him. I massaged him, tried to get him anything he wanted that wasn't drugs, and talked to him.

Around day 7, I was very pissed because he kept irritating me by constantly saying he wanted to get out on February 14 to watch movies with Ava (who he claims wasn't even his girlfriend—he just wanted her to prove something to his friends... sick)

.In the midst of that, our relatives came to meet us, and he started getting very panicky. We didn't tell him they were coming because he tends to take too much pressure—he's ashamed to face people (but now almost everyone knows, even his best friends). He hugged them, cried, and they offered to help him with the cafe and the loans he took. (I think that was a mistake.) (The day before, when family came, he was the most cynical and rude person; now he was the most motivated to get out. I get it's part of an addict's personality and defense mechanisms... but it still hurts.)

After that, he started calling Uncle G and other people again to get released on the 14th (I even told him to send a lavish gift pack to her). I tried to explain that the psychiatrists said if he stays until February 17, he could get naltrexone, which would make it easier for the family to manage his addiction and work on recovery.This time, he changed tactics and told me to go. He said some pretty mean things, including "What did I do to hurt you by using drugs?" He told the person who had been sleeping literally on the floor for 7 days that I was very egoistic like him and we would just fight. (I was being reasonable and trying to establish boundaries.) I was burned out and decided to leave the next day after consulting Uncle G. When I was leaving, he became very concerned for himself, asking who would be there for him.It wasn't even hours after I left—while I was on a very packed bus heading home—that he started calling my family and told them to pay loans to Ava and others. (I had asked them not to without a proper method, but they got tricked by his manipulative lies, and she got the money.)

Fast forward: Ava got into the psych ward again in my absence (I learned this from another caretaker). Later, when the doctor asked if he had used any opioids so they could start naltrexone treatment, he confessed to using tramadol (after being asked 3rd time to have confirmation) and was asked to leave because he didn't follow the rules. (I was reaching the hospital, having taken leave from work again because he was calling, sounding so distressed.) He told me he did something to get out and explained that he lied because someone told him they would discharge him early on disciplinary grounds.

During these time, he even called my youngest brother B to go to the cafe very early in the morning to tell people to go away or he'd call the police. (We don't know what kind of people he was talking about, but I feel they could seriously harm him. We didn't open the cafe that day.)

I still can't comprehend half of these things, but one thing is clear: He doesn't want to change, at least not right now. I don't think we can pour so much into his business if he's even getting peddlers and other dangerous people into the cafe. (My youngest brother is barely 18.)

How, as a family, can we go ahead with this mess?