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Our 73 year old sister lives over 2000 miles for us.  She has been on doctor prescribed opiates for at least 8 years and she needs help! She is extremely depressed, no self esteem, sleeps most of the day, has no interaction with family, doesn't answer her phone or the front door. We are fairly certain  she is addicted to pain meds. What can we do legally to get her help? What are the first steps in reaching out to her. Will Medicare pay for rehab?

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As a recovering addict (opiates) I can tell you that no matter what measures you take to help her, the decision to recover is a decision only she can make herself. You can alert her doctor(s) but an addict will dodge every obstacle you throw in their path. The addict is focused and determined to get to their drug and guard it no matter what the cost. To them it is essential to their existence, without it they feel like they are going to die and early in withdrawal most addicts entertain the wish to be dead. Twelve steps. And no one can take those twelve steps but her. When my family tried to intervene I took more pills. Not out of rebellion, my family didn't know I increased my dose, I did it to drown out the constant echo of their words, the truth I was unwilling to face. Love her enough to let go of her struggle, love her enough to let her hit bottom. That bottom is crucial, it's the beginning of the end of active addiction. She has to do it on her own terms. God bless you all honey.
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She could also be in severe chronic pain in her age. That makes sense why she is prescribed painkillers and depressed because she is in physical as well as emotional pain. There is definately a tie between the two! One feeds the other. Chronic pain equals limitations on a normal life without suffering for any physical exertions, even something as simple as vacuuming and cleaning your house. Not being able to live a normal life without being in pain can certainly lead to depression and low self esteem. I am very aware of these things since I crushed a disc in my lower back a long time ago and it certainly changed my life. I also am a professional caregiver and work with many people who are physically compromised. It does not light up their day to have to depend on others to do simple tasks they used to do themselves. It does make them feel helpless, frustrated and depressed. I can empathize with them so that helps. This is just a theory of what could be happening. Certainly one worth considering.
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As some of the others have said there's nothing you can do for her. We can't force people into getting sober. There is no legal way to do this. If it were possible we wouldn't have the addiction issues we have in our society. If she were to quit it would have to be under a Dr.'s care as withdrawls from opiates are very painful and need to be monitored.
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Rstern96
I'm sorry to hear about your sister. Since you live so far away how do you know your sister is isolating and addicted to drugs?
If you know who your sisters doctor is you could send him a letter advising him of your concerns.
You might also call the area on aging and ask them to do a wellness check on your sister. They can do that anonymously. 
I have a friend whose BIL died and her sister would not allow my friend to visit. She would talk on the phone. At one time it appeared that the sister was being scammed by a bogus social worker. Friend called area on aging and got them to check on her sister. That started the ball rolling to get the sister help. You might also try sending your sister a letter and letting her know you are concerned about her. What have you tried so far? If no one has seen her, she could be incapacitated inside her home. I hope you are able to get through to her soon. 
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Probably your best option is to call Adult Protective Services. If you think she might be in immediate danger, you might also consider calling the police, as I'm not sure how quickly APS will be able to get out there.

You can legally report your concerns in writing to her health providers; they should know about this, esp if they are writing the prescriptions. They might even disclose some information to you, because they are technically allowed to do so in cases of emergency or grave disability.
https://www.hhs.gov/hipaa/for-individuals/faq/

Good luck!
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Sadly, if this is true, nothing you can do. Anything you do is temporary. If she is choosing to live this way, it is her choice. People who have drug or alcohol addictions have to be the ones who make the decision they need help and do not want to continue on their self destructive course. Trust me, I know, I had an alcoholic father who smoked like a chimney and died in his early 60's of cancer. Then, I lost my oldest brother to drugs when he was in his 40's. He was a successful business owner, had a nice condo, a porche but inside he was miserable and, struggled with depression his whole life. The first time he almost ODed, I met him in the ER. He was so out of it, I decided to take the next day off from work to bring him fresh clothes, shoes etc. since the ambulance took him away from his condo without anything. I had a long talk with him. He had done the methadone clinic thing, lived with my Mom during recovery prior to this event and had (we hoped) successfully beaten it.
All it took was for another emotional upheaval to send him back and there I was, at the hospital with him. I told him I loved him and that I was always there for him no matter what, but HE had to decide what he wanted for his life. I could not "fix him" because he had to be the one to make that decision. The hospital put him in a three day lock down and as soon as he got out, he went straight to the city, got his usual dose & that was enough to kill him after being off of the real thing through methadone. Some random stranger or dealer was with him and drove him in his car to the hospital and he was DOA. The person drove him up, yelled, "This guy needs help!"and took off running. Why am I telling you this awful story? Because I have been there, done that. Ultimately it is the individuals decision and there isn't a darn thing you can do except offer your help and support. They have to be the one who wants it. You can call any service, police, etc. and that may help, but when a person has their mind made up, they will always find a way back to that. You cannot control them. My brother simply slipped between the cracks when nobody was watching.
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She is very definitely addicted to the medication. She could get help at Reformers Unanimous, which is a bible-based support group that meets weekly at churches all over the world. Go to ReformU.com. She CAN get well.
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IamAmy,
So glad you made the right decision and you are here! So many others don't realize that you can have a person hauled away by police, put them in programs, tie them to a church pew, douse them in Holy water, etc. but if it is against the persons wishes, it will not work. Does anyone remember we were given free will to do with our lives what we choose whether good or bad? People are always so desperate to control others, but addiction is very difficult to tackle. I know someone who has been in and out of rehab so many times, it never lasts. The persons parents have done everything you can think of, spent a fortune on treatments, let them go to jail, live in special program housing. This person always ends up sliding back at some point. It's heartbreaking. They are not ready. In the end, it is the persons choice whether we like it or not and all the love, support, tears we cry cannot break the cycle of addiction for those we love. I am so happy to hear success stories such as yourself! That means you are one tough lady and that is admirable!
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Thank you Rainey69! That was very encouraging. It would be so much easier if the pew tying/holy water method and other methods like it actually worked! No dice, I had to wait on myself to decide and I'm a procrastinator and stubborn by nature so you can imagine the years it took me to decide. I checked myself into a 90 day rehab facility, with 6 weeks of aftercare and NA meetings I still and will always attend. It was the hardest and smartest decision I ever made. That was 17 yrs ago. It gets easier, it gets better and I'm ok with the fact that there is no cure, that I have to work at my recovery one day at a time. I'm more than okay with it, I'm happy with it and grateful beyond belief! xoxo
Rstern, my concern about your sister is her age. There's a tendency, that some (not all) physicians seem to have, the tendency to dismiss the idea that a person in their 60's & 70's are candidates for addiction. It does seem like the addiction would have reared it's ugly head a long time ago but if the addiction is there and just not fed until a person reaches senior citizen status, it's no less an addiction. So don't put all your hopes into the idea that her physician will be responsive to your concerns but even if the doc is responsive to your concerns, your sister will promptly take her addiction to another doctor. Nothing motivates an addict into action like taking away their 'life support system'. But make sure it's an addiction you're dealing with, as 97yroldmom said, how do you know it's addiction? Does your sister have other health problems that could mimic addiction symptoms, like depression?
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That's true. People can get treatment.
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