How Do You Help a Sibling With Drug/alcohol Problems but Could Also Have Antisocial Personality Disorder?

My younger brother is 20. He has been in rehab twice for drug/alcohol problems. At one point he was taking 30+ Xanax ‘bars’ a day until we got him into a program and detoxed.

Every time he gets out of rehab, he eventually goes out and gets his ‘fix’ again and gets hooked.

He even moved 2,000 miles away for a while to live with my Mother in CA. He did not know a soul there and still managed to find dope.

I think the reason he has such a hard time giving everything up is because he also has antisocial personality disorder. He seems to have no regard for other people’s feelings. He is very impulsive and a terrific liar and con. He plays on our (his family’s) emotions because he knows we want him to get help and always want to believe he is getting better….and then he will steal from us right under our nose.

I have been reading about antisocial personality disorder and know that the treatment of the disorder must be done first. He needs real behavior modification therapy to improve decision making skills. He could also use a mood stabilizer to help manage anger issues.

I guess what I would like to know is….how do you talk to someone about this disorder who has such blatant disregard for other people’s rights/feelings and even his own well being? How do you talk to someone who is virtually impossible to communicate with? How do you talk to someone who only indulges in conversation when there is some hidden motive to get something he wants?

How do you make someone realize the need for therapy?