The only thing you OWE a sibling is respect. You don't owe him your money, your sanity, your precious spare time, or accepting a risk to your family/career. You don't.
But you owe him respect. Respect his choices and his right to make them. IF he chooses not to treat his disability or to be drunk, that's his business. Now, respect him enough to leave him alone... out of respect.
If he ever asks why you're not contacting, helping, whatever... answer him politely and respectfully like you would any stranger. "I am not involved with people who make the choices you make in any sort of ongoing way. But I respect your right to live how you want and not feel judged by me. If you are around me I will have no choice but to come down on you about your lifestyle...and honestly I don't have the energy for it and you don't need the grief from me. Please enjoy your life the way you want. I can't be around it, though, so it's best we just leave things be. Okay?"
He won't change, not from anything you do AT him, but he might change on his own because of the things HE does and what it COSTS him. Effectively losing you in his life may be just the ticket. But it has to be a REAL event for it to be effective.
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