My brother relapsed on cocaine and hasn't slept in 5 days, what are my options here?
He is 31 and also has schizoaffective disorder with bipolar and takes medication for that, I can't remember the names. He had been sober for about a year and recently relapsed with plans to quit immediately. That of course didn't pan out the way he wanted to (planned it during his high) and he has now been using and hasn't slept a wink in the past 5 days. He isn't eating, only drinking lemonade, and has lost 15 lbs in those 5 days alone. He's about 6'4, 230-240 lbs.
He said he doesn't want to go to rehab because he 'has it under control' but at this point, my concern is more so with the lack of sleep, coupled with the continued substance use. I worry that he's either going to have a complete system shut down or a psychotic break like he has in the past. I have no idea what to do here and feel like a psychotic episode is going to happen inevitably.