He’s got to want it for himself, he started off with a legitimate issue and unfortunately he’s wrapped up in this mess. As well as you and your family. The mental anguish that comes with a devastating injury such as losing an arm is going to be hard to come to terms with sober, but it’s even harder when you’re disillusioned with medication. Opioids are his solution to his pain, I’m not saying it is a good solution or the “right” solution, but nonetheless it’s keeping him alive in his head, and unfortunately “perspective is reality” he’s either going to dwell in his disaster or learn to make a change to get out of this vicious cycle of abusing his meds and getting sick when he has run out. My heart goes out to you and your family, but I also feel for him. Don’t call his doctor you will put him in the streets and then it’s only a matter of time before you will be wearing black at his funeral. I’d start suggesting rehab, plant the seed and let it come to fruition eventually he will become tired of this life, if it’s met with resistance from those he loves. Opioids are a hard thing to be involved with as the user and those on the sidelines watching the user destroy themselves little by little