I have no advice to help them, but I'd warn you, as a care giver, to be sure not to let their problems spiral your own life. I've seen several former addicts lapse after trying to rescue their friends - if you're not in a stable place it's important not to let someone destabilize you and just suggest supports that might be able to handle your friend.

Other folks might have more useful advice, but it's important to realize that mental health is a constant struggle and life isn't forever - if your friend has lost a limb they have a very narrow road to walk to recovery and, without proper supports, it's unfortunately a road most people fall off.

How do you keep him on a good path? You can't. The only person you can control is yourself.

How do you be there for him? First, accept that he may never change and may continue to spiral down. If you've accepted that and think you're in a good enough place to tolerate being around him, then do just that, be around him sometimes. It's paramount you have good boundaries though. He may try to use you for money, shelter, or any number of things you will have to say no to, and you need to feel alright with saying no.

until they're asking for genuine help (which starts with help getting clean), any attempt to help would be mostly enabling, i think. I would start distancing myself from this guy, just so I don't have to watch them kill themselves. but I would let them know what I was doing and why at the same time. myself and a group of friends (all in recovery ourselves) cut ties with a really close friend when he relapsed and refused to go to rehab. in our case, that was the final straw he needed to get help again, and now he's been sober for like 10 years. I can't guarantee it'll go well, he's clearly self-destructive, but I don't enjoy watching it

Set up a standing breakfast appointment with him every Saturday morning. The best way to help out a friend who’s going through something hard is to be there consistently. If you can consistently meet with him, it will provide a point of stability in his life.

Provide him a bunch of self help resources and some candid conversation and encouragement. Change starts within and it's solely dependent on the person in question. You cannot champion somebody else's change, you can only really assist and cheer.

Tell the mother fucker to stop digging his hole, because life isn't full of miracles.

Change CAN be swift and efficient but that depends on a lot of factors and it sounds like your friend needs to sort out the home environment and bad habits first.

Try Atomic Habits or The Power of Habits as suggestions since they clearly still struggle with step 0.

Find a positive activity or hobby to do with your friend. Getting outside in nature is great for healing the mind and soul, and doing that with a friend is easier and potentially more enjoyable. Usually pretty cheap also.

Breathing exercises. Meditation.

Your friend has to find willpower and control, then start with that power towards the goal(s).

All you can reasonably do is help him get in touch with resources to help him recover.

And then, if he gets sober and starts to get his affairs in order, you can be supportive.

But his multiple severe challenges coupled with the fact that he has a family who could be supportive of him if he had been supportive of them lead me to warn you to limit your exposure here.

It's too much and you'll get overwhelmed, even if he's able to cope.

But being a supportive friend, knowing he has someone in his life who hasn't fully written him off can still be valuable.