Abstract Ethnic Vietnamese heroin users in Australia typically experience high rates of blood-borne virus infection, opioid overdose, criminal justice system involvement and poor retention in substance use treatment, particularly methadone maintenance treatment. This paper explores the experiences of twenty ethnic Vietnamese heroin users and examines the specific role of families in treatment from the perspective of the person going through treatment. What emerged from this study was a picture of a young, ethnically distinct subgroup of opiate-dependent people struggling to engage in treatment in an environment where heroin was easily accessible. The relational dynamics between participants and their family appears as a key mediator of the experience of treatment: it can be a source of motivation, grounding and connectedness; or it can be alienating and fragmenting. The extended nature of Vietnamese family systems meant that these relationships had implications for family members geographically and relationally close and distant.