The Drug Experience: Heroin, Part 3

In the last Briefing, we started to describe the experiences of people whose lives are seriously affected by heroin. The experiences are based on those described in the seminal book Beating the Dragon: The Recovery from Dependent Drug Use by James McIntosh and Neil McKeganey, and our own research with clients on the Peterborough Nene Drug Interventions Programme.

The recognition by individuals that they are addicted to, or dependent on, heroin can take anywhere from a few weeks to several months or even years, depending upon the amount of drug being used, the frequency with which it was being taken, and the person’s ability to fund their habit.

For the majority of individuals in each of the above research studies, the recognition that they were addicted usually came from the experience of withdrawal symptoms which arose when they purposefully attempted to stop using the drug, or through not having heroin available. The most common reason for being deprived of heroin is a lack of money to purchase the drug.

These withdrawal symptoms disappeared when heroin was used again. Some people are actually surprised to find that they actually needed heroin to function normally. They were no longer in control of their drug-taking; rather, it was controlling them.

These withdrawal symptoms included stomach cramps, vomiting and retching, muscle pains, the shakes, hot and cold spells, and headaches. Some people experience considerable discomfort and pain, and seek out the drug to escape or avoid this discomfort and pain.

The authors of Beating the Dragon: The Recovery from Dependent Drug Use describe Michael’s experience, who was taken to prison at a time of his drug-using career that he had never experienced withdrawal, and never considered the possibility that he might be addicted to the drug.

Once he started to experience withdrawal in the police cell, Michael started to ask for help believing that there was something wrong with him. The policeman knew what was wrong and asked, ‘Did your pals not tell you this?’

Michael continued:

‘But, as soon as I got out next day, I went straight for a hit and that was me, within seconds I was brand-new again. So that was me, I wasn’t usin’ it for fun anymore, I was usin’ it ‘cos I had to use it.’

Being deprived of the heroin they are using, for whatever reason, is absolutely fundamental to an individual’s realisation that they are addicted to heroin. In the absence of such enforced abstinence, and its physical consequences, it is possible for a person to maintain a belief that whilst they are using heroin they are doing so out of choice, rather than because they are dependent on the drug.

Heroin users will say that, apart from the experiences associated with withdrawal, there is little to indicate that they have become addicted to the drug.

“There’s no sign that says, ‘you’re now entering addiction’, there’s no big sign that says, ‘you’ll need to stop now, if you go once more that’s you’. You just cross that line and you don’t realise you’ve crossed it until you try to stop. I didn’t think about withdrawal symptoms or anything like that ‘cos I always had access to money.” (from Beating the Dragon: The Recovery from Dependent Drug Use)

When heroin users realise that they addicted to the drug, they respond in a number of ways. Some accept that they are addicted to the drug, but decide not to do anything about it at this time as they are enjoying using heroin and/or the drug-using lifestyle. They are also able to fund their habit.

Other users do not want to continue using the drug, but they soon discover that it is not just a simple case of stopping. This becomes a difficult and often emotional time as they realise that they have no choice. They have to continue using the drug to avoid the physical symptoms of withdrawal.

Some of our interviewees described becoming depressed, others either considered or tried to commit suicide.

Many heroin users point out that they reached a time where they no longer experienced pleasurable effects of the drug. They continue to take it just to feel ‘normal. Some say that they never really experience the same effect as those first few times that they injected or smoked heroin.

Sometimes, family members or friends inform the heroin user that they believe that they have a drug problem. This appears to happen less frequently than one might expect. This may be because heroin users hide their habit well from their families, or because the family members choose to deny that there is a problem or simply ignore it.

When the issue is first raised, the heroin user usually denies that there is a problem. As long as they can sustain their habit and avoid the distress of withdrawal, they can maintain the belief that they are in control.

Irrespective of whether heroin addicts regard their addiction as a problem or not, once they become dependent their lives become dominated by the need to feed their habit and to secure the means of doing so. In our next Briefing, we will focus on living with addiction.

Recommended Reading:

Beating the Dragon: The Recovery from Dependent Drug Use by James McIntosh and Neil McKeganey, Prentice Hall, 2002.

The Heroin Users by Tam Stewart, Oram Press, 1996.

Using Heroin, Trying to Stop and Accessing Treatment by Aimee Hopkins and David Clark, 2005.

> pdf document

> To be continued.

Anna’s Moment of Clarity

In two recent blog posts starting here, I focused on a qualitative research project we conducted with family members who have been indirectly affected by substance use problems.

Years after this research was conducted, I received a story written by Anna, who lives here in Australia, which relates how her family coped with her brother’s heroin addiction. I published Anna’s Story on  Recovery Stories and recently updated it in my eBook Our Recovery Stories: Journeys from Drug and Alcohol Addiction. Anna’s story highlights the need for family members to accept that they cannot take ownership of their loved one’s addiction. They are not responsible for the addiction and they cannot do recovery for their loved one.

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‘Hope is the Word That Can Free Us From Addiction’ by o2b3

One of the things I will be doing over the coming months is to ‘bring back’ some of the classic blogs from our online community Wired In To Recovery, which ran from 2008 – 2012. People who know me will tell you that I always keep banging on about hope. Yes, hope is essential for recovery! Here’s a real powerful blog about hope which o2b3 submitted to Wired In To Recovery back in 2010.

‘I always thought that the word hope didnʼt apply to me! From where I come from I was never shown or given any hope. I was always put down and told, ‘Thereʼs no hope for you. You are no good. Youʼre bad, you are a liar. You are worthless and rotten to the core.’ When you keep hearing that said to you time and time again, you start to believe in what those people say. That this is you and thatʼs what you are. So I became the person that everyone said I was. I became all of the above, just to get back at those people that hurt me and put me down.

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Factors Facilitating Recovery: Hope

In an earlier blog, I described the nature of addiction recovery, using what was written in the second last chapter, ‘Factors That Facilitate Recovery’, of my recently published eBook, Our Recovery Stories: Journeys from Drug and Alcohol Addiction.

It  is important to emphasise that everyone’s recovery is different and deeply personal. However, whilst there are a multitude of pathways to recovery, there are a number of key factors that facilitate recovery from serious substance use problems. The importance of these factors has been illustrated in the narratives of recovering people about their journeys into and out of addiction. 

In this and future blog posts, I will describe a number these factors, illustrating their importance using primarily quotes from the Stories in my book. It should be noted that many of these factors are inter-related, so there will be some degree of repetition.

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Pathways from Heroin Addiction: Recovery Without Treatment, Part 4

The research conducted by Patrick Biernacki, with 101 former heroin addicts, showed some of the courses that people take in their lives when they give up using the drug without the aid of treatment. This is the last part of this series of blog posts.

When people resolve to stop using heroin, they face a variety of problems that go beyond the cravings for the drug and the temptation to use again. These additional problems are related to their attempts to fashion new identities and social involvements in worlds that are not associated with drug use.

As Biernacki pointed out, ‘The manner of termination and the course [or courses] that follow withdrawal from opiates are closely related to the degree that the addicts were involved in the world of addiction, to the exclusion of activities in other, more ordinary worlds, and to the extent that they had ruined conventional social relationships and spoiled the identities situated in them.’

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Pathways from Heroin Addiction: Recovery Without Treatment, Part 3

I continue my series of blog posts on Patrick Biernacki’s research from the mid-1980s focused on natural recovery from heroin addiction.

People who have been addicted to heroin report experiencing cravings for the drug long after they have given up using. Many people who have relapsed and gone back to using the drug after a period of abstinence attribute their relapse to their cravings for the drug.

A craving for heroin is used to describe a strong desire or need to take the drug.  Craving is often brought about by the appearance of a cue that is associated with the past drug use. These may be cues associated with the withdrawal from heroin, or with the pleasurable effects of the drug.

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Pathways from Heroin Addiction: Recovery Without Treatment, Part 2

In my last blog post, I started to look at the research of Patrick Biernacki, conducted in the US in the mid-1980s, which involved interviews with 101 people who had recovered from heroin addiction without treatment.

This research indicated that once people who have become dependent on heroin decide to stop using the drug, they are often unsure about what they should do with their lives instead. They may know what they do not want to do, but they are less certain about what they do want and how they can go about getting there.

This problem is greater for those who have immersed themselves in the world of addiction. They may have no money, no place to live, and no friends (other than other heroin users) and family to help them get out of their situation.

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Pathways from Heroin Addiction: Recovery Without Treatment, Part 1

Many people believe that if you try heroin, then you are on the path to ruin. They consider that addiction to heroin is inevitable, and the route to being drug-free again is extremely difficult, if not impossible. In fact, the vast majority of people who try heroin do not become addicted to the drug [1].

Many people, including treatment professionals, believe that it is essential that a person who becomes addicted to heroin has treatment to recover. However, research by Patrick Biernacki, conducted in the US in the mid-1980s, and others has revealed that many people recover from heroin addiction without treatment. In this and the following three blog posts, I describe Biernacki’s research and consider the characteristics of this recovery process. We need to learn from this research to help other people overcome heroin addiction.

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Drug, Set and Setting

The effects that a drug has on a person are not just dependent on the drug itself, but also on factors related to the person (the set) and the physical and social setting. (838 words)

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It’s Not Just About the Drug, Part 2

In my last blog, I introduced the idea that drug effects at a personal and community level are not just dependent on their biochemical actions—they depend on drug, set (the person) and setting (social context).

The Vietnam experience
The most dramatic illustration of the role of ‘social context’ centres around heroin addiction and the widespread use by American soldiers of heroin and opium during the Vietnam War. It involved one of the most ambitious and interesting research studies ever undertaken on the use of psychoactive drugs.

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Journeys Into and Out of Heroin Addiction, Part 1:

Common themes that resonate about people’s journeys into and out of heroin addiction, and common factors that influence these journeys. This first part focuses on the descent into addiction (5,300 words).

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Journeys Into and Out of Heroin Addiction, Part 2

Focuses on living with addiction and covers such topics as relationships, changes in personality and lifestyle, hustling, crime and prison, impact on health, and treatment (5,900 words).

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Stopping Heroin Use Without Treatment

Research by Patrick Biernacki reveals important insights into how people recover from heroin addiction. It also illustrates the major challenges that people with a heroin addiction face on their journey to recovery (2,200 words). 

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Russell Brand: my life without drugs

26th Annual ARIA Awards 2012 - Award Winner PortraitsA great article in the Guardian by Russell Brand. He’s doing some great work.

Russell Brand has not used drugs for 10 years. He has a job, a house, a cat, good friends. But temptation is never far away. He wants to help other addicts, but first he wants us to feel compassion for those affected.

The last time I thought about taking heroin was yesterday. I had received “an inconvenient truth” from a beautiful woman. It wasn’t about climate change – I’m not that ecologically switched on – she told me she was pregnant and it wasn’t mine.

I had to take immediate action. I put Morrissey on in my car as an external conduit for the surging melancholy, and as I wound my way through the neurotic Hollywood hills, the narrow lanes and tight bends were a material echo of the synaptic tangle where my thoughts stalled and jammed.

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John Dolan: from homeless addict to street artist and author

John DolanHere’s a wonderful article about street artist John Dolan and his dog George which appeared recently in the UK Guardian.

Aged 10, John Dolan was told a family secret, which set him on the road to crime, addiction and homelessness. Now his life is transformed, thanks to his dog, George, and a gift for drawing

Anyone who has strolled down Shoreditch High Street in east London in the past few years will probably have seen John Dolan drawing, with a cup for coins on the pavement beside his dog.

A tourist from New Zealand browsing an art gallery nearby is typical of many of us: she stops in surprise when she sees a sketch by Dolan on display. “I saw this guy in the street the other day, just opposite,” she says. “I wish I’d stopped now and talked to him.”

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Excerpt from Anna’s Recovery Story: ‘Should I or shouldn’t I?’

stories-02Through his heroin addiction and recovery, Anna’s brother has taught her so much about life, including the most valuable lesson she could ever learn – you can get through anything.

“… there’s no way I can tell this story without saying that my brother is truly the most inspirational person I know. I am in awe of who he is and what he’s achieved. He has taught me so much about life, including the most valuable lesson I could ever possibly learn – that you can get through anything.”

‘6. Emotional release
My parents could see that I wasn’t really coping with what was happening and they convinced me to go and see a counsellor. I went to see a very expensive psychologist for three sessions. The first two sessions were spent crying and telling the same story I’d told everyone else a thousand times.

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Life as a Heroin Addict: Introduction

I was going through our old Wired In YouTube channel and saw that one of our videos – made by Jon Kerr-Smith and Lucie James – now had 0ver 290,000 views. Quite proud of that.

This video is part of a series that Jon and Lucie made with our friends in South Wales: ‘In this series we will be looking at different aspects of heroin addiction, treatment and recovery, as told by the addicts themselves.”

You can find the other videos on our channel. Enjoy!

‘Heroin Addiction, a Mother’s Story’ by Kim

301116_1829390393379_1798948842_1202263_68985599_n-225x300It’s time I put up another blog from Veronica Valli and the following from Kim is special… and very moving.

‘Addiction doesn’t just affect the person using drugs it affects the whole family. I know because I lived through my daughter Kayela’s addiction to heroin.

We raise our children and its hard work, changing diapers and heating formula and lining up daycare, the first day of school and homework we don’t understand.

We care for them until they are ready to go off in the world and we can only hope that we did the right thing, made all the right choices.

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What Works in Treatment?: Sapphire’s Story, Part 1

rsz_img_2357Sapphire’s Story shows the importance of person-centered treatment. Things went well when Sapphire was intimately involved in decisions about her treatment, but poorly when professionals took sole control. We’ll look at various stages of Sapphire’s treatment career.

Sapphire was being prescribed methadone for her heroin addiction, but as the dose was not high enough she was suffering withdrawal symptoms. To counter the discomfort of this withdrawal, she was purchasing methadone on the street and using benzodiazepines. Then a problem arose from her urine sample:

‘When I was 25, my urine screening revealed that I was taking benzos and the CDT sent me to a shared care GP who was to prescribe my methadone and benzos. At my first appointment, I decided to be honest and tell the GP about the methadone I was buying, and how bad my benzo use had become.

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Most visited content: Nos 10 – 6

rsz_img_5024And the drum rolls as we enter the top ten most viewed content on recovery Stories. 

10. Journeys into and out of heroin addiction, Part 2, is an article I wrote that focuses on living with addiction and covers such topics as relationships, changes in personality and lifestyle, hustling, crime and prison, impact on health, and treatment .

9. Opiate detox: methadone or suboxone by Peapod is the third part of Peapod’s Recovery Guide. Peapod was the most visited blogger on Wired In To Recovery.

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