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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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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