Heroin: Addiction and Recovery

Heroin syringe

Heroin addiction is widely regarded as a disease and is commonly used with other drugs, resulting in polydrug addiction. It is wide spread and difficult to cure. There are several ways to detoxify one’s body such as rapid detoxification, ultra-rapid detoxification, and regular detoxification. After the substance is no longer in the body and withdrawal symptoms have ceased, one can start dealing with the psychological aspect of addiction. Narcotics Anonymous and residential therapeutic communities are regarded as effective ways to recover from heroin addiction.

Heroin addiction is defined as “compulsive heroin use.” (Stimmel 157) This is a highly subjective definition, and begs the question why is the addict compelled to use heroin? There are two aspects to look at when answering this question, the physical dependence and the psychological addiction.

The onset of the psychological addiction typically precedes the physical, with the first sign of withdrawal being anxiety over getting more heroin. When addicts first starts using, they are intrigued with the euphoric feeling received, so they seek more. Tolerance builds quickly, forcing the addict to use more to achieve the same feeling. During the early stages of addiction, the addict often does not even realize that he or she is an addict. In the addict’s mind he or she is “just trying to get high,” never realizing that the anxious feeling he or she gets when not high is the first sign of a problem. Other purposive (psychological addiction related) behaviors include extreme nervousness, demands for money and heroin, and an increased level of activity. The desire to be high combined with tolerance inevitably leads an addict to become physically dependent on the drug (Stimmel 158).

Opioid PainkillersHeroin works by binding itself to the opioid receptors in the brain inhibiting the production of norepinephrine. When tolerance occurs, the body has to work harder to produce this chemical. Once heroin use ceases, and the restraints on norepinephrine production are non-existent, the cells that create it are still working overtime, meaning that an excess of the chemical is produced. This is the cause of non-purposive (physical dependence related) symptoms. These symptoms range from mild to severe. The mild symptoms include yawning, tearing of the eyes, sneezing, and sweating. Severe symptoms include insomnia, vomiting, diarrhea, and muscle spasms. Once an addict realizes he or she has a problem, the individual needs to detoxify, and recover from the symptoms of withdrawal (Stimmel 156).

There are many ways people recover from addiction. One method of detoxification, known as Rapid Detoxification, involves the use of clonidine, a drug used to treat high blood pressure. Clonidine is also extremely effective in inhibiting the release of norepinephrine; therefore, suppressing the symptoms of heroin withdrawal. Combined with a narcotic antagonist, or a drug that forces rapid evacuation of opioid receptors, heroin detoxification can occur in three days. The problem with this form of detoxification is that clonidine significantly lowers blood pressure, so it has to be used in a medical setting. If an addict feels that three days is too long, there is another option: Ultra-rapid Opioid Detoxification, or UROD (Stimmel 159).

UROD allows a person to be put under general anesthesia and have all heroin removed from the receptors in a span of 24 hours. The symptoms are controlled using clonidine on the unconscious patient. Upon awakening, the patient is to begin recovery using an opioid antagonist to ensure the addict will receive no euphoria from using heroin. The cost of the procedure ranges from $3,000 – $10,000. There is quite a bit of controversy surrounding it’s safety, due to the use of anesthesia. Deaths have been attributed to this technique, as well as a decreased tolerance to heroin, which could cause someone to overdose after the procedure. If the faster methods of detoxification seem excessively risky or expensive, there is a third form, regular detoxification (Stimmel 159).

Regular detoxification usually involves the use of a replacement drug, usually Methadone or Suboxone; both are safer than heroin and regulated. Since both of these drugs are opiates, they prevent the addict from going into withdrawal. Over time, the addict is weaned off of the drug with minimal discomfort. Regular detoxification takes from 14-180 days depending on the severity of the addiction. After one has successfully detoxified, he or she needs to commence a treatment program (Wasif et al. 10).

Narcotics Anonymous, or NA, is an extremely effective program to combat heroin addiction. NA is a twelve step program that encourages faith in god, and addict solidarity. Advocates of NA believe in the therapeutic value of addicts helping addicts. In a typical NA group, there are weekly or twice weekly meetings where members come together and discuss their experiences with addiction and recovery. Members are encouraged to seek out an addict who has a lot of experience with recovery (a sponsor) to guide them through the twelve steps. NA is free, and a terrific resource for addicts (Narcotics Anonymous World Services).

For someone who has money, and wants to completely change their lifestyle, Residential Therapeutic Communities, or TC’s, are ideal. TC’s are drug-free, live-in treatment facilities staffed by psychiatrists and physicians. These facilities have three phases: induction phase, primary treatment phase, and reentry phase. Induction phase lasts up to two months and is designed to orient patients to the rules and regulations of the TC. Primary treatment phase lasts up to twelve months and focuses on education and therapy. Schedules, during this phase, are highly regimented, and when an addict does not adhere to it, they are confronted. Reentry phase lasts up to two years and prepares the addict to rejoin the community. During this phase, the addict normally maintains a full time job, and lives away from the TC (Stimmel 160).

Addiction and recovery are far more complex than once thought. There is more to discover than is known about the factors that make people susceptible to addiction. One thing that is known: recovering from heroin addiction is extremely difficult. Luckily, as knowledge about this biological phenomenon continues to grow, detoxification and treatment options will continue to become more effective.

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