The Culture of Heroin
Throughout the years, law enforcement officials have used a variety of techniques in order to convince people to stop using heroin. The drug has been declared illegal, and almost every year, prisons fill with people who have been convicted of using, buying or selling the drug. Needles have become harder to obtain, with pharmacies and drug stores requiring patients to submit a prescription before they can buy them. And finally, border patrol officials have cracked down on the drug trade, closing loopholes that would allow people to import heroin and sell it on American streets. While all of these efforts have been noble, and some of them have been somewhat effective, the fact remains that many people in the United States are still addicted to heroin.
As law enforcement officials have worked hard to stop the drug trade, addiction experts have also been hard at work, developing treatment programs that can help people get control over their addictions and learn to live clean and sober lives. People who have heroin addictions can benefit from this research, as their therapists will know just how these addictions develop, and what treatment programs seem to be effective in helping people to fight back.
Heroin locks onto receptors in the brain and brings about a series of persistent chemical changes. When a person abruptly stops taking heroin, the brain must go through a period of adjustment, recalibrating and retooling, learning how to function efficiently even when that addictive drug is no longer part of the body’s chemical mix. It’s a natural process, and it’s considered an important step on the person’s road to recovery, but it can be an uncomfortable process to go through alone. People going through heroin withdrawals have symptoms that feel quite similar to those who have a terrible case of the flu, and those symptoms run alongside a desperate craving for drugs.
According to the National Institute on Drug Abuse, heroin withdrawal symptoms peak within 48 and 72 hours after the last dose of the drug, and the process is rarely considered fatal.
People who are in good health, who don’t have underlying conditions that could be exacerbated by the physical withdrawal symptoms, can go through the process without experiencing severe and life-threatening consequences. However, the process can be quite painful and scary, and it can lead someone right back into taking drugs. In a formal heroin detox program, the urge to relapse might lessen, as people simply will not have access to these drugs within this environment. Without access, no relapse can take place.
There are a variety of replacement medications that work upon the same receptors used by heroin. These medications can play an important role in the recovery process for people who experience debilitating cravings for drugs that simply can’t be eased with other types of care. These people make up about 30 percent of those who enter treatment programs for their heroin addictions, according to the Drug and Alcohol Services Information System.
People who use medications for heroin addictions are often provided with a tapering schedule. Here, they’re given a dosage of replacement drugs at the beginning of therapy that’s similar to the amount of heroin they took on a regular basis. Then, slowly but surely, that dosage is reduced down and down until the person is taking no replacement drugs at all. During the tapering, medical professionals look for signs of distress, including:
Signs of Distress
- Vomiting or diarrhea
- Jerking muscles
- Watering eyes
People who experience these symptoms might be tapering too fast, and their bodies might not be able to adjust to such a quick removal of the drugs. Similarly, people who experience severe cravings for heroin during the taper might also need to slow down and return to a higher level of replacement drugs. Some people are unable to stop taking replacement drugs as their withdrawal symptoms always return, putting them at risk for a relapse. These people might need replacement drugs for the rest of their lives.
Methadone is the most common type of heroin replacement medication, and it’s been used for decades as a reliable treatment for addiction. Newer forms of replacement medication, such as buprenorphine, have also been found to be good tools in the fight against addiction. For example, researchers working for the journal Science provided test subjects with unlimited amounts of heroin, and gave just some of these people buprenorphine as well. Those who didn’t get buprenorphine took 90 to 100 percent of the heroin they were provided with. Those who got 4 milligrams of buprenorphine reduced their use by 45 percent.
Heroin can provide the user with a sense of euphoria and a feeling of calm. During periods of extreme stress, people who once abused heroin might feel their craving for the drug begin to rise. The brain might know that heroin once made the user feel happy and contented, so when pain creeps in, the brain might call out for heroin once more. In a study in the journal Brain Research Reviews, researchers were able to reintroduce heroin addiction in abstinent rats by shocking their tender feet periodically. This foot shock made the rats go right back to heroin. In humans, the same process might be at work.
Addiction treatment programs ask addicts to really think about their addictions. They might be asked to describe, in words or in art projects, what a craving for drugs really feels like, and what makes that craving seem to rise in intensity. This knowledge can help people to spot their own “foot shock moments” and develop skills they can use to fight back when pain and stress seem to make drug use seem reasonable. This treatment, also known as cognitive behavioral therapy, tends to be short, and it’s focused on building up skills.
Instead of spending years in therapy, examining how the past makes its mark on the decisions of today, people spend time thinking about what’s happening right now, and what can be done to change the current reality. Studies suggest that even a few sessions of this type of therapy can be helpful in people who have addictions. For example, a study in the Journal of Nervous and Mental Disease found that people given just five of these therapy sessions were more confident in their ability to handle situations that tended to lead to a relapse. The therapy helped them learn how to cope.
Changing Thought Patterns
People who take heroin have become accustomed to experiencing an immediate and profound response to an action. They push the needle in, and the drug causes a huge and overwhelming response. Over time, as the addiction moves forward, people might become accustomed to this immediacy, and they may begin to demand it in all areas of life. They become impulsive, unable to focus on the future. Instead, they’re exclusively focused on the here and now.
Researchers measure impulsivity in tests in which people are asked to accept an award now, or accept a bigger award in the future. In a study in the Journal of Experimental Psychology, researchers found that people with heroin addictions were twice as impulsive as those who didn’t take heroin. It’s clear that heroin changes the way that people think, and this could have an impact on a person’s ability to recover from addiction.After all, impulsive people might not see why they should go through months of addiction treatment, when they could simply take drugs and feel good now. Contingency management aims to help people overcome these impulses. Here, people are provided with rewards for each step toward sobriety they take.
- Gift certificates
- Vouchers for services
By providing people with rewards now, therapists give those people a reason to participate now. They don’t need to worry about the future, and plan for the future, if they’d rather just focus on the here and now. Each time they attend therapy or complete some other sobriety-related task, they’ll be provided with a gift, and that might be enough to help them stay motivated in therapy. Over time, the therapy sessions will sink in, and the gifts will become less and less important.
Replacement medications and addiction therapy are often provided in intensive programs that take up the vast majority of the person’s time. Inpatient programs, for example, provide care in residential settings. The person lives, eats and breathes recovery. Outpatient care can also be intense, requiring the person to spend a significant amount of time in therapy each and every day. At some point, these programs must end and the person returns to his/her own community.
At La Paloma, we know that this transition period can be dangerous for people in recovery. Returning home means returning to the environments that once harbored an addiction. Our Recovery Assistance Program can help. Here, we provide one-on-one coaching, monitoring, counseling, drug testing and more, all designed to help people step down from intensive care without stepping back into drugs. For people in recovery from a heroin addiction, this can be lifesaving help.
If you’d like to find out more about this program, or any other aspect of heroin addiction care, please call our toll-free line today. Operators are standing by.