I see an awful lot of heroin addiction at my place of work, where I am a nurse aid in a detox unit. I have the opportunity of seeing all sorts of sickness and suffering at the hands of heroin withdrawal, and I call it an opportunity because it is a huge reminder for me of a place I never want to go back to.
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The subculture of heroin
There is a bit of a subculture when it comes to people who do heroin. They tend to create this culture for themselves and it tends to come out through their personality. For example, if there is a group of people in our detox unit together, the heroin addicts will have a tendency to hook up with each other and befriend each other. Not always, but a lot of the time this will happen. It is part of the subculture itself.
Based on what I have seen in treatment, this tendency is usually not a good thing, nor does the subculture that surrounds heroin really benefit these addicts in any way. If anything, I have seen a lot of people who hook up with each other in detox, start talking about shooting dope, and end up leaving together with no intention of staying clean. Even if they do have an intention of staying clean, their addiction knows better, and has led them right into a trap of sorts, especially if they are leaving treatment with other heroin addicts. This ought to be straight out of the heroin for dummies manual.
In other words, the subculture itself can be a negative things, because it has the ability to lead people back to using so easily. One person relapsing by themselves is kind of lonely, but two is a party, and this is how people can help justify each other going back to heroin.
You would think that the greatest support for a heroin addict would be another recovering heroin addict. This is basically true–however, in early recovery, before a baseline of clean time has been established, it almost seems counterproductive in a lot of cases to get a group of heroin addicts together in order to “help” each other stay clean. This is even more true when you start figuring in today’s youth into the equation. They are getting younger and younger every year it seems.
Now I have nothing against younger people, nor am I biased against heroin addicts in general….but I have learned to start seeing these patterns because of the position I am in. I have watched different addicts and alcoholics come in and out of treatment for over four years now, and many times people who
relapse end up coming back. I watch their actions, I see their behavior, and I also hear their follow up stories. And what I’ve learned is this: the subculture of heroin makes it very difficult for two or more heroin addicts to help each other stay clean in early recovery, and this becomes especially true for younger people. That is just what I have noticed.
Possible solution: I know I harp on this all the time but long term treatment could be the answer in this case for a lot of struggling addicts. This is doubly true for younger people. The subculture that surrounds heroin use is so pervasive that getting out of that old environment and living in long term treatment might be just the thing that a person needs. Of course, understand that long term treatment is not a magic bullet, and the motivation still has to come strong from the individual, but if the willingness is there, then using this new environment can provide a strong boost to your chances in recovery.
A lot of heroin addicts keep relapsing and returning to treatment
Another thing that I’ve noticed while working in a treatment center is that the subset of heroin addicts (among all addicts and alcoholics) tend to keep coming back to treatment, over and over again.
Now to be fair, people who are addicted to other drugs (including alcohol) also have a tendency to keep returning to treatment over and over again, but I really notice it a lot more with the heroin users. Part of this might have to do with the age thing too. Most heroin users tend to be younger and it so it just seems like the success rate with this group of people is almost non-existent.
Possible solution: Chronic relapsers generally do not follow through with treatment programs, so one thing they might need to do is to actually follow every suggestion that they get while in treatment, and start attending outpatient therapy or groups or 12 step meetings or whatever the case may be. Recovery is about action and if the person does not follow up after treatment with a lot of action then they are going to be in danger of relapse.
The people who turn to drug therapy for heroin addiction seem to relapse and come back to treatment a lot
Another major problem that I have noticed with heroin is this: there is the option of treating the addiction with drug therapy of some sort, such as by taking Suboxone or Methadone for long term maintenance. The philosophy is that some addicts need a bit of help in terms of staying clean, and drug therapy can provide this type of solution by administering either a full opiate or a partial opiate to the body every day.
The problem is that it doesn’t seem to work. Now again, this is just based on my observations over the last 4 years, so please don’t think that this is scientific or anything. It just seems that almost every single client who has gone on drug therapy has ended up relapsing and coming back for more heroin detox. It really is bizarre.
I still believe, even in spite of this evidence, that drug therapy might be right for some heroin addicts. But the bottom line is that I see if fail more often than I see it succeed.
Possible solution: I think there is this idea with drug therapy that the pill you are taking for maintenance is like a magic cure. People who take a maintenance dose of some sort are putting more faith in the ability of the medicine than what they should be. The drive to stay clean and sober still has to come from the individual, and the footwork and action needed to achieve long term recovery goes far beyond merely taking a medication each day. We have to grow and learn and evolve in terms of our own personal growth if we want to have a chance at making it in recovery.