Why heroin?

09/06/14 8:05 PM

Why do supposedly smart people become addicted to heroin? Why do they use it in the first place, when it has a reputation as a low-class, junkie drug? What’s the attraction? What’s the high?

With the recent death of Philip Seymour Hoffman, I asked myself those questions. As a person in recovery whose drug of choice was primarily alcohol, I experimented with cocaine, used Xanax occasionally to sleep, and smoked a joint now and then – but never, ever thought of heroin.

But it’s not just famous people who die of overdoses from the drug – it’s people I know in my circle of friends, my relatives and in our newspapers. As part of our efforts to make available an antidote to heroin overdoses to first responders (the Naloxone spray), family members came forward and told their stories of loved ones lost to the drug. Very sad. And these were middle-class young adults. It migrates into the best families, but why? Why use it when it has a reputation as a drug no one wants to mess with?

Understand the draw

First, to understand the draw of heroin, you have to understand what it does. According to Robert Aaron, the man who was arrested for providing dope to Hoffman, heroin has “good qualities”:
 

A lot of times you have a deadline and you to work for 24 hours. This lets you do it with no pain, no tiredness. If I have to write a book, get me high – I’ll have that book written in two weeks. You’re lucid. And emotions don’t affect you as much – your anger – it bottles up your feelings. It makes you more rational, or you think you are, anyway. I’m a lifelong insomniac. …. Everything has it good points and bad points. The bad point is the dependence.

 
So there you have it: the perfect study drug to pull an all-nighter on. Or to learn your lines and perform in front of the camera. Or to deliver a speech honoring a family member or friend, as a relative of mine did. It was a brilliant performance – everyone said so – but I could tell by his eyes he had used, which he confided to me while in treatment. And far too soon, he was gone.

I’ve also heard the first few times, it’s better than the perfect orgasm, better than any sex. But then, of course, the intensity lessens each time and the user begins to chase the high, hoping the next time will be like the first time. The irony is that heroin robs many users of the ability and desire to obtain an erection (see Amy Winehouse’s You Know I’m No Good, “Upstairs in bed with my ex boy / He’s in the place but I can’t get joy”).

The connection

As you probably already know, few drug users start out using heroin. In fact, many heroin users are first exposed and addicted to prescription pain medication. You may be wondering about the connection between pain medication use and heroin.

I’d always known that many people with injuries or post-surgical trauma become dependent on prescription pain medications such as oxycodone, hydrocodone and Percocet (oxycodone + acetaminophen). It’s a common phenomenon when taking these pills for only a few days, as I discovered after undergoing hip surgery. I was very aware of withdrawal symptoms when stopping after three weeks of use, and I was very conscientious about limiting the amount per day and the duration.

However, pills are different from heroin in that they numb you out, slow you down and allow you to withdraw from the world. Some people like these feelings because it helps them cope with other problems, they are pain-averse, or they can’t tolerate withdrawal symptoms. So when a pill person first touches heroin, there is a “WOW!” effect that is unlike any pills, which are all about dulling senses, not first focusing the mind and relaxing feelings and then withdrawing into the inner world of nothingness. That is the attraction of the drug, what makes it so popular, and what I never understood until Aaron came forward with his story.

Cheaper and more powerful

With increasing pressure on doctors to limit the number of prescriptions and number of pills prescribed, along with central registries for prescriptions, supply is becoming more limited. Also, copays can be high – higher, even, than the price of heroin. So users who want pills are increasingly buying over the Internet or from friends or dealers. Once they get into this illegal market, the movement to heroin is common.

Because users tend to associate with each other, word gets out that heroin is cheaper and more powerful than pills. More bang for less buck. People who use drugs encourage their friends to join them because it makes them feel better and it helps them justify their use. Dealers also will tout heroin as a better alternative, offering free samples (“One snort won’t hurt; you can control it.”).

Chasing the perfect high

All junkies believe they know how much to use without killing themselves because they successfully do it all the time. But, as we all know, this is a delusion because they are both chasing the perfect high – the one combination of drugs that will really make them feel like the first time they used – and ignoring the fact that due to increasing tolerance, they require higher-potency drugs to do so. Unfortunately, their belief is only valid until it doesn’t work. And then, they are dead.

2 Comments on “Why heroin?”

  1. Dave Cooke Says:

    Why does anyone self-medicate? To feel better or, simply to feel something. We live in a society that is struggling to work through the pain, the fear, the daily battle to simply live and survive. On top of that, the societal conditioning is that a pill, a drug, a behavior can be a quick fix for our troubles. Why do smart people take anything – because they haven’t learned or discovered how to find peace, joy and happiness in some area of their life worth celebrating or feeling good enough about.

  2. Michael McIver Says:

    Hey,Bill,
    I am happy to see that you are doing good work which will hopefully help many people make better choices.I look forward to reading more of your thoughts on addiction and recovery.
    harmony,
    Michael

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