A letter to … My brother, who doesn’t know that I’m a heroin addict

You came to visit me last year. Together we planned your trip. You were to stay at my house – I didn’t even realise that your grown-up form (so much taller and broader now) would be far too long for my short couch.

I came to meet you at the airport. I woke up early so that I could be there, ready and waiting. I imagined standing in arrivals, watching for you to emerge from the crowd. I knew that I would recognise you, even though I hadn’t seen you for many years.

I was late, of course. I’m late for everything now. I used to be so obsessively punctual, anxiously arriving at least half an hour early for appointments, studiously mapping journeys and carefully estimating travel times. But I overslept and then, at the airport, I spent a good 20 minutes in the first bathroom I could find, nervously at first and then gradually becoming less nervous, smoking heroin off the tin foil that I carry with me everywhere I go.

I came out of the bathroom and was calmer and happier and a little bit dozy. I saw you right away. Everything was great. You smiled so wide and hugged me. And everything was comfortably numbed and blurry.

I love heroin. I love it more than I love anything else in this world – more than I ever have loved or will ever let myself love anything or anyone else. My heart is beating so fast as I write this, and my palms are prickling damp with sweat. I’m eight hours without heroin and two hours after methadone.

I love heroin because it numbs me. It gave me just what I needed the first time I tried it, which was the ability to remove myself from my life at last, to remove myself from the self that I loathe so deeply and without reason. When I am high – which is all of the time, now – I can negate everything. Nothing else matters any more. I have chosen to reject prevailing lifestyle norms and the desires, both material and emotional, that come with these norms. I never thought that I could achieve anything anyway, so it is really just me in my 20s, mumbling a neat, easy and lazy “fuck this” as I remove myself from the world and sink into an opiate haze to hide.

Keeping my drug use from you is exhausting and you deserve my honesty, not the lie I present to the world

I meant to tell you, of course. I mean to do a lot of things. A lot of these things are simply forgotten – heroin is very good for forgetting, for removing from conscious thought anything that is not about how much heroin I have right now, or how badly I need it and how much I can buy as soon as possible – but some things, like this, are things that I just cannot bring myself to do.

I wanted to be honest with you. I wanted to start your visit off right, to make you breakfast after your flight and then, when the time was proper, to try my very best to explain to you that, yes, I am a junkie. I’ve got zero money and I’m only just hanging on to a job and I’ve just started on an opiate replacement for the first time. Some days, I do want to stop using heroin; most days, I don’t.

I really wanted to tell you everything. Keeping my drug use from you is exhausting and, more than anyone else, you deserve my honesty, not the duplicitous, multi-natured lie that I present to the rest of the world. I really wanted to tell you, but you’re my little brother. And for some reason you didn’t see the person I have become since we last met; you still saw me as your big sister.

Anonymous

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A letter to … My brother, who doesn’t know that I’m a heroin addict

Do viral videos of heroin overdoses make you uncomfortable? They should | Maia Szalavitz

We’ve all had viral cat videos find their way onto our Facebook and Twitter feeds. We’ll click, watch and continue with our day with a smile. But not all viral videos are cute, or uplifting. Lately, another kind of video is making the rounds. Instead of cute roly-poly pandas frolicking among bamboo shoots, they feature something very different: humans overdosing on heroin.

The viral images are truly shocking, showing overdose victims – often in the presence of little children – unconscious and near death. One featured a couple in East Liverpool, Ohio, who were passed out in their car. Their four-year-old boy sat in his carseat behind them. Another involved the mother of a two-year-old, who overdosed in front of her child at a Family Dollar store in Lawrence, Massachusetts. The latest shows an unconscious couple splayed in strange positions on a Memphis street – thankfully, without kids this time.

Police and others argue that posting these photos and videos will deter drug use. The East Liverpool police said on Facebook: “We feel it necessary to show the other side of this horrible drug. We feel we need to be a voice for the children caught up in this horrible mess.” The argument is that if more people knew what overdose really looks like, the epidemic of deaths would end.

Research, unfortunately, shows exactly the opposite. Studies find that the more coverage focuses on the ravages of addiction, the less likely the public is to support effective policies that favor treatment over punishment. These images also have a counterproductive effect on people with addiction themselves: they increase shame, which is associated with relapse, not recovery.

Many still think otherwise, though. It seems like a self-evident truth that no one would willingly choose to wind up in such a situation. And so, the thinking goes, if we can only show people how bad it really is to take drugs, that no one will ever misuse them.

Unfortunately, the overwhelming majority of addictions begin during teenage years – a time in which the brain responds to risk in a quite different way than the adult brain does. While some data suggests that scare tactics work to stop adults from engaging in risky behavior, they do not work for teens. They may even backfire by making youth more curious about drugs.

And once people are addicted, fear and shame don’t work either. The data shows that treatments that involve confronting and humiliating people with addiction backfire. Greater confrontation is associated with increased alcohol and other drug use in four decades worth of studies reviewed here. Showing people videos of their own intoxicated behavior fails to prevent relapse – it actually increases use. Research finds that the more shame people with addiction feel, the less likely they are to recover.

But perhaps the most insidious effects of these videos is on the general public. Studies show that images and stories of active addiction, without information about recovery, cut support for help, like expanding drug treatment.

The problem faced by people with addiction is not that they are unaware of the negative consequences of their condition, but that they can’t see a way out. If we want to end the opioid crisis, we need viral videos of recovery, not overdose.

Do viral videos of heroin overdoses make you uncomfortable? They should | Maia Szalavitz

Has Obama Neglected America"s Developing Opioid, Heroin Epidemic?

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1 grassroots group believes so –&nbspand its members say they are not “politely and patiently” remaining quiet as the president’s administration continues to disregard the country’s ever-expanding difficulty of opioid abuse, misuse and overdose. The FED UP! Coalition, formed in 2012&nbspwhen a number of organizations from across the country joined forces, will be holding&nbspa [...]

Has Obama Neglected America"s Developing Opioid, Heroin Epidemic?

Are We Prepared For Synthetic Heroin?

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Many of the synthetic drugs streaming like toxic rivers through American cities have their origins in labs that weren&rsquot making an attempt to develop addictive street medicines. But as soon as a potent psychoactive compound&nbspemerges from a lab–meant&nbsppurpose notwithstanding–its physical appearance on the street is only a matter of time. Being aware of that, it&rsquos concerning that [...]

Are We Prepared For Synthetic Heroin?

Sunshine can be addictive like heroin

”Our findings recommend that the selection to safeguard our skin or the skin of our children may possibly require far more of a aware hard work rather than a passive preference.”

Experts had known that sun-looking for behaviour can fit the clinical criteria for a substance-connected disorder. But what underlay this apparent ”addiction” had been unknown until finally now.

Dr Fisher and his group investigated links among UV exposure and the opioid receptor pathway in ”naked” laboratory mice.

Soon after a week in the artificial sunshine, endorphin amounts in the blood of shaved animals increased.

At the finish of 6 weeks, the mice were given an opioid-blocking drug, naloxone. Abruptly denied the drug-like results of UV, they suffered an array of withdrawal signs, including shaking, tremors and teeth chattering.

In addition, UV publicity induced the animals’ tails to stiffen and lift up – an result also observed when mice are given opioid medicines.

When the mice have been eliminated from the UV rays the symptom, acknowledged as ”Straub tail”, slowly faded away.

Mice not exposed to UV light did not display the very same responses.

”It’s surprising that we’re genetically programmed to turn into addicted to one thing as hazardous as UV radiation, which is most likely the most common carcinogen in the world,” stated Dr Fisher, whose findings appear in the journal Cell.

”We suspect that the explanation entails UV’s contribution to vitamin D synthesis in the skin. Even so, in the existing time, there are considerably safer and a lot more dependable sources of vitamin D that do not come with carcinogenic risk, so there is real wellness value in staying away from sunlight as a supply of vitamin D.”

British professionals urged caution when extrapolating the final results of the research to humans.

Dr Clare Stanford, reader in experimental psychopharmacology at University College London, explained: ”This study does not give the sort of proof needed to present addiction to UV light in mice and it is even significantly less particular that the perform predicts addiction in people.

”This would require testing whether or not the mice preferred UV light or non-UV light, which was not completed in this paper.

”The strain of mice employed in this experiment create virtually no melatonin, which is thought to safeguard towards damage from UV light.

“Shaving such mice and exposing them to UV light raises essential ethical inquiries about animal welfare and once more casts doubt on the relevance of the final results to humans.”

Dr Richard Weller, senior lecturer in dermatology at the University of Edinburgh, explained: ”Mice are nocturnal animals, covered in fur, which steer clear of the light, so one particular should be cautious about extrapolating from these experiments to guy.

”Nonetheless, the authors talk about some literature suggesting that a equivalent pathway might also be current in guy.

”It is extremely unlikely that evolutionary pressures would choose for a trait which minimizes survival and reproductive ‘fitness’. If an ‘addiction’ to sun truly also exists in mankind, it suggests to me that there is a benefit to it.

”The authors mention vitamin D, but in addition to this, epidemiological data (specifically from Scandinavia) show that improved sun exposure is associated with reduced all-cause mortality.

”Our recent operate demonstrates how sunlight decreases blood strain independently of vitamin D, which may possibly account for some of the wellness improving effects of sun.”

Sunshine can be addictive like heroin

On Heroin: More Users White And Suburban Than Ever Before

Four years ago, the makers of OxyContin changed the formulation so that it would be more difficult to abuse. It became less crushable and less dissolvable, so users would have more trouble snorting or injecting it. Some people predicted that this change would simply push OxyContin abusers to go for more accessible drugs – like heroin. And they were absolutely right, according to a new study in JAMA Psychiatry. Heroin is no longer a drug that inner city kids experiment with – it’s one that people, often well-to-do suburbanites, graduate to when their prescription drug addiction becomes financially unsustainable.

“In the past, heroin was a drug that introduced people to narcotics,” said study author Theodore J. Cicero. “But what we’re seeing now is that most people using heroin begin with prescription painkillers such as OxyContin, Percocet or Vicodin, and only switch to heroin when their prescription drug habits get too expensive.”

(Photo credit: ShuttrKing|KT)

And the “type” who’s addicted to heroin has shifted considerably over the years, according to the new study. In the 1960s, the average heroin beginner was 16 years old, a minority male, and from an inner city. Now, the average age of first use is 23, and more new users are men and women from suburban or even rural areas: 90% of new users in the last decade were white. And, the study found that most heroin users – 75% – had migrated to heroin from a previous prescription opioid drug addiction.

“Our earlier studies showed that people taking prescription painkillers thought of themselves as different from those who used heroin,” Cicero said. “We heard over and over again, ‘At least I’m not taking heroin.’ Obviously, that’s changed.”

The main reason for this blurring of boundaries is that buying prescription drugs on the street is becoming cost prohibitive. “The price on the street for prescription painkillers, like OxyContin, got very expensive,” Cicero said. “It has sold for up to a dollar per milligram, so an 80 milligram tablet would cost $ 80. Meanwhile, they can get heroin for $ 10.”

And, of course, making prescription drugs harder to crush hasn’t really helped the problem – it’s just changed where it lies. Says Cicero, “these people aren’t just going to stop using drugs. As we made it more difficult to use one drug, people simply migrated to another. Policymakers weren’t ready for that, and we certainly didn’t anticipate a shift to heroin.”

Bringing light to the problem may help to some degree: Certainly celebrities’ public or losing battles with heroin addiction have helped do that, but that’s not the only fix.

Understanding why the problem exists – what heroin use is really a symptom of – is the first step in addressing it. “You can’t effectively treat people or prevent addiction unless you know why they are taking drugs, and we don’t really have a handle on that yet,” says Cicero.

That’s only partly true. Stress, depression, other mental health issues are probably pretty good guesses. But it’s going to take a lot more research to understand all the causes, and more creative thinking to come up with the right treatments.

For more information, or to find treatment, see SAMHSA’s website. http://findtreatment.samhsa.gov/

Follow me @alicewalton or find me on Facebook.

Courtesy JAMA Psychiatry

On Heroin: More Users White And Suburban Than Ever Before

Recovering addicts: tell us about your experience with heroin addiction

Philip Seymour Hoffman’s death Sunday, which authorities think was a result of a heroin overdose, shocked his close friends and followers, many of whom publicly wondered: “How could this have happened?” – but in accordance to a latest review, heroin use is increasing more common in the US, and recovering from the potentially lethal drug remains extremely challenging.

A recent survey by the federal Substance Abuse and Mental Well being Solutions Administration discovered that the use of heroin jumped 102% among 2002 and 2012. In 2012, about 669,000 men and women reported utilizing heroin at some point in the 12 months. Roughly 467,000 of people were deemed heroin-dependent – far more than double the number in 2002. The heroin epidemic has turn out to be so pervasive, that Vermont Governor Peter Shumlin, invested his whole 34-minute State of the State address this yr discussing a “full-blown heroin crisis.”

Recovery is achievable, but extremely hard. Hoffman had been clean for 23 many years ahead of he relapsed, and his encounter is not uncommon.

“Someone with opiate addiction, they are doing pushups their entire lives,” Dr Drew Pinsky advised HLN Monday. “And they need to function on it all the time. And even operating on it, there is a large probability of relapse.”

With so significantly consideration being centered on heroin addiction, we want to hear from individuals who have skilled it firsthand.

• In a recent piece in the Atlantic, Jeff Deeny, a recovering addict wrote that Hoffman’s death reminded him to continue to be vigilant in maintaining [his] psychological well being. How do substantial profile overdoses, like Hoffman’s and Glee’s Corey Monteith impact you?
  
  


• What do you make of the fact that Hoffman was 23 many years clean and then went back to medication? Can you make clear the pull of addiction to an audience who may well not otherwise comprehend its electrical power?
  
  


• Last but not least, if you had 1 piece of guidance for current addicts taking into consideration recovery, what would it be?
  
  

Submit your answers below and we’ll featured selected responses on the Guardian. Please speak to Ruth Spencer with any queries. For all responses published, the Guardian will only publish your initial name. Your electronic mail tackle will remain personal.

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Recovering addicts: tell us about your experience with heroin addiction

Why Is Heroin Abuse Increasing Even though Other Drug Abuse Is Falling?

Converting Heroin Tar into “Monkey Water” for Administration via the Nasal Cavities, Rectum, or Veins. (Photo credit score: Wikipedia)

Peter Shumlin, the Democratic governor of Vermont, brought heroin addiction to the front burner of nationwide information by devoting his complete State of the State address last week to his state’s dramatic improve in heroin abuse. Shumlin described the scenario as an “epidemic,” with heroin abuse rising 770 % in Vermont because 2000.

Vermont is a microcosm of the nation. Across the U.S., heroin abuse among very first-time consumers has increased by nearly 60 % in the last decade, from about 9o,000 to 156,000 new customers a yr, according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

At the same time, non-health care prescription opiate abuse has gradually decreased.  According to the SAMHSA 2012 National Survey on Drug Use and Health, the number of new non-health-related customers of ache killers in 2012 was 1.9 million in 2002 it was 2.2 million. [It bears repeating that these stats are for abuse of non-healthcare prescription soreness killers, not abuse of medicines obtained with a prescription.]

In the exact same time-frame, abuse of methamphetamine also decreased. The quantity of new consumers of meth amid persons aged twelve or older was 133,000 in 2012, compared to about 160,000 in 2002.

Cocaine abuse also fell, from about 640,000 new end users in 2012 from above 1 million in 2002. Crack abuse fell from in excess of 200,000 users in 2002 to about 84,000 in 2012 (a quantity that’s held steady for the last 3 many years).

The statistics suggest that heroin has taken up the slack from fall offs amongst each other key drug (only marijuana and hallucinogens like ecstasy have held steady or slightly enhanced amid new end users in excess of the final decade not surprising given that they’re the medicines of choice among the youngest customers, and given that pot has been angling towards legalization for the final handful of many years).

Most surprising in this sea of stats is the drop in non-health-related prescription opiate abuse overlapping with an increase in heroin abuse. The explanation may come down to basic economics: illegally obtained prescription ache killers have grow to be much more pricey and harder to get, even though the price and trouble in acquiring heroin have decreased.  An 80 mg OxyContin pill runs between $ 60 to $ one hundred on the street. Heroin charges about $ 9 a dose. Even among hefty heroin abusers, a day’s really worth of the drug is more affordable than a couple hits of Oxy.

Laws cracking down on non-healthcare prescription painkillers have also played a position. The amount of medication like Oxy hitting the streets has decreased, but the regular movement of heroin hasn’t hiccupped.  Numerous cities are reporting that preceding non-health care abusers of prescription ache killers—who are often higher cash flow professionals—have turned to heroin as a more affordable, easier-to-get alternative.

One conclusion that can be drawn from the stats is that prescription opiates are serving as a gateway drug for heroin, not so significantly by option but by default. The market place moves to fill holes in demand, and heroin is properly filling fissures in demand opened by legal pressures and expense.

One more fascinating stat is that among very first-time drug users, the suggest age of initiation for non-health-related prescription ache killers and heroin is practically identical: 22 to 23 years old. That would also support an argument that there is a cross-above effect from medicines like Oxy to heroin (in contrast, the indicate ages for 1st-time users of pot and ecstasy are 18 and 20, respectively).

Vermont’s heroin difficulty would appear to be a foretelling of things to come in the much more affluent parts of the nation. In accordance to the U.S. Census Bureau, Vermont’s median household cash flow, residence ownership price, and percentage of folks with graduate and skilled degrees are all higher than the nationwide averages, and Vermont’s percentage of these residing at or below poverty degree is considerably reduce than the nationwide typical.

The bottom line: Vermont’s stratospheric heroin improve is happening the place the income is, and the national drug abuse trends suggest that the identical thing is happening across the nation.

You can find David DiSalvo on Twitter @neuronarrative and at his site, The Day-to-day Brain. His most current book is Brain Changer: How Harnessing Your Brain’s Energy To Adapt Can Alter Your Daily life.

Why Is Heroin Abuse Increasing Even though Other Drug Abuse Is Falling?