Expert: Peter L. - 11/19/2009

Question
Im going out with an ex heroin user he has just come off subutex and  just stated blockers. Over the last week i feel he is very distant and constantly says how his head is messed up. He lost his younger brother a few months ago to heroin overdose. I have never been one for drugs and do not agree with what he has done i know he is doing well and is determined to be totally clean but how do i tell him im effected by what he s going through as well as he is, without upsetting him. and how do i cope with what he s going through?

Answer
Hi Mckenna,

You are getting to know the difficulty and struggle involved in recovering from addiction.  Opiate addiction (heroin) is one of the toughest drug problems to overcome.  The behavioral signs your friend is displaying are typical of some of the longer term withdrawal effects of the opiate class of drugs.

Time is on your friend's side, as the longer he goes without using and can avoid relapse, the better he will feel eventually. The brain is severely impacted by the opiates and has to normalize, and that can take quite a while.  Moodiness and irritability are common in the days and weeks following the last use.

You are in a support role, of course, and can only do so much.  You might pass along my recommendation that this person continue in some form of treatment, and not just rely on the opiate replacement medication.  Counseling geared toward relapse prevention is very important.

If you wish to be involved further with this person you will have to accept the difficulty he is having, and will continue to have.  You can't make your emotional expectations his issue; in fact, if he goes to AA or NA, they will tell him he shouldn't be in a relationship at all before he is more stable with longer clean time.  He can't get better to help relieve your anxiety and distress, his motivation to remain drug-free must be based mostly on that it is a better lifestyle for him.  

You may need to get some counseling help yourself, if you find your concerns about his welfare are detracting from the quality of your own life.  But keep in mind he has his own work to do, which would be the case whether he was involved with you or not.

Hope this is helpful,
Peter