Expert: Peter L. - 11/10/2009

Question
QUESTION: Hi my close friend is a iv. heroin addict and she seems to be crying for help. She cries and complains how she hates her life so much to me and she is kicked out by parents, gets beaten up has to sell herself to support her 200 a day habit..but can't seem to kick it...she is miserable and she seems to be asking for help..she wants to hang out with me be normaland talks but she talks like a junkie not direcg but in code...like I feel sorry for people that detox and then go back and die cause their tolerance is so low and she hates her dealers...and says they are not friebds and she has never really asked me for money...and she gets scared that I will abandon her..she wants to get away and she is so ashamed when she uses when I am around and I can sense her shame..she said she started something she does not know how to stop...but is she asking for gelp? How to know? Why is she hanging with me? I don't use..I am in AA/NA...how will I know..she sas she knows she has a problem...but seems to be waiting for something..a sign that she is ready..I am her only link and non heroin using friend all else she has pushed away...is she begging me for help by opening up? She does not talk to anyone else...unless she can get money from them..

ANSWER: Hi Bo,

When one is as addicted as this friend of yours seems to be, there's a lot of confusion, indecision, and outright denial.  Sometimes people in the worst of their addictive behaviors can appear "possessed."  She's probably begging for help while also completely invested in the power of her substance to take her out of her head and her life.  Opiates have enormously powerful effects on the brain and throw up fierce cravings when someone tries to stop.  Withdrawal symptoms are some of the worst in terms of how they are perceived, but not a serious health risk.

She should immediately seek out treatment which will invariably include some kind of medication assistance, likely opioid replacement therapy like methadone or suboxone.  She needs to stay in treatment for at least a year, gradually stepping down in the frequency of program attendance.  If she doesn't get treatment, she will likely incur legal problems (if she hasn't already) not the least of which will be jail time where she will detox in a very uncomfortable manner.  This, unfortunately, is what happens to many opioid addicts, but often it's the only thing that will break the cycle.

Thanks for your question, and I hope this helps.

Peter

---------- FOLLOW-UP ----------

QUESTION: Thanks it helps...
But what should I do? To support this...she knows she is fucked but seems to lean on me for some kind of stability...I trully believe she wants to be normal and hates that she has to shoot up every four hours still she travels 2 hours just to be with me on my birthday..spends money to give me a card...then travels back..what can I do to make her open up? Make her know that I will be there for her I am reading up on allot of things and talking to ex. Heroin users about what they needed to get clean and what they wanted from their friends...what can I do to help ? I don't want to enable..she says she does not want to be reminded about her being a junkie and just wants to feel normal but its fucking hard to ignore the huge elephant in the room...

Answer
Bo,

Other than being supportive there's not a whole lot you can do.  This woman needs treatment, but you can't force her to get it.  The only way she will be mandated to treatment is through the legal system.  

Sure she wants to be normal.  But in the grip of such a serious addiction she is essentially enslaved to it, if only by the fierce cravings that result when she's not using.  In her mind, she has no choice but to use to avoid the withdrawal. The area of choice opens up when she's out of detox, past the physical withdrawal, and trying to build some clean time.

Is there not treatment available in your area?  Has she checked programs out?  Sit down with her and a phone book or the internet and call treatment centers.  If she refuses treatment, she will continue to use until she lands in a major crisis of some kind that in comparison, will make the present circumstances look like a walk in the park.   

You say she seems to lean on you for some kind of stability.  I have to say that I find this "leaning" suspicious, if not manipulative.

Again, she needs treatment, or that elephant you see in the room will grow to an even more enormous size.  Helping steer her to help is the only thing you can do at this time.  

Peter