Expert: Jacqui - 3/12/2009

Question
QUESTION: i have found that my just weekend partying has resulted in me being addicted to heroin....i want to know if there is anything i can take to subdue the pain...the only reason that i smoke heroin now is simply to take the pain away...im very scared and embarassed...i am really wanting to kick this habbit and dont know where to go to get answers so maybe...hopefully this will provide me the answers i need...thank you

ANSWER: Hey Chris,

Firstly I am assuming you are in the US (I am in Australia but most of the questions I get are from the US).  If you aren't let me know as my answer may differ a bit.

The main pharmacological treatment for heroin depenendency is other opiates which delays and minimises the withdrawals.  For instance, methadone is taken daily and you do develop a tolerance to methadone, but you can reduce off it in a much smoother (but slower) way, with lower level withdrawals, and it gets you away from the 'habit' of using.  Buprenorphine (Suboxone or Subutex) is very similar.  Other options are things like codeine but I don't think this is available over the counter in the US.  

If your habit isn't huge (ie: hasnt been for years, isn't hundreds of dollars a day) it isn't going to be impossible to do it without other opiates.  It will, however, depend on you having a supportive environment, getting some good nutrician, MAYBE some sleeping tablets (I say maybe because they can be habit forming and can also lower inhibition meeaning you might be more likely to use again), warm baths and no stress.  You should feel better after about a week and it won't kill you.  It is likely to be pretty hard to work or do other things.  There are some medications that may help a little, ie: tablets for nausea and diahorrea, but you will feel it a bit.

Let me know if this is helpful.  I am also wondering what you mean when you say "pain" - is it the restless legs or is something else?  

Anyway, good luck!  And remember, you are human.  If you relapse you are not a bad person.  AND if you DO relapse, use safely!!!!!

Jacqui

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

QUESTION: Jacqui....u are amazing....thank u for the no bullshit answer...I am in Canada....is methadone or buprenorphine available over the counter here...the pain that i get is a restless pain....pain in my legs is in my joints and a abking pain...i get cold...very cold but sweating at the same time....very bad akeing pains are the usual and usually keep me up...i am worried about using sleeping pills because of the habbit forming potntial....i will look in to how to get methadone...i hope u can stay intouch a bit by answering me back....thank honestly....i am looking forward to kicking this drug...it is not who i am at all....bye for now

Answer
Chris,

You sound pretty isolated, and I really hope you are okay.  Do you have friends who you trust who could support you through this.

I must add a few things to my first answer.  I want to go into some more detail about the withdrawals.  It sounds like what you are going through is opiate withdrawal.  The common symptoms are joint aches (often referred to as restless leg, where you feel like you need to keep moving otherwise they ache too much), feeling cold, sweat and getting "goose flesh" or "good bumps", stomach upsets and the most common - insomnia.  People also get a bit moody and might find they get feelings of depression then feelings of up and down emotions.  You might not feel entirely sociable!  

I wonder who you are using with, and how you got into it.  I also see that you are smoking heroin (also called "burning") - which does minimise the risks associated with heroin use (which is often related to blood borne viruses from injection with non-sterile equipment).  However all of the usual problems with using something that is illegal still apply.  What is important though, is that if you use, you are careful that you don't use too much (to prevent overdose).  

If you let me know where you are in Canada I might be able to refer you to a service that can help.  Canada's system is vastly better than that of the US, in that they do use a harm reduction policy (which I believe is the best approach to drugs), and there are a few options.  With the buprenorphine and methadone, they are generally available through structured programs.   I wonder though, if you have only been using for a short time, you might want to give it a go without opiates first, and if you just find that too hard, then methadone or bupe might be a good option.  It does, however, mean quite a few visits to medical practitioners, etc.

What I didn't say in my first message was that, although the physical withdrawals are usually over within a week or so, human nature dictates that you will probably want to use again.  It is common for humans to want to feel better, and we are actually conditioned to believe that feeling low or anxious or stressed is bad and that we need to fix it with a pill.  Unfortunately the same society also says that we can use some drugs but not others!  (Which I think kinda sucks).  I light to suggest that people consider options like relaxation strategies, mindfulness and meditation.  They help people to get to know their own emotions and if you decide you don't want to use heroin, it helps you to get through this.

Chris, like I said before, don't be too hard on yourself.  Of course it isn't "who you are".  Just because someone takes a drug doesn't mean that is who they are!  You are a person with a history, family, friends, memories, plans for the future, etc.  I am sure you have a lot to offer.  Unfortunately, our society constructs an image of heroin users as being really terrible, bad, sick, lazy people - which you and I know isn't true.  It is a stereotype, but it does make it hard for people who use heroin as they often feel stereotyped, rejected by society, and alone.  I would really encourage you to find someone you trust (really trust!) and seek their support.

Best of luck!

Jacqui