Heroin Helper

Letters from March 2003

Question

Why does this site recommend use of aluminum foil even though there is extensive literature over the last 6 years associating aluminum and black tar smoking with brain anomalies and death. Further, there are currently a number of deaths and permanent brain damage in Vancouver associated with smoking on aluminum foil---to continue to advise this technique is irresponsible. Have you ever done a literature search on this topic? I recommend that you do.

Answer

I am very sorry for you and your son. Many horrible things happen to people for no good reason. Hopefully, the future will be better.

What you state about aluminum foil and black tar heroin is not really true, however. As you will see if you read our article on the subject, the problem is a disease that is caused by an adulterant used to cut heroin. What's more, this adulterant is more associated with white powder heroin than black tar heroin.

In addition, you misrepresent our position. We do not recommend aluminum foil, nor do we recommend smoking heroin. As is stated time and again on this site, heroin use is dangerous. It doesn't matter how you do it, how rich you are, how much you know, or anything else: heroin use is dangerous.

We have stated that smoking heroin is the safest way to ingest it, of the three common methods: injecting, snorting, and smoking (inhaling). We stand by this. Again: not because it is safe, but because it is safer.

Please accept my condolences. Do note that various doctors have had some success treating Leukoencephalopathy--particularly with the new AIDS drugs. Hopefully, such an option is available to you as well as helpful. I wish you both the best.

Leukoencephalopathy Article

Diseases Article

Question

I am a 17 year old boy, and I live in Australia. I am not a heroin addict, my cousin is. I was wondering if you could give me any advice on the best way to come to grips with this problem, as I have not yet been able to accept this terrible problem that has been inflicted upon my family.

Answer

I am put in a bit of a bind when talking to minors because of the legal issues involved. In the United States, the age at which one has (sort of) full adult rights is 18 years. I don't know what it is in Australia, but it is probably the same. The policy of the site is that if you are not an adult, you must be accompanied by a parent or guardian when using the site. As long as parents are responsible for a child, they should know what kind of information the child is getting. On the other hand, if I had a child I would have no problem with him reading through the site because I think we make heroin sound very technical and boring.

Having said all this, I will do my best to answer your question. But you must show your parents/guardians whatever I write to you and whatever you see on the site. Obviously, I can't enforce this. But this is my wish and assumed agreement.

Heroin addiction is not a problem that has been inflicted on your family. Heroin addiction is a problem that has been inflicted on your cousin. This is a very important distinction, because ignorance of it leads to all kinds of logical fallacies. In most families that include a heroin addict, the drug use is not the problem. If your cousin uses heroin, becomes belligerent and beats you, then you could say that heroin is causing a problem in your family. What is more likely is that your cousin wants to get money to buy heroin and so he steals from you. Heroin didn't cause that problem. Your cousin's mind was not clouded by its effects. Your cousin chose to steal money from you and chose to use that money to buy heroin. If this is the case (or something similar), then your cousin is a problem that has inflicted your family.

People infantilize heroin addicts. They hate that the addict uses the drug (which in most cases has no effect on the family member), but forgive the addict for terrible things that he does (which in most cases has a very great effect on the family member). I try to get people to stop thinking about the reasons for the things that a heroin addict does. There are times when an addict's heroin use affects you. He could be using around you or leaving used syringes laying around. But mostly, the addict harms you in ways that have no direct connection to heroin use. Is he stealing from you? Is he not showing up when he says he will?

You're probably wondering what all this has to do with anything. It's simple: actions matter. Heroin addicts are notorious for taking advantage of their families. They are allowed to do it because the families blame the bad behavior on the drug. They would not allow a family member without such an "excuse" to get away with such a thing. About 90% of the problem of dealing with a heroin addict in the family is learning to simply treat him like he wasn't a heroin addict. Don't give him special rights but also don't expect more from him. (note) This aspect of dealing with an addict in the family is discussed in the following articles that make a lot more sense than I do right now:

Encouraging a Junkie to 'Clean Up'

Do As I Say

The other aspect of dealing with an addict in the family cannot be so easily (not that it's easy) dismissed. We love our family members and so we worry about them when they do dangerous things. Unfortunately, I have not written an article about this (but it is coming). A couple of things help. First, understand that heroin addicts do finally get clean. I think the average length of time that a person stays a heroin addict is about 7 years (it depends upon the time and place). In most cases, they just get sick of it. Second, try to understand that heroin addiction is a process or a journey. Your cousin is gaining something from this experience and it might be something really great. He might have gained that same thing without having to be an addict, but not everyone takes the easiest route to enlightenment. Remember that he isn't just wasting his life. He is looking for answers (just like us all) and hopefully he'll find some really good ones.

Now you are thinking, "But what if he dies before that?" In this instance, I think the average junkie has something to teach most of the world: open your heart and communicate. It isn't just junkies who die without notice, and I think junkies remind us that we must not run through our lives thinking that one day we will tell our cousin (or whomever) that we care about him. I've written an article about this:

A Junkie Dies

I hope this all helps. Those three articles are a lot better than what I've written here. Let me leave you with this: Junkies live almost completely within the junkie subculture. The more welcome they are in the straight world, the more likely they are to visit, and eventually live. This is hard, however. The act of welcoming implies acceptance, and most family members express their concern by trying to control--and that never works.

Good luck to you and your cousin,

Question

I asked that other question about Naltrexone. The reason I am so curious is because I got horrifically bad withdrawal once from taking a dose. Curiously though, my sickness lasted like 24 hours. Normally I would be sick much longer. My boyfriend gets sick for 5-7 days. Would taking Naltrexone help him kick more quickly? How long does this shit actually block the effects of opiates?

Answer

I'm sorry I missed your other question. I will admit that I do "scan" e-mail because I get so much of it, and sometimes I miss things. I've looked for the e-mail you sent and it is not here. You must have sent it to Francis or Helper. I'll go look there if you would like. However, I think I get the idea.

If you took Naltrexone and it made you sick, it means you are physically dependent upon some kind of opioid. It doesn't have to be heroin/morphine. Methadone, Vicodin, Percocet, anything will work, really. You should never take Naltrexone if you are dependent upon an opioid. I don't remember your original letter, so I don't know the situation; but your doctor should have told you this.

In general, withdrawal from morphine (heroin addicts actually detox from morphine, not heroin) lasts about five days. Taking Naltrexone will indeed lower this amount of time. The reason is simple: the Naltrexone rips the morphine off the receptor sites which puts them back in bloodstream where the body can remove them - mostly via the kidney, but also via the liver indirectly. There are now procedures, called "rapid detox" or "rapid antagonist detox" in which exactly this is done. The patient (in theory) goes through withdrawal in four hours. The pain during this time is so intense however, that he is put under general anesthesia. One problem with this is that any time someone is put under general anesthesia, there is the potential that he will never come out. Another procedure that is done is to combine a regular clonidine detox with Naltrexone. As the detox goes along, the patient is given higher and higher doses of Naltrexone. The end result is that the patient walks out of the hospital after three days feeling about as good as he would after about two weeks the old way. I'm in favor of this method, but some people find it very hard on their systems--these people should use the regular clonidine detox (or something else altogether). The "rapid" detox is bad for all but the smallest of habits. I suggest you read the following:

Rapid Nightmare

Under no circumstances should someone try to detox by giving themselves Naltrexone. The possible medical complications would include death from a ruptured esophagus or hearth attack. And those are just the ones that come right to mind. If you managed through it, it is probably because you had a very small habit. It will also depend upon the exact opioid because some opioids hang on to the receptors better than others.

What's more, if an addict does accidentally take Naltrexone (What idiot would do that? Me.) he should go to the hospital. He should not take more heroin or whatever to off-set the effect of the Naltrexone because this can easily lead to an over-dose.

Question

Our Outreach Team does street outreaches, works with detox centers, and provides harm reduction tools like safer sex supplies and bleach kits. we are trying to start a needle exchange program here in Las Vegas, but the Nevada politics are intolerably conservative. Anyway, I am trying to form a group of professionals and users to use as resources. I would appreciate any help and if you ever want to visit Vegas, I'd love to meet with you. Great site! I will definitely recommend it to some of my clients.

Answer

I want to put links to regional resources on the site. If you have anything along those lines (like syringe exchange times and places, MMT locations) that can be made public, please let me know and I'll put the information up.

Keep up the good work.

Question

Hi, I've looked around and can't find the answers to the following:

Thank you, I appreciate you taking the time to better educate me on these matters.

Answer

1. The lifetime of heroin/morphine is too short for the body to get physically dependent upon it after one use. Even using once a week will not do it. In general, it takes three days of constant use (every 6-8 hours) to get a very mild physical dependence. Note that physical dependence is what causes the withdrawal syndrome to occur with abstinence. "Habituation" is another matter. Habituation is the tendency for the user to want to repeat the experience. This is highly variable. Most people do not like the effect of heroin/morphine because it usually comes with a lot of nausea and vomiting. Some people love it. It is rare for someone to use heroin once and think, "I want to do this all the time, give me more." But habituation doesn't have to work that way to cause dependence. Habituation can cause a user to increase the frequency of his use over time. This can continue to the point where the user is physically dependent upon the drug.
   
   How quickly withdrawal symptoms occur after the last use will depend upon how large a habit the addict has. Few addicts have to wait a full 24 hours before they begin to feel the onset of the withdrawal syndrome, although it is probably between 24 and 36 hours when the nightmare really begins--when the addict feels the full brunt of the withdrawal syndrome. The fastest I have ever seen the withdrawal syndrome start is six hours.
2. It is no more illegal to do drug deals online than it is anywhere else. In other words, it is completely illegal. In terms of detection: no computer that is attached to another computer is completely safe from attack by the attached computer. If you are on the the Internet, your computer is attached to hundreds of millions of computers. No one can say for sure that they have privacy in this environment. I always assume any online communication is monitored. Just the same, phones can be as easily monitored, and if necessary, your house and car can be bugged. Who is to say?
3. I am in the middle of an interview right now in which we are discussing the short and long-term effects of heroin on the brain and mental functioning. This is a complex issue. I would not say that heroin is good for the brain. There can be benefits from using it, but they are not great and are certainly not lasting. There do not seem to be long-term negative effects on the brain. Short term, there are negative effects, depending upon how you look at it: one should never use heroin and then drive a car, for example.
   
   I don't think of Heroin Helper as either pro or con in terms of heroin. Does it seem to be a a pro-drug site? I'm interested in all opinions.
4. If you are thinking of using for the first time, we need to have a little talk.

Notes

Every ex-junkie in the world knows the horror of going to the bathroom at a family gathering. They know the whole family is out there counting the seconds, wondering if maybe he's in there shooting up. It can be horrible.

by Dr. H © 2003
Last Modified: 14 January 2004

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