Heroin Is Different
One of the great myths about drugs is that they are all the same. This myth takes many forms, like one of the tenets of the NA pseudo-science: addicted to one drug, addicted to them all. Another, much more important and harmful form of this myth is the belief that kicking heroin is the same as kicking any other drug. Heroin has special attributes that make becoming un-addicted to it particularly hard.
A Tale of Two Addictions
In my lifetime, I've been addicted to two drugs, both considered hard: cocaine and heroin. I would never say that kicking cocaine is easy--in fact, in some ways it is much harder to kick than heroin. With cocaine, the biggest problem is deciding to stop. With heroin, the problems really start when you decide to stop. Giving up heroin presents special--physiological--problems to even the most determined addict, which can keep him addicted for years after he's decided to stop.
Ending Cocaine Addiction
I tried to stop using cocaine many times before I finally succeeded. In the end, it took me over a year stop using it. Cocaine is a very forgiving drug when it comes to this kind of usage. Because it is not physically addictive, going back on it for a short run will not get you re-addicted. Doing so with heroin will result in the onset of the withdrawal syndrome which is extremely unpleasant. Even if you have no desire to continue using, you may find it necessary simply to feel well enough to go to work or manage other parts of your life.
Two Steps Forward, One Back
Cocaine allows you to stop using a little at a time. You can go two steps forward and one step back. All you have to manage is the craving.
When I decided to stop using cocaine, I noticed a pattern to my craving--I was hung up on the number "three". At first, I hit a wall at three days. I would stop for three days, then the urge to use would get strong. Someone would offer some coke to me, and down the garden path I would go--until I stopped again. Eventually, I was able to push past my third-day craving. Then, three weeks became my limit. After I conquered this limit, I hit a three-month limit. After that, there was nothing--the addiction was gone.
Heroin Is Not Like Coke
I couldn't have used the same process to kick heroin. Three days isn't even long enough to get through the withdrawal syndrome. Even three weeks isn't long enough to get thoroughly detoxed, so using for any length of time at all will get you re-addicted. So the "two steps forward, one step back" method doesn't work with heroin. And yet, I found it was still necessary to gradually move away from heroin.
Friends and Family
Most friends and family members understand that mistakes will be made in the process of getting clean. What they don't understand is why motivated heroin addicts don't just "get back on the wagon" when they fall off. The reason is that getting back on the wagon can be really painful.
Although this was never a problem for me, many people get weighted down by expensive detoxes that their loved ones have bought for them. When a father pays $10,000 for his daughter's detox, she will feel immense guilt if she uses for a couple of days and gets re-addicted. She hasn't just relapsed, she's gone back to square one; the $10,000 was simply wasted. Or so it seems--especially to her. She will most likely distance herself in an attempt to hide her failure, and this will only make matters worse.
The Re-Addiction Process
The motivated cocaine addict may have a rocky road to abstinence, but rarely will he ever feel as though he is starting over. As a heroin addict, it seems like the whole journey must be taken time and again before success is achieved. This is not true, however. Just as with cocaine, getting and staying clean is a process.
No Big Deal--And a Very Big Deal
It helps immeasurably to have friends and family members who understand the re-addiction process. This is hard, because on the one hand, they need to understand that it makes the process infinitely harder; but on the other hand, they need to understand that it is part of the process and isn't a big deal.
A Big Deal
It is a big deal in that detox is painful. It is a lot easier to not use when it just means you aren't going to get high than it is when it means you are going to be in physical agony. So an addict's wish to use isn't "irrational" and it isn't just hedonistic drive; it is a rational wish to avoid pain. The addict can only decide not to use by placing long-term goals ahead of short-term, clearly defined interests. This is very hard to do. When friends and family understand this, it makes life (and detox) much easier.
No Big Deal
It isn't a big deal because most addicts will get re-addicted after they first stop. In fact, most do so many times. What normally happens, however, is that the runs: get shorter and less intense; this results in the detox being shorter and less intense. But even when this isn't the case, wisdom is gained--progress is made.
Keep Detoxes in Perspective
The hardest part of this is understanding that getting detoxed isn't that big deal. Too often, everyone involved invests far too much in any given detox--as though it is the final word in the addiction. When this is the case, addicts hide their minor failures, which then turn into major failures; friends and family put unfair expectations on the addict, which often end up tearing loved ones apart in a flurry of acrimony.
Heroin Is Different
Ending an addiction to heroin is not like ending an addiction to most other drugs. Assuming that it is only makes the process harder for everyone involved. Understanding the effect of the withdrawal syndrome on the process is a key ingredient to the least painful road to abstinence.