
What Heroin Addiction Tells Us About Changing Bad Habits - juanplusjuan
http://www.npr.org/blogs/health/2015/01/05/371894919/what-heroin-addiction-tells-us-about-changing-bad-habit
======
cubano
Heroin addiction is a difficult subject for me for personal reasons...in fact,
I am currently on state probation for possession of it in 4 years ago.

I become addicted to numb the pain of my mother's passing and my 13 year
marriage ending, although there is, of course, no excuse.

It started with prescribed Oxycontin and progressed from there. "Why buy
overpriced synthetic molecules designed not to really get you high when you
can get the natural ones cheaper and feel better?" I can still remember my
engineering-mind thinking.

I have been off it now for about 3 years after getting clean, literally, on a
cell floor in a county jail...cold turkey...the first time I ever successfully
kicked it. After that, I checked myself into a South Florida inpatient rehab
(called the Hanley Center...please, do yourself a favor and give them a call
if you need help), and with the help of some amazing people, got better.

I'm convinced the only reason I finally kicked was simply because there was no
other option; jails have pretty much no supply of heroin. To this day I thank
the stars for that county jail...it saved my life.

The best way to summarize the experience was with a "joke" (it was no joke
BTW) I came up with to try to explain how I felt near the end...

 _What 's the best thing about heroin?_ After you do it, you don't feel
anything.

 _What 's the worse thing about heroin?_ After you do it, you don't feel
anything.

~~~
thatswrong0
My girlfriend was recently prescribed Norco for a sore throat. I was
flabbergasted.

I don't know why you were prescribed Oxycontin, but there is definitely a
problem with the way doctors prescribe drugs these days... prescription drugs
kill more people than illegal drugs. And your kind of story is very common (my
brother has / had a heroin addiction).

~~~
sjf
Opiates are the most effective cough suppressants, I'm guessing that was the
reasoning behind it.

~~~
patzerhacker
Cough suppression is one of the first things that heroin was marketed for:
[http://i.kinja-img.com/gawker-media/image/upload/s--
k12ZMisi...](http://i.kinja-img.com/gawker-media/image/upload/s--
k12ZMisi--/c_fit,fl_progressive,q_80,w_636/18p5js1ac32mcgif.gif)

------
swamp40
The last two sentences are fairly profound. (I didn't quite understand what
she was saying until I had read it a few times.)

 _We think of ourselves as controlling our behavior, willing our actions into
being, but it 's not that simple.

It's as if over time, we leave parts of ourselves all around us, which in
turn, come to shape who we are._

~~~
junto
This is cool because once you realise that you can break habits, you realise
you can also form them too.

Habits are about frequency and ritual. Thus I can use the same process to
start good habits that make me a better more effective person.

~~~
aswanson
"We are what we repeatedly do. Excellence, therefore, is not an act but a
habit."

------
tmp-20150107
So, I have been a heroin user (addict) for a long time, about fifteen years. I
have a great job, as a senior engineer in a start-up, and have worked almost
continually in IT while maintianing my habit. I've tried to quit, several
times, and found it incredibly hard.

As the article sugests, a change of scenery really does help, though. So, when
I've been working overseas, or travelling to speak at conferences, then I find
it's _much_ easier to stop. I would take some methadone with me, and wean
myself gradually off using it, over only a week or two.

I have actually done this several times, and found that after a month I am
essentially clean. However, when I return home I have always relapsed, usually
pretty quickly. This is something I currently have a _huge_ problem with, and
I don't really know how to solve it ;( I'm trying to stop again, and
wonderining if maybe a change of location would be the right way to do this
properly?

~~~
pstuart
Changing locations to get clean is called "pulling a geographic" by the
12-step folks (at least those I was hanging out with). Obviously getting away
from bad influences helps.

Glib suggestion: perhaps replacing that addiction with the addiction of
exercise might be worth exploring?

~~~
tmp-20150107
Hm, makes sense. I think hobbies in general can be used to take the place of
an addiction. I should probably cycle to work more, though ;)

However one of the major problems with heroin addiction is the actuall
_process_ of quitting. You can't keep a job during withdrawl, i.e. cold
turkey. There are clinics that offer 'five day detox' under sedation, but
that's expensive (GBP 5K plus) and good luck getting NHS or health insurance
to pay. They offer naltrexone implants, which prevent opiates from working
altogether, which removes the _option_ of relapse completely...

Getting a methadone prescription in the UK is also tedious to say the least -
you are supervised when taking your daily dose, must report for 'assessment'
regularly and so on, which is hard to fit in to a working schedule. And forget
about getting enough to take away with you on a business trip for a couple of
weeks. I generally have to purchase on the black market when required, which
is ridiculous. I'd love to be able to ask my GP for help, and simply be given
a repeat prescription for a week or two's supply to take home, but that's
never going to happen because they're afraid of it being sold. So I have to
buy it from others, which doesn't make sense...?!

~~~
encoderer
There are options aside from Methadone. I've had experience with this in my
family as well. To me soboxone looks like a miracle drug. It gave me my friend
back.

------
danmaz74
I remember a famous animal study about heroin addiction with mice. Almost all
mice that were in a very stressful environment and had easy access to heroin
became addict. But if mice were living in a pleasurable environment, most mice
would not become addict.

So, even if it looks very likely that the association between a habit and an
environment was at work here too, I wonder how much the low relapse rate was
linked not just to a change of environment, but also to a change from an
incredibly stressful situation (war) to a much more satisfying one.

~~~
garrettgrimsley
[https://en.wikipedia.org/wiki/Rat_Park](https://en.wikipedia.org/wiki/Rat_Park)

~~~
canvia
Excellent cartoon version of this story:
[http://www.stuartmcmillen.com/comics_en/rat-
park/](http://www.stuartmcmillen.com/comics_en/rat-park/)

------
josefresco
Unfortunately, most addicts are unable to change their circumstances
drastically enough to use this technique.

To use an analogy from the article, a smoker can't stop going to work because
walking by the entrance stirs cravings.

Would like to see practical tools that addicts can employ that use this
theory, short of flying across the world.

~~~
patmcc
It's interesting, quitting a job and drastically changing your life could
actually make financial sense if it got you to quit smoking.

Assuming: 1 pack/day, $10 a pack (this is close in my province), 5% interest,
over 30 years, has a present value of $55k. I wouldn't be surprised if the
numbers for alcoholism or heroin addiction are similar. Addiction is hugely
expensive to the people afflicted and society at large (barring the usual
discussion of smokers saving health care dollars by dying early).

If flying across the world/country and making other drastic changes really
does stop the cycle with a high rate of success, we should consider funding
it.

~~~
mathattack
Alcoholism is much higher. It's not hard to spend $100+ on a good bender. Add
in the associated health issues (true for smoking too) and the NPV of healthy
behavior is much higher.

~~~
ibebrett
most alcoholics i know don't spend money this way. they buy cheap vodka and
drink alone, not out going from bar to bar.

~~~
genericuser
It really depends on the budget of the alcoholic from my experience.
Alcoholics have a way of making their alcoholism fit/fill their budget.

------
cheshire_cat
It's common practice to tell addicts that they should move to another city
after therapy and therapists are certainly right to do so but I think this is
only a part of the truth.

The soldiers in vietnam were under great stress from (war) that went away when
they returned to the US. If you start doing drugs or any other coping
mechanism because of some emotional problem the problem will travel with you.
You can't run away, the only way to break those habits is to learn other
coping mechanisms or to get to the root of your internal trauma and come to
terms with it.

~~~
jdcarter
This is a huge point I was hoping the article would address, but failed to.
The war wasn't just a matter of location, it was a matter of stress (in a huge
way) and a whole way of living (as a GI vs. civilian).

If you're an alcoholic and you move from one town to another, that other town
is going to have bars and liquor stores just like the one you left. Your
location may have changed, but there are so many things that are effectively
the same, I can't see it having quite the same impact when compared to
returning from 'nam.

~~~
click170
This is more true for alcohol than it is for black market drugs.

While still generally easy to find, its a bit harder to go up to a random
sketchy looking person and ask them for drugs in a new city that you don't
have a network of friends and contacts in.

This makes me wonder if "pulling a geographic" is more successful for people
with substance abuse problems that do not stem from alcohol.

------
somberi
A related and useful article from The Economist (Link at the end). I have
reproduced parts of it that I found interesting (Heavily edited for
telegraphic brevity):

"Like many of America’s new generation of users, Ms Scudo's ddiction began in
2000 when, after a hip injury, a doctor prescribed her ... a high dose of
OxyContin.. Her prescription was later reduced, but she was already hooked. On
the black market OxyContin pills cost $80 each, more than she could afford to
cover her six-a-day habit; so she began selling her pills and using the
proceeds to buy cheaper heroin. As if from nowhere, Ms Scudo had become a
heroin addict."

"last year 11m Americans used illicitly-acquired prescription painkillers,
more than the number who used cocaine, ecstasy, methamphetamine and LSD
combined."

"Though Afghanistan accounts for 80% of global opium production, America gets
most of its heroin from Mexico. Mexico is now the world’s third-biggest
producer of opium, after Afghanistan and Myanmar."

"More than half are women, and 90% are white. The drug has crept into the
suburbs and the middle classes. And although users are still mainly young, the
age of initiation has risen"

[http://www.economist.com/news/united-states/21633819-old-
sic...](http://www.economist.com/news/united-states/21633819-old-sickness-has-
returned-haunt-new-generation-great-american-relapse)

------
domdip
The relationship between drugs and environment is so strong that (in mice, at
least) you can trigger an "overdose" simply by changing the latter.

[http://people.whitman.edu/~herbrawt/classes/390/Siegel.pdf](http://people.whitman.edu/~herbrawt/classes/390/Siegel.pdf)

------
mturmon
It reminds me of "Going to Chicago", an evocative blues about heroin
addiction, habits, and place, sung by the great singer Joe Williams:
[https://www.youtube.com/watch?v=uPcHVqKHkKo](https://www.youtube.com/watch?v=uPcHVqKHkKo)

In the intro to the song, he sets up the background: "He had a woman with a
heroin habit, a monkey woman, a monkey on her back...so he got some fresh
money and said, I'm going to take another city..."

------
bdamm
This could be useful for informing addiction recovery within institutionalized
individuals, such as soldiers or prisoners, but not within the general public.
The addict is unlikely to change their entire life structure to defeat the
addiction since they know that would defeat the addiction, and that's not what
the addiction wants.

~~~
equoid
That is silly. Most addicts don't have the resources to change their life
structure, where would they go? what would they do? how would it be paid for?.
It is only the rich who can check to a rehab clinic.

~~~
bdamm
It's a mistake to think that the only people who are addicts are the poor and
destitute. There are plenty of addicts, perhaps the majority, who haven't
managed to destroy their lives (yet).

------
ribs
A few years back I came across some emails from the previous user of a
computer I was given. (They really should have wiped the hard drive...) They
were messages to his family back in India. The guy had been using heroin, and
had kicked it once or twice. But he fell back into it, and it was when his old
friends rolled into town. That was the trigger for him.

------
code_duck
I've had similar experiences with cigarettes. I've stopped and then decided to
start several times. I've found the easiest way to quit, which makes it so
simple but I don't even have to think about it, is to dramatically change my
circumstances and daily habits, like a new job, new roommates, or moving.

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tomphoolery
"It's as if over time, we leave parts of ourselves all around us, which in
turn, come to shape who we are."

I like that.

------
Cilike88
Interesting to think about the obstacles we unintentionally set in place for
ourselves in living out our good intentions. Emphasizes the need for living
with mindfulness.

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talles
I love articles like these that take a holistic view on human behavior, that's
the way to do it.

