Alcoholism and drug addiction

[phenol]

I posted in my intro here how I feel I relate to Eddie's plight with heroin because I'm an opiate addict too.

I'm addicted to opium/morphine. It's a challenging thing at times, you know? Sometimes it's unbelievable rapture, it feels like it makes me complete. Other times it's pure hell, and I wonder what I'm doing with my life. I have so much potential, so why do I feel so attached to this substance. I'd be so ashamed to have my family find out, but at the same time i feel it has some positive effects on my emotional state when I'm medicated. I feel more me.

I'm just wondering if anyone else here has experienced alcoholism or drug addiction, or is close to somebody with an addiction like this.

How do you guys feel about addiction?

I think buprenorphine and methadone maintainance shouldn't be so stigmatized. If these programs were made easier and more available to addicts I think many more would get off the streets and do something productive with their lives.

[Darkthoughts]

How does the methadone program work in the US then? Over here in the UK, you can be prescribed it by your GP if you decide you want to rehab. I don't know the total in's and outs of it, but I have a friend who's been on methadone for a while now.

[phenol]

How does the methadone program work in the US then? Over here in the UK, you can be prescribed it by your GP if you decide you want to rehab. I don't know the total in's and outs of it, but I have a friend who's been on methadone for a while now.

For methadone you have to go to a clinic every single day until you pass a bunch of urinalysis tests, then you get once a week or something. And they systematically make you jump through hoops the whole time. You must have a lockbox and bring it, if they call you to come in no matter where you are you have to drop everything and go, etc. Plus, a lot of the clinics (not all) have staff that aren't exactly very friendly.

Bupe is better in that a GP who took an 8 hour course can prescribe it. Finding a good doctor can be a challenge though. Some are money hungry and don't give a crap about their patients at all. Bupe has strange side effects for some people too because it's only a partial agonist. It's also insanely expensive without insurance - sometimes approaching the original habit in cost.

I think things may be better over in the UK because healthcare is socialized. Heroin is also a prescription painkiller there (diamorphine), so it doesn't have the crazy stigma it has in america.

[Darkthoughts]

Well, I wouldn't go so far as to say heroin doesn't have a stigma here...and you wouldn't be prescribed diamorphine unless there was a bloody good reason for it - but I expect perhaps people trying to come off opiates are given better support by the sounds of things.

[phenol]

Well, I wouldn't go so far as to say heroin doesn't have a stigma here...and you wouldn't be prescribed diamorphine unless there was a bloody good reason for it - but I expect perhaps people trying to come off opiates are given better support by the sounds of things.

Well it's got a stigma to an extent everywhere, but america is quite unique in it's drug-ignorance.

Everytime I hear a percocet popper say how horrible recreational heroin use is, I just wanna tell them so badly that oxycodone is a u-opioid agonist just like H.

Many americans don't quite understand what Heroin even is, or what an opioid even is.

Then you have the fact that many americans assume that everyone in a methadone clinic is a lowlife street heroin user... forgetting that methadone is for ALL opioid addicts. This further contributes to the replacement therapy stigma. The approval of buprenorphine (suboxone), did help remedy this, I will admit, but not enough good doctors are approved to dispense it yet.

There's scientific evidence that genetic polymorphisms in the coding for the u-opioid receptors may have a 'normal' type and a 'variant' type that is more susceptible to opioid addiction because it's not sensitive enough to the body's natural endorphins. I doubt that addictions are ALL behavioral, there's likely a genetic component.

[Matt]

I think drug addiction can be a real and serious thing. I'd like to throw all destructive behavior in there as well.

Because even if you don't do drugs, jacking off in a theater is wrong too (<--example)

So yeah, I hope you do okay man. I do wish there there was easier access to treatment in this country but in the end, it will only come down to you and your dedication to change your life.

btw...your first line is the exact same way I feel about cigs. Love/Hate

[ZoNeSeeK]

Phenol, what psych services are available to you? Substance use (at any regular level, whether its alcohol or pot or speed or whatever) or substance abuse is indicative of self-medication. I know its obviously a priority to get off the opium but its also important to address the issues behind the self medication. I drink way too much, I think :/

But this isn't to say that everyone who enjoys recreational drug fun has serious psychological problems - this is why the term "recreational" is used. They are fun. Drinking is fun. Ecstasy and speed and pot and coke are fun. This is why people try them and use them. Its an issue if disregarding personal safety to a degree, I guess.

[Darkthoughts]

In agreement with everything Zone just said, I'd also argue that it's practically impossible to be a regular recreational heroin user. Because if you're using heroin on a regular basis you're either addicted or well on your way - and the realities of being addicted to heroin are serious enough to warrant certain aspects of the associated stigma imo.

[phenol]

In agreement with everything Zone just said, I'd also argue that it's practically impossible to be a regular recreational heroin user. Because if you're using heroin on a regular basis you're either addicted or well on your way - and the realities of being addicted to heroin are serious enough to warrant certain aspects of the associated stigma imo.

Well yeah, opiates are physically addictive, so if you use every day even if you don't 'psychologically' need it, your body will start to need it.

However, i'd strongly argue that speed is MUCH worse for the body with long term abuse (assuming the heroin and speed users are either both NOT injecting or BOTH injecting, to keep even ground). Ever seen how horrible a chronic methamphetamine abuser looks after 10 years?

Opioids cause psychosocial problems for addicts no doubt, but physically they're pretty benign, I mean, they can be used long term as pain medication.

[Darkthoughts]

You can't really compare prescription drugs to street drugs in terms of physical damage.

I have known both long term speed and heroin addicts, both of whom have teeth missing, became emaciated, had awful skin, developed tics etc...

[phenol]

You can't really compare prescription drugs to street drugs in terms of physical damage.

I have known both long term speed and heroin addicts, both of whom have teeth missing, became emaciated, had awful skin, developed tics etc...

This is true, and ties in strongly with social class issues and all that, you know?

[Darkthoughts]

What do you mean exactly? In this example you're talking about judging an addict by appearance, regardless of their background - making assumptions about them?

[phenol]

What do you mean exactly? In this example you're talking about judging an addict by appearance, regardless of their background - making assumptions about them?

I'm getting at the disparity between, say, homeless street addicts and middle class housewife oxycontin addicts. They're both addicts, but the former is more likely to end up doing things that ruin his/her body because of the greater desperation when you have nothing.

Meaning, the prognosis for a middle class or rich addict is just better, and it's kinda sad.

[Darkthoughts]

Hmmm...I'd say that's more a case of how and what you're addicted to...I'll expand on my thoughts in a bit, I just have to log off now and take the kids to school ;)

[TerribleT]

What do you mean exactly? In this example you're talking about judging an addict by appearance, regardless of their background - making assumptions about them?

I'm getting at the disparity between, say, homeless street addicts and middle class housewife oxycontin addicts. They're both addicts, but the former is more likely to end up doing things that ruin his/her body because of the greater desperation when you have nothing.

Meaning, the prognosis for a middle class or rich addict is just better, and it's kinda sad.

I think any addict would tell you that the path is the same. Eventually both wind up face down in the gutter. (in the figurative sense)

[Odetta]

Yeah, I don't necessarily think the prognosis is better for someone of middle to upper class. I think for many in the middle to upper class, it is a taboo subject, so many addicts remain quiet about itfor far too long.

[Darkthoughts]

Within her own community/social circle the housewife addict (to use your example) may be just as ostrasized as the homeless guy on the street.
The difference being, the homeless guy's plight is more apparent to more people, which is why he may consequently be judged by more people. Were the housewife to be more prominently in the public eye, I'm sure she'd be judged and generalized about to the same degree.

I think you're drawing comparisions between people and circumstances that vastly differ from the get go despite drugs.

[phenol]

I have to drive one point home that I'm not sure I've made clear as of yet:

I believe for some of the depressed population, long term opioid treatment with methadone or buprenorphine under the care of a doctor with counseling would be the BEST method of controlling depression and other substance use and allowing the person to lead a normal life.

SSRIs don't work for me, and I know this is true of other people too.

Long acting opioids aren't just drugs of abuse - I strongly believe they can be used for psychiatric disorders in a HEALTHY way.

There are several studies using buprenorphine that support this. They reached the conclusion that buprenorphine can cause remission of depression in the vast majority of patients with refractory atypical depression.

Of course with the stigma against opioids I don't have much hope that more studies will be allowed on this, sadly :(

[ZoNeSeeK]

Do you think that would conflict with a medico's duty of care regarding overdose risk with opiods in unipolar or bipolar depressives?

But then again, valium is prescribed, and thats just as dangerous.

What physical side affects are there, over the long term? I've been reading lately that controlled opioid use has resulted in no adverse long term affects, and reports are consistant across the US, UK and Australia.

Personally, I've stayed clear of them as I know my addictive personality would probably cause me problems.

[Jimmy]

I'm sorry that I really don't have anything to add beyond stating that I find this thread fascinating and I that I wish the best for phenol.

[Matt]

Same here, I have been reading this one very closely.

The best of luck to everyone that struggles with things that are less than healthy for them. I will certainly throw myself in that category.