I was on heroin for a few years and I live in the UK. I had managed to keep it hidden for maybe 18 months but eventually it become obvious and my mother started organising help.
Within a week we had some people from the local drugs outreach charity turn up at the house with free Naloxone IM kits and they trained us how to use them. A couple of weeks after that I was assigned a counsellor whom I would meet regularly and talk to over the phone.
A few months after that I finally got into an NHS programme (which was mostly useless, it was all just preaching which doesn't work for me).
In the UK we can pick up injection kits in chemists for free. They include: needles; sterile water vials; cooking spoons; micron filters; a sharps disposal box; and packets of citric acid (the heroin we get in the UK needs an acid to dissolve in the water).
Heroin addiction is a public health problem, and the healthier the public is, the better off everyone else is. The fact that you have to pay for treatment in parts of the US is unbelievable to me.
Having access to naloxone and injection kits for free surely saved me from getting a blood-borne infection, and the counselling from the charity really helped.
On a global level we need to stop treating addiction as a crime but as a health problem. No one wakes up first thing and thinks "Hmm, I think I'll try shooting heroin today". There are almost always deep-rooted issues that the addiction hides, because being addicted to heroin is essentially a full-time job. You just don't have time to address what is causing you to need to feel numb.
> There are almost always deep-rooted issues that the addiction hides
William S Burroughs wrote, at the end of "The Naked Lunch":
"Statistically, the people who become addicted to morphine are those who have access to it: doctors, nurses, anyone in contact with black market sources. In Persia, where opium is sold without control in opium shops, 70 per cent of the adult population is addicted. So we should psychoanalyze several million Persians to find out what deep conflicts and anxieties have driven them to the use of opium? I think not."
Similarly, historical opium addiction in China was largely a function of supply.
I think there's a bit from column A, a bit from column B, and WSB's scoffing at the idea of "psychoanalyzing Persians" does seem a bit... dated (what a concept, that a large number of people might have anxieties and deep conflicts). And I whole-heartedly agree with you about the "health problem not a crime" issue.
However, I often think about that remark of WSB's in connection with some of the more radical ideas about legalization (as opposed to decriminalization/depenalization).
Alcoholism was extremely common in the past from where I come from. High society acceptance as long as the person didn't wreak too much havoc. It has been idolized in folklore songs, books and stories for children. Just part of the life. Kids drank sometimes too.
Fast forward today - access to alcohol is even better (apart from minors). Yet society doesn't spiral into alcoholic madness apart form few fringe individuals. Maybe education about the inevitable addiction is better? Or people are smarter than peasants 200 years ago? Or whole cultural mindset about getting wasted as part of being social in nearest pub shifted.
I'd hazard a guess that alcohol is a lot less addictive than heroin, although full-blown alcoholism and withdrawal is no joke.
I think we also have a lot of customs around alcohol to mitigate the level and constancy of drinking required to get addicted. Lots of jokes about "it's 5pm somewhere" or "the sun is over the yard arm", "no drinking on a school night", etc. I think there are generally enough taboos around day drinking or being constantly drunk that most people are nudged away from veering into physical addiction.
I think it’s very true that availability and norms will have a lot to do with drug use, and heroin often doesn’t give a second chance to people who are experimenting.
However the with regard to the idea of ‘deep seated issues’ affecting addiction, I believe this is also true.
We have communities here that provide the opportunity for perfect control of substances - they’re remote and access to them is strictly controlled.
There was widespread alcohol addiction in these places. So alcohol was banned, and these places became ‘dry’ communities.
Lacking alcohol, the people turned to inhaling petrol fumes, which created a large social problem.
Eventually, an ‘un-sniffable’ petrol was created to solve this problem. Then the people turned to paint and glue.
It’s recognized that the people in those communities have suffered a deep, inter-generational trauma, which is what drives people to seek ‘numbing’ relief from substances.
However, it’s the belief that reducing availability of substances will solve substance abuse that’s kept the fundamental problems these people have, from being addressed.
I think you're taking the wrong point away, which is that the causal implication here runs from "wide availability of a substance -> addiction to that substance".
It doesn't say anything about whether a traumatized group will or won't take to substances; it just denies that all addiction is the result of trauma.
The other open question here - I assume you're referring to remote Indigenous communities in Australia - is whether people use substances strictly out of trauma or also out of boredom. The degree to which Indigenous lives are rendered both traumatic but also incredibly boring is shocking. If you've gotten a low quality education, don't have a job and your traditional way of life is no longer viable (it's quite likely you haven't been taught it), how are you going to pass the time?
> It’s recognized that the people in those communities have suffered a deep, inter-generational trauma,
Really? What about the Jewish people, who have been subjected to extremely high levels of inter-generational trauma. Yet they don't fall prey to particularly high levels of alcoholism or drug addiction.
Sure, current poverty can predispose some to addiction, but the idea of "inter-generational trauma" being a massive risk factor is unproven, to say the least.
> There are almost always deep-rooted issues that the addiction hides,
All crime is a consequence of deep-rooted personal issues.[1]
Part of the purpose of making something a crime is to put somebody on notice about when personal choices are likely to result in intolerable injury to the public and, hopefully, induce them to reassess their needs and expectations, including recognizing their need for help. And that's the logic of making drugs like heroin illegal.
I think I understand your point, but it's a point that is really difficult to articulate coherently. There are many subtleties in arguments that propose more compassionate--for lack of better phrasing--public responses to addiction. And it starkly exposes some paradoxes at the heart of human legal systems, including notions of volition and accountability. I think that's why it's such a difficult public policy issue. But if don't appreciate the inherent tensions at play we'll never understand why the other person doesn't agree with whatever proposal we put forth.
[1] Where issues == dysfunction, otherwise we're just restating a more general truism that all behaviors are consequences of each person's history and state.
>All crime is a consequence of deep-rooted personal issues
That is a blanket statement. Yes, i agree with the most crime being like this, and especially almost all or maybe all violent crime, but quite some crime is completely rational. I would commit a crime if it provided a clear benefit outweighing the risks, it's OK to do - it's government's job to organise laws and enforcement system in a way the set of "rational" committable crimes is minimised.
> I would commit a crime if it provided a clear benefit outweighing the risks, it's OK to do
Whoa, that's not OK in any meaningful way and I presume you meant it differently compared to how it came out. There are plenty of situations where nobody sees you yet I presume you don't murder folks for 50$ in their wallets, ie somewhere high on the mountain. Its called being sane moral person, pretty low bar for existence in society.
In my opinion, the body and mind tell a person exactly what they need to be happy. If we could murder people that offended us, or force sex from a mate we desired, took what we wanted etc. life would be a bed of roses. I genuinely believe the person would be absolutely content. The problem is this is inconsistent with how to live as a society and this is the root of all human suffering.
I think you bring up a good point. So what if the consequence for these crimes (any crimes?) was compulsory treatment? That needn't include being imprisoned except for where it's absolutely warranted.
My former coworker was a recovering addict who was also a addiction counselor. He perspective was that the addict has to want to be there for anything to happen.
If you cigarettes from a smoker or booze from a drunk and the outcome isn’t walking away from the addiction.
In contrast I've heard several counselors and specialists interviewed on the radio who say compulsory treatment is a useful and necessary tool. Some of them even lament the latest round of decriminalization measures in cities like SF because it leaves no recourse whatsoever for compulsory treatment. (And, yes, some of these people are counselors in SF. And, yes, some sort of civil commitment would be better than abusing criminal law, but civil commitment is a less politically likely option.) Before full, de facto decriminalization of drug use, SF already had shifted most cases to specialized drug courts which couldn't send anyone to jail, but could only force people into treatment--and AFAIU only did so if advised by addiction counselors.
Moreover, because SF and similar cities have so fully decriminalized drug usage, and done so asymmetrically to surrounding jurisdictions, they attract addicts to the city (it's not just the weather or social services). Whether or not you think compulsory treatment is ever effective or morally justified, surely one must admit that the last thing any addict or at-risk person needs is such a permissive environment, where they can surround themselves with others suffering from the same affliction and who will give them license to let go, hit rock bottom, and staythere indefinitely. SF has such a concentrated drug problem partly because it's like some platonic ideal of an enabling environment for codependent, drug-centered relationships.
My family has a long history of alcoholism, including both my parents. My grandfather was a regional AA president or some such, though long after he had destroyed his family. I've seen addiction up close and personal. I've been in foster homes and met kids from families destroyed by drug addiction, or who turned to drugs themselves. I've seen how enablement works, how my mother's alcoholism, while never going away, ebbed and flowed, yet at least for her was invariably precipitated by her alcoholic "friends" coming over or inviting her to drink with them. In the aftermath of a long binge we'd be lucky if she only lost her job; on more than one occasion we ended up on the street, though thankfully we never had to sleep on the street.
Over the years I've also met several very intelligent and otherwise perfectly functional alcoholics who chose to give themselves over to alcoholism. (At least one walked away from his life as a well-paid chemical engineer.) It's what they wanted and they literally said as much. They were perfectly capable of scraping together a lawful subsistence, and did so, though in one case that didn't always include regular electricity and running water, which they were fine with. I'm not sure what it means for an alcoholic to "choose" to live like that, but from my perspective if "choice" has any meaning it applies to those particular people just as much as it applies to me or anyone else. But the contrast between people like that, and people like my mother (or especially like my next door neighbors' daughter, someone whose drug addiction is so thorough she has given herself over to the streets and her codependent addicts and won't even entertain offers of help from family or the city) tells me that there's plenty of legitimate need for various forms of compulsory interventions, including short- and long-term treatment. My mom was forced into compulsory treatment once for 3 months. She lapsed a year or so later but if you ask her I'm sure she'll tell you that that experience was important to hastening the day she had her last drink, even though her darkest days were after that stint in the hospital.
There's a dangerous narrative in our culture that beating addiction is about hitting rock bottom so you can come to the realization about your problem and then seek treatment. I have no doubt that such is the experience of many addicts, but it's hardly universal. Other not uncommon experiences are repeatedly cycling through rock bottom for much of, most of, or all of your life, never once seeking treatment; or hitting rock bottom and staying ay rock bottom until you die. There are people who manage to sustain a heavy substance abuse habit but otherwise seem to live a normal, functional, middle-class lifestyle; maybe perfectly contented or maybe hating themselves and wishing someone would discover their secret and force a reconciliation, through legal compulsion or otherwise. Compulsory interventions don't have to cure people to be effective. They can be effective just by breaking whatever cycle they're stuck in. And no intervention need be used as matter of course.
There are countless dimensions at play when it comes to addiction and addictive behaviors. Everybody has their own stories and their own opinions, both addicts and those around them. There aren't many clear answers to even the simpler aspects, but in my experience and opinion categorically excluding options like compulsory treatment is one of the few wrong answers. It's premised on a similarly flawed and overly simplistic concept of volition as that behind excessively punitive responses. Certainly compulsory treatment can be done wrong, and perhaps in many contexts (e.g. many U.S. jurisdictions) the capacity to do it effectively and judiciously doesn't exist. But that's a different kind of argument.
It's good that you can get all that sterile equipment to inject safely. To me the weird bit is that you're necessarily using it to inject very non-sterile heroin with unknown adulterants that you've bought from a (by definition) criminal enterprise. I hope that at some point doctors are able to provide opiates for addicts as further harm reduction.
I know there's been some emergency COVID policies put in place in parts of Canada that allow morphine to be prescribed for that purpose (and possibly hydromorphone, but not heroin since Canada unlike Britain doesn't allow medical use of heroin).
> I've heard so much about it and how crazy addictive it is and seen it in the movies and TV (I'm thinking The Wire here, one of my favorite shows) and it really started to intrigue me. I've always wondered what it would be like to do Heroin. Out of no where I say I'll take the H and we do the deal there.
In his later posts, he admits that was just a story he was telling himself and he was indeed using heroin to avoid dealing with deep rooted problems within himself.
> Heroin addiction is a public health problem, ... The fact that you have to pay for treatment in parts of the US is unbelievable to me.
> Having access to naloxone and injection kits for free surely saved me from getting a blood-borne infection, and the counselling from the charity really helped.
Naloxone and Suboxone are so tightly controlled in the US that many addicts who want to get clean go back to heroin to self medicate (and many die). Why? The DEA bars any kind of relaxation and the private prison companies and the prison guard and police unions fund candidates that oppose any sympathy for addicts.
You have to pay to give birth in the US, like the government doesn't even care about the most fundamental act of creating more citizens, so not funding heroin treatments is no surprising in the slightest
> I was on heroin for a few years and I live in the UK. I had managed to keep it hidden for maybe 18 months but eventually it become obvious and my mother started organising help.
I think it's incredibly brave for you to share this, I appreciate you for your honesty and authenticity.
It's very beautiful to me when the universe helps people who've gone through incredibly difficult times to speak their truths out loud, and become advocates for change. I believe this act can help to shine a light in the darkness for others going through similar challenges (for the first time).
> On a global level we need to stop treating addiction as a crime but as a health problem.
100% agree. I believe society would benefit from an expanded definition of the word 'addiction' too:
"Addiction is manifested in any behavior that a person craves, finds temporary relief or pleasure in but suffers negative consequences as a result of, and yet has difficulty giving up. In brief: craving, relief, pleasure, suffering, impaired control. Note that this definition is not restricted to drugs but could encompass almost any human behavior, from sex to eating to shopping to gambling to extreme sports to TV to compulsive internet use: the list is endless.
“I’m not going to ask you what you were addicted to,” I often say to people, “nor when, nor for how long. Only, whatever your addictive focus, what did it offer you? What did you like about it? What, in the short term, did it give you that you craved or liked so much?” And universally, the answers are: “It helped me escape emotional pain… helped me deal with stress… gave me peace of mind… a sense of connection with others… a sense of control.”
Such answers illuminate that the addiction is neither a choice nor a disease, but originates in a human being’s desperate attempt to solve a problem: the problem of emotional pain, of overwhelming stress, of lost connection, of loss of control, of a deep discomfort with the self. In short, it is a forlorn attempt to solve the problem of human pain. Hence my mantra: “The question is not why the addiction, but why the pain.”
And the source of pain is always and invariably to be found in a person’s lived experience, beginning with childhood. Childhood trauma is the template for addiction—any addiction. All addictions are attempts to escape the deep pain of the hurt child, attempts temporarily soothing but ultimately futile. This is no less true of the socially successful workaholic, such as I have been, than of the inveterate shopper, sexual rover, gambler, abject street-bound substance user or stay-at-home mom and user of opioids." [1]
Within a week we had some people from the local drugs outreach charity turn up at the house with free Naloxone IM kits and they trained us how to use them. A couple of weeks after that I was assigned a counsellor whom I would meet regularly and talk to over the phone.
A few months after that I finally got into an NHS programme (which was mostly useless, it was all just preaching which doesn't work for me).
In the UK we can pick up injection kits in chemists for free. They include: needles; sterile water vials; cooking spoons; micron filters; a sharps disposal box; and packets of citric acid (the heroin we get in the UK needs an acid to dissolve in the water).
Heroin addiction is a public health problem, and the healthier the public is, the better off everyone else is. The fact that you have to pay for treatment in parts of the US is unbelievable to me.
Having access to naloxone and injection kits for free surely saved me from getting a blood-borne infection, and the counselling from the charity really helped.
On a global level we need to stop treating addiction as a crime but as a health problem. No one wakes up first thing and thinks "Hmm, I think I'll try shooting heroin today". There are almost always deep-rooted issues that the addiction hides, because being addicted to heroin is essentially a full-time job. You just don't have time to address what is causing you to need to feel numb.