Can You Beat Heroin?
Stories of those who have become clean and still are doing well.
FS: I was the first person in NSW to receive a naltrexone implant in 2000. Prior to this I had a long history of heroin dependence. My life was chaotic, I had overdosed on several occasions and I was unable to function or achieve my goals. Since then I have not looked back and I am now employed full-time, I am married and have two lovely children. I cannot imagine what my life would be like now without the help I had from Psych n Soul.
GT: In 1993 I suffered severe neck and back injuries following a MVA. I suffered from persistent pain and became addicted to prescription opiates. By the time I found Psych n Soul I was being dosed on over 800mg of morphine daily. As time went on my doctors became more and more concerned about the level of pain-killers I needed just to function. There was pressure on me to go on the methadone program, which meant that my confidentiality in a small town would be compromised and I would be seen as a heroin addict. I became obese, I suffered mood swings, I could not work, my marriage was failing and I was profoundly depressed.
I have come back into Psych n Soul with my husband to thank them for the help you gave me four years after my detox and implant. I think you were shocked to see me as I was smiling (and so was my husband), I had lost a lot of weight, I felt so happy and I was working in a Health Centre as a nurse. I had not been able to work for about 6 years prior to this. When I was asked to record my story I was only too happy to do so. Thanks to Dr Ross and the team I am now well and suffering less pain than I did when I was addicted to morphine.
ME: I heard that Psych n Soul were being attacked and read the stuff in the press which I thought was rubbish about naltrexone killing people. I have offered to speak in public to support the program. My story is that about three years ago I got detoxed and had an implant. At that point I had just got out of jail and was determined to get my life on track and not go back. I now run my own small business, I employ two people, I have a lovely girlfriend and I go back to my old school to tell students about what happened to me and to warn them not to go down that path to destruction. I owe my new life to Psych n Soul
DR: When I was addicted to methadone (on it for 10 years) I felt that I was mentally and physically unwell and that I would not survive much longer. I was suicidal, I was in fear of certain people at the methadone clinic and I was addicted to benzos that I got from people hanging about the clinic. I was constantly harassed by people wanting to buy my methadone.
Today I have just given birth to my beautiful little girl. I am married to a great guy who doesn’t use drugs and up until recently I was working full-time in a shop. I cannot imagine that this would have been remotely possible without the Psych n Soul program. By the way I never paid a cent and I still don’t know why you decided to help me.
SB: When I arrived at Psych n Soul I thought I was mad and that I could never get my life on track. I had only recently tried to kill myself by shooting up as much hammer as I could lay my hands on, but no luck. A local guy (some pathetic hero type saving the girls from sin I suppose) from the Hillsong Church offered to help me get off the gear, but I thought if you are stupid enough to pay well let them. My mother injected me with heroin when I was twelve. I had a habit by the time I was 14 and my mother was selling me to who ever could pay. By the time I got to do the rapid detox I was 19, I had a girl who was 3 years old and I was shacked up with a customer I didn’t trust with her and who regularly knocked me around.
I remember the counsellors from Psych n Soul hung in there with me for 6 months and slowly I started to feel better and even gave up my pot. More than that I started to feel lime I had some brains and that I could do better.
I remember the shock on your faces and the tears in your eyes, when I walked in the door of the clinic two and half years later to tell them I had just finished my 2nd year of a law degree at UWS. Not bad since I left school when I was twelve. I have since gone on and finished the degree and have been doing my time with a community legal service in Blacktown. As I have quite few convictions I might not be admitted to the bar, but I going to try and anyone no-one can take this from me and I can still be qualified to give legal advice to people like I once was and maybe inspire them to do better.
Dr Ross Colquhoun
http://addictiontreatment.com.au/
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
Tuesday, July 13, 2010
Can You Beat Heroin? Note 3
Can You Beat Heroin?
Will it work for me?
Okay so rapid detox and naltrexone implants can go a long way to get the addict on track, but what do you need to do and can you do it?
Obviously no-one can do this for someone and those looking a for a magic bullet will be disappointed. You can lead a horse to water……
Just as obviously, detoxing will entail a certain amount of discomfort including up to two weeks with low energy, little sleep and no appetite, while the natural opiates (known as endorphins) are produced again. Some people coming off methadone will also suffer with some cramping and diarrheoa. So a level of tolerance for this discomfort will be required.
And you ask yourself: what if I do all this and then just relapse. With everyone’s expectations so high and the risk of disappointment so great the pressure will really be on. You have probably failed many times before and you can’t really see why it might be different. The slaps on the back with people saying how great you are to be clean, getting a job and being normal after a week or so only increases the pressure and adds to the mix a deep sense of being a fake as you know you are not so sure it is going so well…. In fact it feels just the opposite… if this is well I might as well be back there on the gear because at least I know where I stand!
Much of the time people become addicted to opiates because the emotional or physical pain you carry is too great. Chronic pain is not well understood and when no physical cause can be found the person in pain finds they are treated as if it is your fault you can’t work or be the life of the party. You are treated like you are bludgers and you start to feel like one. Opiates relieve the pain, but they also make you feel much better about yourself. As the effect slows down over time you need to take more to relieve the pain, you get addicted. A double whammy: not only a bludger, but a junkie.
Young people often leave home, get into the ‘wrong’ group, and start drug use in their early teens. You don’t leave home because you want to but mostly to escape a situation that is intolerable and where you have experienced physical, psychological and sexual abuse that happens in seemingly ordinary families. More than that it feels good and helps numb-out the hurt and at least those around understand what you feel because they have been there too.
The belief is that if you stop using drugs all the pain you are trying to kill off will be all that you are left with, with no-one to help or even understand.
So it is important to sense that those who want to help you know this and there is a feeling that with compassion comes understanding and with understanding comes an ability to self-sooth and to deal with it without drugs.
The most important thing is that you can talk to someone like you who has done this and, while still shaky if it has only been a few days since their detox, they are doing OK. In the next blog I share some examples of the people I have known who are doing well some years later.
Dr Ross Colquhoun
http://www.addictiontreatment.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
Will it work for me?
Okay so rapid detox and naltrexone implants can go a long way to get the addict on track, but what do you need to do and can you do it?
Obviously no-one can do this for someone and those looking a for a magic bullet will be disappointed. You can lead a horse to water……
Just as obviously, detoxing will entail a certain amount of discomfort including up to two weeks with low energy, little sleep and no appetite, while the natural opiates (known as endorphins) are produced again. Some people coming off methadone will also suffer with some cramping and diarrheoa. So a level of tolerance for this discomfort will be required.
And you ask yourself: what if I do all this and then just relapse. With everyone’s expectations so high and the risk of disappointment so great the pressure will really be on. You have probably failed many times before and you can’t really see why it might be different. The slaps on the back with people saying how great you are to be clean, getting a job and being normal after a week or so only increases the pressure and adds to the mix a deep sense of being a fake as you know you are not so sure it is going so well…. In fact it feels just the opposite… if this is well I might as well be back there on the gear because at least I know where I stand!
Much of the time people become addicted to opiates because the emotional or physical pain you carry is too great. Chronic pain is not well understood and when no physical cause can be found the person in pain finds they are treated as if it is your fault you can’t work or be the life of the party. You are treated like you are bludgers and you start to feel like one. Opiates relieve the pain, but they also make you feel much better about yourself. As the effect slows down over time you need to take more to relieve the pain, you get addicted. A double whammy: not only a bludger, but a junkie.
Young people often leave home, get into the ‘wrong’ group, and start drug use in their early teens. You don’t leave home because you want to but mostly to escape a situation that is intolerable and where you have experienced physical, psychological and sexual abuse that happens in seemingly ordinary families. More than that it feels good and helps numb-out the hurt and at least those around understand what you feel because they have been there too.
The belief is that if you stop using drugs all the pain you are trying to kill off will be all that you are left with, with no-one to help or even understand.
So it is important to sense that those who want to help you know this and there is a feeling that with compassion comes understanding and with understanding comes an ability to self-sooth and to deal with it without drugs.
The most important thing is that you can talk to someone like you who has done this and, while still shaky if it has only been a few days since their detox, they are doing OK. In the next blog I share some examples of the people I have known who are doing well some years later.
Dr Ross Colquhoun
http://www.addictiontreatment.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
Can You Beat Heroin? Note 2
Can You Beat Heroin?
Do I have a Problem?
Firstly, the addicted person needs to realise he or she has a problem. Often young people early in their addiction can’t see what is clear to others around them. You still think its fun or tough; that it makes you stand apart from others and that you are different; it makes you feel special, part of an exclusive club; and mostly it makes you feel good when there seems to be not much else going for you. While parents and friends only see lost opportunity, loss of friends and all that is worthwhile and the possibility of disease or death the addict seems not to see any of this. While family and friends are often on a roller-coaster of anger, fear and exasperation, the addict is just focused on his or her next fix as if it is more important than living. Family and friends often have trouble recognising the person they once knew, while the addict thinks those you thought you once knew have now turned on you.
What Help can I get?
Secondly, once you realise you have become addicted and it is no longer fun and it no longer feels good you need to believe that you can do something to help yourself. If you have learned to survive by lying, you become involved in crime and prostitution, witnessed friends die and been to jail and feel that your family no longer loves you, as often you have stopped loving yourself, the good feelings are replaced by a deep sense of shame and guilt. When you are in the middle of your addiction you often feel useless and worthless and that you deserve what you get …. You feel unable to believe that you can be any good as you have changed forever and so have those who you once looked to for support or that you deserve the help you now need.
Does it work?
Thirdly, you need to believe that those who offer help can in fact help you, and that it is worth it especially if there are strings attached. Parents and some therapists think that they can shame you into change and yet it is shame you most vividly feel and this response only makes it worse as it confirm that no-one cares about you. Some believe that punishment will wake you up and yet this means you often end up feeling completely worthless and in the company of those who don’t really care about you, but who share your predicament .
Some also believe that there is no solution, just a matter of reducing risk by putting people on methadone. While it reduces some of the harms associated with heroin addiction it means that it is harder to detox and get clean and almost no hope of being normal.
On the other hand it seems that in an society where drugs are readily available conventional detox and treatment fails far more often than it succeeds. So what to do?
Evidence indicates that relative to conventional procedures, after rapid detoxification more patients transfer to the opiate-blocker naltrexone and stay opiate free in the short-term, but that this does not guarantee being drug free in the long term. In studies where patients are allocated to either rapid detoxification or more conventional detoxification procedures such as a methadone taper lasting one or two weeks or a clonidine-based conventional inpatient detoxification, all the rapid detoxification patients tend to complete the procedure and start to take naltrexone compared to 25% to 30% completion rates for the conventional treatment.
However, by 12 months all those who had completed detoxification had made substantial but equal reductions in use. These studies suggests that with low levels of support after detoxification (monthly counselling or none at all), rapid detoxification’s advantage in starting more people on naltrexone does not automatically lead to better long-term outcomes for those who managed to complete detoxification. And yet this is a good start, but it is not the whole story.
The factors that tend to improve outcomes include selection of those who are most likely to succeed, involvement in an integrated counselling program that deals with other issues such as chronic pain, psychological and social problems and a significant time free of opiates. People taking naltrexone tablets orally often stop too early and then fall back into heroin use. Naltrexone implants that last from 3 to 6 months provide some of the solution, but again the changes the person makes while drug free is the most important factor in maintaining abstinence.
In the next blog I talk about whether treatment will work for you and your addiction to heroin or methadone.
Dr Ross Colquhoun
http://www.addictiontreament.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
Do I have a Problem?
Firstly, the addicted person needs to realise he or she has a problem. Often young people early in their addiction can’t see what is clear to others around them. You still think its fun or tough; that it makes you stand apart from others and that you are different; it makes you feel special, part of an exclusive club; and mostly it makes you feel good when there seems to be not much else going for you. While parents and friends only see lost opportunity, loss of friends and all that is worthwhile and the possibility of disease or death the addict seems not to see any of this. While family and friends are often on a roller-coaster of anger, fear and exasperation, the addict is just focused on his or her next fix as if it is more important than living. Family and friends often have trouble recognising the person they once knew, while the addict thinks those you thought you once knew have now turned on you.
What Help can I get?
Secondly, once you realise you have become addicted and it is no longer fun and it no longer feels good you need to believe that you can do something to help yourself. If you have learned to survive by lying, you become involved in crime and prostitution, witnessed friends die and been to jail and feel that your family no longer loves you, as often you have stopped loving yourself, the good feelings are replaced by a deep sense of shame and guilt. When you are in the middle of your addiction you often feel useless and worthless and that you deserve what you get …. You feel unable to believe that you can be any good as you have changed forever and so have those who you once looked to for support or that you deserve the help you now need.
Does it work?
Thirdly, you need to believe that those who offer help can in fact help you, and that it is worth it especially if there are strings attached. Parents and some therapists think that they can shame you into change and yet it is shame you most vividly feel and this response only makes it worse as it confirm that no-one cares about you. Some believe that punishment will wake you up and yet this means you often end up feeling completely worthless and in the company of those who don’t really care about you, but who share your predicament .
Some also believe that there is no solution, just a matter of reducing risk by putting people on methadone. While it reduces some of the harms associated with heroin addiction it means that it is harder to detox and get clean and almost no hope of being normal.
On the other hand it seems that in an society where drugs are readily available conventional detox and treatment fails far more often than it succeeds. So what to do?
Evidence indicates that relative to conventional procedures, after rapid detoxification more patients transfer to the opiate-blocker naltrexone and stay opiate free in the short-term, but that this does not guarantee being drug free in the long term. In studies where patients are allocated to either rapid detoxification or more conventional detoxification procedures such as a methadone taper lasting one or two weeks or a clonidine-based conventional inpatient detoxification, all the rapid detoxification patients tend to complete the procedure and start to take naltrexone compared to 25% to 30% completion rates for the conventional treatment.
However, by 12 months all those who had completed detoxification had made substantial but equal reductions in use. These studies suggests that with low levels of support after detoxification (monthly counselling or none at all), rapid detoxification’s advantage in starting more people on naltrexone does not automatically lead to better long-term outcomes for those who managed to complete detoxification. And yet this is a good start, but it is not the whole story.
The factors that tend to improve outcomes include selection of those who are most likely to succeed, involvement in an integrated counselling program that deals with other issues such as chronic pain, psychological and social problems and a significant time free of opiates. People taking naltrexone tablets orally often stop too early and then fall back into heroin use. Naltrexone implants that last from 3 to 6 months provide some of the solution, but again the changes the person makes while drug free is the most important factor in maintaining abstinence.
In the next blog I talk about whether treatment will work for you and your addiction to heroin or methadone.
Dr Ross Colquhoun
http://www.addictiontreament.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
Can You Beat Heroin? Note 1
Can You Beat Heroin?
People often talk to me about the “addictive personality”, suggesting that the person who gets addicted to opiates has some fatal flaw… that somehow you are different from the rest of us. It seems to imply that a person, once addicted to heroin or methadone is “always addicted”.
In some ways there is some truth in these statements. For sure, if there is a history of addiction in a family it is more likely that a person might use drugs and then become addicted. We know that some people seem more likely to get addicted than others. In other words, genetics or our inheritance or race plays a role. Probably, more important is the environment we grew up in. A family where drug use is common can mean that children see this behaviour as normal and the chances are that you have been psychologically effected and disadvantaged in other ways. Drug use is closely related to depression and anxiety especially among those who have low self-regard or confidence or who feel valueless or useless.
However, the most important factor in getting people started on excessive and damaging drug use is its availability, that is, how easy it is to get and how cheap it is. When there are lots of drugs about, we know where to get them easily, our friends are using them and, at least to start with, they are cheap. If there is no obvious deterrent, if we believe the chances of being caught are not high it is more likely people will start using, you will get addicted and find it harder to stay clean if you detox.
All this does not mean that a person cannot strive for a drug free life and have confidence that you can do it. It just means that for some you will need to try a few times and you are more likely to need help.
We know that each year many hundreds of people begin drug use and many of these people will get addicted and yet the total numbers addicted to drugs remains the same over prolonged periods. In fact over the past 10 years there has been a large decline on the numbers addicted to heroin in Australia, because of the heroin drought. Whatever caused it, it had the effect of pushing many people to stop. Numbers of addicts have dropped from around 70,000 to about 40,000. In this same period deaths have declined from around 900 each year in 1999 to a bit over 300. Also, the numbers on methadone have grown steadily from 30,000 to just under 40,000. So what happened to all those others who stopped your heroin addiction. So some 10,000 went onto methadone (or buprenorphine), some 4000 tragically died, some took up other drug use and stayed in the lifestyle, but its clear that the majority got clean, cold turkey or with help, and just got on with your lives and left their using days behind.
The people who continue to use heroin have often been using for a longtime or find it really hard to stop and will need help to stop. However, if the right strategies are in place anyone can successfully detox and look forward to a life without addiction, which is your prison and stops you from having a normal life. And of course many will go on and off methadone and some will be content to get dosed for the rest of your lives.
So what are the factors that predict if a person can beat heroin and get back to being normal?
The first factor in beating heroin is to acknowledge that you have a problem and need to get help. In the next post to my blog I talk about this and what help is effictive in beating heroin and then follow up with some of the many success stories from people who have got clean.
Dr Ross Colquhoun
http://addictiontreatment.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
People often talk to me about the “addictive personality”, suggesting that the person who gets addicted to opiates has some fatal flaw… that somehow you are different from the rest of us. It seems to imply that a person, once addicted to heroin or methadone is “always addicted”.
In some ways there is some truth in these statements. For sure, if there is a history of addiction in a family it is more likely that a person might use drugs and then become addicted. We know that some people seem more likely to get addicted than others. In other words, genetics or our inheritance or race plays a role. Probably, more important is the environment we grew up in. A family where drug use is common can mean that children see this behaviour as normal and the chances are that you have been psychologically effected and disadvantaged in other ways. Drug use is closely related to depression and anxiety especially among those who have low self-regard or confidence or who feel valueless or useless.
However, the most important factor in getting people started on excessive and damaging drug use is its availability, that is, how easy it is to get and how cheap it is. When there are lots of drugs about, we know where to get them easily, our friends are using them and, at least to start with, they are cheap. If there is no obvious deterrent, if we believe the chances of being caught are not high it is more likely people will start using, you will get addicted and find it harder to stay clean if you detox.
All this does not mean that a person cannot strive for a drug free life and have confidence that you can do it. It just means that for some you will need to try a few times and you are more likely to need help.
We know that each year many hundreds of people begin drug use and many of these people will get addicted and yet the total numbers addicted to drugs remains the same over prolonged periods. In fact over the past 10 years there has been a large decline on the numbers addicted to heroin in Australia, because of the heroin drought. Whatever caused it, it had the effect of pushing many people to stop. Numbers of addicts have dropped from around 70,000 to about 40,000. In this same period deaths have declined from around 900 each year in 1999 to a bit over 300. Also, the numbers on methadone have grown steadily from 30,000 to just under 40,000. So what happened to all those others who stopped your heroin addiction. So some 10,000 went onto methadone (or buprenorphine), some 4000 tragically died, some took up other drug use and stayed in the lifestyle, but its clear that the majority got clean, cold turkey or with help, and just got on with your lives and left their using days behind.
The people who continue to use heroin have often been using for a longtime or find it really hard to stop and will need help to stop. However, if the right strategies are in place anyone can successfully detox and look forward to a life without addiction, which is your prison and stops you from having a normal life. And of course many will go on and off methadone and some will be content to get dosed for the rest of your lives.
So what are the factors that predict if a person can beat heroin and get back to being normal?
The first factor in beating heroin is to acknowledge that you have a problem and need to get help. In the next post to my blog I talk about this and what help is effictive in beating heroin and then follow up with some of the many success stories from people who have got clean.
Dr Ross Colquhoun
http://addictiontreatment.com.au
D H Sc, M App Sc (Neuroscience), B Sc Hons (Psych), Grad Dip Counselling and Psychotherapy, Member of College of Health Psychologists, MAPsS, MACCP, MAPSAD,
Registered Psychologist; Clinical Director, MindCheck Wellness Centres, Addiction Treatment and Psychology Services, Ultimo.
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