Why Sarah Can't Stop

The Brain recognizes opiates. When we're under stress or pain, endorphins, a kind of opiate, are naturally released in humans. Heroin is an opiate and when mixed with water and injected into the bloodstream can produce effects in 7 - 10 seconds. Injected in the muscle, it takes a few minutes to deliver its effects. The rush or release triggered by heroin is many times greater than the effect produced by endorphins. Ah, the problem begins to appear!

Effects include an euphoric rush, drowsiness, nausea, reduced pain, reduced anxiety, relief and possibly death from an OD. The effects are apparently highly pleasurable, addictive, and sadly, allow buildup of tolerance ... meaning it takes more to get the same high. But what a high it must be!

An addict experiences a psychological and physiological craving for more heroin 4 - 6 hours after the last use. That means Sarah could be using 4 times a day and that's dangerous, expensive, and ultimately life threatening. We witness the addict's increased anxiety, irritability, aggressive behavior, sweating, nausea, and chills. Cramping and vomiting are also not unusual. We've seen it many times.

To address the addiction, the addict often must pass through a detoxification phase, but that is just a beginning. Behavioral modification and reinforcement are required. Narcotics Anonymous or other 12-step programs can be great tools of recovery if the addict can commit to change her lifestyle. Still, the lingering effects, memories, habits, user-friends, places, and things can act as triggers. Addiction is pretty ugly and awfully difficult to confront and reverse.

Effective treatment programs offer no guarantees although their intentions are excellent. Treatment does not inoculate the addict. Once an addict, always an addict ... or maybe the addict will always be at risk of relapse, even tens of years later. The nasty cravings distort judgment, and in fact, remove inhibitions and common sense. Saying "no" is not just a matter of common sense. I can't tell for sure but it seems to rob the victim of free will and dramatically lowers one's sense of right and wrong.

Recovery if and when it happens may be a miracle. So when we think of our loved ones, when we recall joyful memories, it helps to understand that the ugly actions of the addict are beyond their choosing or ability to stop.