HEROIN ADDICTION: Brain Disease or Intended Behavior?
PERSONAL STATEMENTI chose to research this topic because the lives of many of myfriends have been significantly changed due to heroinaddiction. Therefore, it is a subject that I wanted to learnmore about. I was able to do so through my research aboutheroin addiction and the interviews I conducted with aheroin addict, the sister of a heroin addict, a former heroindealer, a mental health worker and a Massachusetts statetrooper.
HEROINThe National Institute on Drug Abuse (NIDA) describesheroin as “an opiate drug that is synthesized from morphine,a naturally occurring substance extracted from the seed podof the Asian opium poppy plant.”Heroin typically appears in the form of a brown or whitepowder. It can be smoked, snorted or injected.
A GROWING PROBLEMIn 2008, the Drug AbuseWarning Network reported,“Over 51% of all accidentaldeaths that occurred as a resultof drug abuse involved heroinuse.”
HIGH ON HEROINPinned pupils andglossy eyes are aneasy way to knowthat someone ishigh on heroin.
OPPOSING VIEWPOINTSAlan I. Leshner of the NIDA believes that heroinaddiction should be considered a disease. Hesupports his opinion by making parallels betweenaddiction and other diseases. Leshner also says thataddiction, like other diseases, cannot be curedwithout proper treatment.
OPPOSING VIEWPOINTSJeffrey Schaler of Johns Hopkins University arguesthat addiction is an intended behavior. He supportsthis by saying that the best available treatment foraddiction is to attend faith based meetings such as AAor NA. He emphasizes that diseases should be treatedmedically, not religiously. Schaler also states thatresearch does not support that addiction is a disease.
HEROIN AS AN ESCAPEKyle Keegan, author of Chasing the High, says “Heroinseemed like a romantic conquest of the ultimate experiencewith the dark side of life.”The first time Keegan used heroin, he felt like he was“enveloped in a shower of medicinal bliss.”
OXYCONTINMany heroin users start their opiate use by abusingOxycontin. The NIDA reports that, in some areas ofthe country, Oxycontin abuse rates are higher thanthose of heroin abuse.Many Oxycontin users graduate to using heroinbecause it is less expensive and provides a betterhigh.
PAUL CLARKEPaul is a 23 year old male who says that all of his sadness andpain disappear as soon as the heroin enters his system.He describes his withdrawals in saying, “They are horrible.Every single thing that I use the drug to escape from comes backten times worse and I am very sick at the same time. When I takethe drug again, I feel better instantly until it wears off. It’s avicious cycle.”Many addicts describe heroin withdrawals as a sickness that is“ten times worse than the flu” for which the only cure is heroin.
SOCIAL CONSEQUENCESHeroin.net states, “Becoming dependent on the drug quicklychanges how the addict spends their time, and hasenormous social implications.”Paul Clarke agrees with this statement. He says, “I get highall the time, I would even get messed up at work. I lost goodfriends that were replaced with awful people who use.”Because of Paul’s addiction, he has lost his job, his truefriends, his credibility, and thus the trust of his familymembers.
PAUL’S OPINIONPaul believes that addiction should be considered a disease.He states, “The second you get that feeling of being high, youalways want to get it back. No matter how bad life gets, youwill always want to feel like you did the first time you gothigh.”Paul believes that recovery is possible, although it is verydifficult. He says that the best way for an addict to maintainlong term sobriety is to completely change their life, and toavoid people who use heroin at all costs.
MEDICAL CONSEQUENCESAccording to the NIDA, users who take too much heroin candie from overdosing. Other consequences include significantweight loss, infection of the heart valves and liver or kidneydisease. Those who inject the drug can develop HIV, AIDSand Hepatitis C. (HCV)According to the Office of National Drug Control Policy,“Approximately 70-80% of the new HCV infections in theUS each year are among injection drug users.”
MEDICAL BENEFITSThere are medical benefits of opiates. Heroin is one opiate,as are medications such as Oxycontin, Percocet andVidcodin. Such prescription medications are used for painmanagement.Timothy Moynihan, M.D. states, “Adequate management ofcancer pain with opioids doesn’t usually lead to ‘drugseeking’ behavior and addiction. The benefits of treatingcancer pain with opioids usually far exceeds the negativeeffects.”
ISABELLE CLARKEPaul Clarke’s sister, Isabelle, is a 22 year old who iscompletely sober. Isabelle says that since Paul has startedusing, “He has become less trustworthy, he does not havethe same sense of humor and he lacks accountability.”She also notes that Paul is unable to live a normal lifebecause the drug controls him.
ISABELLE’S OPINIONIsabelle believes that addiction begins with an intendedbehavior, but turns into a disease when the user is no longerable to control the drug use.Isabelle believes that recovery is possible. She states, “Withthe proper treatment and the will to recover, there is alwaysa chance. However, it is a team effort. A drug addict cannotget sober on their own.”
AMY SANDERSAccording to the National Office of Drug ControlPolicy, “Heroin admissions represented 13.6% of thetotal drug and alcohol admissions to treatment in2007.”She talks about these patients in saying, “It’s almostlike they become the drug. Once you lose yourself it’sso hard to get back, which makes it that much harderto quit.”
AMY’S OPINIONAmy believes that addiction should be considered a disease.She emphasizes that there are both physical andpsychological aspects of addiction.She says that an addict can cleanse their body of the drug indetox, but will often relapse without proper therapy becausetheir mind still needs the drug. She adds, “Recovery withouttherapy is like putting a band-aid on an infected wound. Itjust doesn’t work.”
ZACH ROBERTSRoberts is a 36 year old male who formerly sold heroin. Hechose to sell heroin because it is highly addictive and lessexpensive than other drugs on the market.He states, “Looking back, it was a selfish act because I mademoney off of other peoples’ problems. It never hit homeuntil I lost an uncle to the drug. After that, I realized that Ihad been contributing to the problem while I was dealing.”
CRIME AND PUNISHMENTRoberts spent 5 1/2 years in county and state prisons fordealing heroin. He is currently on probation and will remainon probation for the next three years.The Office of National Drug Control Policy states that in2008, “There were 1,476 Federal offenders sentenced forheroin related charges in US courts. Approximately 97.3% ofthese cases involved trafficking.”
ZACH’S OPINIONZach believes that addiction should be considered anintended behavior, not a disease. He stated, “Each usermade the choice to come to me and buy the drug, and it wastheir decision every time.”
CHRISTOPHER MERKINChristopher Merkin is a Massachusetts state trooper whosays that he is not looking to arrest addicts, but to helpthem.One way Merkin or other law enforcement officials can helpaddicts is to “section” them. According to MassachusettsGeneral Laws, “Section 35 permits the courts toinvoluntarily commit someone whose alcohol or drug useputs themselves or others at risk. Such a commitment canlead to an inpatient substance abuse treatment for a periodof up to 30 days.”
CHRISTOPHER’S OPINIONMerkin believes that addiction should be considered adisease because of the drastic changes a person undergoeswhile using the drug.He believes that recovery is possible. He says that in order tomaintain sobriety, it is important to find another way to feelthe euphoria felt while being high on heroin. For example,Merkin has known a few addicts who have replaced gettinghigh off heroin with running marathons. They are able tolive healthy lifestyles without the drug.
TREATMENT OPTIONSRegardless of the way that society classifies heroin addiction, itis still a growing problem that produces many medical and socialconsequences which need to be addressed.According to the NIDA, heroin addiction treatment optionsinclude behavioral therapy, inpatient detoxification programs ormethadone.Methadone is a medically safe alternative to opiates that relievescravings and enables patients to live stable and productive lives.
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