Why Is Heroin Addiction So Hard To Treat?

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It has been proven time after time that alcoholism and drug addiction are amenable to treatment. Each year, millions of Americans celebrate another anniversary of sobriety, surrounded by grateful family members who remember the agony and misery of days gone by.

But while the success stories are uplifting, the failures are disheartening; unfortunately, the latter are far more common. People dragging the chains of addiction often suffer for years without finding relief, and even those who have apparently entered the ranks of the recovered are vulnerable to relapse at any time.

Recovery is a fragile affair, and when a flirtation with sobriety morphs into a lasting behavioral change, this is the exception rather than the rule. There are currently 25 million to 30 million practicing drug addicts and problem drinkers in the United States. Over time, a good proportion of these active substance abusers will manage to pull themselves out of the quicksand of addiction, but their struggle will be long and difficult with an end result that is far from certain.

Beating addiction is hard, but beating a heroin addiction is a challenge that can break the backs of even the most resilient people. Heroin has become infamous for the tenacious hold it gains on its victims, and the acute pain of withdrawal associated with the recovery process has become the stuff of legend. Heroin users are also vulnerable to lethal diseases such as HIV/AIDS and viral hepatitis, which can be passed intravenously through the sharing of needles. The danger of a fatal overdose is also higher with heroin than with most illegal drugs, which emphasizes the degree to which heroin addicts are constantly menaced by the specter of death.

The Seven Obstacles to Sobriety

It is notoriously difficult to treat heroin addiction. Some of the issues that interfere with the attempts of addicts to overcome their dependency include:

  • Daunting withdrawal symptoms: When a heroin addict attempts to stop using cold turkey, the symptoms of withdrawal can hit with the force of a thousand hammers. Vomiting, diarrhea, insomnia, bone and muscle pain, restlessness, cold flashes and overwhelming cravings for the drug will plague addicts trying to escape from their habit, undermining their resolve and sabotaging their campaign for sobriety before it has the chance to take hold.
  • Belief in the myth of willpower: Overcoming drug addiction is not simply a matter of willpower. It will play a role in recovery, but heroin addiction is a life-altering brain disease and holding it at bay is extraordinarily difficult. The brain must be retrained and reprogrammed over time if addiction is to be defeated, and self-denial alone will not be enough to make that happen.
  • A failure to understand that recovery is a long-term process: A 30-day stint in a rehabilitation center is only the first step on the road to long-term sobriety. Addiction has deeper roots than the mightiest oak and even Paul Bunyan would need years of determined effort to chop it out. The initial stages of recovery will require weeks of detoxification followed by years of consistent follow-up therapy and peer group interaction. In the case of heroin, medicinal cures may also be used.
  • Unrealistic expectations about the risk of relapse: Relapse is normally seen as a sign that treatment has failed, but this is incorrect. With drug addiction, relapse is common and even expected. But thankfully, as recovery progresses, addicts usually have an easier time bouncing back after falling off the wagon. In the battle against heroin, relapses happen, and no one who suffers one should feel overly discouraged or depressed.
  • Underlying psychological problems are too often neglected: In most cases, drug abuse is a coping mechanism for people who have severe and unaddressed psychological/emotional issues. Heroin addiction is such a serious threat, however, that getting through detox and finding sobriety must take precedence for all addicts regardless of their backgrounds and personal histories. Consequently, deep, underlying problems may not be dealt with as quickly, proactively and openly as they should be, allowing them to lurk in the shadows where they can easily torpedo the recovery process.
  • Addicts frequently return to the scene of the crime: When they go back home following a stint in rehab, heroin addicts often fall back in with the same old crowd. Addiction always develops in a (dysfunctional) social context, and when recovering addicts return to their old lives, it can be difficult to avoid the triggers that helped spawn their heroin dependency in the first place. In some cases, they may even continue to see the same friends they were using drugs with when they finally hit rock bottom. Needless to say, old habits can reassert themselves pretty quickly when addicts fail to make a clean break with the past.
  • The motivation to change does not match the intensity of the addiction:  Powerful compulsions to use accompany every addiction, and since the addict’s need for the drug can only be satisfied in one way, the motivation to keep getting high stays strong. On the other hand, an addict must continually swim upstream to get sober, since not using drugs goes against the grain of his corrupted instincts. If succumbing to addiction is the easiest choice, resisting it is the hardest, and for sobriety to become permanent the right decision must be made over and over again, day after day.

A Treatment Revolution in the Making?

Drug treatments for heroin addiction have much to recommend them. While replacing heroin with  buprenorphine or naltrexone doesn’t directly free an addict from drug dependency, it will get heroin out of the addict’s life and give medical professionals a better chance to guide him or her back to sobriety safely and sustainably. Many treatment experts have resisted this type of therapy in the past, based on philosophical objections as much as anything, but attitudes appear to be evolving. Drug treatments of heroin addiction, used in conjunction with traditional therapy, may in fact be the wave of the future.

If drug therapy for heroin addiction really works as well as its supporters claim, it could be a godsend for heroin addicts. These unfortunate souls have been claimed by a brain disease that, up until now, has been extraordinarily difficult to treat. Of course the best “cure” for heroin addiction is to never try it, but human beings make poor choices all the time and are forced to deal with the consequences. Drug addiction is a relentless predator, and when it sinks its teeth into its victims, it will refuse to let go without a ferocious struggle.

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