A friend and a heroin addiction - what to do? Your stories?
May 20, 2011 9:10 AM   Subscribe

A friend and a heroin addiction - What should we do? What is likely to happen?

So unbeknownst to us all, a friend has become addicted to heroin. One bout of inpatient treatment has not been effective - the friend came right back and went out to score. Now the friend's partner has let us know that the friend has accidentally overdosed and is in the hospital.

Our friend has some family and health issues for which we suspect that they are self-medicating. Therapy has been tried. They also have problems with alcohol and soft drugs.

1. What should we do to be supportive of friend and partner? Friend is important in our social circle and widely beloved, generous, friendly.

(Note: I am NOT interested in "leave friend alone to sink or swim; it's their life; they have to want to change". I know that friend won't change unless he wants to; however, I don't believe that everyone is an island or that our behavior can't help them want to change. I also don't believe that it's responsible to cut someone loose when there are still simple or moderately inconvenient things you can do to help.)

2. What are your stories of friends with heroin addictions? Do people kick this stuff? How did you deal with the friendship? Have you seen rehab work?
posted by Frowner to Human Relations (31 answers total) 3 users marked this as a favorite
People get clean. People get clean with rehab. People who get clean have to want to get clean, because it's a lot of work to stay clean (not in any kind of hand-wavy, emotional way, but in the very basic sense that walking away from an urge or craving in the early part of sobriety is like walking up a steep hill). This is why people talk so much about hitting "rock bottom," what they mean is the moment when people get "sick and tired of being sick and tired."

The best thing to do is to provide positive elements to the person's life that are not the drug.
posted by OmieWise at 9:20 AM on May 20, 2011 [3 favorites]

I had a friend who was addicted to heroin. His predisposition to addiction seemed to be inherited, as his father was an alcoholic.

People constantly told me to let him sink or swim; it was his life; he had to want to change. I stood by him, because I loved him. Of course, I did set boundaries. I saw through every lie, refused to lend him money, refused to be with him when he was high, waited in agony for the day that he would embrace the life that he said he wanted with me.

He died at age 30 of an accidental overdose. I vaguely remember a blog by an ambulance driver who said that he almost never saw a heroin addict over age 50, because they never lived that long.
posted by Melismata at 9:20 AM on May 20, 2011 [6 favorites]

I've had several friends with substance abuse problems of varying types and degrees. What I've learned is...

1. Don't lend them money.
2. Don't give them a place to stay.
3. They often show up asking for rides. It's always to go score. Never give rides.

You're right - your behavior can help them to want to change. What you must do is not condone, facilitate, enable or in any other way make it easier or more convenient for their habit to continue. They want help? They have to be in some form of rehab or treatment. No rehab? No help.
posted by DWRoelands at 9:23 AM on May 20, 2011 [7 favorites]

This is very hard to hear and to understand, but there is not really anything you can do. Anything you do that falls into the traditional idea of helping - giving money, a place to stay, etc. - is only going to make it easier for your friend to continue his current lifestyle. The best thing you can do is continue to care about him as a person, and learn to separate his addiction from the person he would be without it. Don't take things personally or hold grudges about his bad behavior. Addicts do things when they're actively using that they would never do under any other circumstances. Don't try to interfere ("help") if he doesn't ask for it. And definitely don't do things to "help" with any kind of expectation that it will change his behavior.

I'm married to an addict. He's been clean for five years, but nothing that I did got him to stop. And believe me, I tried everything there is to try. You really can't do anything to help. You can only love him, and try not to do anything that will contribute to his addiction.
posted by something something at 9:24 AM on May 20, 2011 [6 favorites]

You might look over the HBO: Addiction series website for current information and evidence based treatment regimes for heroin addiction. One of the things that has become better understood in recent years is the seemingly permanent brain chemistry changes that opiate addiction causes, and the importance of replacement therapies in maintaining long term recovery for such people.
posted by paulsc at 9:24 AM on May 20, 2011

If you believe there are medical issues for which he is self-medicating, be an advocate for investigating those issues. Otherwise how is rehab supposed to work? There's going to be a whole lot of people who can't see past the bad, bad drug addict; somebody needs to stand up and insist that these other issues be considered.
posted by Lyn Never at 9:25 AM on May 20, 2011

Also, you'd be AMAZED at the lies heroin addicts are capable of. They'll know you better than you know yourself, push buttons that you didn't know you had, figure out how to touch your soul in ways you never knew about, all for the simple reason of feeding their habit. Don't fall for any of it.
posted by Melismata at 9:26 AM on May 20, 2011 [3 favorites]

Echoing everyone else - don't give money, a place to stay and invite him or her to do stuff that has no drugs and alcohol involved.

Also, you might get ideas from Nar-Anon/Al-Anon.
posted by Pax at 9:34 AM on May 20, 2011

First: I'm so sorry that your friend, and those who love that friend, are going through this.

One of my partner's oldest friends has untreated schizophrenia. I think some of the same things apply here. The affected person has a completely different set of norms than anything we'd ever consider. A lot of the things that we might think could help might be seen as intruding or trying to take control -- and control is a HUGE part of what your friend is going through.

At the same time, you can't be expected to alter your own norms to accommodate your friend. I always remember my airline safety: "Secure your own mask before assisting others." The more secure and healthy you are, the more you can provide support to someone else. Do NOT feel bad about stepping back in whatever form that takes for you.

So I feel that it's appropriate to say, "We're here for you; don't hesitate to call us any time." At the same time, though, you have the right to set boundaries: no rides or money, no using in your presence or in your car/home/whatever, be reasonable about securing your valuables even though this is your friend who under normal circumstances would respect people's stuff.

If you can make note of some of your friend's patterns, that might help everyone. Where does your friend go for comfort? What is your friend's safe place? Where does your friend go to use, either in public or private? Someday you might have to look for them -- if you haven't already. In our case, my partner had to go out and buy a crappy guitar because his friend (the guitarist of a very established band) would either pawn his own guitar or someone else's, and it was better to either protect it in a separate location or be okay with losing it. You're predicting the behavior while protecting yourself and your friend.

Keep the discussion away from addiction, if you can, and on the things you have in common. Don't ignore it, but make sure your friend knows that he/she is valued for things other than being a fun drunk or amazingly creative when high.

The important thing you can do (if you choose) is to maintain communication between the friend and the people who care about your friend but can't be near because they've distanced themselves or your friend has rejected them.
posted by Madamina at 9:39 AM on May 20, 2011 [2 favorites]

(and by that I meant don't give money, a place to stay, etc, but DO invite him or her to do stuff that has no drugs and alcohol involved)
posted by Pax at 9:40 AM on May 20, 2011

One of my best friends just celebrated her 24th Narcotics Anonymous birthday yesterday, 24 years clean. She was badly strung out for maybe 10 years, kicked cold turkey, and even now goes to meetings regularly. Most of her non-addict friends gave up on her after a while, I might have if we had been living in the same city. As it was I only saw her a couple of times a year, but we would talk on the phone more frequently. She says it made a difference to know that there were still people from her old life who cared. I guess that's the most important thing you can do, let them know you care, it does sink in through the haze of the heroin.

Of course back then I had no money she could have tried to con me out of anyway.
posted by mareli at 9:47 AM on May 20, 2011

Both my parents had serious heroin addictions when I was growing up. And they used for a long time. (They met in a hep ward from sharing needles when they were teenagers in the late 60s and they were using up until I got into junior high in the late 80s.)

I can tell you that now they have both been clean for more than 20 years and besides having to choose clothing that covers track marks, they are doing fine.

They both "failed" at rehab a few times. Hitting rock bottom was not necessarily helpful until they truly had something at stake. (Luckily for me, that stake was me.)

My dad said accupuncture helped him -- and this is a guy who thinks "all that new age shit is bullshit." Here's what I remember of my dad going clean for (what I think was) the last time. He moved in with some amazing friends. These friends had a house in another city, so my dad didn't have drug connections or drug friends there (but it was Oakland, so it was available if he sought it out). He went cold turkey and he was very, very sick. He kept odd hours and we couldn't predict what time of day he'd be up. He took lots of baths and showers. I played D&D with him (just a two-person module from a book), watched old Star Treks on Betamax and just talked to him -- whether he could fully follow what I was saying or not. (Looking back on it, I can't tell if the keeping occupied was for me or him, since I was in 4th grade at the time.)

Unlike the in-patient rehab (which he wasn't supposed to tell me about all the celebrities there, but he did), the court-ordered rehab, the AA meetings, the methadone treatment (which is inhumane at best and should be avoided at all costs), going cold turkey with friends was what worked for him, but I think because if he didn't, I was going to have to go away to another state to live with relatives and that was a serious and irreversable consequence that he valued more than he liked heroin. (I know. Awww!) I don't recommend it, but he relied heavily on smoking weed to get him through it as well.

My mom was a heavier user, but higher functioning and had tried rehab less. Doctor-regulated rehab didn't work for her. What finally worked? She moved in with some skeezy guy who had her under 24-hour survelliance and took her to a rock-and-roll Jesus church. She also kept super busy to stay distracted and was personally cared for. She also didn't get clean until she was going to lose custody of me -- losing her (well paid, creative, awesome, totally interesting) job didn't do it at all. Come to think of it, she began to heavily smoke weed, but not until she ditched the skeezy guy.

It took them about 2 years post-using to get back to a mental and physical place where it wasn't the first thing they thought about. It took me a few more years than that to get over worrying if someone spent more than the usual time in the bathroom whether they were cooking up something in there. They moved to a different state where they did not have drug friends and didn't have drug connections and they purposely avoided seeing anyone who had a connection to heroin or their lives on heroin.

Strangely, they both took up professions that involved needles: seamstress and tattoo artist. I think the ritual and all that was just as important.

People who are newly sober are annoying. Sorry. It's true. They find God or themselves or Buddhism or vegetarianism or (god help you) a new relationship with someone they met in rehab. You know how annoying an exsmoker is about "how happy they are to not have cigarettes in their lives" every minute of the day? Yep. That. For years. It is better than having a junkie friend, even if it drives you up a friggin' wall when they want to talk to you about The Power of Positive Thinking or something. Yes, still better than ditching school to drive around Wilshire to score.

Heroin junkies lapse. Or they get addicted to something else. They don't quit being junkies. I've met others (way too many others) besides my parents and the ones who successfully quit get addicted to something else: Jesus, cleaning, local politics (not kidding -- I know a dude who became a state senator), Buddha, vegan food, Jesus (yes, lots o' Jesus).

Hopefully your friend hasn't been using for a long time and the addiction is mostly physical. Hopefully he has a good, positive reason to want to be clean that's more important to him than simply "not getting arrested", "not losing his job", "not losing all his friends", "not getting beated and robbed while trying to cop" that will get him to choose getting clean.

It's a very, very, very evil addiction -- to have and to break. And he may not be the same person he was before it. If you really love him, I don't mean romantically but I don't mean "just someone I think is cool", but really, truly love him, you can help him through this. But you won't ever be the same either. And at some point, you'll have to mourn the old friend you had and, if you're lucky, get to reknow and relove the new, sober friend you're going to get.

I'm in tears just thinking about how sick and sad and horrible the whole thing is and wish to whatever that your friend and your friendship will come out of this whole. "Good luck" seems like such an empty thing to wish, but, being agnostic, I have nothing else. So, to your friend and you: good luck.
posted by Gucky at 9:48 AM on May 20, 2011 [81 favorites]

DWRoelands: "1. Don't lend them money.
2. Don't give them a place to stay.
3. They often show up asking for rides. It's always to go score. Never give rides.

Also: You cannot save your friend. Repeat that to yourself: You cannot save your friend.

A few of my friends fell into heroin habits in college. Setting aside the ones who tried it a couple of times, decided it wasn't for them, and moved on, there isn't one among them who didn't hit rock bottom.

The fortunate ones got clarity and dug themselves out, and now are leading happy, healthy lives. My friend Henry was not so lucky. The only thing that worked, for a while, was his parents coming and physically removing him from an environment where heroin was easily available (SF) to one where it was not (New Orleans, oddly enough). He eventually relocated back to Oakland, where he fell back into his habits and died of an overdose.

There are no "simple" things you can do. Are your friends parents aware of what's going on? If they're not, would they act if they did know? If so, start there.
posted by mkultra at 9:49 AM on May 20, 2011

That is a tough one to kick. I had a friend a long time ago who moved away to Ontario (I'm in Alberta). We was into drugs a little bit, but we all were at that time. Then one day when we called he said "hey guys, I tried Heroin for the first time".

After that, we never heard from him again. He always called us and emailed, but after we heard that, he cut all ties with us and we were his best friends in the whole world, in fact, we were his only family. The sad part is that we could have done something and convinced him to return to Alberta. I don't know if it would have worked, but the sad part is that we could have done something.

I felt at a loss becuase I let him go with the "it's your life thing" so congratulation to you for NOT thinking that way. Do something, look up resources in your town and try an intervention, they do work if done properly. Here is a really good resource about doing an intervention. Good luck and come back here to post if it turned out for you, I will be watching!
posted by Sammieboo at 9:53 AM on May 20, 2011

Oh, and now that I see everyone else's comments, before your friend is ready to get clean, yeah, seriously be zero tolerance and make sure he can't get into your house/guess your online passwords/etc.

My parents screwed over every friend and relative they had -- no matter how wonderful they were -- to get heroin. If he's still using, he'll do the same to you and everyone he's ever met.
posted by Gucky at 9:58 AM on May 20, 2011 [1 favorite]

I just started going to Al-Anon, which is for the family and friends of alcoholics. I hardly even talk when I am there, but it's very helpful to hear from other people who are or have been in my situation. You might look up Nar-Anon in your area at some point and give it a try. It can at least offer YOU a little relief.
posted by amodelcitizen at 10:01 AM on May 20, 2011 [2 favorites]

You might find yourself obsessing over things like how long they've been in the bathroom and what size their pupils are, and at that point it's helpful to remember that you can't control what they do, you can only set boundaries and enforce them.
posted by amarynth at 10:28 AM on May 20, 2011 [1 favorite]

They want help? They have to be in some form of rehab or treatment. No rehab? No help.

No doubt, and this thread certainly supports it, addiction to anything is the definition of a harsh realm. I've known any number of junkies over the years, three of whom come instantly to mind.

1. He was very functional, very charming. A dealer. An art collector. He made it pay. And, in the end, he was one of the most manipulative, deceptive, cunningly Machiavellian individuals I've ever had dealings with. Bad company all the way. I have no idea where he is now, and thank all gods for that.

2 + 3. Rather similar in that both were very talented, very sensitive artist types who shared a rather withering contempt for the bullshit sensibilities of "The System". Both confided to me that, for them, heroin was like a filter of deathly cool. With some of it in your blood, you were untouchable, you were the living personification of Kipling's "he who keeps his head while all around are losing theirs". So yeah, while they were using, the last thing they needed was "help" from anyone. Though they'd always be happy to sucker you for some cash, or a ride, or a place to crash.

As far as I know, one of them's still "on the street", still hustling and jiving, burning bridges, breaking hearts, not giving a fuck. The other has gone evangelical Christian and, based on one or two chance meetings, seems to have gone through a more or less complete change of personality. Where once there was a cool guy in shades and leather jacket sucking energy from the room, there's now a sort of uncool doofus, who laughs at dumb jokes. Which, I guess, is my long way of getting to the real nut of heroin addiction (at least as I've experienced it) -- it's not just a way of life, it's a life. To get beyond it, you have to end that life, kill it, start again. No wonder there's a "higher power" component in most 12-Step-Programs.

Good luck with all of this. You're a good person to care about your junkie friend, but don't fool yourself. As long as they're using, they're a more or less heartless stranger who's only interest in you is as someone who can help them get what they want, which is just more and more pieces of their death. All take. No give.
posted by philip-random at 10:53 AM on May 20, 2011 [3 favorites]

The nice thing about remembering that their addiction isn't your problem (if you don't make it your problem) is that you can like them for the good things about them. I have found that when I make someone else's behavior (including addiction) my problem, they stop being "my friend John, who loves architecture, corny jokes, is great at gardening and happens to be an addict," and they turn into "my addict friend, John."

For some of us with a rescue complex, it's tempting to do this and then, really, they lose me as a friend, and gain me as a creepy control freaky (for their own good!) manipulator mom or something. It's really lose-lose, even as it feels like I have no choice- for their own good! Both of us end up in roles that dishonor our selves as adults.
posted by small_ruminant at 10:57 AM on May 20, 2011 [2 favorites]

they're a more or less heartless stranger who's only interest in you is as someone who can help them get what they want

The part that's heartbreaking is that even when they're deep in it, you so often see the "old" friend you knew back in the good old days- either in glimpses here and there between the BS or, worse, you see glimpses because they're using parts of it to manipulate you and everyone to get what they need.

It's awful in the way dementia is awful only in theory it's fixable, and therefore is so so tempting to try to fix. It's so simple! Why won't they see? If they would just stop! Probably you just haven't presented your argument logically enough. Or maybe if you were able to just show them how much they're hurting the people who love them. THEN they'd realize they need to stop... Ugh. It's easy to make yourself turn inside out over this.

I will second the nar-anon or al-anon suggestions. I include al-anon because the nar-anon meetings I've gone too haven't been very robust- small groups, not too disciplined, lots of bitching and not much change- and I think it really depends on your area. In my experience, Al-anon is a good catch-all program. Everyone there will know what you're going through and I have found that by "detaching" a bit and all those other things, I'm able to stay present, available and useful to people I would otherwise have had to kick out of my life out of self-preservation.
posted by small_ruminant at 11:06 AM on May 20, 2011

in theory it's fixable

This is not to say no one gets better. I know a TON of ex junkies who are doing just fine, now. My point is that sometimes it's fixable and sometimes not, and there's not much you can do except put your own oxygen mask on first - detach enough that you'll be useful to him once he gets serious about quitting. He'll be in a worse spot if you've let him burn his bridges with you, which I bet you he will try to do with a vengence.
posted by small_ruminant at 11:09 AM on May 20, 2011 [1 favorite]

and there's not much you can do except put your own oxygen mask on first - detach enough that you'll be useful to him once he gets serious about quitting. He'll be in a worse spot if you've let him burn his bridges with you, which I bet you he will try to do with a vengence.

Yes to this. Detach yourself from the user so that you may potentially be there for the ex-user, who will need your help, your time, your love.
posted by philip-random at 11:12 AM on May 20, 2011

philip-random: As long as they're using, they're a more or less heartless stranger who's only interest in you is as someone who can help them get what they want, which is just more and more pieces of their death. All take. No give

Just as a counter-point to that, I think we have a tendency to a) demonise addicts as some kind of moral failures, and b) embrace rehab as the One True Way where again, if it doesn't work for someone, it's a moral failure. People who kick do it all kinds of ways, in fact, and the repeat rate is high partly because it can take forever (or never) to find the way that works for you.

There are tens of thousands of high-functioning heroin addicts out there. I have been friends with one of them for 15 years. He holds down a freelance career, pays rent, pays taxes, runs a studio, is fun to be with, is interesting, has never borrowed money from me or manipulated me in any way. I get that this is not the case for many, many addicts but I don't know enough about your friend to make the assumption that we're in the Hallmark After School Special Steep Decline Senario here.

I think small_ruminant's words are worth repeating:

I have found that when I make someone else's behavior (including addiction) my problem, they stop being "my friend John, who loves architecture, corny jokes, is great at gardening and happens to be an addict," and they turn into "my addict friend, John."

One thing I will tell you is that the people who were most valuable to me when I came out of rehab were the people who acknowledged what was going on but treated me like I was still me and not like my addiction was suddenly who I was. "Dude, I'm sorry you're struggling. If I can help you or you need a shoulder to cry on, I'm totally here for you. We're going to the movies on Saturday; do you want to come?"

In other words, this is not a problem you can solve. You can and should draw boundaries to protect yourself, but your friend may always be an addict. You need to deal with that fact and proceed, in my opinion, as if that will be the case. Heroin is oh so fucking hard to kick and I am so thankful that was not my particular problem.
posted by DarlingBri at 11:16 AM on May 20, 2011 [13 favorites]

I am sorry to hear about your friend, and as other posters have pointed out it is not an easy journey dealing with a situation such as this.
I will never forget seeing one of my best friends in middle school and early high school years laying on a table with a tube in his nose, spaced out while I returned him to the ER. We had simply grown apart in HS once he started dabbling with drugs.
We had spoke once he was more lucid and even went out for lunch. He really wanted to get his life together, but then dropped a question of money to me. At this point, I knew I couldn't help him. I feel sort of bad about not trying, but his problems were too great for me to try and aid him in his recovery.
Two days later he was arrested shooting up at a gas station. I have no idea how he is today, but I hope he's well, and contemplate occasionally if I had continued to be his friend, perhaps this may not of been his course (I know its irrational, but he was like a brother to me during those years).

My second experience was a couple years ago when I met this kid in a psychology course on the first day and we quickly became friends. He had physical health problems and was on about 8 scripted drugs ranging from lithium to pain killers. His parents were huge enablers who would give him money to buy marijuana and other street drugs while allowing him to live in a beautiful house in a nice neighborhood alone. This only lead to him becoming more engrossed in the party culture (aspiring dj...he actually had some chops). Soon it got to the point when I would visit him that he'd be so zoned out he would be incoherrent and stumbling to the point of injury. I had to get out of that environment, and stopped seeing him. Id call occasionally to see how he was doing, but he wouldn't call back sometimes and when he did you could tell he was high on something quite strong. Later that Summer, when we hadn't spoke for a few months he called wanting some support. He told me he had been arrested in Detroit @ a McDonalds parking lot shooting up. He wanted positive influences in his life to get clean, and said I had been nothing but a good friend to him (others use to steal from him and lift expensive audio equipment to pawn) but I couldn't bring myself to help him. His parents greatly enabled his behavior and I didn't want to be collateral damage (he always tried to borrow money, my greater sense never obliged).

There are my two stories, I have a couple more but not as in depth as these. Its a very sad situation and I hope your friend the best, but always put yourself first. Good luck.
posted by handbanana at 11:21 AM on May 20, 2011

One thing I will tell you is that the people who were most valuable to me when I came out of rehab were the people who acknowledged what was going on but treated me like I was still me and not like my addiction was suddenly who I was. "Dude, I'm sorry you're struggling. If I can help you or you need a shoulder to cry on, I'm totally here for you. We're going to the movies on Saturday; do you want to come?"

I have not had addiction problems but did have depression/anxiety issues that people did know about, and will say that the people who'd take me out and not get into "so how are you doing" were really really helpful to me and the experience was refreshing after all the therapy, doctor's visits etc...

I don't know how this translates with addiction issues when there is physical deterioration actively in play, but it's still helpful I think to try to think of your friend as a person first and addict second.
posted by sweetkid at 11:22 AM on May 20, 2011 [1 favorite]

Cannot favorite DarlingBri's comment hard enough. Just be a friend.
posted by facetious at 11:45 AM on May 20, 2011

Heroin is a very difficult addiction to quit, but with proper social support it is possible. Unfortunatley, quit rates are only 3 or 4 percent per year (unchanged by medication or any currently known interventions). That said, opioid withdrawl cannot kill a person (alcohol withdrawl can, barbituate withdrawl can, and benzodiazepine withdrawl can).

Our current drug policy does not provide a safe, legal way to get heroin to addicts. In Great Britain, heroin was available through the prescription system for many years. Addicts were provided with safe, clean medication. Unfortunately, that ended. Failing to provide for these people - people with what should be considered only a medical problem - caused major social problems.

Given the low success rate of quitting programs, I believe that the best way to reduce the dangers of using heroin is to replace one opioid addiction with another. Doing so is proven to reduce HIV transmission rates. I know people who have led normal lives for many years while on methadone maintenance.

Methadone maintenance is less convenient than Suboxone (which is available at ordinary chain pharmacies). I say this because a <10% chance of quitting long term is pretty dismal. Right now, maintenance programs can help people stop engaging in risky behavior and start becoming useful members of society.
posted by candasartan at 11:58 AM on May 20, 2011 [1 favorite]

Tons of great suggestions. I'd strongly suggest getting to an Al-Anon meeting or reading the chapter "Working With Others" in AA's Big Book, specifically towards the end where they discuss how to avoid enabling and intolerance yet maintaining boundaries.

Good luck!
posted by fiasco at 12:17 PM on May 20, 2011

quit rates are only 3 or 4 percent per year

Who did this study include, do you know? I'd be interested in hearing more about these numbers. Does it mean that in any given year only 3-4% quit? Or out of all the people in rehab, 3-4% stayed clean for X amount of time? Does it include court mandated cases? How does this rate compare with alcohol or meth? I know enough people who've kicked it that I'm a little skeptical of it if it's being used to mean "you only have a 3-4% chance," but maybe I'm reading it wrong.
posted by small_ruminant at 12:37 PM on May 20, 2011

Agree with all the above -- be a friend, don't enable, let them be the person you love. As an addendum to that, be careful that you set clear boundaries. It sounds like you mostly see the nice, happy, (probably sober) friend that you love. Once you are in the know, there may be more of a blurring of lines, where you see the nodded-out addict. It doesn't fundamentally change who he is, but it may change his behavior. I had to be very careful not to let my friend (three-time rehabber for heroin) verbally abuse me or mental harass me when he was high. I kept out of his way, hung up the phone on him, refused to let him hang out, etc. when he was high. I was supportive as I could be, but my mental health came first.
posted by mrfuga0 at 1:19 PM on May 20, 2011 [1 favorite]

Yes, people do kick this stuff. I have a number of people in my life who have had problems with heroin. They are now lawyers or teachers or treatment counselors or work for the federal government, or are my co-workers. People do get better. People do change and heal. I've also lost people I care about to heroin overdoses. There's no getting better from that.

People stop using in different ways and for different reasons. 12 step works for some people but not all. Others do it cold turkey. Methadone and buprenorphine are the most effective treatments (as determined by research) available in the US, although access varies widely by state.

I recommend Dr. Gabor Mate's book In the Realm of the Hungry Ghosts to get a better understanding of addiction and recovery, if you're interested in getting more insight into that.

I encourage you to figure out how to continue to be compassionate and supporting to your friend. As a very wise friend of mine (and a former user of heroin) once said "people don't change when they feel bad about themselves." Mefi's own maias, among others, has written about the importance of support and compassion in helping people succeed at recovery. Take care of yourself, but don't lose hope in your friend and their ability to heal.
posted by gingerbeer at 3:29 PM on May 20, 2011 [2 favorites]

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