A social worker has given an incredibly honest and thought-provoking account of what it is like to have a heroin addiction.
Sarah Boumphrey made the profound comparison between heroin addicts and hostages, saying they are being held against their will by a drug which is hijacking their brains.
Most people reading this are unlikely to have taken heroin as it famously can lead to addiction from just one hit.
Reddit user PimpSLAYR187 posted a personal account of the addiction written by her friend Sarah.
The post read:
I’m not an expert on anything, but I’ve held weeping parents on the day they permanently lost custody of their children due to their inability to get clean, and I’ve held weeping children on the anniversary of their parent’s heroin death.
I’ve read the results of random drug tests which, based on the heroin metabolite present, indicated that the parent tested had used heroin within 6 to 25 minutes of coming to visit their children at a supervised children’s services visit. It’s wholly tangential, but I feel like I have at least a bit of experience with heroin and its effects.
Most people don’t understand what it means, on a neurological level, to be addicted, because it’s a really, really complex chemical and biological process, one that I am ill-equipped to explain.
I’m going to try to anyway, so bear with me if you’re in for a read, and correct me if you’re in a position of experience and education to do so, because there’s no way to make it short, and I’m likely not going to get it 100% correct, biology-wise.
Sarah uses an analogy of a locked door, and heroin is they key to happiness.
She went on to write:
Every emotion you feel is the result of the relationship between chemicals that occur naturally in your brain (neurotransmitters) and the receptors they bind throughout your nervous system. Think of the receptor as a locked door, behind which lies something important, and the chemical as the key that unlocks that door.
Let’s say you’re out walking on the sidewalk with your child somewhere, and suddenly your child darts out into the street in front of a car. That flood of terror you feel is caused by the stress hormones epinephrine and norepinephrine (known as adrenaline), with adrenaline “unlocking” adrenergic receptors.
These stress hormones are meant to put you on high alert to activate your “fight or flight” response. They increase your heart rate, breathing rate, your focus, and get your blood moving around your body to your skeletal muscles so that you can react FAST to the potentially terrible situation at hand.
Sarah explained that heroin releases ten times the amount of dopamine you would feel naturally.
The post went on to say:
You grab your child and pull him back to safety JUST before the car hits him. That flood of relief you feel is caused by a couple of things: GABA (gamma-Aminobutyric acid), a neurotransmitter whose job is basically to tell your receptors to disengage the adrenaline key, and lock that terrible heart-pounding, high-alert reaction back up, effectively communicating “Hey, now, calm down. No more need to look at what’s behind this door, anymore. Shhh…” and gently closes the door again.
GABA is responsible for regulation of anxiety through inhibition of various stress and feel-good neurotransmitters.
You are so thankful your child is okay. Dopamine, the feel-good hormone then “unlocks” the dopamine receptor and tells you to relax and calm down now that your child is safe. When you then tell your kid afterwards, “You’re responsible for all my new grey hairs,” you’re kind of right.
It’s been found that cortisol, another lingering stress hormone, is one of the factors involved in the depigmentation and loss of your hair.
The Reddit post, which has garnered a lot of praise, read:
Dopamine, oxytocin, serotonin and endorphins are also responsible for causing all those happy moments in your life: The moment you saw your future spouse down the aisle on your wedding day, when you went over the top of that roller coaster, when you went skydiving, the day you graduated from college, that incredible orgasm you had, the first time you saw your child’s face after delivery, that amazing food you just ate, the day you got the news that the chemotherapy had worked and the cancer was gone.
That’s dopamine and endorphins at work. It is relaxation, happiness, euphoria, relief from pain. Not incidentally, the regulation of dopamine in your primitive brain stem is also required to keep breathing.
During those happy moments, a certain number of dopamine and opioid receptors are unlocked, but not all of them. Imagine what you would feel like if 10 times the receptors were unlocked during those moments. It would be intense, right? Well, heroin unlocks about ten times the dopamine you would feel naturally.
Sarah explains how heroin breaks down into two chemicals:
Heroin (and many other drugs) can pick the “lock” on your dopamine/opioid receptors, and throw that happiness door wide open. It does this by breaking down into two different chemicals, 6MAM (6-Monoacetylmorphine) and morphine. 6MAM is the chemical that gives users that initial rush, and morphine is the chemical that causes the lingering relaxation. (6MAM also breaks down into morphine over the course of 6-25 minutes).
What’s more, when GABA starts saying “Hey, I think you’ve had enough,” and tries to close the door, 6MAM and morphine say “Nope, asshole, we’re not done here, yet,” strong arm the door open, and beat GABA back.
The post continues to talk about what an overdose is:
If too much dopamine is released, it can actually affect your brain stem receptors to a point where you stop breathing. That’s a heroin overdose. Your body “forgets” to breathe.
Over time and repeated use, the receptor lock kind of gets worn down, so to speak, and doesn’t respond to the chemical key as well anymore (pharmacodynamic tolerance), so the same amount of heroin won’t produce the same amount of unlocking.
This means that more heroin is needed to produce the same effects. Alternately, if you stop using heroin, your dopamine and opioid receptors will still be worn down and unable to respond adequately to normal levels of dopamine for a long, long time.
The post continues:
In other words, you will be incapable of feeling genuinely happy for a long, long time. It may be years before your receptors and natural brain chemicals can interact normally.
Chronically high levels of stress hormones can also dull your ability to feel happiness. Let’s say you can’t pay your bills, you’re in a violent relationship, you’re being abused by your parents/guardians, you’re losing your home, you’re trapped fighting in a war zone, you have a seriously ill child…any of these things can cause your life, and your neurotransmitter/receptor interactions to be a total mess.
It’s cortisol pumping through your body 24/7, just corroding the receptors in your brain. (There’s also the matter of the effects of adverse childhood experiences (ACE) on the development of the brain and how that affects lifelong neurotransmitter/receptor interaction, but that’s another topic for another day).
She helps you understand how people get addicted:
And then someone tells you they have something that will make you feel really good. You haven’t felt good in ages. You don’t even remember what it feels like. And they’re right, you will feel good for a while.
And for someone who’s had very little happiness in his or her life, or has lost the ability to feel happiness naturally for whatever reason, this feels transformative, and you never want to go back to life as it was, because life was terrible.
And, because of the hideous effects of tolerance, withdrawal, and brain changes, you may not be physiologically CAPABLE of stopping.
Sarah explains that the ‘hostages’ can be saved, but it is important not to blame and label them:
Not without significant help: from doctors, therapists, drug counselors, education, a network of support cheering you on, resources that help you to change your socioeconomic status, physically moving away from the area and people that trigger your urges to use, etc.
Even if you initially kick the habit through the use of these resources, because of the changes in your brain and the initial inability to feel happiness, you may not even recognize the ultimate reward of getting clean. Not for a long time.
The point Sarah is making is that ‘heroin is a fucking hard habit to break, because your brain has been hijacked. It’s NOT because you’re not strong enough, or good enough, or don’t love your kids enough to get clean’.
She made the situation much more relatable to those who have not suffered from such an addiction.
Numerous commenters on Reddit expressed their gratitude to her for helping them to understand their loved ones who struggle with heroin addiction.
She ended on the great point that ‘no sane, non-sociopathic person has ever said, “If he loved his kid enough, that hostage would have found a way to escape”‘.
Sarah called for the nation to recognise heroin addiction as a ‘drug-caused Stockholm Syndrome’ and that the ‘hostages are lucky to get out alive’.