I spent some fifteen years living with a drug addict. Due to that fact I know many other addicts and understand their addictions and how they think about their addictions. Without exception, every one of the hundreds of addicts I have come to know have each, at some point (often multiple times), expressed a desire to get clean. In fact, despite our broken addiction treatment system, I have facilitated many doing so over those fifteen years. Among those is my roommate who had to beat heroin, crack, GHB and alcohol. I’m proud of her and all those who find recovery.
A high percentage of addicts are addicted to the devil, “heroin”.
In Victoria, it seems that at least 90% of addicts have multiple addictions with some 80%+ of those addicted to heroin. [Authors Note: The percentages spoken of here and throughout this posting are not from any official poll. They are from my observational experience.] Understanding drugs and their various effects and withdrawal symptoms as I do, I can tell you that heroin is the devil.
Unlike most other drugs, withdrawing from heroin (opiates) is physically brutal. The addict goes through ten days to two weeks of absolute hell. They soil themselves for days and dry heave consistently because they can’t eat anything. They writhe in pain, curled up in a fetal position as the heroin gradually leeches out of their bones. Their body temperature drops and they drool and shiver. While all of this is occurring, their legs kick uncontrollably as their muscles spasm. [The legs kicking is why they call getting off of heroin is called “kicking”]. On top of all this, they must suffer through severe abdominal cramps.
There is an alternative though; it is called methadone. Methadone is a legal opiate substitute available by prescription and covered by PharmaCare.
The addict drinks methadone once daily. After a period of time, generally over two years or longer, the addict then begins to gradually reduce the daily methadone dose. This gradual reduction continues over a period of six to twelve months, or even a number of years. Eventually they reach a point whereat the physical withdrawal symptoms from discontinuing its use will be minor. It should also be noted that the patient cannot, from day one, take a dosage that will substitute for his/her heroin needs. Methadone is highly toxic and the addict must be slowly built up to a dosage that will sustain him/her. Generally this build up occurs over about a month, depending on the size of the addict’s habit.
Desire to be Drug Free is Not Constant
So, why isn’t every heroin addict rushing to methadone in order to cure himself/herself of their heroin habit? Because our broken addiction treatment system is foreboding. Although most heroin addicts would love to get on a methadone treatment program, doing so requires that addicts jump through a series of hoops.
These hoops sound reasonable and easy to a non-addict. However, they appear almost insurmountable to all but the most motivated addict. To addicts, motivation is something that ebbs and wanes, but mostly wanes, because their lives and their minds are controlled by their addictions.
Let assume for a moment that there are one hundred heroin addicts who all wake up one morning and decide that they have had enough. Each on has decided to get on the methadone program.
Losing Sixty of the One Hundred, Forty Remain
They walk, skateboard, bike or bus to the methadone clinic. There they are greeted with a genuine smile and a prescription to get some blood work done. Anxious, they then ask how long it will be before they can actually be using methadone. They are told that once their blood work is back from the lab they will be able to book an appointment to see the doctor. That waiting period can be anywhere from two to six weeks. Our broken addiction treatment system just lost sixty of the original one hundred aspirants.At that point, sixty of the aspirants.
They never even get their blood work done. You see, they wanted to start getting clean quickly. They didn’t have the patience to wait two to six weeks for anything. Lack of patience is the nature of addiction.
Now we are down forty who have gotten past the first hurdle of the indeterminate waiting period. They ask the lab how long before the lab will be able to send the blood work results to the doctor. They are told two or three days. Now, that’s cool. All the addict has to do now is to remember to check back with the clinic in few days.
Losing Another Ten of the One Hundred, Thirty Remain
Sadly, we will lose another ten addicts out the remaining forty here. Our broken addiction treatment system doesn’t recognize that an addict remembering to check back with the clinic and remaining motivated to do so is by no means a given. Instead, they could be laying dope sick somewhere. Or perhaps, they are sitting in jail or so high that they blow off ever checking back with the clinic. Remember please that an addict is driven to get high, and until high, little else matters. And in the case of heroin, the addict needs to stay unsick. He/she needs to not go into heroin withdrawal. Until the addict is assured he/she won’t get dope sick, there will be know appointments kept. The problem is that if the addict doesn’t go to the clinic by a certain date, he/she will have to redo the blood test.
Yes, the clinic could have called the addict to inform him/her that the blood work is in. The problem is that even if the addict had a cell phone, it is probably a “pay and talk” phone. If it happens to have time on it, it might not be charged. Perhaps he/she hasn’t been able to charge it because of homelessness, or perhaps, one of their buddies because stole their charger.
Anyhow, the thirty addicts out of the original hundred addict sample who still remain motivated after the blood work obstacle, and after getting back in touch with the methadone clinic must confront the next obstacle. In our broken addiction treatment system, they are now met with a two to six week waiting period before they can see a doctor.
So, out of the previously remaining thirty, we now lose half (fifteen) because they will never see the doctor. Staying motivated for a few days while waiting for blood work is one thing. However, staying motivated for two to six weeks is a horse of an entirely different stripe. This does not take into account the other factors of having to remember the appointment date. Hell, they could be high or passed out when that date and time finally arrive. Anyhow, we are now down to fifteen out of the original one hundred.
The problems have just begun folks. Methadone is only free if you are on PharmaCare. Additionally, no heroin addict is going to consistently spend $10 for methadone when he/she can get a half point of heroin for that money. So, the addict needs to get on PharmaCare for the free methadone. There is only one problem here. You must have filed your taxes to get on PharmaCare.
Oops, another obstacle in our broken addiction treatment system
In most cases it costs money to file taxes, roughly $30. Do you seriously believe that a drug addict is going to invest $30 in something that is weeks down the line? It’s not going to happen. Yes, there are some free tax services but those require a specific appointment and a several day to two week wait before one can actually see the person who will help file their taxes. We already know what waiting periods do to addicts.
Seeing Somebody to Help File Taxes
So we lost another five aspirants because of the tax filing requirement. That brings our total of those remaining in the methadone hunt down to ten. Tell an addict that you can see him/her any time on Monday, fine, the appointment might be kept, but tell an addict that he/she needs to be at your office at 2:00 P.M. on Tuesday, or whatever day, and it probably won’t happen.
Actually Getting Taxes Filed
So, out of the ten that remained and made the tax appointment, we just lost another five. Thus, we are down to five who actually keep the tax appointment. Our broken addition treatment system isn’t through getting in the way of recovery yet though.
Now, the next hurdle must be confronted and at that obstacle we lose another three of our aspirants. We lose them because they have no ID or because they cannot remember the last address from which they last filed their taxes, both are prerequisites to actually file taxes.
Two Out of the Original One Hundred Actually See the Doctor
Out of the two remaining aspirants, both have jumped through all the hoops and both keep their appointment to finally see the doctor and to get on the methadone program. Do you remember earlier that I told you that you have to be eased onto methadone and that it takes approximately a month to achieve a dosage that will actually replace the heroin habit?
Well, if we are lucky we only lose one of the two during this process. That’s because when methadone will not totally replace the heroin, the addict maintains his/her heroin habit and misses appointments to actually drink their methadone. When one has missed several appointments in a row, that person must start over at ground zero with what was the original dose.
So, on a good day, the broken addiction treatment system is able to successfully get one addict out of one hundred into a methadone recovery program. The good news here is that seventy-five percent of the time, that addict will be successful in kicking heroin.
Folks, the system is not just broken; it is shattered. It is laying in pieces up and down every drug corridor of every BC township.