The Archaeology of Addiction

Virtually all alcoholics and drug addicts have either mental health issues or psychological problems. The unpleasant side effects and problems drugs cause are severe. No one in their right mind buys unspecified powders off rough looking strangers on the streets and injects them in to their body. I must make this clear. Drug addiction is not a healthy life choice. It invariably leads to unhappiness on a scale you previously could never have imagined. It is very rarely an extension of partying. Whilst the addict may hide within a group of recreational drug users they are quite different in nature. The issue of responsibility is one we have yet to resolve. Whilst it takes volition to find drugs and take them it is clearly self destructive behaviour. As with obesity and depression it puts huge pressure and expense on the NHS. The costs of treating addicts are far lower than putting them in prison, though, and the sooner addiction is seen in terms other than criminal the better. Many people in jail would not be there were they not drug addicts. There is a recidivism that sees criminals finding drugs as a reason to make sense of their crime, a reason to go out robbing.    There is no clear way to separate the addicts who can be 'cured' from those who choose to indulge. All systems so far have seen addicts find ways to cloud issues. Often the requirement for remorse expressed whether real and felt or acted out over shadows any findings. Our courts, indeed our common morality requires they deny their addict lives whether they feel so inclined to do or not. This confusion, our inability to decide how we think of addicts is preventing us solving the problems. Whilst, as Irvine Welshs book Trainspotting helped to explain, many addicts do not see the straight life on offer as desirable. Some have no wish to take part in a society that deems 'a big fat television, mind numbing and spirit crushing game shows' an alternative. Many reject the healthy, noble world of achievement straights aspire to.

I can now look back, think of my school year and guess to a high degree of accuracy who would go on to use heroin. Children are shaped as soon as they get to school, often before. Those who get in to trouble or get too excited are told they are bad. The death of a parent or being the victim of abuse can compound the label. Once you are 'bad', as I was, it all seems to follow. Each telling off stamps in a fresh layer of the bad in to you. Some find they are still going to court, being told they are bad right through their lives. It is only in the last year I have accepted that I am good. I am still learning how to be with this new understanding.

The instinct is to improve your environment. The aquisition of wealth permits us to buy and decorate our surroundings. Some see they will never be able to alter their immediate environment so choose to change their relationship to it. Others who never learn to save, never find the secret of long term thinking go for the quick fix.

 As a young recreational drug user, heroin was taboo and extremely rare. In the 1990s Britain was flooded with Afghan heroin and is still awash with it. The rare exotic intellectual addict in the William Burroughs mold, familiar but rare in 1970s London, numbering in the hundreds spring to older peoples minds. The reality now is that the drug is everywhere, throughout society. Sadly, at the bottom of the pile, whole housing estates have succumbed to heroin use. To be a drug user when I was in my teens was exotic and strange. Psychonauts, expanding our consciousness. Sadly many took up the heroin habit when the epidemic hit. Now, in those areas of Leeds the divide is different. Heroin is not cool but a hazard for all. With the arrival of crack cocaine in the late 90s the twin habit of brown and white is common. So from a few hundred addicts in 1970 we now have over a million.

Most, I would say have at least a little of that rejection of societies norms in them. A hunger for a more meaningful life than contemporary British society offers. A lack of interest in wealth. What often riles the straight is the rejection of all they hold up as  sacred. Seeing the flat screen tv they hold up as a false idle, stolen and sold for a bag of brown powder hurts their sense of values. This inversion of values reveals the trivial nature of much straight aspiration.

Another aspect of modern life is the lack of desperation. In a country where we have little difficulty feeding everyone, all poverty becomes relative. Consequently there isn't the need that makes sacrifice meaningful. I have witnessed selfless acts between addicts. Times where an addict has helped out another knowing they will suffer for doing so. This kind of interaction breeds a solidarity. A community with real ties. Only in places with severe poverty where the sharing of food means ones own hunger can gifts carry such importance. It may not be survival at stake as it is with the starving but it is much closer than any desperation I have seen elsewhere in society.

For these reasons it is often difficult to help. For some addicts the pay off isn't there. Many I have known are aware that there is nothing there to promise them as a reward for stopping. All you are doing to them is taking their culture away. They will have no bond with their old friends. Each morning would have seen them rising, perhaps hurting but with purpose. Going out to see friends who can help, maybe commit crime for cash. In some city areas I know, where there is little work it is only the addicts who move with any purpose. Taking care of business. Depriving this from them takes away the only meaning they have.

But the suffering, the deaths of friends, the lack of touch with ones own emotions, not truly being your self, living in a state of delusion, can all be reasons for change. Knowing that while they are addicts they will not find a greater meaning. It is hard to articulate the separation heroin brings but it is this emotional detachment that gives it value in both pain relief in medicine and to those who take it as a life choice. It was finding my emotional reactions to everyday life too intense to handle that drew me in. I have met several schizophrenics who find it preferable to the barbarity of anti psychotics.

Most addicts are in a state of denial if not to others then to themselves. As with serious eating disorders such as anorexia the addict can be aware of their descent yet unable to quantify or apply the knowledge to help themselves. Most find ways to accommodate their habits. If the habit is heavily ritualised as with the injecting heroin addict or even the smoking off running beetles on tin foil, it can be hard to hide. Indeed it could be argued that with such visibility the addict is regularly reminded of their condition, prevented from avoiding the issue. With heroin the hit is short lived but profound. The gouch, the meditative trance like state and running around along with the practicalities of consumption keep all but the none working, be they very rich or very poor away from the practice.

More often, particularly in Britain the addict will begin this way before finding medical help. Not all but most heroin users, once they are addicted, seek medical help. Frequently as soon as addiction takes hold both to get free of the horrific surprise at their dilemna and as a safety net. Once they talk to their GP they will be referred to their local addiction services. This can take anything from 2 weeks to a year depending on how stretched the service provider is. In Leeds this is Leeds Addiction Unit, in Somerset it is Turning Point, formerly Somerset Drug Service and in Bath, with the best name of all BADAS, the Bath Addiction Drug and Alcohol Service. Here they will be allocated a key worker. The key worker will assess the depth and history of the addiction. Normally they will start with the softest touch, suggesting the addict taper off. This is incredibly hard and very few succeed.

The next step is to prescribe substitute medication. Usually they will be asked to provide a urine sample and say how much gear a day they are on. The addict will usually lie, giving a higher amount so they are not left under prescribed. On their first prescription they are expected to achieve cross over from heroin to methadone or subutex and then given a swift reduction.

Usually, if it is the addicts first habit they will underestimate the pull of the drug. Heroin withdrawal is difficult to explain. I have seen films and read books that try to capture it. They all have been wide of the mark. These first reduction courses are brutal. Often taking a few days to a month.

Usually the addict will fail these. Normally there will be several attempts and many relapses.

The next step is controversial. Containment. The addict is given a maintenance prescription.

They must continue to see their key worker and will be put on a daily pick up of their methadone or subutex. They will be required to take it in view of the pharmacist. A carrot and stick system follows. Once the addict has given three clean screens they may be able to take their medicine away. Further clean screens will earn them perhaps a bi weekly pick up.

Most addicts will go for many years on maintenance scripts. Dropping in and out of heroin habits as trauma, opportunity and other factors dictate. Methadone or physeptone, another brand is virtually interchangeable with heroin. Some claim it won't fully stave off withdrawal symptoms. The effects do not give such a clear effect. An addict maybe prescribed anywhere up to 150 ml. The policy a decade ago was to match 10 ml to a £10 bag. Bags of course vary in size and quality but as a rough guide it wasn't too bad. These days much higher doses are more common.

There is a ridiculous, unhelpful impasse in treatment. Unless you are rich and can pay for a private doctor to prescribe pharmacutical heroin , doctors are insistent the drug you take not be pleasurable. In the event of showing pleasure any medication would be stopped. This ties the doctors hands. Most see addicts as a drain on their resources and stick to whatever the current fashion with doctors is. They love to give out new untested over time drugs that alter brain chemistry such as Prozac but are reluctant to prescribe a drug that we have thousands of years of trials with. Opiates may have there faults but we know what they are.

If the addict uses on top, and methadone does not give the same pleasurable gouch of heroin so they often do use on top, it shows up in the screens they are required to give. The key worker will ask if the dose the addict is on is sufficient to hold them. The addict either has to admit that methadone doesn't hit the spot, that they just enjoy heroin or do as is required for everyone to stay happy. They say the meth doesn't quite hold them. The doctor will prescribe a bit more. An addict will not often say no to free drugs so the dose goes steadily up.

Once they are on 120 ml or more their system is pretty saturated with opiates, (bare in mind 10 ml can kill a none addict.). They may still use on top as they have often developed a quasi religious belief in heroins' properties. Most or any effect they get now will be psychological. Methadone settles in your fat deposits, it saturates your bone marrow, it has a huge half life. Because of this it is a much longer, much more savage withdrawal. Once this addicted to opiates you need godlike powers to get off it. I have known many addicts but few who have had a large methadone script for a year or more who have ever come off it.

Less popular with addicts is subutex. The replacement opiate of choice in drug treatment in France this is what is known as a partial agonist and it blankets the opiate receptors. If given a dose of 10 or more mg heroin has no effect. The addict must stop heroin for 12 or so hours, wait till withdrawal sets in then take a dose. This provides no relief and shakes off any remaining opiates. Three days follow of symptoms roughly the same as withdrawal; mentally worse but not so bad physically. On the 4th day the addict normally feels ok if they have stuck it out.

After this it can be used as a maintenance drug that acts as a heroin blocker. If the addict takes 12 or 16 mg no amount of heroin will get through. The effects are subtle but uplifting compared to methadones treacle wading sludge.

To sum up, there is no easy answer. Maintenance opiate prescriptions shock people who know nothing on the subject. Most opiate addictions take a good decade to solve, and that is only if the addict wants to. Any withdrawal involves the inverse opposite to the drugs effects. All the pain that was held back will come down on you. What is most misleading in all fictional descriptions is the duration. Ten years ago I found myself hopelessly addicted. I had been told it was like a bad flu to come off, that the worst was over in a week. It is far bigger than you can comprehend. Every part of you to the furthest corners of your soul needs to change. You can not change your nature; here the 12 steppers are right. You need a quantum shift in your self understanding. After three weeks I managed a couple of hours sleep. Even in amphetamine marathons I never knew a human could be awake that long. Six months after stopping each day was still total depression.

Now that I have decided to work in drug treatment and addiction councelling I have decided to run through my thoughts on the subject. Beware, there will be more on the subject.

Having gone through addiction and being unable at the time to find any accurate help I have chosen to put what I have learned to good use. I have theories as to the nature of addiction that I haven't seen written anywhere. There is a way to beat this but it isn't anything like I thought.