If an opioid user begins injecting heroin, has the addiction progressed?
Opioid addiction, whether it be the abuse of prescription painkillers or the use of heroin, tends to be a progressive condition, much like alcoholism or other addictions. However, the severity of any addiction exists on a continuum. Can the decision to suddenly use a needle indicate that the disease is progressing? It can, but not always, and there are many other factors to consider.
For example, the amount used of a substance, as reflected by either dose or frequency, is often the best indicator of how severe the addiction has become.
And the more of a substance someone uses, and the longer he or she has been using, the more difficult it may be to crack the addiction.
Still, that does not mean that those with the most severe addictions will be the least likely to recover or the most likely to die – anytime someone messes around with high doses of opioids or street heroin or fentanyl, he or she is putting himself at risk for a fatal overdose.
Methods of Administration
Addicts who use needles to administer drugs are very stigmatized, whether or not their addiction is any worse than the middle-aged mother down the street who is addicted to painkillers. I surmise there are a few reasons for this, including the long-standing view of the heroin addict as a homeless street person who steals or prostitutes themselves to support their habit.
Also, putting a needle in a vein is a very off-putting practice to many people – often those who don’t like having blood drawn or getting shots for that very reason.
Also, pills do their damage from the inside only, while needles leave nasty marks and bruises that are a red flag to everyone that this person is a heroin addict.
But truthfully, someone’s level of addiction is not solely determined by the means used to administer the drug. Heroin can be ingested in other ways (specifically smoking or inhaling) none of which are good.
The act of injecting heroin, however, pulls the drug directly into the bloodstream, resulting in a rapid delivery of the drug and a very intense high. Some heroin users start out this way, but others “progress” from other seemingly more benign methods, including the use of prescription painkillers.
Regardless, if you or someone you know is regularly snorting or smoking, this is a serious problem, just like when someone is regularly injecting heroin. Regular use of any substance implies that a dependence is forming.
However, if the person in question has transitioned to injecting to receive a faster and more intense high, there is an even greater chance this is due to increased tolerance and dependence.
When tolerance occurs, increasing amounts of the drug are needed to achieve the same effect. So it goes without saying that when someone begins looking for a new, more effective method of delivery, it could mean that they are attempting to overcome their level of tolerance.
And the simple fact is, heroin users say that the injection method is by far the best method to get the euphoric rush, so once this is experienced it may be truly difficult for the user to return to any other method of delivery. This rush only lasts a short time, so once experienced, users often seek to feel it again and again.
It’s not uncommon for heroin or opioid abusers to swear that they will never resort to injecting heroin, due to the increased risk of disease, skin and blood vessel damage, and the general stigma surrounding IV use. But once someone has begun to administer heroin in this way, they are likely to stop worrying about disease and those other trappings.
Like other once important life decisions, caring about such things tends to fall by the wayside in favor of the addiction.
Casual Use and Addiction
Statistics show that about 1 in 4 heroin users will become dependent. Yes, people can become hooked after the first or second use, but they can also be casual users. Because heroin is illegal and so addictive, it’s hard to imagine this could be true, but honestly, I’ve known a few in my life.
Dabbling may not be as destructive regarding lifestyle, but it is just as dangerous. Whether you are injecting heroin once a week or once a day, the risk of overdose and ongoing health conditions, including infections, are still present.
There are certainly other factors at play that help determine the severity of one’s addiction, and how functional he or she is in society. Gender, education, mental functioning, income, family and social environment, personality, genetic/biological characteristics – all these things factors can contribute to someone’s vulnerability to addiction, or their ability or inability to function.
Some people are not genetically prone to becoming physically dependent on heroin or other drugs or have personality traits inconsistent with addiction. Moreover, the use of needle does not necessarily indicate addiction, especially for very casual users or first-time users.
Verdict? If a person has begun using a needle to administer heroin after abusing painkillers or using other methods of heroin ingestion first, the chances are good he or she was addicted long before picking up that needle. Moreover, if a person has recently begun using heroin intravenously and feels this transition reflects a progression of the disease, it probably is.
Call it chasing the dragon or whatever you will – but if your use of a needle is an attempt to step up your game, so to speak, then seeking recovery from your addiction is probably long overdue.
~ G. Nathalee Serrels, M.A., Psychology