I was at my hometown bus station a few nights ago, in Springfield Massachusetts – the town where I spent the bulk of my time as a heroin “addict.” A young girl – let’s call her Jennifer – started chatting me up, and although she was well put together, I could tell from the look in her eyes that she was a heroin user. She was probably gearing up to ask me for money, with a story about how she couldn’t get home. One thing lead to another, and it came out that I was once a heroin addict. Jennifer quickly said that she has had a problem with heroin for four years, has been on and off methadone nearly that whole time, had just started at the clinic again this week, and had used two bags of heroin that day.
Our conversation only lasted 15 minutes, and she did most of the talking. The bulk of what she discussed was her heroin addict origin story. She’d been through a bad marriage, and when she finally divorced, she started hanging with her old friends again (at about age 29), and snorted something with them that she thought was cocaine, but turned out to be heroin. From there, she discovered that it “took away all the pain” and helped her to “escape,” and within a few weeks of use she began experiencing withdrawal. And that is a sufficient explanation of why Jennifer is the way that she is today, according to her.
She repeated the part about unknowingly sniffing heroin, at least 5 times, as if this is a sufficient explanation of why she’s been struggling to quit for the past four years. It’s not an accurate explanation though, no matter how sincerely she believes it. In fact it’s nothing more than a socially acceptable justification, excuse, or rationalization. If she stays focused on this origin story, I fear she will never get anywhere close to getting over her problem. The circumstances of her addict origin story do not explain why she continues to struggle today – but the fact that she’s so focused on those circumstances today does explain why she continues to struggle.
I want to be clear before I continue, to say that I am not trying to put Jennifer down in any way. What she’s doing, by focusing on this origin story, is very common with heroin/opioid addicts. I once had what I thought was a significant heroin addict origin story myself. It had to do with being psychologically abused as a child, being an outcast throughout my school years, and a number of other life difficulties, as well as finding that heroin helped me to “escape.” I should note though, that I didn’t come up with this origin story until a few years after I first started using heroin. I didn’t diabolically create the story, I didn’t intend to lie, but rather, it sort of came to me when family started finding out about my heroin use and tried to make me stop using it. I think the creation of such an origin story is a very natural response in this situation. It’s a means of self-defense, and it makes you feel a little bit better about yourself as everyone sends the message that you are a monster. Before I created and believed the origin story though, I simply liked getting high on heroin. I didn’t see myself as being forced to use it / addicted.
The currently popular opioid addict origin story revolves around prescription opioids, like in this example reported by German Lopez on Vox:
Mandy, who asked I use only her first name, said she struggled with addiction for six years. It started with back pain, which a doctor tried to treat with Vicodin.
“I had tried [opioids] in high school,” she said. “I had an older boyfriend, and I tried some of his wisdom teeth painkillers to get high off of. And I was like, ‘Whoa, this is awesome.’ When I got a Vicodin prescription for my back, I was like, ‘Oh, I remember these being really great.’”
Mandy took the drugs as prescribed at first. But every once in a while, she would sneak in an extra pill or two to help deal with a bad day. Then she started taking extras on good days, and, finally, at work.
The story often goes that the opioid addict didn’t intend to get high, or didn’t know they were taking an “addictive drug” or some way or another innocently “got hooked” on these drugs. They were often the victim of psychological pain that opioids miraculously relieved, as they tell it:
Finally relief. Not only for the pain of the broken collar bone but, most importantly for my mind. I loved the filling of euphoria. I finally felt comfortable in my own skin. I could talk to anyone I felt what I thought I was supposed to fill like. Extremely happy. I knew I found the secret to my happiness. Well I was wrong it ruined my life.
The stories often focus on initial exposure to opioids, as if it’s the same as being exposed to a deadly virus, and dooms us forever.
If you’re struggling with opioids, and focusing on an origin story, you need to stop doing that now.
Your origin story is holding you back. It will only keep you stuck in place. It doesn’t matter how true the origin story is, because there is one important defining feature of the origin story that is always untrue: that you are doomed to a lifetime of “addiction” to opioids. As long as you believe you are doomed to a life of addiction, you will be. You cannot be motivated to achieve a goal (quitting) that you believe to be impossible.
This sense of doom is based on two falsehoods:
- That opioids are especially “addictive” by virtue of their pharmacology that leads to withdrawal symptoms.
- That opioids are inherently euphoric and provide relief or escape from all the psychological pain of living.
So on the one hand, the opioid addict is doomed by withdrawal to keep using, and then if they are able to make it through withdrawal without using, they are doomed because they’ve tasted the forbidden fruit that takes away all the pain of living, and will inevitably be drawn back to the drug. If they hadn’t tasted the forbidden fruit, they wouldn’t be in this inescapable trap, but alas, the stars aligned and pushed them into their first use of opioids. That’s the end of the story for the opioid addict who remains obsessed with their no-fault origin story. They were exposed to the pathogen, bitten by a radioactive bag of heroin, and are now forever changed.
[NOTE: I don’t care about fault or blame. The origin-story-obsessed opioid addict does care about it, because they are forced to defend themselves to others. Other people who judge opioid addicts negatively are obsessed with fault or blame, but please know that I am not. I don’t think using opioids is inherently bad, and I don’t know how you can fault or blame someone for doing something that isn’t bad. But I’ve digressed here, only because I know I’ll be attacked, and hate having to repeatedly reply to this common attack in the comments. Now let’s get back to those two falsehoods.]
Opioids aren’t inherently addictive.
It is true that at least half of the people who use heroin in a given year fit the diagnostic criteria for addiction (formally, Substance Use Disorder, Opioid Use Disorder, Substance Abuse, or Substance Dependence). But consider this – prescription opioids are prescribed to nearly 100 million americans per year, and yet only 2 million currently have prescription opioid addictions. These drugs are nearly identical, and in fact many of the prescription opioids are far more potent than street heroin.
The origin story makes the initial exposure to “addictive” opioids out to be an all-important event of doom. Yet the massive gap between the number of yearly users who are “addicted” – 50% for heroin versus 2% for the same thing in prescription form (these are rough numbers) – suggests something else is going on. More people “get addicted” to heroin than prescription opioids because their reasons for using are always to find a high or comfort. We can’t say the same about prescription opioid users. They are using the drugs, in most cases temporarily, to deal with acute physical pain. Some people will look to prescription opioids for the same reasons people look to heroin use – to find a high or comfort – and those are the people who will “get addicted.” If it were the drug that did the addicting, then prescription opioids and heroin should both “addict” the same percentage of users. But they don’t. In fact the rate of prescription opioid users who are addicted in a given year (2%) is 25 times lower than that of heroin (50%), and also more than 4 times lower than the rate of alcohol users who are addicted to alcohol in a given year (9%).
These drugs can lead to withdrawal symptoms, but even NIDA admits that withdrawal isn’t sufficient to make someone “addicted.” It is an easily solvable medical condition, and from my years of heroin use, I know, anecdotally, that most opioid addicts have fully detoxified more times on their own cold turkey than with medical assistance. Withdrawal certainly is a problem, but in the bigger scheme of things it doesn’t mater much. Most people who’ve ever become physically dependent on opioids (surgery patients for example) haven’t even known it, and thought they were just sick with something like a flu as they detoxified.
Opioids aren’t inherently euphoric, nor do they take away emotional pain.
There is a downright stupefying amount of evidence proving that the highs and other psychological effects of drugs are subjective. What I mean by that is that the effects are dictated also by our mindset – by the beliefs, expectancies, and intentions in our minds when we take the drugs. I recommend reading The Cult of Pharmacology by Richard Degrandpre as a great in-depth source for this point. I also recommend chapters 17-20 of my own book The Freedom Model for Addictions: Escape the Treatment and Recovery Trap where we focus on the ‘drug, set, and setting’ model of drug effects for a quicker overview of this point. As one quick example that opioids aren’t inherently euphoric, Degrandpre cites “an early British investigation into the initial experiential effects of opiates.”
Two consecutive doses of morphine were given to 150 young males with no previous opiate experience. After finding that only three chose to have the experience repeated and that none believed they would seek out the drug recreationally, the authors concluded, “Opiates are not inherently attractive, euphoric or stimulant” in nature. Clearly, a love of opiates had yet to be cultivated for these individuals.
I could never give a succinct enough explanation of the subjectivity of drug effects in this blog post, but suffice it to say that drugs aren’t all they’re cracked up to be. They certainly are not as wonderful as the addict’s romanticized view makes them out to be. Please take my word for it now, and check out the sources later so we can move ahead with the significance of this fact.
Here’s the significance: The typical opioid addict origin story keeps the romanticized view of opioids alive. The origin story completely hinges on the view that opioids provide the best objective possible feeling available to humans. Exposure to this feeling, knowledge of this feeling, supposedly dooms us to a life of addiction even when we are able to get through withdrawal. In fact, it’s just the holding onto this view that keeps us doomed. The average person accepts and endorses this origin story because they think it helps to scare others away from trying opioids in the first place. “Don’t try heroin / painkillers, you’ll never forget how great they are!” They also accept it out of sympathy for opioid addicts – not wanting to “blame” them for their current state. Yet most average americans – nearly 100 million of whom are prescribed opioids in a year – didn’t have this experience of opioids providing an irresistible level of euphoria and escape from existential dread that addicted them. In fact, the majority of painkiller prescriptions don’t even get fully used. Local police departments regularly set up deposit boxes for people to safely dispose of their unused opioids. What kind of highly addictive drug that “takes away all the pain of living” would people regularly throw out??? Maybe, just maybe, you should consider that these drugs aren’t as miraculous as they’ve been made out to be.
What is the purpose of the opioid addict origin story then?
In part, we hold onto this story because we believe the hype about opioids. However, we probably create and hold onto it as more of a defense mechanism. We know how we are seen as opioid addicts. Then when people find out about our use, they begin shaming, coercing, and all sorts of attempts to control us. Nobody likes being controlled by others. Nobody likes feeling like a monster. The opioid addict origin story helps us to escape these negative feelings about ourselves, and it helps us to convince people to give as a damn break from the shaming. It’s not that we invent these stories whole-cloth though. They just conveniently fit with a narrative about opioid addiction that we’ve seen in the culture, and that is acceptable to others. The origin story of getting accidentally addicted because a doctor prescribed opioids for pain is a common one that you hear everywhere now. However, the evidence shows that this is a fairy tale. For example, one review of research on chronic pain patients found that only about a quarter of one percent (.0027) of them developed addictions to their painkillers. The origin story is just about feeling better about our problems and giving pleasing explanations to others. It isn’t about reality, and thus it NEVER points us toward a solution.
Parents and other loved ones also often focus on these origin stories. We hear them all day long at the offices for The Freedom Model Retreats when they call looking for help. Oftentimes, the parents think they played a part in their loved one’s addict origin story, and feel great guilt as a result. They also point to other extenuating circumstances, harp on those circumstances, lament them, wish they’d never occurred. This often comes from wondering “what happened, what went wrong?” They often talk through the origin stories with their loved ones, and this only reinforces the power of the origin story to keep troubled opioid users stuck in place.
But you need to know that if you’re focusing on an origin story – even if many of the details of it are true (your life circumstances, emotional state, the degree to which you enjoyed the opioids at the time, etc) – it is also robbing you of the chance to get beyond your problems. Maybe you’re just saying it out loud but not believing it. My experience was that I believed it. I also developed a much more involved narrative around it that I continued to tell myself when I felt down about my situation. That helped to keep my heroin problem going for another 5 years.
The origin story looks backward to events that can never be changed. We think the events of those stories are the most significant issue pressing on the state of things today. That’s exactly what Jennifer demonstrated as she kept repeating the circumstances of her first use of heroin to me again and again. Those circumstances have very little to do with why we continue to feel addicted today though.
The reason we feel addicted today has to do with how we see the drug today.
Because the origin story paints the drug as a pathogen, and as providing miraculous benefits that cannot be rivaled by any other life experiences, then it ensures that we will keep seeing the drug as necessary to our existence today. Which means we will keep wanting, desiring, craving it today. This holds no matter how much we recognize the costs that continued use entails. We may simultaneously see the drug as both miraculous and evil, which means we will see it as a necessary evil. Which again, means that we will keep having an “overpowering” urge to use it.
To stop wanting the drug, you have to stop seeing it as so damn miraculous. You have to reassess it’s value. You have to reassess the value of going without it. You have to consider the possibility that life can be genuinely more enjoyable with heroin and other opioids. Your origin story is blocking you from doing this.
I know that many readers are now thinking “I know that life would be better if I stopped using heroin.” That’s only partly true. You know it would remove a bunch of terrible costs such as the monetary costs, risks of arrest, poor health, and overdose, etc. You know that if you got the time back that you spend chasing this drug, you’d be able to get your life back in order and achieve other goals. I’ve been a heroin addict. I’ve talked to many. I know we know these things. However, we also believe that if we stop using, then today will be miserable, tomorrow will be miserable, as will next week, next month, and perhaps the next few years, as we struggle to resist doing the only thing we think can make us feel good.
So again, the thought “I know that life would be better if I stopped using heroin” is only partially true. We think it will be better in the long-term, but unbearable in the short-term. This perspective needs to change or we will never make it through the short-term without reverting back to heavy opioid use. The prerequisite to changing this perspective is to let go of your addict origin story. You can let go of your origin story whenever you choose to, and start thinking about your options differently today.
When you decide to let go of your addict origin story…
I hope you’ll check out the book I wrote with my colleagues Mark Scheeren and Michelle Dunbar (from BRI, Saint Jude Retreats, Freedom Model Retreats). It’s called The Freedom Model for Addictions: Escape the Treatment and Recovery Trap. It gives you the knowledge you need to throw aside all the baggage of the addict identity, and figure out what will make you happiest going forward. It shows you how to make a change in your substance use habits that you can enjoy and carry out easily. It isn’t a “recovery” method, because we don’t see addiction as a disease. Instead, it’s an educational approach, helping readers to make newly informed choices about substance use, empowering you with information. It isn’t for battling addiction – it’s for moving on from addiction. It’ll run you about 13 bucks on kindle or 30 bucks on paperback if you’re willing to give another perspective a try. The ideas in it helped me to end my heroin use 16 years ago, and I haven’t lusted after heroin ever since.
But even if you don’t get the book, please know this: 17% of opioid addicts get over their addiction within a year of developing it, 50% get over it within 5 years, and the odds are that 96% will get over it eventually (further detail here). You aren’t doomed to continue using the way you are now. You can get past it. Remember that, because I know it’s easy to feel doomed when you spend your time in meetings, rehabs, and clinics where everyone is struggling. Being in those places gives you a horribly skewed view. The reality is that most get over this and move on with their lives. You can too.
Another really great article, Steven, and we must add this point to the next edition of The Freedom Model!