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Letters from May 2003

Question

List the pros and cons of the drug heroin.

Answer

That sounds like a game show question.

Heroin is an exceptionally useful drug with many therapeutic, recreational, and spiritual uses. Like anything, it can be over-used. It is so similar to some of the main brain neurotransmitters, that the body easily adjusts to a new steady-state with heroin. The process of adjusting back to the no-heroin steady state ("withdrawal") is quite painful and potentially life threatening.

The danger of a fatal overdose of heroin is over-stated, but very real. In the United States, there are fewer fatal methadone (which the body reacts to almost exactly like it does heroin) overdoses than fatal acetaminophen (Tylenol) overdoses.

Question

I'm pretty embarrassed to be asking this, but I have to ask someone. I've been using H for about two months now, and in the last two weeks I've developed a rather unpleasant side effect--constipation. It has been about 6 days now since I last defecated, and it's starting to be quite uncomfortable.

Last night I tried a "gentle fiber laxative" which said I should have results in 6 to 12 hours. Its been about 18 hours and nothing. I took the maximum recommended dose. On the package it said that if you take it and nothing happens that you should call a doctor because something could be wrong.

I'm scared to call a doc because I don't want to tell him about the H. So if anyone has any suggestions or if you can help me in any way, I would greatly appreciate it. I just figure I can't be the only person who has experienced this problem.

Answer

I'm sorry for the delay in responding. I was sick for some time and then we were hit with major financial problems that will almost certainly cause HH to be scaled back in a large way. [And then your mail bounced back.]

Yes, this is a very common problem. Some people use laxatives. Some people physically remove what they can. An enema might work (perhaps with coffee mixed with salt water -- all lukewarm). I think the best bet is to let yourself withdraw a little; go for as long as you can without using (as little as 12 hours might be enough)--that should solve the problem.

Good luck. Don't be embarrassed.

Question

My friend has acquired methadone in the form of what are know around here as biscuits. They are quarter size and divided into four with breakage lines. Are you familiar with them? If he is taking 5 Percocet® tablets a day after only remaining clean from heroin for 2 weeks, last month, how would you suggest doing a 7 day taper detox with these?

Answer

Indeed, I am familiar with them. They are made by Mallinckrodt, Inc and are called Methadose® Dispersible Tablets. They contain 40 mg of methadone, which is a lot for a non-addict. They look like Holy Communion wafers. (I have *got* to write an article about that observation.)

How did he detox from heroin? If he used methadone, he probably wasn't completely detoxed after two weeks. You might tell him this so he realizes that he needs to give himself a lot more time without using before he can "chip". Three months is a good target.

Read this article:

Estimating Your Habit

Five Percocet® tables? That should be 25 mg of oxycodone. Oxycodone is roughly as potent as methadone, but methadone lasts 8 times as long. So his equivalent daily methadone dose would be 25 mg divided by 8: 3 mg. To be safe, I'd start a little higher: 5 mg probably.

If you have access to a scale, get it. Crush up a pill and divide it into 1 mg doses. Go to a health-food store and buy some empty pill capsules. People use them to for herb concoction. Using these, you can make up a bunch of 1 mg pills. You might also want to make up some 2 mg and 3 mg pills too.

The detox should be easy. Something like this should work:

DayDose
15 mg
25 mg
34 mg
43 mg
52 mg
62 mg
71 mg
81 mg

This is just my idea. I'm not a medical doctor. I'm assuming he is in good health. If he isn't, you should seek medical attention for this His habit is not very high, and most people would not have too bad a time with a cold turkey detox. But someone with high blood pressure can die from such a detox. Before starting on the methadone, he could slowly lower the number of Percocet® tablets he's doing.

Good luck to you both. If this doesn't work, contact a local methadone clinic or see a doctor about buprenorphine:

Doctor Locator

Question

I just got your site from Heroin Pages. I am curious to know if you're still an active user. I am an addict in recovery, with 2 years clean from heroin. I really do not get the concept of this site. And are you an addict? I noticed in one article it said, "how not to get addicted". What's that about? Every addict wanted that, and thought they could have that when they started using... until the nightmare got started. Help me out here. I'm really pissed right now.

Answer

By "pissed" do you mean "drunk" or "angry"?

What this site is all about is that I got sick of perfectly good people getting sick, spending years living in a cage, and in many cases, dying. Every addict has his own route out of addiction; mine was writing.

Am I an active user? I'm not sure how that is relevant, nor do I see why you think you have a right to ask? Why not ask, "Are you gay?" "What is your yearly income?" "To the nearest cm, how long is your penis?" The answer, however, is "no"; I am not an active heroin user.

From a purely practical standpoint, I can't be a drug user; I have far too high a profile. You may not be aware, but HH is a *very* popular website. But more than this, I'm just not interested in using drugs anymore. For a year or two speedballs called to me, but even that has passed. I don't even drink alcohol or caffeine, by and large. It isn't a decision; it's just not what my life is about.

People get the wrong idea about HH. There are roughly 250 articles on the site. I get e-mail from people who tell me they have read most of the site. In almost all cases they are grossly mistaken. So what is the site about? It is my attempt to help in keeping with my anarchist philosophy. I might think an addict should get clean, but that isn't going to stop me from keeping him safe while *he* thinks he wants to use. In my mind, at least 99% of what passes for "drug treatment" is nothing more than people with power trying to control people without power.

Most of the HH visitors are *not* users. This site draws the friends and family of heroin users who are trying to understand and deal with their loved one. Of course, I do get my fair share of users and I help as I can. And I get a lot of questions from people who are "thinking about trying heroin". I have no doubt that I stop more potential users per capita than Partnership for a Drug-Free America and other like-minded groups.

As for how to avoid addiction, this is a big issue. Everyone "knows" that everyone who does heroin becomes an addict. Dr. Zinberg showed that this was decidedly untrue over 30 years ago. But Zinberg's work can be dismissed because it doesn't reinforce our prejudices. The fact is that far more people use heroin in an un-addicted manner than use in an addicted manner. But the addicts are far more visible. My high school algebra teacher was fond of the following quote that sums up modern thinking about drug users: "All Indians walk in single file; at least, the only one I ever saw did."

The point is to help. I truly believe the vast majority of our culture wants to see heroin addicts tortured and murdered. Heroin addicts are the ultimate scapegoats for a culture that does not want to deal with the real problems it faces.

Would a doctor refuse to set the broken leg of an incompetent rock-climber because, "He shouldn't be rock-climbing"?

by Dr. H © 2003
Last Modified: 14 January 2004


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