The needle and the damage done

The Guardian has asked heroin addicts to describe their thoughts and experiences. These responses are often eloquent and always revealing. One says,

Heroin encases you in a little cotton-wool house and nothing hurts anymore. When times are hard, heroin encases you in a little cotton-wool house and nothing hurts anymore. If you haven't put in the work to become truly mindful, it's very easy to relapse. We know what heroin feels like, even twenty or thirty years after a hit. The memory of that wonderful warm feeling remains.

I have had vague thoughts that in years to come, growing old with heroin wouldn't be such a bad way to fade out of this life. But those thoughts are emanating from my 'addict brain' not my rational brain.

And this:

Hoffman's death has not resulted in feelings of sorrow, but thoughts and feelings of nostalgia. After been clean for 3 months. I am at a stage now where I'm starting to feel good again about myself and my life. But Hoffman's death has aroused a whole new fresh public discourse around heroin addiction, and I must say that its effect on me has not resulted in feelings of sorrow, or relief, but thoughts and feelings of nostalgia. The fact that nostalgic thoughts and feelings have been aroused from hearing about the tragic death of this great actor, just shows how utterly irrational the addicted mind is. It's not thoughts of relief that I have, such as "Wow that could have been me, I'm so lucky." But rather it is thoughts of reminiscence; thoughts of how euphoric he must have felt in those last few weeks of relapse, or even in his last few moments. The addicted mind is a selfish mind, no doubt, but also an utterly helpless one.

And many more like that. The point is, heroin addiction is not a moral failing or a lack of willpower. It is a permanent change in the brain, a physical fact about a person. First of all, of course, don't start. Second, don't put people in jail, that's utterly absurd. Third, provide treatment on demand -- and that includes methadone and buprenorpine maintenance therapy, because for most addicts, that's the only thing that works. Fourth, needle exchange and naloxone availability to keep people alive while they are using.

Oh well, dream on.