Why Can't People Just Stop Using Drugs, and Should Addicts Be Maintained on Drugs?

Written by Stanton Peele

Why can't people just stop using drugs, and should addicts be maintained on drugs?

Maureen

A big distinction, obviously, is between controlled and addicted use. It's oversimplified, but obviously why people don't give up occasional or moderate drug use is a non sequitor — why would they want to? In one case at my site, a man who was formerly addicted worked to resume moderate substance use, which he finds a great and desirable pleasure in life.

In a number of places, I answer the question that people give up drugs when they have something reliable with which to provide replacement (and superior) rewards. Check my review of the book, "The Steel Drug."

I will return to the methadone question. People do give up opiates all the time, but some don't and some take a while. So (harm reduction goes), let's allow them to lead a life in the meantime. Isn't that a modern, humane, medical approach?

Best,
Stanton

Dear Stanton,

The question, "Why can't people just give up?" has still got me confused. As you said, some people give up, some don't and some take a while. Methadone is a fine compromise for those who take a while. Is methadone treatment part of "therapy impeding the cure" (that you speak of) which makes giving up opiates harder by taking away the dependant person's sense of power and self control? Or does methadone allow for periods of "time out" from the hassles of heroin use until the person reaches the appropriate time for them to give up all opiates completely?

It would be ideal to have a methadone program which allowed you to drop in and out of treatment and didn't punish you for using heroin when you wanted to. Hassle-free heroin use!

bye for now,
Maureen

Dear Maureen

I can't add much to your excellent summary, other than to add something to the question of, "Why don't people just stop using drugs?" It's the same as asking, "If addiction isn't a disease, then what continues to propel the addict in using drugs?"

My answer is that not much off an explanation is needed for why people do more or less the same things over time. When you wake up in the morning, and think of your day, you think of yesterday. Familiarity and habit dominate. It's the human condition.

Meanwhile, I talk below with a woman who wants to continue here addiction without hassle, raising some of the same pros and cons you do about maintenance.

Best,
Stanton

Dear Stanton:

First, I would like to thank you and your staff for this informative and enlightening website. I found it through DRCnet while doing research for my problem.

I am a recovering addict (drug of choice was prescription opiates, barbiturates). I have been clean of these drugs for three years now. However, I continue to have problems for which my questions will be forthcoming.

First, I need to give you some background on my particular situation. I suffered from endometriosis as a very young teenager and was finally given narcotics for the pain in my early twenties. My doctor apparently did not realize the severity of the situation, but continued to prescribe the drug (phenaphin #3) for over six years to me before he finally did a laproscopy and found the reason for my pain. This was in 1986 and I finally had a complete hysterectomy in 1987. I was free of narcotics for the next four years until I developed migraines for which I sought help from a neurologist. He put me on several drugs (elavil, fioricet, fiorinal). It was finally discovered that I had a severe hormone imbalance and was suffering from rebound headaches due to the drugs I was taking.

That's when the addiction, in my opinion, finally took hold of my life. I had always enjoyed the tingling sensation of well-being that the drugs produced as an asset second to the primary reason of pain relief. But now I missed that feeling and wanted to maintain it daily, if possible. In addition, I had another pain problem from consecutive herpes outbreaks, which had been diagnosed in 1981. Now, I've learned the nerves have been permanently damaged as a result of all the outbreaks I've had over a 17 year period. To conclude, the addiction progressed from 1992 to the end of 1995 when I finally went in for treatment after a 48 hour blackout. I got off the drugs, but the other problems persisted. A couple of months later I was prescribed Ultram for pain, supposedly because it was not a narcotic and non-addictive. Then in 1997 a warning by the FDA came out that said Tramadol did have the potential for abuse. To be perfectly honest with you, I was already aware of this because I was having problems with it by that time myself. I wasn't abusing heavily, but was taking the maximum daily dose of 400 mg. daily. This dose achieved the level of pain relief I needed.