Roleplay Guide 016: Drugs (Heroin)
As a person who has an intimate history with this drug, I felt like I could be somewhat qualified in offering a firsthand experience with it. In this guide it will follow the imaginary stages of someone becoming addicted, becoming a user, and the aftermath of recovery/former use. Hopefully this will help writers with any characters they are creating, or going to take on. (Helpful links included)
TRIGGER WARNING: DRUG ABUSE & ADDICTION
I ask that anyone who reblogs this please tag it with an appropriate trigger warning. Thank you!
PERSONALITY TRAITS OF ADDICTION
Before we begin talking about Heroin use, we must first explore the mind of an addict. While “addictive personality” is not a real psychological diagnoses, some personality traits still do seem to be more common in people with addictions.
SEEING THE SIGNS
Many psychologists and doctors are able to tell when someone has an addiction, almost naturally. Now, of course there is no such thing as having a “sixth sense” for this kind of thing, but there are definitely behaviors and attitudes addicts are prone to have.
People with addictions may
- Suffer from depression and anxiety.
- Appear anxious
- Seem awkward, arrogant or angry, and impatient
- Ask for narcotics without a valid reason to
TRAITS AND BEHAVIORS
There are certain traits and behaviors that accompany a person who has an addiction. While many of these differ from person to person, there are still an astounding amount that all exhibit similar ones.
- An addict may make impulsive choices
- An addict may constantly look for excitement and/or new sensations
- An addict might feel alienated
- An addict might value deviant and/or nonconformist behavior
- An addict may find it hard to have patience, especially anything that delays instant gratification
PERSONALITY DISORDERS AND ADDICTION
Not everyone with a personality disorder is an addict, and not every addict has a personality disorder. However, there are disorders out there that do seem to have a connection with addiction.
- Antisocial Personality Disorder
- Borderline Personality Disorder
(To learn more about these disorders, please do the efficient research before having a character tackling either of these.)
GENERAL BEHAVIORS IN ADDICTS
For a person who is addicted to alcohol or drugs, the substance becomes more important than almost anything else. Addicts may lie about their whereabouts or who they’re with so that they can drink or use drugs without being discovered. They may spend their savings or money that belongs to a friend, spouse or child to get more alcohol or drugs. People with addictions often become defensive or angry if the addiction is addressed. They may also feel guilty and go through periods of remorse during which they decide to get help, only to relapse later.
A WORD OF CAUTION
One reason why addictions tend to go undiagnosed is that every addict is different. While some people with addictions behave recklessly, seem depressed or make poor decisions, others are able to carry on their lives amazingly well. Looking for personality traits of addiction can help you decide if friends or loved ones have a problem, but it won’t tell you for sure whether they’re an addict.
Also, just because a person has some of the personality traits of addiction doesn’t mean they are, or will become, an addict. Doctors do consider certain traits to be warning signs, but that’s all they are. No personality trait guarantees addiction.
HEROIN: WHAT IT IS, EFFECTS, & SYMPTOMS
Heroin is a “downer” — which is a depressant that often gives its users a low feeling. It is a highly addictive drug that is processed from morphine, a naturally occurring substance extracted from the “seed pod” of certain poppy plants. It typically comes as a white or brown powder, or as the black sticky substance known on the streets as “black tar heroin”.
Although purer heroin is becoming more common, most heroin is “cut” with other drugs or with substances such as sugar, starch, powdered milk, or quinine. Street heroin can also be cut with strychnine, or other poisons. Both new and experienced users risk overdosing on heroin because it is impossible for them to know the purity of the heroin they are using. Heroin overdoses—which can result whether the drug is snorted, smoked, or injected—can cause slow and shallow breathing, convulsions, coma, and even death.
Heroin is usually injected, sniffed/snorted, or smoked. Typically, a heroin abuser may inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (seven to eight seconds), while intramuscular injection produces a relatively slow onset of euphoria (five to eight minutes). When heroin is sniffed or smoked, peak effects are usually felt within ten to fifteen minutes. Although smoking and sniffing heroin do not produce a “rush” as quickly or as intensely as intravenous injection.
HEROIN ADDICTION SYMPTOMS AND EFFECTS
Typical signs after consuming some heroin may result in
- Shortness of breath
- Dry mouth (cotton mouth)
- Small pupils
- Abnormal and sudden changes in behavior and/or actions
- Cycles of hyper-awareness followed by nodding off
- A droopy appearance (as though looking extremely tired)
Definitive signs of heroin abuse are the paraphernalia used to prepare, inject, or consume
- Needles and/or syringes
- Burned and/or bent silver spoon
- Aluminum foil or gum wrappers with burn marks
- Missing shoelaces
- Straws with burn marks
- Small plastic bags with white and/or brown residue
- Pipes (water pipes)
BEHAVIORAL SIGNS OF A HEROIN ADDICT
- Lying or other deceptive behavior
- Avoiding eye contact, or distant field of vision
- Substantial increases in time spent sleeping
- Increase in slurred, garbled or incoherent speech
- Sudden worsening of performance in school or work, including expulsion or loss of jobs
- Decreasing attention to hygiene and physical appearance
- Loss of motivation and apathy toward future goals
- Withdrawal from friends and family, instead spending time with new friends with no natural tie
- Lack of interest in hobbies and favorite activities
- Repeatedly stealing or borrowing money from loved ones, or unexplained absence of valuables
- Hostile behaviors toward loved ones, including blaming them for withdrawal or broken commitments
- Regular comments indicating a decline in self esteem or worsening body image
- Wearing long pants or long sleeves to hide needle marks, even in very warm weather
AFTER BUILDING A TOLERANCE
Users build tolerance to heroin, leading to increases in the frequency, and quantity of heroin consumption. With a growing tolerance, more definitive physical symptoms of heroin abuse and addiction will emerge.
- Weight loss
- Runny nose (not explained by other illness or medical condition)
- Needle track marks visible on arms
- Infections or abscesses at injection site
- For women, loss of menstrual cycle (amenorrhea)
- Cuts, bruises or scabs from skin picking
SIDE EFFECTS OF HEROIN DEPENDENCE
Side effects from heroin abuse and addiction vary as the disease progresses. Other chemical dependency/ies may impact the presentation of complications and side effects of heroin use.
Following heroin consumption, the user experiences a “rush” that is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the body. Given the challenge of precisely calibrating the dosage of such a powerful narcotic, this initial rush can frequently be followed by nausea, vomiting, and severe itching.
Short-term physical side effects of heroin use include
- Depressed respiration (shallow breathing)
- Clouded mental functioning
- Decreased pain from either physical conditions or emotional challenges
- Uncontrollable feelings of itching that result in compulsive scratching or picking at skin (itchy blood)
Heroin abuse and dependence produce serious medical side effects, which may directly or indirectly result in death
- Heart problems, including infection of heart lining and valves
- Infectious diseases spread by shared needles (HIV and hepatitis B and C)
- Chronic pneumonia or other pulmonary diseases
- Blood clots or tissue death resulting from collapsed veins or impurities
- Bacterial infections
- Liver disease
- Arthritis and other rheumatologic problems
Because heroin addicts do not know what the strength of the heroin purchased on the street may be or what it may be mixed with, they are at risk of overdose and/or death. Studies show that after five years of use the average heroin user has a ninety percent chance of having contracted hepatitis C. A person injecting heroin is also at high risk for the transmission of HIV and other diseases from sharing non-sterile needles.
HEROIN WITHDRAWAL & DETOX
Withdrawal can happen when a person quits, or after heavy use. The initial coming down can vary with time and intensity, although typically withdrawal symptoms will begin six to twelve hours after the last dose, peaking within one to three days, and gradually subsiding over five to seven days. However, some users experience weeks or months of withdrawal symptoms, known as post acute withdrawal syndrome (PAWS).
Although not everyone withdrawals the same off of heroin, there are a few common features.
- Sleep problems (insomnia, and excessive yawning)
- Restlessness (usually brings about aggressiveness)
- Nausea & Vomiting
- Diarrhea & Stomach Pains
- Excessive Bodily Fluids
- Aches & Pains
- Mood Changes
- Cravings (for drugs, etc.)
A safe, comfortable detox is the first step to a better life. Basically, detoxing is cleaning the body of the toxins within it. In this case, it is heroin.
Many users go to a facility for their detox, as at-home detoxing can rarely ever work. Many rehabs provide a comfortable atmosphere for their patients so that triggering their desire to use is minimal during their stay.
Typically during a detox, users are encouraged to eat better, exercise, and find healthy outlets for dealing with their newly discovered emotions.
RECOVERY FROM HEROIN & AFTERMATH
Many users after they get clean have a sponsor, which is a person they can turn to immediately when they get cravings to use. It is typical that rehabs will have follow-up treatments that may include a psychologist, and intensive outpatient programs.
Ex-users can also rely on going to meetings in their local area, as being in a group is commonly a great support system that addicts need to stay clean. All follow-up treatment should be met with optimism, taken seriously, and approached with enthusiasm.
- Stay away from “friends” and family who used to enable the habit
- Avoid triggers that used to make you want to use
- Release emotions in healthier ways
Relapses often occur for many addicts trying to stay clean. When this occurs, most addicts will fall back into a routine of using until they detox/withdrawal.
Relapses generally happen when an addicts self-control is tested early on in their recovery; however, many addicts clean for years can still fall off the horse. Recovery should be taken one step at a time, day-to-day, as it is a lifetime battle to deal with.
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