A journey into and out of heroin addiction - Part 2

In my last Background Briefing, we began the story of Lydia’s journey into addiction. In this Briefing, we hand over to the imaginary character of Lydia, to explain how addiction took control of her life, and her first experiences of treatment.

“Trying to juggle being in treatment and getting enough money for my heroin habit was really difficult. My days were taken up with being at the treatment centre, so I had to take risks to get money in the evenings. It was becoming increasingly difficult, but I couldn’t see a way out. I felt like I was losing even more control of my life.”

A journey into and out of heroin addiction

In this briefing I decided to use a fictitious character's life as the viewpoint to learn about addiction, as I feel it is important to look at the nature of the problem with which we are dealing.

'Addiction is a multi-faceted problem, involving psychological, biological and sociological aspects. Addiction is about people’s lives. It is about their substance-using careers. There are an infinite number of pathways in to and out of addiction. Here, I start to look at one person’s life, an imaginary life drawn from the lives of many people I have met or heard about. In later Briefings, we will consider what we can learn from Lydia’s life as a heroin addict, and as a recovering/recovered heroin addict, in order to help other people.'

A letter to a friend

In this briefing, I describe my thoughts about my change of career to an old neuroscience friend in America.

'I remember our times together in the neuroscience field very fondly. It was great! However, as you know, the time came when I felt I was not doing what I wanted to do – help people. Despite what I had achieved, and the great talk I could give on addiction and the brain, I felt that my work – and that of most other neuroscientists – was not actually helping people overcome substance use problems. I certainly made the right decision to leave neuroscience! I’m now in a fascinating field and I know that I am doing something that will contribute to helping people, albeit indirectly.'

Nature of the problem: Addiction as a chronic disorder (part 3)

In this Briefing, it is emphasised that we must be careful how we communicate the message about the chronic nature of addiction.

‘Appropriate treatment for chronic addiction is not simply a succession of short term detoxifications or treatment stays. Appropriate continuing care requires personal commitment to long term change, dedication to self management, community and family support and monitoring.’

Nature of the problem: Addiction as a chronic disorder (part 2)

In this Briefing, we continue to focus on a major problem: while addiction resembles other chronic disorders, society uses an acute model of care for treatment.

The striking similarities between severe substance use problems and chronic medical disorders do not imply that similar disease processes underlie these disorders. However, it does strongly suggest that we should be using chronic or continuing care strategies for substance addiction that resemble those used for other chronic medical disorders.

‘Importantly, the acute care model sets the field (and individuals) up to fail. This erodes long-term societal confidence in addiction treatment as a social institution.’

Nature of the Problem: Addiction as a chronic disorder

In the next set of Briefings, we look at the time course of addiction and how it influences the way that we should be building systems, including for the delivery of treatment, that help people find recovery. In this first Briefing, we look at acute and chronic disorders and how they are managed in today’s medical world.

‘The terminology used to describe addiction can be influential in a variety of ways. It can shape people’s attitudes towards whether they can overcome addiction, shape the way we deliver treatment and the way we help people along the path to recovery, and influence society’s attitudes towards people with substance use problems.’

Along the Route to Recovery: Choosing the form of help required to change behaviour

In this Briefing we look at some of the factors that are likely to influence decisions about what route to recovery a person chooses to pursue.

‘Once a person has made a decision to attempt to change, the ways they approach this objective must start from their knowledge about how to change and what assistance might be available.’