I’m a behavioral pharmacologist who has lived the experience.
We are in the midst of an epidemic of opioid addiction and death. Almost everyone knows someone living an opioid addiction or who has died from one. And they all have the same question: why can’t we, didn’t we, stop?
Why, they wonder, do we hock, trade, sell everything we own; why do we steal and hurt the ones we love just to get our roxies, dilaudid, our heroin? But the answer to that question is really very simple.
I started using heroin in 1976 when I was 20 years old. For the next 13 years I used occasionally, never enough to become addicted. I earned a B.A. in psychology, a masters in experimental psychology, and a doctorate in biopsychology. After I completed the doctorate in 1987 I was awarded a national institute on drug abuse post-doctoral fellowship in the pharmacology and toxicology department at the University of Arkansas for medical sciences.
My area of research was behavioral pharmacology which is the study of how drugs affect the brain and behavior. During all of this time I was still, on occasion, using. In April of 1989 I got into a bottle of methadone hydrochloride from the behavioral pharmacology lab and the whole time I was shooting that methadone I told myself that I would stop. And I believed that. Until I couldn’t.
For the next 22 years I lived the life of opioid addiction. The last year and a half of my addiction I was homeless, living on the streets and sleeping on the ground, homeless shelters, and people’s floors. The last time I used an opioid was December 11, 2011.
I am sharing this because I want you to know that I understand what your child, what your loved one, experiences in their addiction. I have lived it. And that because of my education and research, I also understand the neurocircuitry, neuropharmacology, and behavioral aspects of opioid addiction.
I believe in science. I believe in its truth. And science has shown that opioid addiction is a disease of brain structure and, thus, function. The continual intake of these opioids, day after day, year after year, alters the brain on a cellular, molecular basis. These alterations are opioid addiction. And they are manifested as behavior directed toward the survival of the individual.
The neurobiological explanation of this illness is beyond the scope of this article. But maybe this will help.
Let’s say that you haven’t had anything to eat for three or four days. You are starving. Can you feel it? What it’s like to be really starving? What would you be thinking about? You would be thinking about food. You would be needing, craving food. This craving that you feel is the brain’s mechanism that drives you to survive. Its purpose is to make everything else fall away and to force you to focus solely on acquiring what you have to have to live.
Now, let’s go further. Let’s say that food is restricted. There’s a famine or some kind of government control that limits the amount of food. There are no soup kitchens; there are no food banks. And no one will give you any food because they don’t have enough for themselves. There is, however, a black market in food. But the food in this black market is scarce and expensive. And it is illegal. It is against the law to buy food in this black market. What would you do if you were starving? Would you break the law? Would you steal to eat and to live? How much of yourself would you sacrifice? How much of who you are and what you are would you let go of to survive?
This craving for food is measured in days. Our craving for opioids is measured in hours. Four to five hours after our last use we begin to starve. And we crave. Everything but our need for these opioids falls away. And we focus solely on what we have to do to survive. We don’t have a choice. We really don’t.
Please understand I’m not trying to excuse our behavior. I am, though, trying to help you to see why we do these things. I know it may be difficult to believe that even when were stole from you, were verbally and maybe even physically abusive, we loved you. We are not narcissistic hedonists. When we hurt you we hurt too. We do these things not because we want to do them, but because we have to survive. We become desperate, and in our desperation we do things that we know are wrong; we do things that we know are not us. But this doesn’t mean we don’t care. If you are starving, you still love. What it does mean is that we are so desperate in our starvation that we will hurt the ones we love to end that hunger.
What is sad is that we don’t understand why we are hurting the ones we love. And because we don’t understand, we can’t explain it to you. We can’t explain why we are hurting you. No one told us that these opioids cause changes in brain structure such that they become more important for our survival than food. We don’t understand this, and neither do you. And this lack of understanding can rip a family apart. It can replace love with resentments and anger. On both sides. And in this pain, in this lack of understanding, we lose each other.
The knowledge that I hope you take away from this article is that your child or your loved one did not hurt you so that they could go out and buy roxies, dilaudid, or heroin. What they bought was their survival.
For those of you that have lost a child or loved one to overdose and addiction, I hope this article will help you to understand that there is no blame here. Whatever you did, however you tried to help the one you loved, you did your best. Because that’s what love does. And I hope you also understand that your child or your loved one also did their best. They fought, they struggled, they did all they could to stop. But, ultimately, their disease took their life.
Understanding and knowledge is power. The lack of it is confusion and helplessness.