It is important to prepare for the long haul when you are dealing with a new heroin addict in particular, but the same can be said of all of us no matter the length of time addicted. The simple central fact is both discouraging and true as the sun coming up. Heroin addiction is generally going to have life of its own. It may last 5 years, ten years, or even much longer. It depends on a number of factors.
Let me go over the factors mentioned:
1. Family support- this one is self-evident in its meaning. It does not take a rocket scientist to figure out that an addict with both the background and current support of a family and other caring people is going to have a leg up when it comes time to put all the heroin toys away and come back to the world of human relationships. This can be abused by the addict but that should go without saying. All things in the way of using have potential for abuse. More on this later.
2. Work History- Life in recovery is much more doable when a newly recovering person does not have to invent themselves from the ground up. A skill, trade or previous work history that adds up to a resume is very useful. Also implied here is the addict knows what getting up for a job is and how to present themselves during the interview.
3. Social Network_ Anyone who uses is dangerous for a recovering addict. For each and every recovering person, someone who uses your drug of choice has the plague and it is extremly contagious. Anyone. This is why 12 step programs recommend taking along at least one other recovering person when going to see someone who uses. Notice there is no age or clean time exceptions. The assumption is no one is safe doing it alone. New friends or sane old connections need to make up the circle of support. There is also some who believe in not forming romantic relationships in a therapy group or a 12 step program. The reasoning is simple. One person in a relationship with recovery challenges is enough. Two people with these challenges can get complicated even more than most.
4. Education- The more schooling or trade education in a person's past, the easier it will be to integrate back into the work force.
5. Health- Basic health needs such as dentistry are very important. No one wants to hire someone with no teeth. Many of us have viral challenges and these can present their own load of concerns. Medication protocols such as interferon for Hep C or cocktails for hiv/aids cause a number of side-effects that are hard to live with. Focus in early recovery should be on physical and mental health as much as possible. Mood disorders are common in early and later recovery due to the damage that is done to the brain and also because many people get into drugs to deal with a pre-existing mental health disorder. Chronic pain may also become an issue for many heroin addicts in early recovery. Part of this is because the chronic use of heroin will help to atrophy the brain's natural painkillers (endorphins). This means that each pain is felt without the benefit of the gifts of natural pain relief. Their hurts hurt more and cause more secondary damage as a result. Also the brain cells directly connected to heroin become hypersensitive during chronic use, resulting in early detection of pain signals. There is so much more to discuss on this little appreciated area. If you read this and have a question....
6.Living quarters- While it is true a motivated addict can get clean anywhere we are like the rest of the world in appreciating nice surroundings. More important however, is a person feeling comfortable where they recover. Many counselors want to send clients from ghettos to pastoral or rural settings. This is not always the best solution and represents some counter-transference on the part of the professional. Remember that lots of people get clean in parts of cities where many fear to tread but to them is home. Recovery is partly based upon finding peers who relate to you. While it is not impossible to do this in foreign locales, I believe it is more likely at home. Of course, the danger then lies in people, places, and things, but it always does. The only difference is in intensity.
I have brought up some of the factors that can influence a person's chance at recovery. Most of these factors are of a socio-economic variety. Money can make recovery more likely. Do not get this part wrong. Money does not guarantee it, but does help.
I have worked at facilities where all the clients came from backgrounds that can be called difficult. Others might call them the disenfranchised. Whatever the case, they do not have a lot of factors to fall back on in recovery. I have also worked in a famous rehab in California where everyone who came had to come up with 30,000 cash before coming in the door. Those clients with all the advantages see a success rate of about 30% if you define success as being clean one year after the treatment episode is over. Relapse may or may not have occured but if you are clean and still trying a year later you qualify. The clinics paid for by medicaid etc. run at about 10% if success is defined the same way. Much of the evidence for this is anecdotal but not all and that evidence that does exist can be extrapolated easily.
So family member and caring person, there you have a picture of who gets better and how long it takes. Much patience and perseverance is going to be needed so it is best to settle with this right off the bat. Otherwise you are going to get very hurt and not be able to survive the long run.
Some of the rules you will need to follow and how to maintain yourself are coming up in another blog.
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