The basic material for the following article was originally an e-mail. A person wrote to me saying that he'd just stopped taking methadone and was having trouble staying clean, could I give him some advice. That was all the information I had to go on.

Well, this seems to be a pretty common problem - it's extremely unpleasant, but not so difficult, to detox for a few days. The biggest difficulty comes with staying away from it. Cravings can be very strong for months, even years afterward, leaving the ex-addict in constant danger of relapse.

This was my reply (added to and edited a bit) and I figured that the advice in it could well apply to anyone. I do get asked for this sort of advice frequently, so for those who need it here it is:

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First you need to work out what you want to do. Do you want to be completely clean? Never to take it again, or at least to take nothing at all for a certain amount of time? Or do you want to just use less than you are using now? You need to get this straight in your mind. Because if you are telling yourself that you're not going to take junk, but also telling yourself that a bit is alright (and don't we love to fool ourselves like that?) you are setting yourself up for failure.

I'm certainly not saying that taking less is not worthwhile - if that is what you want to do. I also don't think that abstinence is the only answer. Just that you have to be straight with yourself as to what you want and what you can cope with, without regard to what others expect you should be thinking, feeling and doing.

I'll work on the assumption that you want to be completely clean. If you are having trouble there, the best piece of advice I can give you is to completely break all your contacts. This often means leaving friends behind. The best way I know of doing this is to move away. I too had a lot of trouble staying clean. I moved to another city where I didn't know anybody, except my mother. She had moved here only a few years before so although I had family here there were no roots, no acquaintances. Once you get to your new location you need to avoid areas where you are likely to see drug activity. So long as you keep it that you have no local drug contacts you are much less likely to score. When I thought of scoring, I just didn't know where to go. I am in a country town of around 20 000 population, so the drug scene has no visible area. I could have driven for 7 hours, but the thought of that was enough to turn me off. A couple of times, only when I was experiencing severe depression, I have contacted a friend and asked him/her to mail it to me, but that takes a couple of days so I usually said, 'Why bother?' I suppose the main thing is that by moving away you create a huge buffer, a safety zone.

I moved away from my friends 6 years ago, it's been tough sometimes, but it is the best thing I could have done. I couldn't have done it without the clean, total break. Of course, you may not be in a position to just pick up and change cities. If you can't make a geographical buffer at least try to isolate yourself totally from the drug circle. Things tend to move fast in drug circles - people stop dealing, get busted, move house, etc. While you're participating in the circle you follow all this so closely you don't notice it, but don't be surprised if within a few months of being cut off you will find that you don't know where to score without doing some research or going through other people. Every little thing that makes scoring harder makes it less likely that you will. Of course there are those times when you are just so desperate that a bit of difficulty isn't going to deter you. You'll drive that 400 miles; you'll wait the 2 days for the package. I'm not saying that it fixes everything, but you'll be much less open to whim.

Unfortunately the urge to take heroin lasts for a long, long time, even after many years of abstinence. If you are desperate enough to move away, don't move back after a month or two - that's just not long enough. A couple of years, maybe, but you'd still have to be very careful.

Another thing you may want to try is Narcotics Anonymous, or some other support group that helps people stay away from drugs. I have never tried this. I have heard reports that range from it's fantastic, to it's a total farce. Obviously, like most things in life, some people thrive on it, some people can't stand it.

What do you do with your life? Do you have a job? Do you have a career, hobby, or some time and concentration consuming activity that you enjoy? For many people in your position heroin is their life, job, hobby and all-consuming activity. Something MUST replace this. If you have nothing else to do you will sit around thinking about heroin. To fill the void left by heroin, I got married and started my own family. That was incredibly important to me, we are now a very close-knit family. But even with that I wasn't really happy - I needed more. I got involved with doing my web page and that was a great outlet, not only for the feelings I had been keeping bottled up for the previous 5 years, but creatively and intellectually as well because it has involved a lot of study and a lot of writing. Then I found out I could draw. I have been turning out everything from comics to portraits and it feels great. How about you? Do you write? Draw? Paint? Play music? These sorts of things can be great therapy.

Many people experience depression. There is medical evidence that when the brain is exposed to opiates for a long time, certain brain circuits are changed quite substantially. If you are experiencing depression you will be much more likely to relapse because opiates will relieve the depression and when you are depressed you have much less control, self-esteem, concentration and will power. To avoid relapses caused by depression, see a doctor about getting some anti-depressants. Just tell them you are depressed; you need to work out for yourself whether you tell him about the drug connection. Some anti-depressants increase the effects of heroin; if you are taking those and you score you MUST BE VERY VERY CAREFUL because this is how so many overdoses happen.

Well, they are my best suggestions for now. I should stress here that I am not a doctor or a counsellor and have no qualifications or formal education in these fields whatsoever. I just speak from experience and what one person experiences can be totally opposite to what another experiences.

I wish you luck, you're going to need it. A lot of the time you're going to feel like shit and wonder why the hell you're bothering, but you know that already, don't you? *smile* It helps to have your reasons and strategies straight in your mind. Better still, write them down so you can look at them when you have these crises... because these crises WILL come.

All the best, drop me a line to tell me how you're getting along, I'd love to hear.

- November 1998

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