Heroin Vice "Functional Heroin Users"

[nznity]

Off topic, are you from Peru? I've been down there four times, I really enjoy visiting. Not that I've ever done drugs down there, though I'm sure it could be interesting to be so near all that coca. Beautiful mountains, history, people, food. Fucked up governments, though

Yes, I am. In fact, I got a lil Mountain of some A grade stuff beside me. Cheers xd

 

[Smuck_Hey_Dee_Hewitt]

I watched this Vice documentary on YouTube a while back, and found it a bit appalling. They seemed to make the claim that heroin isn't all that bad, and that the vast majority of heroin users do not become addicts.

I know that heroin itself is a pretty benign substance, and essentially perfectly safe if you don't overdose and don't develop a habit.

However, I've never really heard of the "casual heroin user" who uses a couple times per month and it doesn't become a problem. Similar to someone who has an occasional beer or joint. Do users like this exist?

I have personally never tried heroin and never will, due to all of the lives I've seen ruined by it. I found the vice reporting somewhat irresponsible, but wonder if there's any validity to this concept of the "occasional" dope user.

[Obviously not an apology of Heroin (ab)use but, ] Ever considered you´ve "never heard of the ´casual Heroin user ` " just cause all you´re shown is the terminal/dark side of said substance?
Tbph the main "problem " with heroin is the Culture at its periphery -how it´s presented ,perceived ,promoted even ( very explicit in your text, mind you ) ...our tendency towards instant gratification and avoiding pain at all costs too.
Ultimately and in hindsight ,after years of personal, extremely gratifying "casual Heroin use " -just like with any other substance one may get hooked on -my downfall can be attributed to lack of self control ,weakness (although some like to brush off responsibility and very conveniently call it a "Disease ".).

 

[pharaoh]

Nowadays it is deliberately marketed towards troubled people who have suffered a lot of trauma. I reckon that the percentage of actual "functional users" would be below 5%.

 

[paranoid android]

It's possible to use opiates and not become addicted for sure. I have never used heroin but i used to be addicted to morphine but i kicked that about 5 years ago. I still take it but i never use for longer then about 2 weeks in a row without a long break now as i don't want to become addicted again. I have been taking it for about 5 years like that now with no problem

In the past i was addicted to oxycodone, dilaudid and fentanyl as well. I never tried heroin because i always had a script so taking it was a unnecessary risk

 

[cocoleti]

The vast majority of all drug users aren't addicts and never become addicts. And that goes for all classes of drugs.

The reason recreational heroin users in particular fly under the radar to the extent that they do is threefold. For one, there's a HUGE social stigma attached to opiate use, and especially heroin. It has such a disastrous reputation that people with 'respectable' lives and careers cannot afford to be associated with it. These people go to great lengths to hide their use from anyone but a handful of other opiate-using associates.
For another, well, since their use isn't excessive they neither have nor cause problems which would make them visible as users. You won't find them in trouble with law enforcement or in need of detox or therapy. This is also why researchers only ever come across the more extreme users, ie addicts, because the only places they look for study subjects is prisons, street outreach projects and rehab facilities. T Which leads us to the third reason, it's sociology / drug researchers and doctors who drive the public narrative, and both groups have a clinical bias. 'Junkies' are all they see and interact with, so they assume that's the only kind of heroin user that exists. Since problematic users THEMSELVES typically due to their situation only associate with other addicts, that general impression only gets further cemented.

Imagine what sort of scenario we'd have if alcohol consumption was regarded like heroin. Imagine we taught people the idea that it's absolutely impossible to use alcohol responsibly or in moderation, and that EVERYONE who enjoys a pint or two is on an INEVITABLE path to ending up living under a bridge and starting the morning with half a bottle of vodka. Imagine it was totally unacceptable for someone to drink, and being found out would get you shunned from 'polite society' and fired from work etc etc.
I guarantee there'd be a lot more alcoholics (self-fulfilling prophecies are a thing), and the non-problem drinkers would be forced to conceal their habit so well that the very idea of moderate alcohol use would come to be regarded as practically mythical. If it 'can't' / 'shouldn't' exist, then it DOESN'T exist, right? ...

I can recommend two excellent books on the subject. One is a landmark study by Norman E. Zinberg, entitled "Drug, Set & Setting - The Basis for controlled Intoxicant Use", which includes users of all classes of drugs, including heroin. He emphasises that of all the people he interviewed, he had the greatest difficulty getting hold of moderate opiate users as they were so extremely guarded, and generally had to recruit heavy users (with whom casual users have to have some connection in order to get their drugs) to persuade those individuals to be willing to participate.
The other one is heroin-specific, and is called "Occasional & controlled heroin use - Not a problem?" by Hamish Warburton, Paul J. Turnbull and Mike Hough. It is available as a free download from JRF Drug and Alcohol Research Programme. It's very insightful as it includes many direct quotes from the study subjects.


PS I'm one of these casual heroin users, and I used to be an addict.

There is nothing 'irresponsible' about that report, because it merely reflects a fact.
If anything's irresponsible, it's continuing to perpetuate this entirely lopsided image of heroin and heroin users according to which user = junkie and heroin = one-way ticket to personal degradation. That's a distortion of reality and is helpful to no-one.

I am also one of these casual users, you explained this perfectly! Ill have to look into those studies you mentioned, sounds intriguing!

 

[TheUltimateFixx]

Nowadays it is deliberately marketed towards troubled people who have suffered a lot of trauma. I reckon that the percentage of actual "functional users" would be below 5%.

I think the troubled people have always been a self-selecting sample for obvious reasons. No need for 'marketing'

 

[pharaoh]

I think the troubled people have always been a self-selecting sample for obvious reasons. No need for 'marketing'

It is tho in a way. 'bangin food 24/7 delivery', 'back on' - these are dealers advertising their service to junkies and they go to the phones of people at the bottom of the junkie food chain. You know what I'm getting at without pedantry anyway, most young people stay well away from heroin coz they've seen what it did to previous generations. As a young hoodlum I thought junkies were scum even tho I took and dealt other drugs. Didn't become a junkie til I started to deal it and I took to it like a fish to water. I have used it with aristocrats I knew from uni and homeless prostitutes but the only people I know who truly had habits were people that were highly damaged by trauma in early life, myself included. The drug will die out eventually I reckon, at least in my part of the world.

 

[TheUltimateFixx]

Didn't become a junkie til I started to deal it and I took to it like a fish to water

And this is a lottery.
How well you 'take' to any given drug is highly dependent on your own personal brain chemistry and how the drug tickles that, which you can never know beforehand.

but the only people I know who truly had habits were people that were highly damaged

Yes obviously. Any substance that has a combined neutralising plus euphorising effect will attract damaged people.

The drug will die out eventually I reckon, at least in my part of the world.

It likely won't because the same class of people just desperate for relief will still exist. To which you can add the genuine 'recreational' users who DON'T do it to escape from a shit life, but merely because they enjoy it.

 

[dneusingyrsago]

If you took a snapshot of the using population of just about any drug using subculture, including highly addictive drugs like heroin or methamphetamine, the majority of users aren’t addicts.

was around opiates for a few decades and never ever met even 1 of these so called casual users...met many that had there rationales ie i can use now and again or i dont get hooked etc etc but always would watch them turn into addicts ...so dont kid yourself use that shit for an extended time it will grab you by the booboo and getting loose is a monumental task

 

[Burnt Offerings]

I used opiates for many years too. The significance of the word “snapshot” means that you’re simply capturing a moment in time, you’re not taking into account the progression of time. You are not watching particular users go from experimental or recreational use to full-blown drug addiction. If you were to take the progression of time into account, you may very well see many of those users who were functional and not addicted eventually turn into drug addicts, either because of a change in life circumstance or just because it ultimately developed in that direction for them.

But, nevertheless, it remains true that if you were to just look at the using population on one day, only a relatively small minority of that population are addicted to these drugs.

 

[lineup]

The vast majority of all drug users aren't addicts and never become addicts. And that goes for all classes of drugs.

The reason recreational heroin users in particular fly under the radar to the extent that they do is threefold. For one, there's a HUGE social stigma attached to opiate use, and especially heroin. It has such a disastrous reputation that people with 'respectable' lives and careers cannot afford to be associated with it. These people go to great lengths to hide their use from anyone but a handful of other opiate-using associates.
For another, well, since their use isn't excessive they neither have nor cause problems which would make them visible as users. You won't find them in trouble with law enforcement or in need of detox or therapy. This is also why researchers only ever come across the more extreme users, ie addicts, because the only places they look for study subjects is prisons, street outreach projects and rehab facilities. T Which leads us to the third reason, it's sociology / drug researchers and doctors who drive the public narrative, and both groups have a clinical bias. 'Junkies' are all they see and interact with, so they assume that's the only kind of heroin user that exists. Since problematic users THEMSELVES typically due to their situation only associate with other addicts, that general impression only gets further cemented.

Imagine what sort of scenario we'd have if alcohol consumption was regarded like heroin. Imagine we taught people the idea that it's absolutely impossible to use alcohol responsibly or in moderation, and that EVERYONE who enjoys a pint or two is on an INEVITABLE path to ending up living under a bridge and starting the morning with half a bottle of vodka. Imagine it was totally unacceptable for someone to drink, and being found out would get you shunned from 'polite society' and fired from work etc etc.
I guarantee there'd be a lot more alcoholics (self-fulfilling prophecies are a thing), and the non-problem drinkers would be forced to conceal their habit so well that the very idea of moderate alcohol use would come to be regarded as practically mythical. If it 'can't' / 'shouldn't' exist, then it DOESN'T exist, right? ...

I can recommend two excellent books on the subject. One is a landmark study by Norman E. Zinberg, entitled "Drug, Set & Setting - The Basis for controlled Intoxicant Use", which includes users of all classes of drugs, including heroin. He emphasises that of all the people he interviewed, he had the greatest difficulty getting hold of moderate opiate users as they were so extremely guarded, and generally had to recruit heavy users (with whom casual users have to have some connection in order to get their drugs) to persuade those individuals to be willing to participate.
The other one is heroin-specific, and is called "Occasional & controlled heroin use - Not a problem?" by Hamish Warburton, Paul J. Turnbull and Mike Hough. It is available as a free download from JRF Drug and Alcohol Research Programme. It's very insightful as it includes many direct quotes from the study subjects.


PS I'm one of these casual heroin users, and I used to be an addict.

There is nothing 'irresponsible' about that report, because it merely reflects a fact.
If anything's irresponsible, it's continuing to perpetuate this entirely lopsided image of heroin and heroin users according to which user = junkie and heroin = one-way ticket to personal degradation. That's a distortion of reality and is helpful to no-one.

Thank you for your sharing these two sources, both of which are invaluable. It is clear that controlled dependent use and non-dependent use are far more common than people tend to think, and I agree that falsehoods are irresponsible while truths are responsible, particularly in this case.

Your statement that recreational users vastly outnumber addicts, however, is not supported by the two sources you cite, although I believe your statement is nonetheless correct. The 2005 Warburton et al. article does not attempt to measure population-level patterns of use, and the introduction cites a broad range of estimates of controlled use from other researchers. I've only started the 1985 Zinberg book, but it doesn't seem like any population-level evidence will be presented or cited. In any case, patterns of opioid use have changed drastically since 2005, let alone since 1985. The pathway from prescriptions opioids to heroin is undoubtedly more common now than in 2005, and I would speculate that, as a result, addicts now make up a larger share of heroin users than in 2005. But that doesn't mean your statement is wrong.

The most recent SAMHSA data do seem to suggest that the majority of non-prescribed opioid users aren't addicts, at least in the U.S. (https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables, tables 1.62A and 1.63A). With 8.9 million who have used in the past year and 2.9 million who have used in the past month, it seems like a stretch to imagine that there are more dependent than non-dependent non-prescribed opioid users. That would only be possible if an enormous number of past-year/ not past-month users were previously dependent but stopped altogether before a month ago, and if past-month users were almost all dependent. And while I would expect the ratio of dependent to non-dependent users to be higher among heroin users than opioid users overall, it seems unlikely that it would be too far off.

If there is other good data out there, especially data that is more fine-grained than past-year/past-month, I would be very interested. I'm studying hospital provider misconceptions about opioid use as part of my social work degree, and although my focus is provider aversion to methadone maintenance therapy, I hope to address the use=addiction fallacy at some point. Again, thank you for turning me on to those two sources.

 

[fairnymph]

I’m not a casual user, as I use daily for chronic pain, and have for over 14yrs. But I AM a functional user. My late husband was a functional user (& outright addict) of many drugs (not simultaneously). I’ve known plenty of others as well. I don’t know how common we are, but I think the snapshot concept is correct.

 

[TheUltimateFixx]

I’m not a casual user, as I use daily for chronic pain, and have for over 14yrs. But I AM a functional user. My late husband was a functional user (& outright addict) of many drugs (not simultaneously). I’ve known plenty of others as well. I don’t know how common we are, but I think the snapshot concept is correct.

We are WAY more common than you might be led to believe. Message me if you'd like

 

[fairnymph]

We are WAY more common than you might be led to believe. Message me if you'd like

I have no trouble believing that. I’ve spent a lot of time in academic and upper middle class to high class circles, where most drug users are functional. But I don’t like to assume that my experience can be applied to the general population.

 

[TheUltimateFixx]

I have no trouble believing that. I’ve spent a lot of time in academic and upper middle class to high class circles, where most drug users are functional. But I don’t like to assume that my experience can be applied to the general population.

I'd still wager there's more recreational opiate users than addicted, and more functioning addicts than hopeless junkies any day. The general research bears that out.

 

[fairnymph]

I'd still wager there's more recreational opiate users than addicted, and more functioning addicts than hopeless junkies any day. The general research bears that out.

Definitely agree with regards to most drugs. Not so sure about some of the opiates (h/fent) & crack.

Most IV users go down bad paths from what I’ve seen, but then most users don’t IV.

I don’t have much faith in the research on this topic, but to be fair, I haven’t looked at the methodology.

 

[skunkworks]

This thread is fucking fascinating and a credit to the participants.

 

[TheUltimateFixx]

I’ve spent a lot of time in academic and upper middle class to high class circles, where most drug users are functional. But I don’t like to assume that my experience can be applied to the general population.

Nope it can't. But according to your own observation the deciding factor here would seem to be personal life circumstances above anything else. Certainly was true to my own experience and that of many others I knew.

 

[fairnymph]

Nope it can't. But according to your own observation the deciding factor here would seem to be personal life circumstances above anything else. Certainly was true to my own experience and that of many others I knew.

Personal life circumstances are at least in part a reflection of genetics and personality, though!

 

[TheUltimateFixx]

Personal life circumstances are at least in part a reflection of genetics and personality, though!

Sure, but the genetic factor isn't as all-powerful as we're all led to believe. A possible predisposition isn't an inescapable destiny.

For instance, the majority of addicted heroin users are white, male, young and working class. What so-called 'disease' selects its victims by sex and social status?!

Also yes I find it entirely sensible to blame certain personality traits for the subsequent development of an addiction (or at least that they make addiction more likely), and sure there's genetic factors involved in THOSE. But still.

Like for instance I am sensation-driven, hedonistic, with low conflict/stress tolerance and not good at delayed gratification. The 'addict blueprint' basically. Yet I know others with those same traits who never became addicts of any sort. I myself wasn't an addict right from the get-go and I NO LONGER fit that description. Neither my genetics nor my basic personality changed, because these are not changeable. The only thing that changed was my relationship to the drug and what I saw in that drug.