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Heroin Addiction & Dopamine

answered 01:49 PM EST, Fri October 26, 2012
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anonymous anonymous
I have been a daily heroin user for more than 7 years. i have gone through detox a couple of times but I have never stayed clean for more than a couple of weeks at any one time. One thing that always gets me is how crappy I feel when I don't use, even after I am over the worst of the withdrawals. I understand that my dopamine systems can be damaged for a long time after a long time of heroin use and that this can make it hard for me to feel pleasure like I used to feel before I started using heroin What I want to know is how much of my dopamine systems I can expect to recover and how long this is going to take. If I know that things will get better then maybe i will be able to stick it out when I try next time.

Dr. James Strawbridge Says...

There is only one addiction---dopamine addiction. When heroin addicts shoot up, the street drug causes their brains to produce dopamine. Heroin is a trigger. It's the dopamine flow that actually creates the sensation of being 'high.' When it comes to scoring dopamine rewards, there are many triggers. For some the target is cocaine. For others it can be nicotine, alcohol, sex, gambling, or food. Psychological dopamine addictions are more insidious because the dopamine is triggered by highly addictive emotions, memories, thoughts, fantasies, ideologies, rhetoric, and deceptions. Researchers have recently added video games and texting to the list while continuing to ignore the most dangerous triggers that have come to be considered “normal” behaviors. 

The treatment of opioid addiction can be grouped into opioid maintenance with methadone versus abstinence approaches. Choice of proper treatment depends on ones characteristic. The course of heroin addiction typically involves a 2 to 6-year intervals between the start of regular heroin use and seeking of treatment. Treatment takes total psychosocial rehabilitation.

Methadone programs substitute a long-acting methadone for short-acting heroin, and then gradually withdrawal from the methadone. They transfer the addiction from heroin to methadone. Methadone is administered to the patient orally at established methadone clinics. Although a mainstay of treatment, these programs reach only 29% to 25% of addicts, with program retention rates between 59% and 85% (Stimmel, Goldberg& Rotkopf, 1977). Opioid detoxification should be slow to avoid relapse. The drug should be removed by as little as 10% per week. Total abstinence may be the only alternative for many patients. Best of luck. 

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