Feeding a Habit
It isn’t exactly a reasoned choice oxycodone addicts make in switching to heroin. As is typical, Graham developed a tolerance to OxyContin and had to keep upping his dosage to get the same effect. Because the addict has to continually up his dosage to get the same effect, the addiction can be life-consuming, Lewis Galway says, licensed professional counselor with Intermountain Healthcare system. He has counseled substance abusers for 20 years.
Heroin offers a much more rapid delivery system for addicts, Galway says. While in his work he meets people who grind up and snort the opiate-based pills, the needle system or smoking of heroin is preferred.
At one point, Graham tried to quit OxyContin by illegally buying suboxone, a synthetic substance used in treatment. Galway explains that suboxone blocks the opiate at the brain synapse receptor site and stops both the craving and the subsequent withdrawal. “It is the method of choice for maintenance treatment for opiate addiction for many facilities and outpatient clinics,” Galway says.
Says Graham: “It worked so well the first time, I figured I could use again.” But soon he was trading pills for suboxone, simply repeating the cycle of quitting and relapsing back into his habit.
Eventually, he was arrested for identity fraud and forced to detox in jail. He left jail clean, but Graham started using again while on probation. He tried to cheat his court-ordered drug tests by quitting a couple of days before the tests and “cleansing” his body with a drink addicts believe will trick the system.
Kristin Howell, 19, first took two of her stepfather’s Lortabs, then used them occasionally. Eventually, it was OxyContin. “A good high,” she says, “but very expensive.”
She first paid $35 for an 80-milligram pill. Then the price rose to $55. She was 16 when she overdosed on OxyContin. “I was really sick. I threw up everywhere,” Howell says. “I told my parents I quit, but I never did.”
Instead, she discovered that heroin was stronger, easier to get and cheaper at $10 a balloon—one hit. Economics count, Galway says, who cites one case of OxyContin addiction that set back the user $30,000 a year.
“People don’t take Lortab or Oxy thinking they will eventually shoot up heroin,” Galway says. “It’s a pill; somebody has a prescription. It’s legal, it’s clean. A buddy gives them one, and they take it. They take one more and like it, and the next thing you know, they are addicted.” Odyssey House’s Schmidt agrees. “We are a pill society, and there isn’t a stigma related to a pill. The misconception is that this is a prescription medication and is therefore safe. People are more willing to cross that bridge.”
But again, financing the habit becomes crucial. One client of Odyssey House told Schmidt he could sell 80 milligrams of OxyContin for $60, while $18 to $25 could buy a balloon of heroin, which gets into the bloodstream faster and lasts all day.
Still, “some folks work very hard to stay with pills,” Schmidt says. “They aren’t willing to go as far as using heroin because they feel it carries a stigma. They will pay a lot of money, doctor shop, steal a prescription pad. And they are scared. They think, ‘If I smoke or shoot heroin, I really am a junkie.’”
The self-deception continues, up until pharmacies will no longer fill an addict’s prescriptions. “They know that if they run out of ideas and have hard time getting the pills, they can always get heroin,” Schmidt says.