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Comment by hessenwolf | Hacker News Reader

This is interesting, as it turns my viewpoint on its head. I firmly believed heroin addicts were all zombies. You are arguing they are quite completely saveable.

It changes my view on whether it is useful to help somebody. Do you have any references for this?

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I've shared my experiences a number of times, and you'd be amazed how many other programmers have contacted me to express their situation. "Functional" addicts are far more numerous than common knowledge would have you believe, but the stigma is so great that it's something that remains rather impossible to find out.

Heres an interesting fact. About 23% of people who use heroin (not opiates in general, heroin specifically) become addicts[0]. I've always found that rather interesting, and matches up perfectly with my anecdotal experience. I'm one of the 23% unfortunately.

Edit: As I said in a comment above, no-one wants to remain on heroin forever. You truly will want to stop at some point, even if it causes no issues in your life (good luck with that!) -- every addict I've known has hit that point eventually. I did. I was just lucky my government and society supported me in getting clean. Others in other countries aren't so lucky, and I think that's a shame.

[0] http://www.drugabuse.gov/publications/drugfacts/heroin

Your 23% statistic is very revealing; in recent years there's been a lot of research into the underlying neurobiology of addiction. Turns out that addicts are often quite predisposed to getting addicted, either through genetics (such as variants in the components of neurotransmitter systems) or their early environment. And through long-term changes in the brain from substance abuse - as an example, over-consuming alcohol over time can damage the frontal cortex, impairing decision-making, including deciding to stop drinking, so you end up with this feedback loop of sorts.

I find it very unfortunate that society hasn't caught up with this way of thinking and mostly still regards addiction as a moral vice, rather than a lifelong illness.

I hold the suspicion that if you check up on most addicts of any kind, you will find someone that had social issues before touching drugs.

Possibly. But for me 'social issues' is a bit too vague for comfort.

Very normal, in itself healthy social interaction could bring one to alcoholism for example, and nobody, including the addict, will be aware of the problem for a long time.

I believe a more interesting claim would be to say 'social issues involving a significant other'. It's easy to hide problems of various kinds from your friends; it's much harder to do so with a partner, especially living together.

I'm not saying having such a partner prevents addiction, but I do think that it makes it harder to maintain without ramifications. I suspect a significant part of addicts either lack in a significant other, or have one who suffers from 'compatible' issues.

Personally I've found that partners and flatmates (family or otherwise) are a primary reason for not spiraling into bad habits (or addictions). With friends it's too easy to 'manage' yourself.

The Rat Park experiment provides a lot of insight here:

https://en.wikipedia.org/wiki/Rat_Park

If you prefer the graphic novel:

http://www.stuartmcmillen.com/comics_en/rat-park/

I think you might be surprised by the number of functional heroin "addicts" there are. There are a lot of people holding down "good" jobs while using.

I don't feel great about posting non-throway, but hey.

My anecdata (10 > N < 20) are that most opiate users generally work out OK (<10% problem rate). Like most habits though, it's not a great thing to be stuck with. Worse than being a smoker although the smart ones will be quick to point out it's biologically better.

It's a thing you can actually grow out of, too. The people who don't usually have other problems.

Yeah, I actually know of at least one doctor who was on heroin (while practicing). Started with an opiate (painkiller) addiction and then led to heroin. Actually, it's pretty common for people who've been prescribed painkillers to start using heroin once they can no longer get their painkiller prescriptions filled/represcribed.

Given that Herion is pretty much distilled opium, that's not really a surprise.

Reminds of an anecdote from when a needle room was opened in Oslo, Norway. Sure, they expected may homeless and such. But what they also got was people in suits driving fancy cars, that stopped by to do a dosage before heading to so big wig office or party.

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