Heroin is a highly addictive and highly rewarding drug that gives the user a sense of euphoria, detachment from environment and a temporary escape. While some experiment with heroin, others use it to cope with environmental and societal factors that contribute to trauma, poverty and disease because of its ability to provide the user with short-term relief. These people fall through societal cracks and reemerge only to be judged and penalized by society and its legal system. Mental health and substance use programs run the gamut from abstinence to harm reduction and services range from inpatient programs, 12-step meetings, residential treatment centers, methadone clinics to safe-injection protocols with various health care professionals ready and willing to help individuals with substance abuse. But their underlying trauma and environmental factors often remains unresolved. They feel once again compelled to turn to Heroin as a temporary escape from their emotional distress and squalor in which they live; a respite from the harshness of life. One user describes the effects of heroin as “Covered in a warm blanket, where worries are gone” (Kane-Willis, Schmitz, Bazan, Fraguada, Narloch & Wallace, 2011)
In a study done by the Illinois Consortium on drug Policy at the Roosevelt University on suburban heroin use among youth in Chicago, Illinois, had found that one third of those in the survey had misused prescription Opiod pills such as OxyContin or Vicodin before turning to heroin. Most importantly this study discovered that more than 75% of the youth had used heroin to self medicate due to an underlying concurrent mental health disorder such as depression, bipolar disorder or ADHD. Stephanie Elsass, the Stevenson High School substance abuse prevention coordinator, mentions that students suffering from depression and anxiety are at high risk for drug use…...(Kane-Willis et al., 2011)
The following are statements from individuals in this study F- Female, Age 22, Polydrug Use to Heroin
"I loved it. I was happy - I wasn't worried about anything. I have really bad anxiety and depression. I had been diagnosed before I took the heroin"
This individual had taken heroin for two reasons. To self medicate her depression and to maintain close relationships with others. She had lost her father at the age of 9 and her mother was later diagnosed with breast cancer. She as well, has a terrible fear of being alone.
- She goes on to saying -
"I get depressed when I am by myself. I feel like - I don't know. When I was using, I could go to getting high. And now that I am clean, when I get depressed, I go straight to thinking about suicide".
A- Male, Pill Use to Heroin
"A and his two younger brothers were raised in a western Chicago suburb. A's parents divorced when he was about 5 or 6 years old. A described his father as an alcoholic, who in turn abused his mother growing up. A's mother suffered from both anxiety disorder and depression, and A has a panic disorder. After the divorce, A's mother began dating a man who was physically abusive toward him and his mother, and who was also criminally involved" (Kane-Willis et al., 2011)
"He was a bad guy - into coke and associated with the mafia in [a suburb]. He used to beat me a lot and he beat my mom. I have 2 brothers - one 6 years younger than me and one 4 years younger than me. All from the same dad. But I was the only one that was hit"
E- Female, Cocaine to Heroin
"E is Latina; her parents are married and she has an older sister. E was involved in many extra-curricular activities, including drama club, Hispanic club and sports such as basketball, but her attendance in the events decreased as she got older. Her father's relationship with E (and the rest of the family) was extremely volatile and abusive"(Kane-Willis et al., 2011):
"He was never sexually inappropriate but everything else. I had bruises. Nothing on the face. Always on my arms. He was arrested but never charged because my mother would drop the charges".
"E went to a treatment facility after confessing to her mother that she had a heroin problem. At that time, she was diagnosed with depression and placed in the psychiatric ward. After her release, she quickly relapsed. She was still able to buy heroin"(Kane-Willis et al., 2011):
"My mom was still giving me money because she thought I was fine, but I started using about a week later".
- E also felt depressed and lonely as a child - "When I was in the hospital, I was diagnosed with depression. As a kid and a teen I would cry a lot, so maybe I was depressed then".
A Heroin user's lifestyle is chaotic at best. Individual initially uses the drug to cope with existing stressors, which then leads to the deterioration of their health, lifestyle and safety. The user will then continue to use to escape their present conditions. It is a vicious cycle that cannot be stopped without addressing the root cause of their problems. The following are a few risk factors associated with use that may lead to depression and continued use, even if the individual had not suffered depression prior to use as discussed in the study.
Health
Among half of the female interviewees had experienced unwanted pregnancies while they were using
Others had experienced overdoses, and scars or other physical deformities.
Education
As heroin is a short acting opioid the user's constant search for the drug leaves room for little else. Thus both education and employment suffer after a person becomes dependent on heroin.
"More than a third lost jobs due to heroin dependency'
"More than half left educational programs due to heroin dependency (this includes high school and college)"(Kane-Willis et al., 2011)
Homelessness
Loss of support from family members, loss of income, and the cost of supporting their habit may result loss of housing.
"Half of the sample experienced a period of homelessness. It's important to understand that homelessness does not mean that the individual actually slept on the streets' (Kane-Willis et al., 2011)
Victimization
"More than half of the female interviewees had been subjected to a crime. Three were victims of violent sexual assault (all while living in precarious housing/homelessness situations)"(Kane-Willis et al., 2011).
"One time, I was with a dealer and they brought me to a hotel room and locked me in there. And they shot me up [with heroin] and I was real high and I passed out and there were a whole bunch of guys in there and they raped me".
Pharmacodynamic Tolerance of Heroin and depression In time, the neurons become less sensitive to the drugs effect. This can be best described as the brains attempt to maintain homeostasis (Hart et al.2012). Now more drugs are needed to maintain the same level of euphoria. Withdrawal symptoms of heroin range from anxiety, mood swings, chill and sweats but the most compelling symptoms deal with depression ("Heroin.net", 2013). No longer is the individual full of chemically induced "good feelings"; the proverbial warm blanket has been removed and the individual is now faced with the harsh reality from which he was attempting to escape.
Heroin and Depression
Heroin is a highly addictive and highly rewarding drug that gives the user a sense of euphoria, detachment from environment and a temporary escape. While some experiment with heroin, others use it to cope with environmental and societal factors that contribute to trauma, poverty and disease because of its ability to provide the user with short-term relief. These people fall through societal cracks and reemerge only to be judged and penalized by society and its legal system. Mental health and substance use programs run the gamut from abstinence to harm reduction and services range from inpatient programs, 12-step meetings, residential treatment centers, methadone clinics to safe-injection protocols with various health care professionals ready and willing to help individuals with substance abuse. But their underlying trauma and environmental factors often remains unresolved. They feel once again compelled to turn to Heroin as a temporary escape from their emotional distress and squalor in which they live; a respite from the harshness of life. One user describes the effects of heroin as “Covered in a warm blanket, where worries are gone” (Kane-Willis, Schmitz, Bazan, Fraguada, Narloch & Wallace, 2011)
In a study done by the Illinois Consortium on drug Policy at the Roosevelt University on suburban heroin use among youth in Chicago, Illinois, had found that one third of those in the survey had misused prescription Opiod pills such as OxyContin or Vicodin before turning to heroin. Most importantly this study discovered that more than 75% of the youth had used heroin to self medicate due to an underlying concurrent mental health disorder such as depression, bipolar disorder or ADHD. Stephanie Elsass, the Stevenson High School substance abuse prevention coordinator, mentions that students suffering from depression and anxiety are at high risk for drug use…...(Kane-Willis et al., 2011)
The following are statements from individuals in this study
F- Female, Age 22, Polydrug Use to Heroin
"I loved it. I was happy - I wasn't worried about anything. I have really bad anxiety and depression. I had been diagnosed before I took the heroin"
This individual had taken heroin for two reasons. To self medicate her depression and to maintain close relationships with others. She had lost her father at the age of 9 and her mother was later diagnosed with breast cancer. She as well, has a terrible fear of being alone.
- She goes on to saying -
"I get depressed when I am by myself. I feel like - I don't know. When I was using, I could go to getting high. And now that I am clean, when I get depressed, I go straight to thinking about suicide".
A- Male, Pill Use to Heroin
"A and his two younger brothers were raised in a western Chicago suburb. A's parents divorced when he was about 5 or 6 years old. A described his father as an alcoholic, who in turn abused his mother growing up. A's mother suffered from both anxiety disorder and depression, and A has a panic disorder. After the divorce, A's mother began dating a man who was physically abusive toward him and his mother, and who was also criminally involved" (Kane-Willis et al., 2011)
"He was a bad guy - into coke and associated with the mafia in [a suburb]. He used to beat me a lot and he beat my mom. I have 2 brothers - one 6 years younger than me and one 4 years younger than me. All from the same dad. But I was the only one that was hit"
E- Female, Cocaine to Heroin
"E is Latina; her parents are married and she has an older sister. E was involved in many extra-curricular activities, including drama club, Hispanic club and sports such as basketball, but her attendance in the events decreased as she got older. Her father's relationship with E (and the rest of the family) was extremely volatile and abusive"(Kane-Willis et al., 2011):
"He was never sexually inappropriate but everything else. I had bruises. Nothing on the face. Always on my arms. He was arrested but never charged because my mother would drop the charges".
"E went to a treatment facility after confessing to her mother that she had a heroin problem. At that time, she was diagnosed with depression and placed in the psychiatric ward. After her release, she quickly relapsed. She was still able to buy heroin"(Kane-Willis et al., 2011):
"My mom was still giving me money because she thought I was fine, but I started using about a week later".
- E also felt depressed and lonely as a child -
"When I was in the hospital, I was diagnosed with depression. As a kid and a teen I would cry a lot, so maybe I was depressed then".
A Heroin user's lifestyle is chaotic at best. Individual initially uses the drug to cope with existing stressors, which then leads to the deterioration of their health, lifestyle and safety. The user will then continue to use to escape their present conditions. It is a vicious cycle that cannot be stopped without addressing the root cause of their problems. The following are a few risk factors associated with use that may lead to depression and continued use, even if the individual had not suffered depression prior to use as discussed in the study.
Health
Education
Homelessness
Pharmacodynamic Tolerance of Heroin and depression
In time, the neurons become less sensitive to the drugs effect. This can be best described as the brains attempt to maintain homeostasis (Hart et al.2012). Now more drugs are needed to maintain the same level of euphoria. Withdrawal symptoms of heroin range from anxiety, mood swings, chill and sweats but the most compelling symptoms deal with depression ("Heroin.net", 2013). No longer is the individual full of chemically induced "good feelings"; the proverbial warm blanket has been removed and the individual is now faced with the harsh reality from which he was attempting to escape.