Psychology of drug overdose

[Gary7]

One of my very favorite actors died from a drug overdose recently. You probably all know who I'm talking about: Philip Seymour Hoffman.

I have a friend who lives in the same building where he was residing, on Jane St in Manhattan. She and her family knew Philip and his wife (light casual, not close). Philip was very friendly to everyone and just an all around great guy. You'd never think he was some Academy Award winner and highly sought out for Hollywood films.

So here's this man living his career dream, but his personal life wasn't so good. His partner, Mimi O'Donnell, was just his "partner" and mother of his children, but they hadn't married. Curious. They were together from 1999 until 2014. Was his public life taxing their relationship? Possibly. Rumor had it she was leaving him. Divorce/separation is nothing new and almost always an emotionally wrenching experience. Was Philip so isolated that he didn't have anyone to talk to? Or was it more about the pain killers leading him back to heroin, and just the insidious nature of the drug that consumed him?

Philip had plenty of warning signs around him. Look at all of the celebrities who recently suffered drug related deaths. And yet... just to think of his kids, them suffering his loss and an impact that would be with them for the rest of their lives. If he loved them with all his heart, how could he allow himself to ignore that and risk his life with a heroin binge? I just don't get it...

 

[thestrangequark]

Brains are complicated, lives are complicated, and the mechanism of addiction, physiological and psychological, is complicated. Love for one's children doesn't preclude risky behavior, especially with all the compounding factors involved in drug addiction. Cognitive dissonance can allow someone to feel that being there for his kids is the most important thing in the world, and that shooting up is an acceptable (or even necessary) risk. None of us can know what was going on in his head, but his drug use doesn't mean he was ignoring his love for his family.

 

[Gryffindorian]

More PSH/addiction discussion here.

 

[Gary7]

The cognitive dissonance must've been really strong with him. When you've reached that rare level of success (just think of the extremely small percentage of people who win a Best Actor Academy Award), life is even more precious. It just goes to show you how powerful drugs are at warping your perspective.

Apparently heroin is a growing problem in the USA once again (1970's repeats). I have a friend living in Vermont and there's practically an epidemic among young adults using the stuff up there.

Anyway... I just wanted to talk more about what things can be done to help people who've been sucked into the heroin syndrome, so I opened a new topic instead of enmeshing it with the PSH thread. I know this is nothing new and that experts in this subject would have better luck... but I think creative solutions can come from people outside the box.

 

[Saga]

If he loved them with all his heart, how could he allow himself to ignore that and risk his life with a heroin binge? I just don't get it...

because he was an addict. its the law of diminishing returns. after awhile your body builds up resistance. they always chase after the ultimate high they've felt at some point.

i've lived with and worked with people like this. they knew it was wrong to spend the rent on drugs, but it didn't stop them. no matter how much you love someone if you're an addict and you have a bad day at work or whatever you'll do anything to feel good. or to just feel nothing for awhile.

 

[CorporalCaptain]

The cognitive dissonance must've been really strong with him. When you've reached that rare level of success (just think of the extremely small percentage of people who win a Best Actor Academy Award), life is even more precious. It just goes to show you how powerful drugs are at warping your perspective.

Sorry, but the idea that rare success makes life more precious is utter nonsense. Something that's already irreplaceable can't become more irreplaceable. Conversely, nor can something that is fundamentally irreplaceable be any less than that.

That false premise, that how worthwhile living is depends upon achievements, isn't a good place to begin in order to understand addiction, much less life itself. That false premise implies that failure must diminish the reward of living, just as it implies that success should overshadow all one's concerns. Both of those consequences are false, which is enough to demonstrate the falsity of the premise itself.

One of the things that addicts must deal with to stay clean is to learn to respond to the things that trigger them in healthy ways. Treating addiction under the premise that addicts can better stay clean, if only they're successful in their endeavors, just asks for them to relapse, relapse, and relapse again. Generally speaking, that approach simply fails to address the issues that need to be addressed. It's a poor substitute that will ultimate prove insufficient.

 

[TEACAKE'S PLEATHER DOME]

I think the subject of this thread is poorly worded. "Psychology of substance abuse and addiction" would be better. Overdose is generally an unsought after side effect.

I've known people who have been IV drug users for over a decade, sometimes a lot longer than that. There is a lot of harm minimization information out there (and this country has free needle exchange etc.. and you're not criminalized for your kit). Making the conversation about responsible drug usage and harm minimization has saved a lot of lives as I understand it, as opposed to previous methods of dealing with addiction which were punitive and all or nothing.

The reasons for ongoing addiction is as varied as people.

I remember when I was in the fourth grade we had anti drug people come to assembly. In the middle of the dramatic tales of death and disease one of the presenters read out a description of the effects of a particular drug, what the high did to people. My friend sitting next to me whispered in my ear, "that sounds FANTASTIC."

 

[think]

Apparently heroin is a growing problem in the USA once again (1970's repeats). I have a friend living in Vermont and there's practically an epidemic among young adults using the stuff up there.

My mom did enough heroin in the 70's till she died from it in 1975.,, I would of liked to of known her better, I inherited her library included was the book licit and illicit drugs, getting jump start on drug use,..

 

[HaventGotALife]

I suffer from addiction to food and cigarettes. Both are legal, and readily available. I am quitting smoking on Tuesday, a hard quit day, as I have been decreasing the amount of cigarettes I smoke per week.

What I can say about this is imagine craving a glass of water. You are thirsty and only water will quench your thirst. That is what it feels like to have a craving, an addictive substance. You feel the same sense of urgency you do to quench your thirst.

Each trigger is different. I smoke when I'm bored and to entertain me. I have to replace those behaviors, but because it lights up certain areas of my brain, nothing feels like a cigarette feels after a long absence. So I can chew gum, but I chew gum knowing that a cigarette will make me feel better.

I hate cigarettes. They are killing me and I had a HBP reading at 29-years-old. My Dad was a 3-pack-a-day smoker for 30 years and dropped dead of a heart attack at the age of 55. I hate them. But I still feel like I need them and only reasoning myself out of it--they are horrible for my health, all the studies, my dad's death, etc--can I convince myself that they are bad for me. It feels good. The high always does. Quitting is taking that knowledge and combining it willpower. Sometimes we are weak, even after a long time. It never goes away.

So, if you are successful, do you never get thirsty? One doesn't have to do with the other. It affects all walks of life. It is dangerous to experiment with any drug because it can become the most important thing to you in your life at the expense of just about everything else.

So I say: "DON'T EVER SMOKE!!!" as I continue to have this beast I have to watch every second of every day. If they are in the house, I won't even think about it, they will be in my hand and lit. It's that simple. You don't think about breathing, sometimes you don't realize you took a hit off a cigarette. It's in the autopilot mode of our lives. It's that innate. It's that compulsive. And no amount of education can stop you if you want it. Nothing tethering you to this life--kids, jobs, family, success, money--will stop you when you give in.

It's not about the kids not being enough. It's about quenching the thirst, the appetite for something that makes you, eventually, just feel normal. It feels like something is missing from your life and you have to have it back. People cry over cravings. People mourn losing their substance.

 

[Gary7]

Is "utter nonsense" really necessary to refute something?


Well, here's the deal from what I've learned thus far:

Philip Seymour Hoffman abused drugs some 20+ years ago. He abused heroin then. Then he got clean. He'd been drug free for a very long time.

Unfortunately, once you have subjected your body to heroin addiction, it is forever extra susceptible to becoming addicted to the drug again. The real problem with PSH was that he had a back injury and was taking an opiate based pain relief drug. Well, legal prescribed opiates are related to heroin (they all share the poppy). Thus, once on the opiate pain killer the urge to take more and more of it increases faster than it does for those who never had a heroin addiction.

PSH ended up switching over to heroin when the pain killers were either exhausted or not "giving enough."

Base line, it does beg the question... shouldn't anyone who had a prior addiction to heroin be prohibited from using opiate based pain killers? Or if they do use them, they need to be kept under close observation. Never left alone for long periods. That sort of thing. Such a rule could have saved PSH's life, IMHO.

 

[thestrangequark]

^Similar rules are already in existence, and in my experience, all they do is make life fucking miserable for the few ex-users who end up needing pain medication.

 

[CorporalCaptain]

Is "utter nonsense" really necessary to refute something?

I assume that was directed at me, since I said:

Sorry, but the idea that rare success makes life more precious is utter nonsense.

Since I thought the idea was "utter nonsense" and still do, was it necessary to call it that? Yes.

Additionally, I went on to give a very specific enumeration of some of the reasons why it's spurious to assume that some people experience life to be "more precious" than others do. Was it necessary for me to back my assertion up? No. But in the interest of engaging in constructive discussion, I did.

However, since I did in fact back up what I said, going beyond what was, strictly speaking, necessary, it can't really be said that my calling the notion "utter nonsense" constituted any part of the actual refutation. So, were the words "utter nonsense" used to refute anything? No.

I also led with a word of apology, in acknowledgement that I was about to be blunt. Was that necessary? No. But I said it anyway.

Bottom line, when a statement has been made suggesting that some peoples' lives are worth more than others, or at least implying that movie stars have a greater reason to hang on to life than regular folk, in what world is a strong refutation of that statement unexpected or even unreasonable? The courtesy in leading with a word of apology was just that: an unnecessary courtesy.

Do you have anything in the way of counterargument?

 

[Gary7]

Do you have anything in the way of counterargument?

I could, but what would be the point if only to entertain you?

 

[Gary7]

^Similar rules are already in existence, and in my experience, all they do is make life fucking miserable for the few ex-users who end up needing pain medication.

Perhaps the rules need to be refined then. Certainly if it has been ascertained that someone was a heroin addict, they should either be strongly advised against taking opiate based medications, or that they be assigned a proctor to keep tabs on them for the duration of the prescription. Life is precious, is it not? I do realize it would become more complicated with a chronic condition, but in PSH's case he needed relief from back pain he was experiencing, at least until the damage could be fully healed.

 

[thestrangequark]

Do you have anything in the way of counterargument?

I could, but what would be the point if only to entertain you?

CC is correct in this one, just because he had success as an actor doesn't make his life any more or less precious than anyone else's. I don't really see how you can back up that assertion.

^Similar rules are already in existence, and in my experience, all they do is make life fucking miserable for the few ex-users who end up needing pain medication.

Perhaps the rules need to be refined then. Certainly if it has been ascertained that someone was a heroin addict, they should either be strongly advised against taking opiate based medications, or that they be assigned a proctor to keep tabs on them for the duration of the prescription. Life is precious, is it not?

It can feel a lot less precious when you're in constant pain and aren't allowed proper medication because of a mistake you made decades ago. Yes, abuse is a legitimate concern, but denying medication isn't the answer. Ex-addicts are highly aware of the risk of addiction again, but not all addicts are the same. The idea that you do it once and you're hooked is a myth, and the idea that once you're clean, you're forever at risk of again being hooked is also a myth. They're gross generalizations, true of some, in some circumstances, but by no means all in all circumstances. I'm not going to pretend I have a solution...the idea of a proctor is nice, but expensive and impractical.

 

[thestrangequark]

This has been making the internet rounds in the wake of Hoffman's death, Gary7, you might find it interesting. It is an eloquent answer to the question, "What does heroin feel like?" originally posted on Reddit. I can't attest to its accuracy, having never done heroin, nor ever having become addicted to a substance myself. However, I have taken other opiates, and he's spot on with his description of how it makes you feel.

Actually this is an obvious question but it’s not what you might think. Let me explain it to you, I’ve been an opiate addict for a long time and tried many drugs. Drugs that are ‘uppers’ have the most ‘obvious’ euphoria. For example if you take adderall/coke/meth/speed/MDMA you will get this shining bright euphoria, self confidence, energy, and other drug-specific feelings (for meth like you are king or for MDMA like you love everyone).
However, you owe these drugs back what they delivered to you. After a meth binge, or lots of MDMA use, or staying up all night on coke you will feel like shit. To an extent this aspect is similar to an alcoholic hangover.
On the other hand, for many people who experiment with heroin they are underwhelmed (not including IV usage, but most experimenters rarely ever IV first time). They just feel good, chill, happy, but they feel like this spooky drug ‘heroin’ hasn’t delivered. They are just mellow. Oh obviously it has all been a lie they will think.
Heroin isn’t spooky, it’s chill. It’s not addictive like everyone else thinks. It doesn’t make you do stupid shit or stay up all day and hallucinate like amphetamines or coke. It doesn’t empty your serotonin like MDMA or give you a hangover like alcohol. People tend to just think oh, what a nice drug.
So the next day they wake up and everything is normal. No headache or shitty feeling—just a slight afterglow of that nice feeling. Oh it was cheap as well! It only cost $10 for a whole night of being high! I thought people said heroin was expensive? And then next weekend comes… There are all these drugs I could do but I liked heroin.
It didn’t ‘fuck me up,’ I could still think clearly. No hangover. No feeling like shit later. I still was awake. It just made me happy and content with life. Oh and it’s only $10! Well, I should get some more for the whole weekend. This is great! I will use heroin on the weekends now!
Now let’s say this person works and has responsibilities. He knows he can’t go into work drunk, or on MDMA, or high. So he doesn’t. It’s actually simple. But heroin… Well the user might actually find they do better work on heroin. Instead of being sad or grumpy or depressed with his job… he is just… happy. Mellow. Content. Everything is fine and the world is beautiful.
It’s raining, it’s dark, I woke up at 5:30AM, I’m commuting in traffic. I would have had a headache, I would have been miserable, I would have wondered how my life took me to this point. This point I’m at right now. But no, no, everything is fine. Life is beautiful. The rain drops are just falling and in each one I see the reflection of every person’s life around me.
Humanity is beautiful. In this still frame shot of traffic on this crowded bus I just found love and peace. Heroin is a wonder drug. Heroin is better than everything else. Heroin makes me who I wish I was. Heroin makes life worth living. Heroin is better than everything else. Heroin builds up a tolerance fast. Heroin starts to cost more money.
I need heroin to feel normal. I don’t love anymore. Now I’m sick. I can’t afford the heroin that I need. How did $10 used to get me high? Now I need $100. That guy that let me try a few lines the first time doesn’t actually deal. Oh I need to find a real dealer? This guy is a felon and carries a gun - he can sell me the drug that lets me find love in the world. No this isn’t working, I need to quit.
To answer your question, heroin feels nice. That’s all, it just feels very nice. You can make the rest up for yourself. Attach your own half-truths to this drug that will show you the world and for a moment you will feel as clever as Faust.

 

[Emher]

I was for a while suffering of an eating disorder akin to food addiction. And it's an odd thing. While of course different then drugs, since you actually need food to survive, it's still that feeling of trying to feel better. I didn't eat all that because I needed to for energy, I ate it because I felt like shit and hated my life.

Look, I'm not going to have any illusions that I know how a drug addict feels. It's just my way of looking at it.

 

[TEACAKE'S PLEATHER DOME]

That was very interesting tsq, thank you for posting it.

 

[Gary7]

Thanks for that post, tsq. I do admit that I made a generalization that was founded on hearsay, and I don't have any scientific studies to reference it, about once being an addict that there's an "imprint" making it so much easier to rekindle the addiction. I do know from friends who have smoked then quit for years, only later to go back and find it takes one or two cigarettes to ease right back into it. And another anecdotal citing was a friend who was addicted to cocaine, quit, went back, then quit again who attested that the relapse required more drug to get high than the first time he'd done it. I imagine heroin has similar qualities but if there's a propensity for it to be worse? Unconfirmed.

But the quote brings about just how insidious heroin is. Hardly any side effects. But each time you need a little more to achieve the same high. Until you've built up such a tolerance that getting off it ends up being a serious crash. Heroin does alter your mood and your perspective. Who knows how much and in what ways it did it for PSH. Whatever it was... we all know the ending.