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The American Society of Addiction Medicine defines addiction as a chronic disease resulting from dysfunction in brain circuitry, especially regarding the reward system. This dysfunction manifests itself in a variety of ways and is characterized by a lack of self-control, intense cravings, and diminishing concern for any negative consequences that might arise with continued use.
There are effective ways to treat drug addiction, but some substances are inherently harder to quit than others. The hardest drugs to quit in order of difficulty are heroin, crack cocaine, methadone, and crystal meth.
Heroin is an opiate derived from morphine, and it is often called the most addictive substance on earth. According to the National Institute on Drug Abuse, heroin produces feelings of intense euphoria. When users smoke or inject it, it hits the brain fast, bringing on the high quickly, which can result in powerful cravings once it subsides.
Heroin is an illegal drug, so individuals never know what they are actually taking when they purchase it from a drug dealer. Pure heroin is a white powder, and it has a bitter taste, but drug manufacturers and dealers regularly cut it with a number of toxic additives to increase their own profits. Since users have no way to truly know how potent their batch is without performing a chemical analysis, they have the potential to overdose every time they use. According to the Centers for Disease Control and Prevention, the number of fatal heroin-related overdoses nearly quadrupled between 2002 and 2013.
There are a variety of treatment options following medical detox for individuals who are trying to quit heroin. A combination of pharmacological and behavioral therapies can help restore the circuitry in the brain that the addiction altered. For example, medications that affect the same opioid receptors as heroin can treat withdrawal symptoms and minimize cravings during recovery. Methadone is a popular opioid agonist that people often take under the guidance of a doctor when they are quitting heroin. Once individuals have overcome the worst of the withdrawal, they can then taper off methadone in a safe and healthy way until they are eventually entirely drug-free. Buprenorphine is another medication option in treating heroin addiction.
An important part of quitting heroin is undergoing a complete physical because persistent use of the drug can result in certain diseases and issues. For example, individuals who share needles are at risk of hepatitis B and C, as well as HIV. Quitting heroin may be the hardest thing that some individuals ever have to do, but it is always worth it.
The first step to quitting heroin is entering medical detox. Quitting heroin at home is dangerous because withdrawal can get so uncomfortable that individuals relapse just to ease the symptoms. The intensity and duration of withdrawal vary, but there are a few symptoms that many people experience.
Crack cocaine is a powerful stimulant derived from powdered cocaine. According to the National Drug Intelligence Center, it first emerged in the 1980s and grew in popularity because it is easy and inexpensive to create, and it produces an immediate high. People who use crack cocaine almost always smoke it in order to feel an intense euphoric effect immediately. According to the National Survey on Drug Use and Health, 354,000 people were using crack in 2014.
Crack cocaine is hard to quit because it produces one of the most powerful psychological dependences of any substance. Many people develop a compulsive crack habit shortly after starting use, and individuals can build up a tolerance quickly. Once a person enters recovery and physical dependence subsides, psychological dependence may still remain.
The amount of time it takes an individual to get over an addiction to crack cocaine varies depending on a variety of factors. Psychological withdrawal symptoms like anxiety and intense cravings can last for months or even years. Initial withdrawal symptoms include panic and anxiety followed by depression. A few days after the last dose, some people experience a kind of “honeymoon stage,” where they suddenly feel fine and believe they have kicked the addiction; however, it is usually followed by strong cravings. One to two weeks after last use, the compulsive cravings return because the brain is struggling to regain its normal circuitry.
Luckily, there are ways to ease the worst crack cocaine withdrawal symptoms. Medications can address specific symptoms, and holistic treatments are often employed during detox. Many individuals find support groups especially helpful, as well as gentle exercise, a healthy diet, meditation, and therapy.
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According to the Substance Abuse and Mental Health Administration, methadone can minimize the most painful symptoms of opiate withdrawal, and it has been used for decades to help people quit heroin and some narcotic medications. Under proper medical guidance, methadone can help individuals struggling with addiction; however, methadone itself is also highly addictive. Individuals who abuse it can develop a dangerous tolerance that prompts them to take hazardously large doses.
According to the Centers for Disease Control and Prevention, statistics show that in 2010, methadone was involved in 31.4 percent of fatal opioid pain reliever overdoses in 13 states, but it only accounted for 4.5-18.5 percent of the opioid prescriptions distributed in those states.
Individuals who are addicted to methadone will experience intense withdrawal symptoms if they try to quit, but the withdrawal process can be managed in a medical detox setting. Within the first few hours of quitting methadone, individuals experience anxiety and restlessness followed by flu-like symptoms. Symptoms usually arise within 30 hours of the last dose and can last for several weeks.
For many people, it takes the body longer to cope without methadone than it did to become addicted to it in the first place. People suffering from severe withdrawal symptoms can take clonidine or buprenorphine to ease them, but it is critical they only do so under a doctor’s careful watch. In severe cases, doctors actually prescribe methadone to people who are trying to quit methadone, which means they essentially help the person taper off the drug slowly until it is no longer needed.
Methamphetamine, or crystal meth, is a highly addictive illegal drug. It is a synthetic stimulant made with pseudoephedrine, which is an ingredient found in many cold medications. Crystal meth produces a powerful high that leads many individuals to crave it again almost immediately. Using crystal meth for an extended period of time leads to tolerance, and taking it in increasingly higher doses is incredibly dangerous. According to the National Survey on Drug Use and Health, there were an estimated 569,000 methamphetamine users in 2014.
Individuals who want to quit crystal meth can expect to go through five stages of recovery. Withdrawal is the first stage and usually lasts for 1-2 weeks. In extreme cases, it can last for more than a month. Some common withdrawal symptoms are shaking, tremors, fever, chills, nausea, vomiting, and heart palpitations.
Similar to crack cocaine withdrawal, the second stage of quitting crystal meth is often called the “honeymoon stage.” During this phase, many people actually feel great, and they think they have overcome the addiction entirely. A lot of individuals relapse at this stage because of their overconfidence in kicking the habit, but those who do not use again will experience the third stage: the wall.
At some point, the honeymoon stage ends, and individuals feel like they are facing an insurmountable wall. They may feel depressed, bored, and lonely. This stage typically occurs about 45 days after quitting and may last for up to three months. Like the honeymoon stage, many people relapse once they hit the wall. Those who do not relapse will eventually enter the adjustment phase, which occurs when they start adjusting socially, physically and emotionally to a life of sobriety. The fifth and final stage is ongoing recovery, which is the ultimate end goal. Many people have to make multiple attempts to quit crystal meth because it is so addictive, but once they make it to the ongoing recovery stage, they are well on their way to leading a fulfilling life of sobriety once more.
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