Derek Gentile: In fight on drugs, withdrawal and stigma both hurt

GREAT BARRINGTON — Over the past few months, The Eagle has carried stories about needle exchange programs in North Adams and Pittsfield. It's an excellent idea, as far as I'm concerned. One of the more gratifying things about publicizing these programs is that there is much less pushback, locally, than I've seen in previous years.

But that doesn't mean there is no stigma about being a drug user. There is.

I just wanted to talk about the whole "sense of responsibility" issue. I read and hear people all the time explaining that they would never stick a needle in their arm — that they have been brought up better, or something like that. That such an action would be the line they would never cross.

I don't want to sound too snarky, but the ignorance of that point is breathtaking. So let me explain. Let me put forward a scenario.

You have a drug problem. Maybe it started out as the use of opioid painkillers to treat your bad back. But the painkillers eventually ran out. And your back still hurts. And you still have to work.

Buying more was pretty expensive (up to $100 per pill in some cases), so you chose to use heroin to alleviate your pain. It's cheaper and much more available.

Now, heroin is pretty scary. You don't know how it will react with your body. But boy, one good snort and the back pain disappears in minutes. It is hard to argue with the results. And best of all, you control the dosage! No doctor to restrict your use. That's not bad. And hey, you know you can handle it. You'll be very, very careful. You're not like these other losers! You're way too smart to become a junkie!

But you find yourself using more and more. Your body, you realize, builds a tolerance. And every time you cut back, you begin withdrawal. And one night, you run out of drugs. Maybe you have to wait till the morning to buy more. Or your drug guy is out of town. Or in jail.

I've actually never seen a perfect description of heroin withdrawal. But here's an imperfect one: Imagine all your bones aching at once. You've bonked your arm on a counter or your knee on a table. Man, that hurts!

Suppose that pain coursed through your whole body? And it was relentless. It didn't go away after an hour or two. It remained for 40, 50, 60 hours. That would be real tough.

But in addition, you have diarrhea. And you are throwing up. And throwing up is pretty painful because you still have that muscle pain. You have to do it, but doing it really hurts you.

In the end, the easiest thing to do is simply to lie on the bathroom floor. For what, 20 hours? 30? 40? A while. A long while.

And remember: The pain doesn't go away. You certainly can't sleep. And after a while, you get dizzy because you're so dehydrated. Your muscles start to spasm. You feel as though you might actually die from this combination of ailments. You have no interest in food or drink because of the prospect of it coming out of one end of you or the other. You don't even want to move, actually.

But there is a very simple solution. If you inject a little heroin into your blood, all the sickness, all the pain, all the nausea goes away. All of it. And, heck, you feel pretty good! After hours of pain and sickness, that pleasant feeling is just euphoric. Beyond euphoric.

And yes, you can snort it, too, but the pain and the nausea and everything else doesn't go away right away. It takes a few minutes.

So here's your choice: You know this stuff is bad for you. But heck, you're beyond that right now. You'll maybe deal with that when you feel better.

So if you sniff some dope, things get better in a few minutes. Inject it, and things get better immediately. You can get up and drink some water, maybe eat something. Life, in the very short term, doesn't seem so bad. (It is, and you know it, but again, first things first.)

One of the lessons you learn from this is that it's not a matter of moral strength, or willpower or even a knowledge of the consequences. This is a chemical problem, one that's triggered by hormones in your brain that you can't control. And one we need to understand to combat.

Reach writer Derek Gentile at or by calling 413-854-8162.


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