Dear Dr. Levy: Some of my friends have been snorting heroin. They said they won't get addicted and you can only get addicted if you inject it. Is that true?
A: I am glad that you are questioning your friends because they are completely misinformed. A person can definitely get addicted to heroin by snorting it. The heroin we now see is very potent. Not only can it lead to addiction, it is not uncommon for a person to first begin snorting heroin and then start injecting it. In fact, many people have first started to snort heroin and over time, they eventually start using it intravenously.
I strongly encourage you not to use heroin. Nothing good can come from this for so many reasons. Again, please do not try this drug.
Dear Dr. Levy: I'm worried about a friend of mine. She has been taking methadone for a few years now (not through a clinic). I've heard her express how she wants to eventually get off it, but she's afraid of withdrawals. She's been taking a few milligrams a day for two years. She works full time in a respectable company and has a great position. Her children are very grounded, but confided to me that they do not know if her using this drug is wise. She mentioned that she got off methadone once before, stopping cold turkey. She said it was very bad for two months, and is afraid to do that again, but that's what she's planning. As a concerned friend, I want to be there for her. Could this be dangerous for her? That's what I've been told.
A: Generally, withdrawing from methadone is not particularly dangerous or life threatening, although withdrawal among heavily dependent users who are in poor health can potentially be fatal. However, in general, withdrawal from methadone and other opiates is considered less dangerous than alcohol, barbiturate and benzodiazepine withdrawal.
But it can be quite uncomfortable, and there can be a protracted withdrawal that can last for several months when she continues to struggle with some anxiety, insomnia and energy issues..Acute withdrawal typically.produces drug cravings, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (experienced by those going cold turkey), kicking movements, and other symptoms.
To avoid extreme discomfort, it would make sense for her to slowly detoxify herself..Even though she is taking only a few milligrams, a slow, steady taper would be helpful..While your friend may not be willing, I would encourage her to consider doing this under a physician's supervision, either on an outpatient or even on an inpatient basis. If I can be of further help, please contact me again..
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Send questions about addictions or related problems to: Take The First Step, c/o Salem News, 32 Dunham Road, Beverly, MA 01915; or send e-mail to michael_levy@cabhealth.org. Questions will be answered in confidence by a clinical team led by Dr. Michael Levy, director of clinical treatment services at CAB Health & Recovery Services in Peabody and author of "Take Control of Your Drinking...and You May Not Need to Quit."
