Vice Squad
Wednesday, April 18, 2007
Informal Heroin Maintenance

The Guardian today reprints (from Black Poppy magazine) a moving story about a family that is being devastated by a son's ten-years-and-counting heroin addiction. The author of the story is the addict's mom, who also serves as his drug dealer. (She's a college teacher, too.) That is, she decided that the best way to minimize the harms of her son's addiction -- and they have tried many, many alternatives -- is to buy heroin herself and to dole it out to him. But this measure has not made the situation bearable, in part because the purity of the black-market heroin is variable and the cost of street heroin, as her son's tolerance grows, is close to prohibitive.

The son tried various treatment regimens, including methadone maintenance -- all have failed. The article does not mention heroin maintenance, but it seems like it offers the best (short-term, perhaps) hope for improvement. After all, the son already is on a heroin maintenance scheme, but one that is partly undermined by variable purity and high cost. An official heroin maintenance scheme, one that would eliminate these two problems, could hardly be worse.

There are many small insights in the article. I'll only mention one here, the notion that an addict's knowledge of his own failure to handle his addiction can spur more drug use, as a way of blotting out a painful self-awareness.

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