What is a trigger for heroin use disorder?
Like the trigger of a gun, a trigger for an addict is the event or emotion that drives you toward your addiction–like cause and effect. The trigger or cause creates a craving in the addict, prompting the effect of using their substance.
One of the most important steps toward addiction recovery is to identify your triggers, and either avoid them, or create new, healthier effects. These triggers vary widely from person to person, and can be either internal (such as negative emotions) or external (such as an unhealthy friendship).
Can a former heroin addict ever use again?
Some former addicts think that if they could only learn to manage their addiction better, they can learn to have just a little bit of their substance every now and then. But the risks of heroin are too great to ignore.
First, there is the legal risk; the risk of being charged with a felony for heroin possession is not a reduction of harm.
Its illegal nature also makes it a health risk, as you do not know what other substances might be mixed into the drug. And that is not the only health risk; needle sharing and sexual behaviors lead to an increased risk of HIV, not to mention the risk of death by overdose or suicide.
Triggers for former heroin addicts to avoid
Common substance abuse triggers
- Negative emotions. You may have turned to heroin in the past to cope with or avoid unpleasant emotions, like being stressed, anxious, or depressed. Obviously you are not going to be able to avoid feeling uncomfortable forever; instead, you will need to find healthier ways to cope with stress. Seek some kind of therapy such as stress-reduction or cognitive behavioral therapy.
Uncomfortable physical sensations can also make your negative emotions worse. Try to get an adequate amount of sleep and eat a good diet so you don’t put too much stress on your body. - People. It will be important for you to distinguish the supportive people in your life–friends and family that respect that you’re abstaining from drugs and alcohol–and the toxic people in your life. If you still have people that don’t support you in recovery, especially friends that you used to use with or friends that are still addicts, you may need to set boundaries with those people.
- Places. Any places where you used to use drugs, or places that you associate with your former drug use, should be avoided. That said, for many people, their favorite place to use was while sitting at home. If that’s you, try to find any excuse you can to get out of the house. Visit a park, a cafe, the library, a support group–whatever you can so that you’re not home alone. (See also “Boredom” below.)
- Social situations. Social situations, including holidays, can be extremely stressful for a former addict. You may have to interact with family or friends that you don’t particularly get along with, or even try to interact with people who you knew while you were still actively using.
If a particular holiday or party is going to overwhelm you, you don’t have to go. Instead, surround yourself with people who love and support you. - Pain. Relief from pain is what starts many people on the road to addiction to opiates; those who have previously used opiates to treat pain are 19 times more likely to later turn to heroin. If you suffer from chronic pain, talk to your doctor or a chiropractor about your options–they may prescribe you something non-addictive, or recommend a therapy technique like mindfulness or meditation.
Less common substance abuse triggers
While the above forms a great starting point on triggers to avoid, the path to recovery is very individualized and personal. Here are some other less common triggers that former addicts shared with me.
- Music. Whether it’s a song with lyrics that glorify substance abuse, or a certain artist that reminds you of an ex-friend or partner that used to use with you, music can be a big trigger for some people. Take those songs or artists off of your favorite playlists.
- Five senses. In addition to the sound of music (pun intended), make sure you consider whether you have any associations with tastes or smells–particularly if you used to use cigarettes or alcohol alongside the drug. The taste or feeling of alcohol in your mouth or the smell of cigarette smoke may bring back strong memories. This one is difficult to avoid, as there’s a high chance you’ll encounter that triggering smell in your everyday life; however, don’t go out of your way to seek those associated sensory experiences, either.
- Media. Even if you can’t avoid every depiction of substance abuse in the media, there are some obvious shows to avoid, such as Mad Men and Breaking Bad (and even animated shows like Archer). In addition, many former addicts find any depiction of veins to be a trigger; you may want to avoid shows with bodybuilders, or people that are otherwise bulky enough for their veins to show.
- Boredom. Sometimes people turn to substance abuse in lieu of anything better to do. In “Places” above, I’ve given you some tips for how to keep yourself out of the house. You may also want to find an engaging hobby. The more creative the hobby is, the more accomplished you’ll feel!
- Positive emotions. We’ve mentioned that people use in order to hide from negative emotions–boredom included. But some people may also use to reward themselves for meeting a goal or making it to the end of a busy week. Rewarding yourself for a job well done is an important part of self-care, but there are healthier options, such as a dinner out, a new haircut, or a small purchase.
Alcohol use in former heroin addicts
Some addicts in recovery are tempted to turn to alcohol instead of their substance of choice. They think of this in terms of harm reduction, as they see alcohol as less detrimental to the body than heroin.
In some cases, recovery from one substance can provide a “toolbox” of recovery skills (such as better mental health and emotional support), which can prevent a future substance use disorder (SUD). However, be warned: according to a 2014 study in JAMA, 20% of studied individuals that successfully remitted from their first substance use disorder developed a new substance use disorder. Former addicts need to be extremely mindful and cautious when using any other substances to avoid another painful process of addiction and recovery.
Marijuana use in former heroin addicts
Many turn to heroin for self-medication for chonic pain, anxiety, and depression–all features that advocates say marijuana can help. However, is marijuana really a healthier or safer option? We think not, and here’s why:
- Legality. Marijuana possession is decriminalized in North Carolina, but possession of large amounts is still a felony under NC law.
- Purity. Because you have to turn to illegal avenues to purchase marijuana in NC, you cannot guarantee the safety or purity of what you’re buying.
- Triggers. Many of the back-alley vendors of marijuana may also sell other illegal drugs, including heroin; it’s better to avoid the temptation.
- Lack of research. On the federal level, marijuana is classified as a Schedule I drug, meaning that research on the safety or potential medicinal value of marijuana is limited. That said…
- Health risks. Along with risk of addiction, the limited research we have (compiled in a 2017 review by the National Academies of Sciences, Engineering, and Medicine) suggests marijuana use comes with a heightened risk of motor vehicle crashes and trouble with the respiratory and bronchial tract. (That study did show substantial evidence of marijuana’s efficacy in treating chronic pain, but did not have conclusive evidence on its use to treat anxiety or depression, as proponents claim.)
For all these reasons, using marijuana in place of heroin cannot be recommended.
Replacing your heroin addiction with healthy coping mechanisms
It’s impossible to avoid all triggers when recovering from a heroin addiction. You will come face to face with people, places, and situations that remind you of your old life, and you’ll need some way to handle the urge to use again.
The best way to prepare for this is through healthy coping mechanisms. Lucky for you, we’ve already discussed some of the most important coping mechanisms you can use instead of turning to your substance of choice:
- Therapy
- Healthy sleep and food patterns
- Removing toxic people from your life
- Relying on a support network of friends
- Staying mindful of your surroundings and your triggers
- Finding hobbies that interest you
There are dozens of different coping mechanisms or self-care techniques that might help you in your recovery. For some more ideas, check out one of my favorite articles on the 5 Pillars of Self-Care by my Twitter friend LoveMeTreatMe.
The Bottom Line
By replacing your old habits with new, healthier coping mechanisms, you can overcome your addiction, get your old life back, and create a stronger, healthier you!