(general disclaimer: kids, don’t do drugs)

Heroin is considered one of the most addictive drugs. I keep seeing info like: “The National Institute on Drug Abuse estimates that nearly one-fourth (23 percent) of people who try heroin will become addicted.” - and I can’t figure out if that means that 23% of people who use heroin will become addicted and 77% won’t - or does it mean that 77% of the people who try heroin once or twice stop doing it and that is why they don’t get addicted?

I know I don’t really get addicted to things. I smoked for more than 10 years, then, when my wife-to-be asked me to quit, I quit and never smoked again. It was not hard to do. When I was a kid in college and a bit afterwards, I got drunk, recreationally, quite often. I quit drinking alcohol at the tail end of my 30s and don’t drink at all anymore. And not in the AA manner, just don’t really feel like it and I prefer my sugars the tasty way.

From the “23%” statistics - I wonder if that means that people who are not prone to addiction can use drugs and not get addicted at all? It’s probably genetic - but is there such a thing and are such people (again, looking at the “23%” thing) a majority? It is hard to wade through all the anti-drug propaganda and find out, have there been studies that would determine that?

If you smoked for 10 years you were addicted. Your wife provided a stronger stimuli than the smokes allowing you to overcome it easier. Smokes are more psychologically addictive than physical anyway I believe. Heroin has powerful physical withdrawals as well as emotional. I do agree with you however that there is a big difference in how some of us become addicted or don’t become addicted to things.

How do you know? There are plenty of things I’ve done or consumed for 10 years or more, but I don’t think that proves I’ve been addicted to them.

Crack, I’ve heard, is addictive at the first hit.

Same is claimed for heroin, but the question is - for everybody, or just to the “23%”?

For example, here it says:

"Carl Hart, author of High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society, told CBC Radio’s Day 6 that crack “is not uniquely addictive, or it’s not something that is special, as we have all been taught.”

Hart said that the percentage of people that become addicted to crack is lower than most think. “For example, 10 to 20 per cent of people will become addicted — that means that 80 to 90 per cent of people won’t become addicted.”"

There’s a lot of confusion about addiction.

They give people opiates for pain management, and after taking them for a long time, people suffer from withdrawals after they stop taking the opiates. That’s physical addiction. But most people going through that unpleasant physical withdrawal don’t think to themselves, “You know, this withdrawal is unpleasant, so I’m just going to have to keep taking opiates for the rest of my life so I don’t experience it.”

Physical withdrawal is easy to get over. That’s why addiction treatment talks about “detox” which just means getting over the physical effects of withdrawal of the drug of choice. What makes you an addict is not that you’re afraid of withdrawal, it’s that you return to the drug.

So if you’re an alcoholic, it’s not like relapsing and taking that famous “first sip” turns you into a booze-chugging robot. It’s just that if you choose to drink despite knowing the likely negative consequences of drinking, then that’s addiction. Taking the drink didn’t turn you back into an addict, choosing to drink demonstrates you’re an addict.

The thing is, if you’re “trying” heroin, what does that mean about you? It means you’re the type of person who decides to do heroin, even knowing all the, you know, bad outcomes from doing heroin. It isn’t like you were walking along minding your own business and somebody came by and dosed you non-consensually and now you’ve become an addict. The most that could happen if that happened is that you discover, “Wow, I really really like the feeling of taking heroin.” That feeling won’t make you an addict unless you decide to go out and get some more heroin, because taking heroin is your new best friend.

And again, I really wonder if that is true about the “23%” or everyone. Again, taking my example, I had some serious surgeries in my life, and was on very strong drugs (morphine, demerol etc.) for literally a couple of months straight in the hospital. When the pain stopped, and I didn’t have to take that stuff anymore, there was no “withdrawal”. Granted, the hallucinations under demerol were kinda fun, but I didn’t have any “suffering from withdrawals” from it (or from any vicoden I was prescribed numerous times in my life) and have no hankering for it.

My understanding is that it’s impossible to literally become addicted to anything on the first try.

That said, crack comedowns are apparently pretty unpleasant, and if you have just taken some crack for the first time;

  1. You probably have some crack on hand to ease the pain

  2. You are probably less hesitant than your average person to use crack.

I’m not sure that this entirely squares with my experience of quitting smoking. Perhaps it’s not the same thing.

After the initial couple of weeks, I had absolutely no desire to resume, I found the idea of smoking a cigarette utterly unappealing. Around 3 months later, after a few drinks, I had a couple of drags on a friends cigarette, and it really was quite like the stereotypical “first sip”, an almost instant rush, quickly followed by an overwhelming desire for another. Over that evening I smoked several more, and I have never experienced such intense cravings as I did the next day. All I could think about was cigarettes, I had to ask people to stop me from buying a pack.

Right, but it’s not the first puff of the cigarette that made your body physically dependent on nicotine again. It’s the mental conditioning of years of associating the smell and sensations of smoking with the drug.

The craving to smoke isn’t because you were detoxing from nicotine, it’s because you were addicted to nicotine. Inter-related but not identical things.

The word “addiction” carries a negative connotation. That may be undeserved, and a result of phobias and bigotry, at least according to the Consumers Union book, Licit & Illicit Drugs, ca. 1972.

That book, from what most would consider a reputable source with no axe to grind, claims that heroin addicts pre-Anslinger and pre-xenophobic days, were, or at least could be, productive members of society, not gutter-huggers.

IOW, if you can afford it and access it, as doctors of the 1800s could, heroin didn’t result in emaciation, incapacitation, or malnutrition as we commonly assume. The reason for these symptoms are ascribed to poverty and legal prohibitions, not medical attributes.

Yes, plenty of opiate addicts are like Rush Limbaugh. If you’re just taking masses of commercially produced opiates in pill form, you’re going to have much better health outcomes than if you’re shooting street heroin.

It’s also hard to disentangle the direct physical effects of taking opiates from the socioeconomic effects. Start taking heroin, lose your job, end up on the streets. But also if you’re deciding that trying heroin sounds like a good idea you’re already probably messed up in some way or for some reason, so how do you separate “He had problems and started taking drugs” from “He took drugs and started having problems”. It’s usually more like “He had problems and started taking drugs and the problems got worse and he took more drugs and the problems got even worse.”

I remember a guy I worked with in college who told the story to anyone who would listen about his first, and last, experience with cocaine.

He was at a party and there was some available, and he decided to try it out of curiosity. Not only did it burn his nose, it wasn’t even that pleasant; he felt like he’d chugged about 2 pots of coffee for about 30 minutes, and then it wore off. When it did, he had this overwhelming urge to do it again, and he knew that if he had this urge to do repeat an experience which wasn’t even all that pleasant, this was something he needed to avoid at all costs.


Heroin isn’t exactly a first-line drug of abuse anyway. Anyone who’s willing to try it usually has a long history of addiction to other drugs and/or activities.

Chances are, a lot of those 77% had such an unpleasant experience with heroin, regardless of the route they used (prolonged vomiting is a very common reaction) that it wasn’t an experience they wished to pursue again.

I’m dubious of this. When you do cocaine one time, it’s the good feelings it brings that cause you to want to do it again. Not an instantaneous physical addiction. Cocaine doesn’t even have a physical dependence risk.

Same here. Chronic pain patient, I took morphine and oxycodone for ten years and went to a new pain management doctor who “didn’t believe in drugs”. I was cut off cold turkey and I swear that except for the pain it didn’t bother me. After a month or so I fired the quack, went back to my old doc and I’m still on pain meds. However I’m taking Tramadol, with 800mg ibuprofen and Tylenol with codine now, so better I guess. Doesn’t work near as well as morphine, but takes the edge off the pain and I suffer through what’s left. Bad thing about morphine was how tired I was all the time. But I digress, I’m wondering why some can walk away relatively easy and other have it rough?

I also agree with your demerol experience. The only pain drug that ever got me high. After my 2nd surgery they had me on a drip of the stuff for like for days. I stated to hallucinate. Wow, done ever want to go there again.

From my own issues with alcohol, one helpful insight was that addiction, at its core, is about using a substance to cope with negative feelings. Over time, your normal coping skills get weaker and weaker until every tiny setback feels like a crisis that only a drink can solve.

Until that maladaptive coping kicks in, you’re in little danger of losing control. An experimental dose won’t turn you into a drug fiend. Though as others have mentioned upthread… most people boarding the heroin train are already carrying the baggage that makes it a big addiction risk.

I’ve sort of given up trying to get addicted to cocaine. I’ve tried it, I dunno, more than a half-dozen times but fewer than a dozen, including the ghetto variety that you smoke in a glass pipe a couple of times. Either I’m just plain fortunate or it doesn’t chemically work with my peculiar flavor of endorphins or something, but I get more kick and pleasure from a good cup of black coffee.

Heroin is different. I can totally see how a person could get addicted to that stuff. But no, it doesn’t automatically happen on the first experience. It’s deliciously nice when smoked, way too nice to go there again, nuh uh.

So far my sole addiction has been cigarettes (or nicotine, more accurately, I guess). Took several tries to break loose of the stuff. Been a nonsmoker since 1983 and still have occasional nightmares in which I’ve started with a single puff from a friend’s cigarette then bumming a smoke here and there and finally breaking down and buying my own pack. ** shudder ** In real life, no slips. And I can be around smokers and it doesn’t bother me, don’t crave it, don’t miss it etc.

Addiction is not a switch, it’s not on or off; addicted or not. It’s a complex and complicated process with psychological, physiological, and emotional components. And everyone is different, anyone can find themselves anywhere along the spectrum from “take it or leave it” to “nothing else matters” for any given drug. Just because you’re at the “meh” end of the spectrum for cigarettes, for example, doesn’t mean that you won’t fall prey to anything else.


I think it is highly individual. I have a friend who was incontravertably an alcoholic during the 70s and early 80s. He went to a dryout camp around 1985 and came out dry. He then refrained from drinking for several years. He then very cautiously tried drinking a glass of wine with dinner. This had no effect on him and he started having a glass of wine with dinner regularly. He also drinks a bit in addition, but no more than any ordinary drinker would. On several occasions my wife and I have spent two weeks in Barbados with him and his wife, sharing accommodations. We bought a 40 ounce bottle of rum when we arrived and he would made some frozen daiquiries every evening, each of us taking a couple of drinks from it. He would also have an occasional beer with dinner and wine when we ate out. I was watching closely and he is just a plain social drinker. Whatever anyone says he is a fully recovered ex-alcoholic.

I know that it’s not physically addictive, but I have heard about the post-use cravings (never did it myself) and it happened to him and he knew he needed to completely avoid that drug.