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Heroin Addiction, Cravings, and Withdrawal:

Can a person become dependent on heroin after a single dose? In truth, heroin is less addictive than nicotine or cocaine. Some people can use it occasionally without developing a habit. But the fact remains that the intense rush of pleasure associated with a heroin high is quite seductive. The same is true of the longer-lasting sense of well-being and freedom from anxiety that follows the rush. If a user makes a point of seeking the drug a second time, that could indicate the onset of habitual behavior.

Repeated use of heroin requires higher doses to achieve the high. This is known as "tolerance." Eventually, when dependence sets in, the user rarely achieves the same high that drew him or her to the drug the first time. Instead, the user seeks the drug to avoid WITH DRAWAL symptoms. Life becomes a constant struggle to find the money to pay for another fix, to find the dealer and buy the fix, and to find a way to achieve the high.

Some experts estimate that as many as 80 percent of heroin addicts never free themselves from opiates. Once the habitual use is established, it is extremely difficult to stop.

Heroin withdrawal begins with a three- to five-day period of intense anxiety, INSOMNIA, and a host of flu-like symptoms from uncontrolled coughing and yawning to stuffy nose, cramps, chills, sweating, diarrhea, and "goose bumps." Having goose bumps led to the origin of the phrase "quitting cold turkey." Additionally, muscles that have been relaxed by the drug tighten and twitch, causing severe pain and uncontrolled, reflexive motion ("kicking the habit"). A recovering addict named Joey Peets told Scholastic Choices: "It's the worst feeling. Most people say they'd rather be shot than be sick on drugs. … Being addicted and having to get off drugs is the worst experience. I wouldn't wish it on my worst enemy."

Yet, these desperate physical symptoms of withdrawal are not the worst aspect of opiate addiction. The addict experiences psychological CRAVINGS that are so intense that they become nearly impossible to fight. To quote Alfred Lubrano of the Knight Ridder/Tribune News Service: "The smell of burned matches, the sight of a $10 bill (the price for a 'dime bag' of drugs), even those 'Just Say No' anti-drug posters with a crossed-out needle, all act as potent cues that could bring even long-clean addicts to their knees, screaming for dope." Scientists have actually shown recovering addicts films of drug abuse while monitoring the drug users' brain activity. The results: Watching someone else use drugs, even on a film, spurs activity in the parts of the brain that govern motivation and craving.

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