Ask Dr. Dope – Is it possible to use heroin recreationally?

Bruce asks: Is it possible to use heroin recreationally?

Hi Bruce,
The short answer to your question is yes but it comes with a whole bunch of caveats.
The  1980 Am. Psychiatric Association estimated that only 23% of American heroin uses would meet diagnostic criteria for heroin use disorder meaning that most users would be either experimental or social/recreational users of heroin on any given day. However, there is most often a “honeymoon” period when one starts using drugs to when they may develop full blown addiction. That period is determined by genetic, environment (epigenetic) and pharmacological adaptive processes (allostasis). So at some point in their use of heroin most are actually in experimental or social/recreational use behaviors but continued use most often results in addiction. There is also the problem of denial resulting from both emotional and pharmacologic influences of heroin. Many users get emotionally attached to the feelings that heroin induces and are unwilling to looking at or totally ignoring the consequences that occur for their use of the drug. Heroin alters states of consciousness and cognition also making the user less able to be aware of or of consider consequences from use. So many heroin user may actually be addicted but are not able or unwilling to accept that fact. Experimental use of an addictive drug is limited to one or two lifetime exposures only with no drug seeking behavior and no reuse of the drug if negative consequences occur from their “experiment”. Social/Recreational use of any addictive drug does consist of drug seeking behavior but use is sporadic, limited, with no developed patterns in use, and especially with no negative life, social or even spiritual consequence from using the drug. I have know a few social/recreational heroin users who remained at that level throughout their lives but would find it medically inappropriate and unethical to promote continued use for social/recreational purposes of any addictive substance and would fully educate and warn those who claim to be doing so. Addiction is horrible to those who develop it regardless of the drug whether it be marijuana or heroin and its development should strongly be avoided if possible. One of my clients in group last week wondered out loud why everyone who’s ever tried heroin is not immediately a full blown addict to it. I also worked with Dr. George R. “Skip” Gay who wrote the book: Heroin, its so good don’t even try it once. Though heroin is one of the most addictive drugs, nicotine is much more so with an estimated 32% of users being addicted to it any any one time in America.
If a client or even a friend told me that they were a social/recreational user of heroin, I would immediate recommend and challenge them to stop use immediately to prove that they are not already fully addicted and if not to stay away from it to avoid ever developing addiction to it because of the catastrophic consequences that come with opiate/opioid addiction.
Hope this helps Bruce and let me know if it is ok to post your question and my response on our CNS web sites. We can post it without identifying who posed the question if that is preferred.
Best regards,
Dr. Darryl Inaba

Darryl S. Inaba, PharmD., is recognized internationally as one of the foremost authorities on drugs and addiction. He was one of the original founders of the Haight Ashbury Free Clinics, Inc., in San Francisco and directed its Drug Detoxification, Rehabilitation and After Care Program until 1998. Dr. Inaba also served as their Chief Executive Officer and President.

He currently serves as the Director of Education and Training for CNS Productions, Inc. During his career he has supervised the clinical treatment of over 120,000 substance abusers most of whom were self-referred into “recovery oriented”, outpatient treatment. Dr. Inaba is noted for his work in developing innovative treatment and culturally relevant services especially in the Asian and African American communities.

Dr. Inaba was appointed the first Haight Asbury Free Clinic Fellow in 2006. He is an Associate Clinical Professor at the University of California San Francisco Medical Center. He is also a Special Consultant and Instructor at the University of Utah School on Alcoholism and Other Drug Dependencies and an Adjunct Professor at College of San Mateo Department of Alcohol and Other Drug Studies. Dr. Inaba is the author of Uppers, Downers, All Arounders, a text/reference used at over 400 colleges nationwide, and he has produced several published articles and a series of award winning educational films on various aspects of addiction science.

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