Anna Grace You Naughty Girl!

I WROTE SOME BABBLESOME CRAP at 3:30am that even I couldn't understand so I'm leaving it.

My friend Anna Grace "untruthed" about relapsing back on to heroin. That is she said she DID relapse when she DIDN'T.

Somehow I wasn't too surprised and I do believe she's telling the truth now.

I believe her for these reasons:

1. I know Anna pretty well and she glorifies opiates a lot, yet doesn't use them. I know that if she was using over the last 2 years or so it was very light because heroin (or Dilaudid* which she also loves) take your life over completely and that would have shown.

Her reason, she said, for not using was that it upset her parents too much and she's living in their home. I said "if you truly wanted to use heroin, you'd just go out and do it whatever your parents thought".

When I wanted gear, I never gave anybody else's opinion a second thought. Or my own shame for that matter. When I wanted it I went out and got it immediately. Anna didn't do that, which tells me she isn't into it as much as she thinks she is.

2. Anna does have mental health problems very similar to mine but she's no weirdo and it would be very strange to say "I said I was on heroin but I'm actually not I just thought it would make me seem more interesting" and that not to be true.

The "heroin makes me more interesting bit" seems to be the crux of her problem. When she was on heroin, despite the misery and pain and being lost in it all, it probably gave her an Identity (that of the Junkie) and a purpose. It might be a purpose most people can live without ~ a desperate need to get funds, get heroin, get high, get more funds, get more heroin, use again... and so on. But you're always busy and never bored. I think Anna looked back to this time and romanticized it and though she gave up the drug she couldn't give up the fantasy.

She's booked into a Dual Diagnosis Rehab in about 2 weeks where for once she will get mental health treatment and addiction therapy at the same time. Anna is already on Suboxone (glorified Subutex) so she's done the nasty bit in switching on to that stuff (it puts you into withdrawal). Buprenorphine reduction is a walk in the park compared to a rapid methadone taper so she really should not find the detox hard.

Anna's mood issue is currently depression that just does not go away despite mood stabilizer, antipsychotic and antidepressants. I keep telling her that her meds aren't working the way they ought to and I hope this clinic will recognize this and tweak or better still switch them to something better.

She's on nightly sleep meds which I'm sure she'll be allowed to stay on for the sake of her mental stability. The "going 100% clean" thing isn't done in Dual Diagnosis where most patients are expected to be on medication long term if not life-long.

Dual Diagnosis means mental health problems as well as drug addiction. In practical terms this is usually severe depression, bipolar, schizo-affective or schizophrenia. With these conditions you do not play around with medications, so she'll get a much easier ride than she would in a straight rehab where you still find the rather dated attitude that using any psychiatric medication is the same as using heroin and crack when this patently is not true.

The rehabs I've been in were all "regular" ones where the street drug users prevail. There's lots of prison talk, lots of crime talk, everyone's full of front and "we're all in the same boat" (except we weren't: it was me getting the extra meds and endless counselling sessions, nobody else seemed to have a breakdown every time they detoxed...) This isn't the type of place you necessarily want to be if you have mental illness so she's definitely doing the right thing going to a specialist unit.

Good luck Anna!


*Dilaudid is hydromorphone. Diamorphine (pharmaceutical heroin) is banned in America (to back up the American government's fictitious and politically motivated claim that heroin "has no medical use") so hydromorphone, another semisynthetic opiate, is used in its place. Dilaudid is known in America as "hospital heroin". In British hospitals actual heroin is used when a powerful painkiller is required. Heroin is very occasionally prescribed to addicts here, but prescription is so rare you have practically no chance of getting a heroin script, hence the widespread heartache and misery of oral methadone which leaves addicts craving heroin all the time and using on top every single day they can afford it and feeling they have to bullshit the methadone clinic that they're doing really well when all the addicts I knew were doing terribly. For years I told them I was using on top "nearly every day" so when diamorphine therapy did come in I'd be first in line. Then I got a bitch worker who basically put me under blackmail and duress (literally) so I just lied and said I used twice a week. I might use twice a week on Mars, but not in London. Now I use zero times a week because I hate heroin. I'm turning back into my old self from the mid-90s. Someone who actually enjoyed being clean. Wow.