Coming Off Drugs

Abstract

Heroin withdrawal is perhaps one of the most taken-for-granted components of the addiction framework. Heroin users as well as researchers, policy makers, and practitioners have become dependent on it for thinking about and acting upon the process of heroin leaving the body. It is thought to be among the most challenging aspects of the recovery journey and has been linked to a range of public health, legal, and social problems. The taken-for-granted nature of heroin withdrawal has arguably limited its scrutiny in sociological and historical analyses. This article offers an alternative and critical perspective that draws attention to the heterogeneity of historical events and strategies that have left their mark on the withdrawing body of the heroin user. It maps changes in the discourse from the 18th century to the present and closes with developments in the neuroscience of addiction, which have relocated withdrawal from the body to the neurocircuitry of the brain and reframed it as a negative emotional state. This new language suggests the future of the discourse of withdrawal might be relatively short. The analysis moves beyond existing understandings of withdrawal as the simple absence of drugs from the body.

How do patients feel during the first 72 h after initiating long‐acting injectable buprenorphine? An embodied qualitative analysis

“…Sometimes participants found it difficult to identify their subjective feelings, for example, whether they were experiencing withdrawal symptoms, an unrelated pain, a cold or COVID-19 [66][67][68]. Equally, they were occasionally unable to identify the causes of their embodied states, for example, whether sleep problems were generated by withdrawal symptoms, having a history of sleep problems, drinking alcohol or being in a different environment [66].…”

Self-detoxification, embodiment and masculinity: a qualitative analysis of dependent heroin users’ experiences of coming off drugs in prison

“…In her analysis of heroin withdrawal, Koutroulis (1998) found that heroin users make sense of, and respond to, withdrawal through the subject positions of dirty and slaved. Similarly, Walmsley (2016) has argued that meanings of heroin withdrawal have been shaped by historical events. In particular, and important to the analysis of the participants' responses to their detoxing bodies, is the meaning of the addicted body as a poisoned object and withdrawal as a form of poison removal.…”

“…Heroin withdrawal symptoms are typically understood as caused by key regions of the brain readjusting to the unfamiliar state of abstinence (Koob, 2015). The link between withdrawal symptoms and abstinence, once commonly known as the abstinence syndrome, has been traced to the emergence of addiction science in the early twentieth century (Walmsley, 2016). There are echoes of this way of thinking about withdrawal symptoms as caused by heroin's absence in the self-detoxification literature (Gossop et al, 1991;McDonnell and Van Hout, 2010;Noble et al, 2002).…”

Making risky decisions to take drug: Effects of cocaine abstinence in cocaine users

“…A clear example of this is the changes in drug taking and seeking that occur when drug users are abstinent and perhaps experiencing withdrawal. Changes in drug-taking as a function of abstinence could reflect changes in risk-taking behavior (Walmsley, 2016). Impulsivity is often viewed as a trait and as such changes in impulsivity should be slow to occur, yet risk-taking behavior can be state-dependent and often does change in response to acute drug-administration (e.g., Jentsch et al, 2014).…”