What happens to heroin addicts when they quit cold turkey, and why is it so unbearable? originally appeared on Quora - the knowledge sharing network where compelling questions are answered by people with unique insights.
Answer by Lee Garibaldi, writer and editor, on Quora.
The last time I quit heroin, I went cold turkey on a friends couch. It wasn't really planned but it happened something like this:
I was living with some junkie in her parent's house. Her parents were both coke heads and they knew I was doing heroin but they had a 'no needles' policy so when they found out we were shooting up, they "politely asked me to leave." I was left with very little money and no place to go. I had been homeless before and did not really look forward to it. Luckily an old friend of mine had reached out to me a week before and offered me her couch for as long as I wanted. So I got in touch with her and told her I had nowhere to go. She agreed. I bought bus tickets along with ten bags of dope and ten new needles. I was going for a gradual reduction technique.
The bus trip from Tampa to Miami took about ten hours with about half a dozen stops. By the time I got to my friends house, I had one bag of dope left. One. It was the middle of the night when we reached her house and I took a small shot before going to bed. I finished it off the following morning in her bathroom and committed to going cold turkey. I knew nobody in the area so there was no way I could get anything even if (when) I caved. It was Nov. 10, 2007. I'll never forget. The first morning, I was very nervous as I sat and waited for the inevitable. My friend sat with me chatting and catching up and I tried not to let her see how much I was freaking out inside. As the hours went by, I kept running into her bathroom to do what the people I knew called "cotton shots" and "scrape bags" (keeping empty bags and used cottons to try to get a tiny bit of dope just to take the edge off). I thought doing this would help or delay the withdrawal or something (because this is what I had been told when I was a wee junkie and it stuck with me). But in reality, it was just like a nervous tic. My body said "it's time for a shot" so I did whatever I could to comply. The first thing I noticed was that I was shaking violently as I tried to shoot up what was basically just dirty water. I was jabbing at my arms and bleeding everywhere. I was also sweating profusely. Or what some junkies may call the cold sweats because I was freezing cold and burning hot at the same time. Over the course of about a week, week and a half, I kept doing this. I spent most of my time in my friends bathroom. Between shooting up water, vomitting constantly in her toilet, and soaking my achy body in a hot bath, I didn't do much else. Or I don't remember much else. The pain is indescribable and I won't even try to describe it. Suffice it to say that I hurt in places I didn't know I had. Every inch and every cell of my very being screamed out in endless agony for days on end. I begged my friend to help me find something - anything - that could "get me through this." She tried (or claimed to) but she didn't have a clue. One day she came to me with some prescription strength ibuprofen and I almost strangled her. But after all she was letting me stay in her house and puke in her toilet so I couldn't afford to be a bad house guest.
Interestingly enough, my parents had a vacation home nearby and were coming in from Israel around that time. Which worked out well for me because a few days after they arrived, my friend informed me that her roommate needed the couch for some of her friends who were coming to stay for awhile. Luckily by that point I had already gone through what was to be the worst of it. I told my parents I was coming down with a bad case of the flu and needed a place to crash for awhile. My parents knew the truth and they had seen me go through it several times in the past but they didn't say a word. I threw away all my bags and needles and headed to my parents. I spent the next few weeks there shacked up in their bedroom, sleeping on an air mattress, refusing to leave the room. Once the physical pain started to recede, the mental anguish hit like a train and I couldn't move. I cried a lot. At first I tried to hide my pain from my parents but it was pointless and I just didn't care. Seeing as how I've been diagnosed bipolar, I figured what is the difference between this and a depressive episode, anyway? So I rode it out like anyone else. I thought about killing myself but didn't have the strength to follow through with any of my half assed plans. I thought about trying to find dope in this city - how hard could it be - but I was so depressed that the idea of trying to get out of bed was exhausting enough, let alone getting dressed and leaving the house. Besides, I had no money and I knew my parents didn't trust me so what was I going to do? Steal money? Forget it. I didn't have the strength. I started going online and hoping to connect with people who might be able to help but no luck there. I ended up reaching out to the guy who I had been "dating" for like a week before I had skipped town. As it happened, he had also been kicked out of his house around the same time and had left the state. But he missed me a lot and wanted to come back. I asked my mom if my "boyfriend" could stay with us for awhile and she agreed. So he hopped the first plane over here. And that's how my real life started, I suppose. I ended up marrying that guy and having a child and then divorcing and now we are working things out or whatever. But we don't do heroin. And we don't use needles. We are both well aware of the pain and the consequences of the drug. Still we seem to have different views. I feel like there is a junkie living in my head and she will never go away. For this reason, I think of myself as forever an addict and I don't trust that I will turn down a shot if offered. He claims to feel no desire for the drug at all but he was not as hard into it as I was nor was he using for nearly as long as I had been using. He didn't even know how to shoot up on his own; I had shot him up a few times and clearly he wasn't as much an addict as I was. Lucky him. But I will never rid myself of that voice in my head, my inner junkie. She is locked away in the back of my mind but she is always screaming and begging to be let out. There's always that suggestion of just one time. Just one hit. For fun this time. I'm in control.
Except I'm not. Because I'm shaking now just thinking about it. Thinking about using. Thinking about the pain of withdrawal. Thinking about the feeling of the needle jabbing into my skin again and again in a fruitless effort to find a vein as the tears stream down my face, blinding me and I tell myself to stop - just stop it. But I can't stop. I keep pulling out and searching around, digging inside my skin and I don't feel that pain. Not that pain. Because that is nothing compared to the other pain. The real pain. I wrote once about the very first time I shot up by myself - the day I learned how. I'm not sure if I posted it on Quora or somewhere else but it was a bloody affair. I'll never forget the hours of anguish sitting on my bathroom floor screaming and crying and throwing things as I tore my arms apart trying to find a vein. I started in the morning when I woke up sick. It was long past sundown when I finally hit a vein and my bathroom looked like a murder scene and I was soaked - soaked in my own blood (as well as sweat and tears but mostly blood - so much blood). But it didn't matter because I had hit and I felt no pain. The blood didn't phase me. I developed a fetish for it. To this day, I enjoy the taste of my own blood and the sight of blood in any situation. And to this day, when I look down at my arm, it is a perfectly natural reaction for me to unwittingly trace my finger softly across my arm in search of a good vein. Because that's what I do when my hands are not busy. I'm always searching for the perfect vein. My eyes search, my fingers search and my inner junkie screams for just one more time to play.
What does cold turkey heroin withdrawal do to a person, you ask. It searches deep within the reaches of your mind for any shred of hope and joy or anything resembling such and it kills it, brutally and mercilessly. It leaves you as just a shadow of your former self. And for some, it never ends. In some form or another, it stays with you for life.