Preferred Name: Nick
Nick has worked in the construction industry but due to ill health, he’s no longer working. He’s separated from his wife and has two adult children. He lives with his parents and cares for his brother who has a disability. He describes his ethnic background as ‘Greek’: he was born in Greece, as were his parents.
Nick first started taking heroin regularly after he was involved in a car accident. He stopped when he moved overseas and was working full time as the ‘breadwinner’ for his family. He resumed taking heroin when he returned to Australia over ten years ago and is currently on opioid pharmacotherapy treatment (methadone maintenance treatment [MMT]).
He started taking heroin regularly in his twenties after he was involved in a car accident. After about two months of regular consumption, he says he started to ‘feel really sore and tired’ and realised he had ‘a drug habit’. A couple of years later, Nick moved overseas, where he got married and had his first child. He lived overseas for nearly ten years, working full time and managing a local sporting team in his spare time. During this time he stopped taking heroin.
When he was in his thirties, he moved back to Australia with his family. After his return, he resumed taking heroin and a few months later, after being ‘spotted by police [with heroin on him]’, he was charged with possession of heroin. On the advice of his lawyer ‘to show that [he was] making an effort in getting off drugs’, he began opioid pharmacotherapy treatment (MMT). He then went to a residential rehabilitation centre for six months, where he stopped taking heroin and slowly ‘got off’ methadone. Since then he has resumed taking heroin.
Nick has been diagnosed with depression but is not on treatment. He says that when he’s depressed, it feels like ‘nothing’s worth it’. He’s currently on MMT but believes the ‘best treatment’ would be ‘if [he] could somehow detox from heroin and methadone and go back overseas’ where he feels the ‘lifestyle suits’ him.
According to Nick (M, 50, not working due to illness, heroin), he realised he had a ‘drug habit’ when he started to experience unpleasant physical symptoms when he didn’t take heroin.
About two months after [I started taking heroin] I realised I was doing it every day and I […] didn’t feel right. You know, I was starting to feel sore and I realised that I had got a drug habit […] My stomach, bad stomach cramps. Your legs feel really sore and tired and hot and cold flushes. That’s what done it.
[…I haven’t been diagnosed with drug dependence]. I realised for myself and through other drug users telling me that you’ve got a habit when you are sick like that.
Nick finds the ‘mental part’ of heroin addiction harder to deal with than the physical symptoms he experiences.
I find [it’s] not the physical pain or the physical attributes of the heroin addiction [that are] hard. I find the mental part of it the hardest. It’s trying to stay away from thinking about it, which is the hardest for me.
I have been withdrawing from heroin that much that I’m sort of used to it. But the physical part is easy, it’s the mental part that is hard, to maintain that clean life. Don’t think about heroin. Also triggers, things like seeing a discarded syringe on the foot path, or a discarded syringe top on the footpath would do [it] for me sometimes. [It] would trigger my thought process straight to heroin, and therefore trigger another thought process of how to obtain it. That’s my problem, is how to not think about it.
Nick says his family discriminate against him because of his heroin consumption and this really hurts him.
The relatives didn’t want their kids associating with me any more, my cousins. Even though I didn’t encourage them to take drugs or anything of the kind. Yeah, that hurt a bit.
They don’t trust me. And they think that a user is a junkie, a stereotypical junkie that’ll steal from anybody. And I noticed that, you know, at a family do […I] went to my cousin’s place with the family and they were looking at me, where I was going and what I was doing. And after ten minutes I went home […] and from then I have never been back to any relatives’ houses.
They have got their own view and told me not go to their house and things like that […] It really hurt me. It really hurt me […] After that, all I wanted to do was use more.
For Nick, moving overseas, doing meaningful paid work and contributing to his local community helped him stop taking heroin for about ten years.
For me personally, the best treatment is if I could somehow detox from heroin and methadone and go back overseas […] To really get off the drug, the person has want to get off the drug, first of all. I mean not [just] say it, not let you hear what you just want to hear. The person has really want to get off it and never see it again. Now for me to do that, I’d have to leave the country.
[When I lived overseas] I was the breadwinner. I was doing a very heavy job, a job that an Aussie here wouldn’t even look at. And I enjoyed it. I was being talked about in the village good, you know. Like, I was being praised. My mother-in-law was saying […] ‘The village is saying how good a son-in-law you are’. I was proud, you know, because I was working a job that was really hard. I was also managing the village soccer team and I was always on the go. I was […] working, looking after the oval on my own time, cutting the grass and doing the lines and everything. Looking after the jumpers […] Things like that, really getting involved. And I thought, it can’t get any better, you know […] The lifestyle, it just suited me. But […] we ran out of places to live and [we were] not forced to come back but it seemed a better option. Deep down I knew, deep down I thought, I shouldn’t really go back to Australia because of the fear of using again.
Nick describes some unpleasant side effects of methadone and says the obligatory daily supervised dosing limits his ability to travel.
My teeth, I lost every single tooth in my mouth [from being on methadone maintenance treatment]. These are falsies […] It’s a synthetic heroin, to tell you the truth. And it dries your mouth out, as you can see. The reason you lose your teeth is because you get no saliva to protect the enamel on your teeth.*
[Also] you’re restricted in your travel. I suppose, you can get takeaway doses but you can only get five at most. So to go on a holiday, you have to […] try and get methadone for the entire stay of the holiday or you don’t go. We have a nickname and we call them ‘liquid handcuffs’ because you have to go to that chemist to get your dose otherwise, you know, you couldn’t function.
*Methadone, like other opioids, decreases saliva production, which encourages bacterial growth and can lead to dental problems.