This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty and prostitution in Hunts Point, Bronx. For more on the series, look here.
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Millie, Hunts Point, Bronx. Courtesy of Chris Arnade.
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Millie held up her bottle in the car's backseat, a small see-through one with a childproof cap, no taller than her pointer finger. "See?" She had gone into the drug building to buy "meth," methadone, not drugs, before traveling to her mom's home further away in the Bronx. She's been trying to ease off heroin for a while.
It looked as if she had bought a shot of medicine.
Methadone, a means to recover from opiate addiction, is something both admired and hated by those suffering from substance dependencies. Some, like Millie, prefer it to other methods of addiction coping, while others do nearly anything to avoid it.
Here's a bit on how heroin and methadone work from an earlier post:
Despite the desperate want to be rid of the needle, the opiate enslaves parts of the brain’s message transport system. Heroin (a few biochemical processes down) triggers the overproduction of a neurotransmitter in the brain called dopamine, eliciting a euphoria that heroin abusers come to crave. As users become reliant on the drug, the body adapts to the heightened amount of dopamine and seeks what has becomes its normalcy: a raised level of the neurotransmitter. Over time, addicts need more and more of the drug to feel the same initial high, and when off heroin they become “dope sick,” feeling the debilitating drop in dopamine production. The perpetual upping of the drug dosage ante becomes a reckless cycle, both in life and in neural pathways, causing chaos in the brain’s signal transport system.
In Hunts Point, Bronx, addicts like Roland occasionally find themselves court mandated into rehab programs, many of which include methadone treatment, a form of opiate-abuse therapy that stabilizes the amount of dopamine released. After a pattern of opiate abuse, the brain cannot fill the divots of dopamine shortage on its own, and needs a physical crutch to stabilize the neurotransmitter level swings associated with heroin cravings. If such a crutch isn’t found, an addict reaches dope sick withdrawals — nausea, headaches, insomnia. Methadone stops the craving cycle, taking residence in needy receptors that have previously been occupied by heroin and regulates dopamine release. Once taken, methadone blocks heroin’s violent highs and malaise lows.
The trouble is, like most things, methadone can be abused, but also, it must be consistently sought and taken. Patients start with a dosage ranging from double digits to several hundred milligrams then ween themselves off over time, sometimes over a period of years.
Some on the streets find methadone worse than an original heroin addiction, while others find the maintenance system workable. The documentary "Methadonia" interviews those in NYC recovery. For those curious, this is the closest thing I've seen to those I speak with every day, an accurate portrayal of life for low-income residents struggling with heroin addiction and recovery. Take a look for the stories.
You can watch in its 88-minute entirety below, or on Netflix Instant.
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More Hunts Point Addiction Writing
Writing Beyond Addiction in Hunts Point
Chris Arnade's Photos and his Facebook feed