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tweet by Johann Hari: The core of addiction is not wanting to be present in life, because pour life is too painful a place to be. This is why imposing more pain or punishment on a person with an addiction problem actually makes their addiction worse.
Isn't there also a chemical element to it that makes trying to get a heroin-addict to go cold turkey kinda like shaming a diabetic for using insulin?
Yes. The withdrawal symptoms are real and physical.
I have a nerve disorder and the original neurologist kept trying different opiates on me (they didn't work). I never got mentally addicted, but there must have been some physical addiction because I definitely had withdrawal symptoms when I switched to another type of medication and it was not a pleasant few days. I can't imagine what it must be like for people with serious heroin or fentanyl addictions.
Probably about the same. They they take low doses usually, only a a subset of users go on to take heroic doses and or IV. That's what makes it so dangerous, you are yo-yoing dosage trying to find that sweet spot, all it takes is one too large of a dose with a few drinks and you are night night forever, or choke on your own spit or vomit.