Long-Term Effects of Drug Addiction

From knowing someone who was a long-term alcohol and prescription drug (Vicodin) abuser:

-diminished capacity to deal with stress
-forgetfulness--loses set after set of car keys, house keys
-emotional balance undermined--swings between up and down
-makes irrational accusations--"he's stealing my stuff"
-health problems: chronic pain, compromised immune system, signs of possible liver failure--"sick all the time"

There's more of course, but these are my first-hand observations. I've noticed two things in general: that even when drug/alcohol abusers come clean, they still (frequently) have cognitive and memory deficits; and they have trouble keeping a stable emotional baseline.

I think you need to tell which drug she was addicted to for that two years. It is usually crack cocaine that is smoked. Opiates, such as heroin, is usually injected into a vein. Cocaine is a stimulant and heroin depressant, and while addicts sometimes mix these types of drugs together, they usually don't.

Typical long-term side effects of injected drugs (opiates, like heroin) are AIDS, hepatitis C (if needles are shared), inflamed veins at the site of injection (forearms, feet) what can, in severe cases, result in the gangrene of the fingers/toes. Infective endocarditis (inflammation of the heart valves) is also common. Now, you can search for the exact symptoms of these conditions...

A long-term side effect of cocaine abuse would be the bowel gangrene - this would require surgical treatment.

If you insist in smoking opioids, I suggest you to do your own research. This is an unusual way to use them, a lot of drug may be wasted this way...Seizures are more likely the effect of overdose than a long-term permanent complication of opioids.

Some of this is anecdotal, some is from pharmacology:

Smoking opium is actually a fairly method of consumption in the areas where it's available. It's supposed to be safer than ingestion because you can more easily control the dose. Injecting raw opium would probably be lethal.

As for long term side effects, opium is actually pretty safe. The major risk is overdose which would cause death by respiratory depression. The comedown after 2 years of abuse would be hell (heightened sense of pain, nausea, diarrhea) but after that the person would be relatively harm free. They might experience strong urges to use the drug if exposed to environmental or social triggers which remind them of their past use.

Since your opium is hallucinogenic, you could have side effects like the flashbacks that are seen after LSD use.

"Flashbacks" are a reported psychological phenomenon in which an individual experiences an episode of some of LSD's subjective effects long after the drug has worn off. In some rarer cases, flashbacks have lasted longer, but are generally short-lived and mild compared to the actual LSD "trip". Flashbacks can incorporate both positive and negative aspects of LSD trips, and are typically elicited by triggers such as alcohol or cannabis use, stress, caffeine, or sleepiness.

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Two years drug use when you're young isn't going to do much long-term damage. The body is amazing in its capacity to heal. Twenty years of smoking/booze/whatever drug, now we're talking significant damage to organs. Or if the two years came when you are 62-64, yes, there could be damage.

The addictive mindset issues will probably be the worst. It's not just a craving for the drug, but that the "setting" and paraphernalia of addictive drugs will trigger mad desires in the former addict. Recovered heroin users have a hard time looking at an innocuous soup spoon on the same table as a cigarette lighter--they'll start salivating and itching, quite literally. Stick a cotton ball on the table, too, and you may trigger relapse in the poor person (or certainly fleeing and a panicked call to their NA sponsor). Driving by a house or park where they did the drug back when can trigger the craving, too. Add a cue like that to having a Really Bad Day, and you can imagine how fighting relapse is a tough job.

I have a family member who did heroin for years. She does not have any apparent physical problems that I know of, but she definitely has psychological ones. She has poor impulse control, steals from loved ones, parties a lot, etc. She has the emotional maturity of a teenager even though she is in her mid-twenties, can't handle stress, is self-centered. Even when she is not using, the addict behaviors are still there.

Also, from the smoking aspect:
-Nasty cough
-Stained teeth/fingernails
-Difficulty breathing
-Raspy voice

Mrs. de Winter said:

I have a family member who did heroin for years. She does not have any apparent physical problems that I know of, but she definitely has psychological ones. She has poor impulse control, steals from loved ones, parties a lot, etc. She has the emotional maturity of a teenager even though she is in her mid-twenties, can't handle stress, is self-centered. Even when she is not using, the addict behaviors are still there.

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Yes and yes and yes. I had a cousin who you are describing. He eventually died after using heroin and having a few beers on top of it. Died in his sleep at age 37.

Sad thing is his parents 'tucked him in' when they found him. They would go and check on him most nights to see that he was okay. (He had been clean and had his own apartment, was working for his Dad.)

So death, that's a side effect, too.

I'm a graduate student focusing on cocaine addiction, but I have worked with opiate addicts as well.

I will say that many "chronic" opiate addicts have been using for decades, not two years, and a 14 year old may present differently than adults. The brain is nowhere near finished developing at that time, and that is too young, in most cases, to even determine if she will go one to become a chronic drug addict or grow out of it. Was she using every single day continuously for two years? Then you may find a lot of these effects. Was she just doing it on the weekends with her friends? Then its less likely. Another important question to consider-how long has she been clean? This may determine the severity of her symptoms.

I will say that persistent seizures are not a long term effect of opiate use. Seizures can occur during acute withdrawal, but not after that. Of course, yours is a made-up drug, so you can add that in if you want, but know it's not typical.

One of the most notable long term effects of chronic drug use is anhedonia. This is a diminished ability to feel pleasure from everyday stimulation, and is often associated with depression. It's especially bad during and directly after withdrawal.

Reduced executive capabilities are also commonly associated with drug use (although there is evidence that it recovers in successful abstinence). This includes things like poor inhibitory control, inability to plan for the future, and aggression. The reduced inhibitory control is especially bad in emotional situations. However, these difficulties are often associated with increased risk toward drug use, and may not necessarily be purely a result of drug use. The research is unclear so far. These problems are also, unfortunately, associated with being fourteen, so she may not present that much differently from her peers. Female teens who abuse drugs have been shown to display more antisocial tendencies than non abusers, though.

Like posters above have mentioned, putting your character in a situation that she associates with drug use or exposing her to drug cues can cause intense cravings. (In rats, this can also work with withdrawal-put them in a place where they experienced withdrawal, and they will begin experiencing those symptoms again to a lesser degree).

There have also been associations demonstrated between heavy opiate use and development of chronic pain later in life.

Also note that tolerance plays a large role in opiate dependence-so if she relapses and uses the same amounts she was using before being clean for a long time, she runs the risk of overdosing. This is a reason many opiate addicts OD.