Opiates change the mechanisms of the brain, Mizzi said. They “replace the dopamine receptors. The body stops make dopamine, so you need to ingest from the outside.”
For a while, “you can maintain the facade that everything is fine, but lives fall apart,” she said. “All your non-high time is in service of the purchase and use of the substance; it takes over. And then you start with heroin.”
The first time you use heroin, “it’s absolutely fantastic for them,” said Ioannou. “People describe the feeling as a total body orgasm.”

Warning signs and seeking help

For an addict, Mizzi said, getting clean is “not all about willpower. The brain has changed and must [recuperate]. It will take six months or more for you to feel better after you have gone through a medical detoxification. We saw this during the cocaine epidemic; it’s part of the post-acute-withdrawal syndrome.”
“We need your help,” Barbieri said. “If you see something, say something. Don’t be afraid to call us.” If the police are called to the scene of a drug overdose, he said, “we don’t make an arrest. We are interested in getting that person help.”