Typically, it starts with someone being prescribed opiates. Maybe they use them as prescribed, maybe they don't. If they don't, or they have the kind of genes or psychological issues that make it more likely for them to get hooked, they get hooked. Once they're addicted to the opiate, and discover how much cheaper heroin or fentanyl is on the street, compared to their oxy prescription, they start using them instead, upping their risk a ton.
From there it's all downhill unless the right kind of intervention happens, and the psychological issues underlying that addiction are resolved.
A big contributing factor, I think, is the overprescription of opiates to treat pain when it isn't 100% necessary
I’ve tried to help her over the years.
She tried going to an Ibogain clinic in Mexico and was sexually assaulted by a nurse while there. I paid for her to give it a second try for her and her boyfriend (also an addict) but after a few days clean they went back to their old life and relationships and couldn’t stay clean.
Her underlying trauma was sexual abuse as a teenager.
She’s spent most of her adult life living with her parents, using heroin, and committing petty crimes or doing sex work to stay high.
She told me that every time she’s OD’d, she knew she was going to and a part of her kind of took over and did more heroin than she knew she should but she just didn’t care.
She’s been brought back to life several times.
She’s still alive, so that gives me hope she might have some insight or be able to try Iboga again with a better supportive context for integration.
Her 10 year old son is going to have a lot of work to do as an adult to heal from this.
EDIT: as stated above, I belive in drug legalization with tax revenue going to Support free access to trauma healing centers for everyone along with an educational program that helps people understand the link between trauma and addiction.
And yet there are tons of addicts on those:
https://en.wikipedia.org/wiki/Opioid_epidemic