Heroin. Scary word, right? The reality is that it has become the self-medication choice of the late-teen and young adult population in our community, especially in the affluent neighbourhoods. Many of our young people are captivated with the drug’s romance, regardless of type, be it street or synthetic (prescribed opioids). The culture of the substance and how it has become romanticized has literally become an epidemic in our communities. The perfect recipe in understanding the pathology of the young opiate addict is this: intimate knowledge of the heroin culture; an informed clinical perspective of the individual user; and the current behaviours occurring within the family system.

The entire family of a young heroin addict must be treated. The Best Practice within my setting supports that this is the only road to success; the family needs as much support and education as the addict. My experience in treating family systems—those who are living with young opiate addicts—has given me the ultimate viewing window into families that are simply blown apart. Yet, the young addict often provides an eloquent, if not enigmatic, perspective of heroin that tends to describe the drug as a nurturing, loving best friend and companion. Hence, the romance of the drug. There are impediments and roadblocks to treating these people. Time is the clinician’s first enemy, and denial within the family system ranks extremely close behind in the initial phase of addressing the challenge. Defining, accurately, the level of chaos within the family system as a whole is the centrepiece to the broken puzzle. I share this with the reader because I have placed over 100 young adults in treatment just in the past five years. The skill in navigating and guiding these families through the long term treatment process is crucial.