Let's be honest, television does not exactly handle the issue of drug abuse very realistically. Unfortunately, it handles the issues of detoxification and withdrawal with even less candor. The wildly popular series Lost deals with the issue of detoxification (in this case, heroin withdrawal) via the character Charlie. Here is what life would really be like for Charlie on the island if he were actually withdrawing from heroin usage without treatment (such as usage of Suboxone).

Unfortunately it is difficult in the show to determine exactly when Charlie "kicked the habit" (quite an understatement for what is a difficult and painful process without proper medical care). So, what should Charlie been going through if his story was grounded in reality?

1. Within a few hours, drug cravings begin...
   Heroin requires regular use. Even within a few hours of the last dose, a heroin addict begins to feel the pangs of withdrawal. These early symptoms include...
   
   
   • Muscle and Bone Pain: It is important to note here that we aren't talking about just feeling a little sore. In some cases it is wholly debilitating and extremely painful. Charlie would be curled up on a bed writhing.
     
     
   • Cold Flashes and Goose Bumps: Ever wonder where the saying "cold turkey" comes from? As a heroin addict withdraws, blood is drawn towards the individuals internal organs. This leaves the skin cold, clammy, and bumpy like a plucked turkey.
     
     
   • Restlessness: Maybe he was restless - we don't really get a chance to know how much sleeping Charlie's been doing. But as this restlessness turns into insomnia (see below), I think we would expect more.
     
     
   • Death: Heroin withdrawal is rarely fatal for otherwise healthy individuals, and it is noted that alcohol and barbituate detoxification is more dangerous. Charlie is young and in decent shape, but had just been in a plane wreck. While he should survive this ordeal, the severity of the situation is definitely understated. Heavy addicts can and do suffer extreme consequences from rapid, unabated detoxification.
     
     
2. 24-72 Hours...
   • Diarrhea: On an island with few toilets (especially after the hatch blew up.), it would be hard to cover this one up. Nevertheless, Charlie certainly doesn't exhibit the characteristics of an irregular fellow.
     
     
   • Vomiting: Yeah, we definitely don't see anything like this going on with Charlie - no weight loss, no rushing off every few minutes hand-over-mouth.
     
     
   • Insomnia: The fun loving adventurer sure shows no signs of insomnia. From long hikes to deep-swimming rescue attempts, Charlie doesn't seem like a guy whose addiction is causing him to lose any shut-eye.
     
     
   • Kicking / Jerking Reflexes: This is actually the source of the "kicking the habit" expression. However, we see nothing like this out of Charlie.
     
     
3. Months Later...
   Unfortunately, heroin withdrawal symptoms can persist for several months. While the worst symptoms tend to cease after 24-72 hours, insomnia and other symptoms can last multiple months. Once the withdrawal symptoms are going, craving and relapse can occur long after. An accurate portrayal of Charlie throughout the show would include these flashes of cravings and long-term side effects.

While it is not the responsibility of shows to portray everything accurately (and I am sure some Lost addicts will claim that "the Island kept him healthy"), the portrayal of Charlie's withdrawal (or lack of portrayal, honestly) disregards the true battle that real people have with addiction. There are real, measurable, incontrovertible side effects to withdrawing from addiction to drugs like Heroin and other opiates. Individuals who go through this process often need much more than a friendly gate-keeper like Locke, they need medical assistance.