The Missing Question about Addiction: Are The Highs of Drugs Really That Good?
There’s one aspect of drug use that goes mostly unquestioned: the pleasure provided by drugs. The reputation of heroin is probably the best example of this. It has this mystique about it that both users and non-users find fascinating. Heroin is believed to be a sort of pandora’s box that you had better not open, or else you’ll be hooked by how amazing it is. The “amazing experience” of heroin is something you can supposedly never forget, and will keep you wanting the drug for the rest of your life.
NBC News recently did a series on heroin addiction. Here’s a segment in which the very title upholds this mystique – Hooked on Heroin: ‘It Only Takes Once’ – and the interviewer just accepts this idea at face value as true:
Now that segment isn’t necessarily a glaring example of romanticizing the effect of heroin – but I was struck by it, because of the subtle way in which the romantic vision of heroin’s great powers is taken for granted, and left unquestioned.
The heroin user in the video, Ben, says that “it only takes one time [to get hooked].” The interviewer, Kate Snow highlights that, accepts it, and moves on to explore the feeling of heroin, which we are to assume explains why it only takes one time to get hooked:
Kate Snow: What does it feel like?
Ben: It’s just a euphoric high. You feel like you have no pain, you have no worries, it’s just nice. You just wanna forget about your problems and that’s what it makes you do. It’s definitely a different high from any other drug I’ve done.
Then she moves on to asking him about his track marks, and about the negative side of his heroin usage.
“It only takes once” to “get hooked”? Do we really believe that? The same thing was said about crack cocaine in the 80’s and 90’s, and fortunately, it hasn’t turned out to be true. People don’t become crack addicts by smoking it one time. This has been shown repeatedly in research data collected by SAMHSA. And for the record, those whose crack use is considered an addiction are still choosing and in control of it – this has been demonstrated in laboratory experiments, recently well publicized as the work of Neurobiologist Carl Hart has made the rounds in the media.
The reality is, people do not literally lose control of their use of these drugs – and most people who have used these drugs do not find them attractive enough to continue using them on a regular basis or at problematic levels. Yet, some people do lust after these drugs and go on to use them with extreme frequency. Many people who quit these drugs also continue to lust after them, and repeatedly “relapse” into heavy use again as a result. Keep in mind those who “get hooked” are the minority though. What motivates this minority? Most would tell you it’s a disease of the brain that causes them to have an “overpowering” desire for drug use. I am here to tell you this is not the case. The answer to the cause of their desire and choice to use drugs is in their beliefs about these drugs. Their own statements of their beliefs about the benefits of drugs stand as testimony to this fact.
Comedian/Actor Russell Brand
Ben, in the video above, expresses the belief that heroin takes away all your pain and worries. That belief was the motivating force of 4 years of heroin use for Ben.
Outspoken “recovering addict” Russel Brand believes this about heroin:
“I cannot accurately convey the efficiency of heroin in neutralising pain. It transforms a tight white fist into a gentle brown wave”
And with such a belief in place, it’s no wonder that Brand still craves heroin often – even after 10 years of abstinence. Brand is convinced that he’ll be a lifelong addict, and have to deal with these cravings, seeking support from fellow 12-Step members for the rest of his life.
While not everyone finds heroin so attractive, Ben and Brand’s beliefs aren’t odd at all. They’re commonplace. Here’s what a heroin addict character in the iconic heroin movie Trainspotting has to say about the positive effect of heroin:
Trainspotting
Take the best orgasm you ever had, multiply it by a thousand and you’re still nowhere near it.
If that’s not romanticizing it, I don’t know what is. Who WOULDN’T want to keep doing something that feels better than an orgasm multiplied by a thousand? And that’s the point. We can talk all we want about chemical imbalances, mysterious diseases, “impaired self-control”, etc etc etc – but these drug users are telling us EXACTLY what powers their supposed addiction: their beliefthat the effects of drugs are better than any other worldly joy possible. Self-control isn’t the issue at all – their “self” believes the high of heroin is the best thing going, therefore their “self” desires it, and their “self” is in control, doing exactly what it wants when it decides to use heroin – or feeling deprived and conflicted when they decide not to use heroin because of the negative consequences it may bring. All of this is caused by the belief in the mystical powers of heroin.
Don’t believe me? Take a look at this quote from a heroin user on a drug message board, and think about it:
In essence, the first time you inject it… it as if you are kissing the creator. I won’t give a description of my first time… because I in no way wish to romantacize or sanitize it. It is safe to say though, that you will NEVER feel that way again, although you will certainly try–to the point of losing everything–maybe even your life.
“Kissing the creator”??? Again, who among us wouldn’t want the feeling of “kissing the creator” every day for the rest of their life?
Don’t these claims seem at least a bit exaggerated? Yet we take them unquestioningly at face value – or if we’re a user, we hold these beliefs unquestioningly. Maybe it’s not really that good. Maybe it pales in comparison to the joy you’d feel in your life without it. Maybe drugs don’t make your problems and worries go away. Maybe these drugs don’t really cure pain, anxiety, depression, etc.
Unfortunately, nobody questions the amazing benefits of drugs. We just accept it as true. And then we try to focus on the negatives (costs and risks) – as interviewer Kate Snow did in the video above. In fact, the whole process of “confronting denial” in the recovery culture is about trying to wake someone up to the negative side of drug and alcohol use (while implicitly accepting the benefits). But the big secret is that most people with substance use problems are fully aware of the negatives. In fact, they’ve experienced many of the negative consequences – yet they keep using. Why do they keep using? That’s the big mystery that’s really no mystery at all. The evidence is right in front of your face. They keep using because they believe it’ll provide the best feeling possible – the feeling of wiping away pain and worry; the feeling of a thousand orgasms at once; the feeling of “kissing the creator.”
The reality is that while drug and alcohol induced highs can be enjoyable, they are not as good as we give them credit for. And as long as you give them that credit, you will either continue using at high levels, or you will experience a high level of desire (usually referred to as “craving”) that leaves you feeling painfully deprived when you choose not to fulfill it (while employing the strategy of staying painfully aware of the costs as a way to drum up the will to deprive yourself).
The tragedy is that the recovery world takes the supposed allure of drug and alcohol use for granted, and in fact reinforces it with the “self-medication” model of addiction. In the self-medication model, they assume people use substances to cure stress, depression, etc. – and they offer the solution of “alternative coping skills.” They encourage people to seek support when they’re feeling negative emotions – or else they’ll succumb to the lure of substance use as a solution to those problems. This lends credence to the idea that drugs and alcohol actually provide relief from these problems – if not by explicitly giving substance use credit as a solution, then at least implicitly, by teaching that we will turn to them in lack of a better solution.
The danger with this approach is that every moment of experiencing an emotional difficulty – or god forbid feeling hungry or tired (ever heard of the recovery culture acronym HALT – Hungry, Angry, Lonely, Tired?) – becomes a dire moment of potential relapse – because you still believe that substances will help you to deal with these discomforts. It sets up these moments as either-or: either I get to work applying a better “coping skill” or I use substances heavily (if the coping skill isn’t good enough, or doesn’t work, or you’re just too lazy to cope properly. But if you don’t think heavy substance use is a solution, then you will NEVER feel the desire to use it as a solution – even if you hold on to high levels of un-coped-with anger.
So I beg of you – question the benefits of substance use. They are small. It just provides a physical sensation. But we’ve heaped a ton of meaning on top of that physical sensation. We’ve given that feeling more credit than it deserves. We’ve given drugs and alcohol more credit than they deserve.
By Steven Slate
Steven Slate has personally taught hundreds of people how to change their substance use habits through choice - while avoiding the harmful recovery culture and disease model of addiction.
Notice how “pain” gets generalized. The “addict” learns to generalize pain while specifying their response to it. This is not a functional coupling of sensation with motion… and the “addict,” if you take the time to ask them, knows this!
What a great point Joseph!
Kissing the creator sounds like this quote (mis)attributed to Lenny Bruce (on injecting heroin): “I’ll die young but it’s like kissing God!”
While this article is interesting and i love to hear theories and viewpoints that deviate from mainstream societys belief in only one form of treatment for addiction..the AA format…frankly, i disagree. Firstly,i do NOT believe that twelve step work is the only way to TREAT addiction, because nowhere else in medicine is there only one approach to treating any disease. Thats right, i said disease. While it may be true that the so called “beliefs” of an addict lead them to addiction,that is all part of the problem. If you dont believe in the disease concept, how do you explain all the scientific evidence we have nowadays showing the changes in the brain of addicts through bran scans? That is exactly what opiods, in particular, do. Alter the brain to the point that there are severe physical and mental effects on the user. I find myself wondering if the writer is even an addict? Its unfortunate that at this.day in age, even with our technology, we are still living in a time that people still do not accept addiction as a medical issue, thus causing addicts to be further stigmatized and judged, portrayed as morally deficit by stating its their “beliefs”…aka, “all in their minds”that make them this way. People from all walks of life can and do become addicted to opiods. Their beliefs may change from pre.addict state to current addictive state. Also, ANYONE can become dependent on opiates, which is different from addicted, the writer, for example, could become dependent. Say you suffered terrible injuries in a car accident and were instructed to take oxycodone for a period of 30 days or more. Your doctor would need to slowly reduce your dosage to get you off of it because it is inevitable at this point that your body would develop physical dependence after extended daily use. Do you think it would be your “beliefs” causing your body to ache, your eyes to water, sweating, chills, diarhhea, vomiting? And if not, if you dont question the pain these drugs can bring on, why would you question the pleasure? They go hand in hand. Extreme pleasure turns to extreme pain, thats.why with heroin and other opiates, you will always have to pay the piper. If it wasnt so incredibly euphoric, i highly doubt people all over this world and throughout history.would be losing their lives over it, just because they “believe” its something its not. It IS something so pleasurable its indescribable. And though that sounds like glorification, in this instance, its not. The horrors of the pain it ultimately brings shouldnt be left out either. Has it ever occurred to you that thats why so many addicts attempt to describe the allure and euphoria of the drug? To try to bring understanding to those who just dont understand. They cant, and wont, unless theyve been there too. And in the end, anything anyone says to the contrary, well, guess what? Its just a theory. Interesting, maybe, but not factual. When it comes to this topic, id rather form my theories based on two things, scientific evidence, and more so, the overwhelmingly similar and reoccuring accounts of those who have walked down the dark road of opiate addiction. Statistically, theyll give you the same answers. After all, experience is the best teacher.
Casey,
It is admirable that you recognise the wide array of alternative addiction treatments out there, and that you gave the article an open mind. I am not the author, but having read quite widely in this area, and having been through addiction myself (that’s right, I said “been through” because I do not regard myself as addicted any more), I find myself agreeing more with him than with you. As for your objections, I will attempt to counter them as follows:
“If you dont believe in the disease concept, how do you explain all the scientific evidence we have nowadays showing the changes in the brain of addicts through bran scans?”
Brain scans do NOT show addiction. No brain scan has ever been used to diagnose an addicted person, or could ever be, because these brains scans do not discriminate between regular users and addicts. All they show is that consuming substances causes instant changes in the brain (changes which almost always eventually revert). They also cannot show any difference between a former heavy user and someone who has never taken drugs. All this talk of changing brains sounds dramatic to someone unfamiliar with neuroscience (and sadly much of the field in this area can only be considered as lazy and propagandistic), but the reality is simple: people’s brains change all the time. Your brain is probably changing right now as you read this comment, and will change again once you’ve finished reading it. None of this is really proof of anything about the mysterious power of substances.
“Its unfortunate that at this.day in age, even with our technology, we are still living in a time that people still do not accept addiction as a medical issue, thus causing addicts to be further stigmatized and judged, portrayed as morally deficit by stating its their “beliefs”…aka, “all in their minds”that make them this way.”
I don’t know who this is targeted at. The author, certainly is not making that point, and it seems unfortunate and unnecessary to me that admitting that addiction is a behavioural problem with causes within the normal human experience rather than the consequence of simple chemical reactions in the brain should lead to stigmatization and judgement.
“When it comes to this topic, id rather form my theories based on two things, scientific evidence, and more so, the overwhelmingly similar and reoccuring accounts of those who have walked down the dark road of opiate addiction. ”
The scientific evidence says quite a lot about people’s attitudes and their influence on substance use. G. Alan Marlatt for instance has written much about the “think drink effect” which shows amongst other things that alcoholics who think they are drinking alcohol will binge in response even when given a placebo, and that they will not binge if given alcohol and they are unaware of it. The accounts of addicts I find are often inaccurate. In my own experience, I drank very heavily, developed withdrawals and turned to the internet to look for help to quit. After a long period of exposure to materials written by steppers, and accounts of their own problems etc, I became convinced that I was in denial, that I would never be able to drink again, that I was an addict for life and so on and so forth. I also rejected what I knew was the truth about my drinking, that I had started because I was depressed, because AA brainwashed me into thinking I was in denial. Since my life has stabilized and I have learned to drink moderately, I have begun to re-analyse my drinking patterns back then and realized that, aside from the attitudes described in this article (I have to say I practically worshipped alcohol while I was drinking, and believed that heroin or sex could not possibly compare to it.), my initial analysis that depression and misery were causing my drinking was correct. I have seen time and time again however that AAers and NAers are taught to lie about their own experiences, and over time they come to believe things about themselves that they never believed before they came into contact with NA. I thus have difficulty believing addicts who are “in recovery” because by and large I cannot take their own analyses seriously as they have long ago “left their brain at the door”.
“People from all walks of life can and do become addicted to opiods. ”
This is technically true, but misleading. Addiction is far, far more common amongst disadvantaged sections of the community than amongst the privileged. The reasons for this are fairly obvious, when addiction is taken as a choice, which can compete with the other choices available to a person, than when it is taken as a lifelong disease.
Having quit smoking almost entirely painlessly recently, and having felt agonizing withdrawal every previous attempt, I can honestly say that in my experience, expectations have a massive effect on what a person experiences. There are other factors at play here too, but it is worth bearing in mind that even heroin addiction is largely self-correcting. The majority of users never become addicted, and of those who do, a significant majority quit without treatment. A good example to ponder over, in case you think that my experiences of tobacco and alcohol are not equivalent to heroin, is the seminal study of Vietnam war veterans. Roughly a quarter of Vietnam War vets returned home addicted to heroin (on the subject of withdrawal, somewhat surprisingly physical withdrawal symptoms varied by unit, so different communities of soldiers claimed to experience different symptoms). Of those, approximately 90% were no longer using within a year. Of course, this does not entirely back up the author’s claim insofar as it shows that there is more to addiction than simply expectation. However, it also seems to prove that addiction is not a permanent disease. The Vietnam war vets stopped taking heroin because they no longer had any desire for it when they weren’t trying to soothe the pain of being in a traumatic war zone. No changes in their brain chemistry affected their ability to quit, because unlike typical addicts, their motivation to use was immediately and rapidly taken away on their return home.
First – my thanks go to Simpry for replying to several of Casey’s issues.
I would add, Casey, that if you think I’m somehow ignorant of the claims and “evidence” that addiction is a brain disease, then maybe you’d at least take a peak around the site before putting that accusation down in print. The links to my article analyzing the brain disease model and associated “evidence” are all over the site. It’s my most popular article, gets over 7,000 hits a month, has been printed on textbooks on addiction, has been the top result for “addiction is not a brain disease” for a few years now, and addresses exactly the talking points you’ve entered here. You’re obviously more than welcome to express your disagreement here, as many people do, but to pretend as if I’m completely ignorant about the issue? Come on. Just look at the homepage of this website.
And since I’m no PhD, and you’re probably the type who only responds to appeals to authority, here’s a link to an article by a PhD who says some of the same things, and appears in an academic journal: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644798/
Also, I don’t deny the existence of physical effects of withdrawal. In many places on this site, I have recommended that people get help from the medical establishment for such problems. These are, however, separate problems from a long term substance use habit, or “addiction” as it is called. You even noted this. Also, just scroll down the page to see the footer text on detoxification which appears on almost every one of the hundreds of pages on this website. Here’s some of the text:
DRUG & ALCOHOL DETOX INFO
We are critical of the idea that “addiction” is a disease that robs heavy substance users of the choice to use substances. This is mythology.
However, the symptoms of detoxification that occurs when people choose to stop using drugs and alcohol can be serious; are a REAL medical issue; and sometimes require real medical help for safety.
Particularly, detoxification from alcohol and the prescription drugs known as benzodiazepines can lead to fatal seizures in some cases. Opiates, according to Dr Carl Hart of Colombia University, cannot cause fatal withdrawal symptoms.
Whatever substance you’re quitting, if you sense any danger at all, the best thing you can do is to check with your doctor, a local detox clinic, or emergency room when necessary.
The treatment locator can help you to find detoxification clinics: Click here for SAMHSA Treatment Locator
Do I sound like someone who denies the existence of withdrawal symptoms? Or do you sound ignorant?
I don’t like to get into pissing matches about being a real addict, but I’ve been there. I used to think heroin was the greatest feeling possible to me. Then I stopped it for a while and started building a better life. I no longer think heroin is the greatest feeling available to me. I think it’s pretty empty and small. The last time I used heroin was a single instance a few months after detoxing cold turkey from a several hundred dollar per day habit. It was real heroin. I felt a real high. But I saw that high in a different light at that point, and believed that my new direction in life felt far better to me. As a consequence of my changed perspective, I don’t crave heroin; I don’t struggle to resist heroin; and I do NOTHING to “prevent relapse.” It feels great, as compared to the previous times I tried to end my substance use problems in the recovery world, and felt deprived, on edge, and in danger of “relapse” at all times – which inevitably “happened.”
People who get loaded up on morphine in the hospital don’t usually think it’s this amazing euphoric thing better than anything in life. They want to be clear headed again. Doctors often do not step down their dosage. They pull the plug on the morphine, and the patients detoxify as if they have the flu. They get the hot & cold sweats, muscle and joint pain, and gastrointestinal problems, etc – but somehow, it isn’t accompanied by “craving.” Do you know why? Because they don’t see the physical sensations provided by opiates as a means to happiness or emotional medication. They don’t think of that feeling as “kissing the creator” or whatever ridiculous imagery is conjured up by people who romanticize opiates.
-Steven Slate, Author, The Clean Slate Addiction Site
Kudos Steven! Congratulations on creating such a wonderful site.
Thanks for the responses to my post. Id like to touch on several points that were made. I dont desire to get into a pissing contest here either, only a discussion, or perhaps we could say debate. Firstly however i would like to state that i certainly never called anyone ignorant and that was not my implication either. Also, i am not prone to only commenting or referring to “professional” opinion or advice-in fact, as previously stated i am much more inclined to respect those of people who have personal experience with these issues. That said, i believe everyone is different, and that means addicts too. Just as a one size fits all approach doesnt apply to treatment of addictions nor does it apply to the way in which drugs affect a person and clearly, their opinions on the matter as well. Some people feel relaxed when they smoke marijuana for instance, and others have paranoia and anxiety issues. So, it should not be surprising that we differ in opinion regarding opiod addiction-what you, i , or the next person find works for them, should not be considered a matter of “right” or “wrong”, because what i believe may not be what you do and what keeps you sober may not do it for me. Now. I must disagree with the comment on brain scans. If you re read my original statement, i never said addiction can be diagnosed with a brain scan. I clearly stated what was reiterated- that they HAVE been proven to show changes in the brain caused by drug use. Also, they do indeed show long term damage in the brains of heavy long term users. The changes in my brain before and after writing this are not comparable to the changes caused by long term opiod use. If you abuse these drugs on a daily basis for years, your brain is not going to repair itself instantaneously the day you quit. Just as it took time to get there it takes time to heal. The initial withdrawals as well as post acute withdrawals are all results of brain and nervous system changes. However, to the author, you are correct that i have not read any other articles on this site discussng this issue and in that regard i stand corrected, point well made. I stumbled across this particular article accidentally. Next, it IS indeed unfortunate and unnecessary to stigmatize an addict. But is there seriously any denying that it happens, A LOT in our world? And this isnt targeted at anyone in particular, but to me, adamency toward the idea that it is simply ones beliefs or “behavioural problems” that are to blame for their addictions implies that there is some lack of morality and willpower in that person, which is clearly judgmental, not to mention stereotypical of a whole group of people who again, are all different. While we seem to agree that na and aa formats are not necessarily the answer, there are plenty of people out there who swear by it and can honestly proclaim themselves clean and sober and they will credit these organizations for it. Just because i dont agree that its some magical solution, if they do, im certainly not going to knock them for it. I myself am clean from heroin and several years of opiod addiction, and i dont work a “program”, but what finally worked for me was accepting that i do not have a willpower issue, or a behavioral issue, or whatever other term you want to attribute to it…when i stopped being down on myself that i couldnt “overpower” the substance, and i accepted that the way these drugs made me feel absolutely WONDERFUL when high, i realized that the price id have to pay for it would be absolutely painful and horrific and id exist for the rest of my life as a slave to the drug. You see, i decided not to exist, but to live, and i didnt do this by MINIMIZING the pleasure these drugs bring, but by embracing that its the truth, realizing addiction is a dance with the devil. If these beliefs cause someone to continue using, then i guess ive simply been lucky to stay sober for two years. Lucky that i dont want or intend to use in the future. However, i dont think so. I think this is what works for me. I would also like to know where you are getting your information stating that the majority of heroin users never become addicted and most quit without treatment?! That seems an incredibly bold and, frankly, outlandish statement to make…is there some statistical figure you are quoting here? I imagine not…just based off anything ive ever seen or read, 90% of heroin users dont quit and stay sober for the remainder of their lives. Basically a pretty grim outlook on “recovery.” Not to mention, seizures are most definitely a risk of opiod withdrawal! Your blood pressure can spike dangerously high and your entire nervous system is in overdrive during withdrawal. If it wasnt dangerous medical detox would not be of any significance, and i think its rather dangerous to imply that its not. I personally witnessed a girl have a seizure in rehab-simply from a heavy VICODIN habit! Also, stating that addiction is much more common in disadvantaged communities, well, sure. What percentage of society is not upper class anyway? Not that poverty doesnt inevitably bring more crime, drugs, etc…but That right there should show why its more common, its a larger group. Besides, those are just hypothetical reasons why someone would begin using-not why they continue once addicted. Sometimes beginning to use IS a choice ,but addiction, i have to disagree is not. To steven-i, very much like you, do not attempt to work a program or some such thing to fight relapse. Like you, i no longer feel, as you said, “on edge” like i did when i was trying to abstain this way. In that way, we are similar. But you know what? You yourself stated that when you did, in fact, relapse, you felt high, but decided your new direction in life felt far better. This clearly shows that you are doing something to fill that spot that you once used drugs to fill, and in that respect, you arent any different than anyone else who is currently abstaining from heroin. Something has to fill that empty hole in all of us. When you relapsed, you said you felt a high. Did it not feel good? Sure, you said you decided sobriety felt better, but did you perhaps minimize that being high did and does feel quite pleasurable? Likely you did, because you dont want to “romanticize” that feeling. Its also worth noting that in long term addicts, myself included, after some time you no longer even get high yet you continue to use every day of your life. Not because you are driven by the belief that it feels so good. It doesnt feel good at all. You are driven by the need to avoid withdrawal. You use to feel normal, not good anymore. Surely that aspect is something you are familiar with if you had a large habit. Again, i am not writing this to argue or point fingers…This is a topic im passionate about for obvious reasons. All in all, everyone should be entitled to their own opinions, and mainly, thats what i take issue with. Facts are facts, but the topics discussed here, my comments of course included, are merely OPINIONS. Thus they should not be portrayed as anything more.
“So I beg of you – question the benefits of substance use. They are small. It just provides a physical sensation. ”
Not true of all drugs, and in particular not the big one I am thinking of: amphetamine. Let’s examine some of the effects it has:
-Reduced need for sleep, especially in the short term.
-Reduced feeling of fatigue
-Reduced feeling of hunger
-Greater focus
-Faster reaction times
-Increased physical strength
And those are the less subjective of the effects: increased motivation, sexual desire, and self-esteem are a few more I would list.
The distinction is important, because amphetamine users don’t just “nod out” until it is time to go get more and nod again, but can be directed towards doing. A prime example is the German armed forces during World War II, whose tenacity up until the final battle in Berlin is well documented.
Military aviators are still offered amphetamine (Adderall, I understand) for extended operations. The slang name current is “go-pills”.
Amphetamine is, unlike some drugs, only pleasurable in relation to doing something else. Being locked up on it is utterly painful.
I honestly miss amphetamine like hell. I was on it daily from age 11 to 24 (with occasional days skipped for various reasons) and miss absolutely everything about it.
Every other ADD or depression medication, in my opinion, is a waste of money or worse.
Ryan,
I appreciate your thoughtful response. I agree that energy can be borrowed in the short term with the various upper drugs. And that this can be seen as quite the benefit.
However, I think that whether the uppers cause people to have greater focus is debatable. A wide range of effects is seen when it comes to this matter – from extremely focused to extremely scatterbrained and unfocused – so I’m not sure that the drug itself is the cause of these effects, but that it may be a learned response to these drugs.
Alas, my main point is that most of those supposed emotional/psychological benefits – the soothing of various psychological pains – the conference of confidence and courage – the supposed disinhibition – are nonsense. They are mostly the products of expectancy.
The emotional “relief” (that people believe they pharmacologically receive from drugs/alcohol) is the product of a freely chosen process of turning one’s attention away from emotionally painful thoughts, and toward thoughts of “this high/druk feels good.” This same exact process is carried out by countless billions of people every day as they turn their attention towards Television, a book, Facebook, fishing, shooting hoops, painting, gardening, et cetera. The chemical doesn’t do it. The activity of refocusing your thoughts is what does it. For proof of this, note the rapid onset of stress that would occur if you get high/drunk, and then get stopped by the police while driving. The chemical stress reliever is coursing through your veins, yet you are incredibly stressed! How is that possible if the drug is the cause of stress relief? It is plainly impossible.
Again though, I agree, the physical waking up that uppers can provide is a benefit. How high does this rank on the scale of meaningful benefits? That’s an important question that individuals should carefully consider if they;re having problems with substance use. It’s worth noting that the repeated borrowing of energy through use of these substances can result in crashes that reduce the overall value of the experience.
Thanks for your interesting comments,
-Steven Slate
Thanks for your article. I am a little late but wanted to react to it. I think that thing about the beliefs about the drug is very interesting and certainly important. But I would regard it as only one aspect of addiction. There are many addicts and many different behaviors. Some are very addicted and some others are less. I know some people who stopped their relatively heavy use of alcohol without any outside help, and just with willpower. Some heavy smokers quit smoking just because they decide to, and with no more complex strategy. So I can accept that some people stop their drug use just because they realize they believed it was better than it actually is. But I am sure that for a lot of others this is not enough. From my own experience there are so many other beliefs that fuel addiction. There is also how I look at myself and my relationship to others, how I deal with my emotions, how I tend to struggle instead of grieving… etc…. I know the short and long term consequences of my addiction, I know very well that it is not a perfect solution, that I don’t kiss god when I use, and I know that there are bad long term consequences. But there are many times when this is not going to be enough for me. Personally, I have been sober for a few years, and at this point in my life if I don’t do anything to prevent relapse, no amount of logic will be able to save me. I will eventually go to “screw it” mode and simply relapse.
That being said, I feel it is really true that the belief that the drug is better than it actually is is an important aspect, and I thank you for pointing this out, I am going to think more about this.
Kate Snow: What does it feel like?
Notice how “pain” gets generalized. The “addict” learns to generalize pain while specifying their response to it. This is not a functional coupling of sensation with motion… and the “addict,” if you take the time to ask them, knows this!
What a great point Joseph!
Kissing the creator sounds like this quote (mis)attributed to Lenny Bruce (on injecting heroin): “I’ll die young but it’s like kissing God!”
While this article is interesting and i love to hear theories and viewpoints that deviate from mainstream societys belief in only one form of treatment for addiction..the AA format…frankly, i disagree. Firstly,i do NOT believe that twelve step work is the only way to TREAT addiction, because nowhere else in medicine is there only one approach to treating any disease. Thats right, i said disease. While it may be true that the so called “beliefs” of an addict lead them to addiction,that is all part of the problem. If you dont believe in the disease concept, how do you explain all the scientific evidence we have nowadays showing the changes in the brain of addicts through bran scans? That is exactly what opiods, in particular, do. Alter the brain to the point that there are severe physical and mental effects on the user. I find myself wondering if the writer is even an addict? Its unfortunate that at this.day in age, even with our technology, we are still living in a time that people still do not accept addiction as a medical issue, thus causing addicts to be further stigmatized and judged, portrayed as morally deficit by stating its their “beliefs”…aka, “all in their minds”that make them this way. People from all walks of life can and do become addicted to opiods. Their beliefs may change from pre.addict state to current addictive state. Also, ANYONE can become dependent on opiates, which is different from addicted, the writer, for example, could become dependent. Say you suffered terrible injuries in a car accident and were instructed to take oxycodone for a period of 30 days or more. Your doctor would need to slowly reduce your dosage to get you off of it because it is inevitable at this point that your body would develop physical dependence after extended daily use. Do you think it would be your “beliefs” causing your body to ache, your eyes to water, sweating, chills, diarhhea, vomiting? And if not, if you dont question the pain these drugs can bring on, why would you question the pleasure? They go hand in hand. Extreme pleasure turns to extreme pain, thats.why with heroin and other opiates, you will always have to pay the piper. If it wasnt so incredibly euphoric, i highly doubt people all over this world and throughout history.would be losing their lives over it, just because they “believe” its something its not. It IS something so pleasurable its indescribable. And though that sounds like glorification, in this instance, its not. The horrors of the pain it ultimately brings shouldnt be left out either. Has it ever occurred to you that thats why so many addicts attempt to describe the allure and euphoria of the drug? To try to bring understanding to those who just dont understand. They cant, and wont, unless theyve been there too. And in the end, anything anyone says to the contrary, well, guess what? Its just a theory. Interesting, maybe, but not factual. When it comes to this topic, id rather form my theories based on two things, scientific evidence, and more so, the overwhelmingly similar and reoccuring accounts of those who have walked down the dark road of opiate addiction. Statistically, theyll give you the same answers. After all, experience is the best teacher.
Casey,
It is admirable that you recognise the wide array of alternative addiction treatments out there, and that you gave the article an open mind. I am not the author, but having read quite widely in this area, and having been through addiction myself (that’s right, I said “been through” because I do not regard myself as addicted any more), I find myself agreeing more with him than with you. As for your objections, I will attempt to counter them as follows:
“If you dont believe in the disease concept, how do you explain all the scientific evidence we have nowadays showing the changes in the brain of addicts through bran scans?”
Brain scans do NOT show addiction. No brain scan has ever been used to diagnose an addicted person, or could ever be, because these brains scans do not discriminate between regular users and addicts. All they show is that consuming substances causes instant changes in the brain (changes which almost always eventually revert). They also cannot show any difference between a former heavy user and someone who has never taken drugs. All this talk of changing brains sounds dramatic to someone unfamiliar with neuroscience (and sadly much of the field in this area can only be considered as lazy and propagandistic), but the reality is simple: people’s brains change all the time. Your brain is probably changing right now as you read this comment, and will change again once you’ve finished reading it. None of this is really proof of anything about the mysterious power of substances.
“Its unfortunate that at this.day in age, even with our technology, we are still living in a time that people still do not accept addiction as a medical issue, thus causing addicts to be further stigmatized and judged, portrayed as morally deficit by stating its their “beliefs”…aka, “all in their minds”that make them this way.”
I don’t know who this is targeted at. The author, certainly is not making that point, and it seems unfortunate and unnecessary to me that admitting that addiction is a behavioural problem with causes within the normal human experience rather than the consequence of simple chemical reactions in the brain should lead to stigmatization and judgement.
“When it comes to this topic, id rather form my theories based on two things, scientific evidence, and more so, the overwhelmingly similar and reoccuring accounts of those who have walked down the dark road of opiate addiction. ”
The scientific evidence says quite a lot about people’s attitudes and their influence on substance use. G. Alan Marlatt for instance has written much about the “think drink effect” which shows amongst other things that alcoholics who think they are drinking alcohol will binge in response even when given a placebo, and that they will not binge if given alcohol and they are unaware of it. The accounts of addicts I find are often inaccurate. In my own experience, I drank very heavily, developed withdrawals and turned to the internet to look for help to quit. After a long period of exposure to materials written by steppers, and accounts of their own problems etc, I became convinced that I was in denial, that I would never be able to drink again, that I was an addict for life and so on and so forth. I also rejected what I knew was the truth about my drinking, that I had started because I was depressed, because AA brainwashed me into thinking I was in denial. Since my life has stabilized and I have learned to drink moderately, I have begun to re-analyse my drinking patterns back then and realized that, aside from the attitudes described in this article (I have to say I practically worshipped alcohol while I was drinking, and believed that heroin or sex could not possibly compare to it.), my initial analysis that depression and misery were causing my drinking was correct. I have seen time and time again however that AAers and NAers are taught to lie about their own experiences, and over time they come to believe things about themselves that they never believed before they came into contact with NA. I thus have difficulty believing addicts who are “in recovery” because by and large I cannot take their own analyses seriously as they have long ago “left their brain at the door”.
“People from all walks of life can and do become addicted to opiods. ”
This is technically true, but misleading. Addiction is far, far more common amongst disadvantaged sections of the community than amongst the privileged. The reasons for this are fairly obvious, when addiction is taken as a choice, which can compete with the other choices available to a person, than when it is taken as a lifelong disease.
Having quit smoking almost entirely painlessly recently, and having felt agonizing withdrawal every previous attempt, I can honestly say that in my experience, expectations have a massive effect on what a person experiences. There are other factors at play here too, but it is worth bearing in mind that even heroin addiction is largely self-correcting. The majority of users never become addicted, and of those who do, a significant majority quit without treatment. A good example to ponder over, in case you think that my experiences of tobacco and alcohol are not equivalent to heroin, is the seminal study of Vietnam war veterans. Roughly a quarter of Vietnam War vets returned home addicted to heroin (on the subject of withdrawal, somewhat surprisingly physical withdrawal symptoms varied by unit, so different communities of soldiers claimed to experience different symptoms). Of those, approximately 90% were no longer using within a year. Of course, this does not entirely back up the author’s claim insofar as it shows that there is more to addiction than simply expectation. However, it also seems to prove that addiction is not a permanent disease. The Vietnam war vets stopped taking heroin because they no longer had any desire for it when they weren’t trying to soothe the pain of being in a traumatic war zone. No changes in their brain chemistry affected their ability to quit, because unlike typical addicts, their motivation to use was immediately and rapidly taken away on their return home.
First – my thanks go to Simpry for replying to several of Casey’s issues.
I would add, Casey, that if you think I’m somehow ignorant of the claims and “evidence” that addiction is a brain disease, then maybe you’d at least take a peak around the site before putting that accusation down in print. The links to my article analyzing the brain disease model and associated “evidence” are all over the site. It’s my most popular article, gets over 7,000 hits a month, has been printed on textbooks on addiction, has been the top result for “addiction is not a brain disease” for a few years now, and addresses exactly the talking points you’ve entered here. You’re obviously more than welcome to express your disagreement here, as many people do, but to pretend as if I’m completely ignorant about the issue? Come on. Just look at the homepage of this website.
Here’s a link to my article on the brain disease model of addiction:http://www.thecleanslate.org/myths/addiction-is-not-a-brain-disease-it-is-a-choice/
And since I’m no PhD, and you’re probably the type who only responds to appeals to authority, here’s a link to an article by a PhD who says some of the same things, and appears in an academic journal: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644798/
Also, I don’t deny the existence of physical effects of withdrawal. In many places on this site, I have recommended that people get help from the medical establishment for such problems. These are, however, separate problems from a long term substance use habit, or “addiction” as it is called. You even noted this. Also, just scroll down the page to see the footer text on detoxification which appears on almost every one of the hundreds of pages on this website. Here’s some of the text:
Do I sound like someone who denies the existence of withdrawal symptoms? Or do you sound ignorant?
I don’t like to get into pissing matches about being a real addict, but I’ve been there. I used to think heroin was the greatest feeling possible to me. Then I stopped it for a while and started building a better life. I no longer think heroin is the greatest feeling available to me. I think it’s pretty empty and small. The last time I used heroin was a single instance a few months after detoxing cold turkey from a several hundred dollar per day habit. It was real heroin. I felt a real high. But I saw that high in a different light at that point, and believed that my new direction in life felt far better to me. As a consequence of my changed perspective, I don’t crave heroin; I don’t struggle to resist heroin; and I do NOTHING to “prevent relapse.” It feels great, as compared to the previous times I tried to end my substance use problems in the recovery world, and felt deprived, on edge, and in danger of “relapse” at all times – which inevitably “happened.”
People who get loaded up on morphine in the hospital don’t usually think it’s this amazing euphoric thing better than anything in life. They want to be clear headed again. Doctors often do not step down their dosage. They pull the plug on the morphine, and the patients detoxify as if they have the flu. They get the hot & cold sweats, muscle and joint pain, and gastrointestinal problems, etc – but somehow, it isn’t accompanied by “craving.” Do you know why? Because they don’t see the physical sensations provided by opiates as a means to happiness or emotional medication. They don’t think of that feeling as “kissing the creator” or whatever ridiculous imagery is conjured up by people who romanticize opiates.
-Steven Slate, Author, The Clean Slate Addiction Site
Kudos Steven! Congratulations on creating such a wonderful site.
Thanks for the responses to my post. Id like to touch on several points that were made. I dont desire to get into a pissing contest here either, only a discussion, or perhaps we could say debate. Firstly however i would like to state that i certainly never called anyone ignorant and that was not my implication either. Also, i am not prone to only commenting or referring to “professional” opinion or advice-in fact, as previously stated i am much more inclined to respect those of people who have personal experience with these issues. That said, i believe everyone is different, and that means addicts too. Just as a one size fits all approach doesnt apply to treatment of addictions nor does it apply to the way in which drugs affect a person and clearly, their opinions on the matter as well. Some people feel relaxed when they smoke marijuana for instance, and others have paranoia and anxiety issues. So, it should not be surprising that we differ in opinion regarding opiod addiction-what you, i , or the next person find works for them, should not be considered a matter of “right” or “wrong”, because what i believe may not be what you do and what keeps you sober may not do it for me. Now. I must disagree with the comment on brain scans. If you re read my original statement, i never said addiction can be diagnosed with a brain scan. I clearly stated what was reiterated- that they HAVE been proven to show changes in the brain caused by drug use. Also, they do indeed show long term damage in the brains of heavy long term users. The changes in my brain before and after writing this are not comparable to the changes caused by long term opiod use. If you abuse these drugs on a daily basis for years, your brain is not going to repair itself instantaneously the day you quit. Just as it took time to get there it takes time to heal. The initial withdrawals as well as post acute withdrawals are all results of brain and nervous system changes. However, to the author, you are correct that i have not read any other articles on this site discussng this issue and in that regard i stand corrected, point well made. I stumbled across this particular article accidentally. Next, it IS indeed unfortunate and unnecessary to stigmatize an addict. But is there seriously any denying that it happens, A LOT in our world? And this isnt targeted at anyone in particular, but to me, adamency toward the idea that it is simply ones beliefs or “behavioural problems” that are to blame for their addictions implies that there is some lack of morality and willpower in that person, which is clearly judgmental, not to mention stereotypical of a whole group of people who again, are all different. While we seem to agree that na and aa formats are not necessarily the answer, there are plenty of people out there who swear by it and can honestly proclaim themselves clean and sober and they will credit these organizations for it. Just because i dont agree that its some magical solution, if they do, im certainly not going to knock them for it. I myself am clean from heroin and several years of opiod addiction, and i dont work a “program”, but what finally worked for me was accepting that i do not have a willpower issue, or a behavioral issue, or whatever other term you want to attribute to it…when i stopped being down on myself that i couldnt “overpower” the substance, and i accepted that the way these drugs made me feel absolutely WONDERFUL when high, i realized that the price id have to pay for it would be absolutely painful and horrific and id exist for the rest of my life as a slave to the drug. You see, i decided not to exist, but to live, and i didnt do this by MINIMIZING the pleasure these drugs bring, but by embracing that its the truth, realizing addiction is a dance with the devil. If these beliefs cause someone to continue using, then i guess ive simply been lucky to stay sober for two years. Lucky that i dont want or intend to use in the future. However, i dont think so. I think this is what works for me. I would also like to know where you are getting your information stating that the majority of heroin users never become addicted and most quit without treatment?! That seems an incredibly bold and, frankly, outlandish statement to make…is there some statistical figure you are quoting here? I imagine not…just based off anything ive ever seen or read, 90% of heroin users dont quit and stay sober for the remainder of their lives. Basically a pretty grim outlook on “recovery.” Not to mention, seizures are most definitely a risk of opiod withdrawal! Your blood pressure can spike dangerously high and your entire nervous system is in overdrive during withdrawal. If it wasnt dangerous medical detox would not be of any significance, and i think its rather dangerous to imply that its not. I personally witnessed a girl have a seizure in rehab-simply from a heavy VICODIN habit! Also, stating that addiction is much more common in disadvantaged communities, well, sure. What percentage of society is not upper class anyway? Not that poverty doesnt inevitably bring more crime, drugs, etc…but That right there should show why its more common, its a larger group. Besides, those are just hypothetical reasons why someone would begin using-not why they continue once addicted. Sometimes beginning to use IS a choice ,but addiction, i have to disagree is not. To steven-i, very much like you, do not attempt to work a program or some such thing to fight relapse. Like you, i no longer feel, as you said, “on edge” like i did when i was trying to abstain this way. In that way, we are similar. But you know what? You yourself stated that when you did, in fact, relapse, you felt high, but decided your new direction in life felt far better. This clearly shows that you are doing something to fill that spot that you once used drugs to fill, and in that respect, you arent any different than anyone else who is currently abstaining from heroin. Something has to fill that empty hole in all of us. When you relapsed, you said you felt a high. Did it not feel good? Sure, you said you decided sobriety felt better, but did you perhaps minimize that being high did and does feel quite pleasurable? Likely you did, because you dont want to “romanticize” that feeling. Its also worth noting that in long term addicts, myself included, after some time you no longer even get high yet you continue to use every day of your life. Not because you are driven by the belief that it feels so good. It doesnt feel good at all. You are driven by the need to avoid withdrawal. You use to feel normal, not good anymore. Surely that aspect is something you are familiar with if you had a large habit. Again, i am not writing this to argue or point fingers…This is a topic im passionate about for obvious reasons. All in all, everyone should be entitled to their own opinions, and mainly, thats what i take issue with. Facts are facts, but the topics discussed here, my comments of course included, are merely OPINIONS. Thus they should not be portrayed as anything more.
“So I beg of you – question the benefits of substance use. They are small. It just provides a physical sensation. ”
Not true of all drugs, and in particular not the big one I am thinking of: amphetamine. Let’s examine some of the effects it has:
-Reduced need for sleep, especially in the short term.
-Reduced feeling of fatigue
-Reduced feeling of hunger
-Greater focus
-Faster reaction times
-Increased physical strength
And those are the less subjective of the effects: increased motivation, sexual desire, and self-esteem are a few more I would list.
The distinction is important, because amphetamine users don’t just “nod out” until it is time to go get more and nod again, but can be directed towards doing. A prime example is the German armed forces during World War II, whose tenacity up until the final battle in Berlin is well documented.
Military aviators are still offered amphetamine (Adderall, I understand) for extended operations. The slang name current is “go-pills”.
Amphetamine is, unlike some drugs, only pleasurable in relation to doing something else. Being locked up on it is utterly painful.
I honestly miss amphetamine like hell. I was on it daily from age 11 to 24 (with occasional days skipped for various reasons) and miss absolutely everything about it.
Every other ADD or depression medication, in my opinion, is a waste of money or worse.
Ryan,
I appreciate your thoughtful response. I agree that energy can be borrowed in the short term with the various upper drugs. And that this can be seen as quite the benefit.
However, I think that whether the uppers cause people to have greater focus is debatable. A wide range of effects is seen when it comes to this matter – from extremely focused to extremely scatterbrained and unfocused – so I’m not sure that the drug itself is the cause of these effects, but that it may be a learned response to these drugs.
Alas, my main point is that most of those supposed emotional/psychological benefits – the soothing of various psychological pains – the conference of confidence and courage – the supposed disinhibition – are nonsense. They are mostly the products of expectancy.
The emotional “relief” (that people believe they pharmacologically receive from drugs/alcohol) is the product of a freely chosen process of turning one’s attention away from emotionally painful thoughts, and toward thoughts of “this high/druk feels good.” This same exact process is carried out by countless billions of people every day as they turn their attention towards Television, a book, Facebook, fishing, shooting hoops, painting, gardening, et cetera. The chemical doesn’t do it. The activity of refocusing your thoughts is what does it. For proof of this, note the rapid onset of stress that would occur if you get high/drunk, and then get stopped by the police while driving. The chemical stress reliever is coursing through your veins, yet you are incredibly stressed! How is that possible if the drug is the cause of stress relief? It is plainly impossible.
Again though, I agree, the physical waking up that uppers can provide is a benefit. How high does this rank on the scale of meaningful benefits? That’s an important question that individuals should carefully consider if they;re having problems with substance use. It’s worth noting that the repeated borrowing of energy through use of these substances can result in crashes that reduce the overall value of the experience.
Thanks for your interesting comments,
-Steven Slate
Thanks for your article. I am a little late but wanted to react to it. I think that thing about the beliefs about the drug is very interesting and certainly important. But I would regard it as only one aspect of addiction. There are many addicts and many different behaviors. Some are very addicted and some others are less. I know some people who stopped their relatively heavy use of alcohol without any outside help, and just with willpower. Some heavy smokers quit smoking just because they decide to, and with no more complex strategy. So I can accept that some people stop their drug use just because they realize they believed it was better than it actually is. But I am sure that for a lot of others this is not enough. From my own experience there are so many other beliefs that fuel addiction. There is also how I look at myself and my relationship to others, how I deal with my emotions, how I tend to struggle instead of grieving… etc…. I know the short and long term consequences of my addiction, I know very well that it is not a perfect solution, that I don’t kiss god when I use, and I know that there are bad long term consequences. But there are many times when this is not going to be enough for me. Personally, I have been sober for a few years, and at this point in my life if I don’t do anything to prevent relapse, no amount of logic will be able to save me. I will eventually go to “screw it” mode and simply relapse.
That being said, I feel it is really true that the belief that the drug is better than it actually is is an important aspect, and I thank you for pointing this out, I am going to think more about this.