Drug Induced Quotes

Was drug induced happy still happy? Was it the right kind of happy? Did it count?

Because who knows? Who knows anything? Who knows who's pulling the strings? Or what is? Or how? Who knows if destiny is just how you tell yourself the story of your life? Another son might not have heard his mother's last words as a prophecy but as drug-induced gibberish, forgotten soon after. Another girl might not have told herself a love story about a drawing her brother made. Who knows if Grandma really thought the first daffodils of spring were lucky or if she just wanted to go on walks with me through the woods? Who knows if she even believed in her bible at all or if she just preferred a world where hope and creativity and faith trump reason? Who knows if there are ghosts (sorry, Grandma) or just the living, breathing memories of your loved ones inside you, speaking to you, trying to get your attention by any means necessary? Who knows where the hell Ralph is? (Sorry, Oscar.) No one knows. So we grapple with the mysteries, each in our own way.

In the City Market is the Meet Café. Followers of obsolete, unthinkable trades doodling in Etruscan, addicts of drugs not yet synthesized, pushers of souped-up harmine, junk reduced to pure habit offering precarious vegetable serenity, liquids to induce Latah, Tithonian longevity serums, black marketeers of World War III, excusers of telepathic sensitivity, osteopaths of the spirit, investigators of infractions denounced by bland paranoid chess players, servers of fragmentary warrants taken down in hebephrenic shorthand charging unspeakable mutilations of the spirit, bureaucrats of spectral departments, officials of unconstituted police states, a Lesbian dwarf who has perfected operation Bang-utot, the lung erection that strangles a sleeping enemy, sellers of orgone tanks and relaxing machines, brokers of exquisite dreams and memories tested on the sensitized cells of junk sickness and bartered for raw materials of the will, doctors skilled in the treatment of diseases dormant in the black dust of ruined cities, gathering virulence in the white blood of eyeless worms feeling slowly to the surface and the human host, maladies of the ocean floor and the stratosphere, maladies of the laboratory and atomic war... A place where the unknown past and the emergent future meet in a vibrating soundless hum... Larval entities waiting for a Live One...

One thing that pisses me off royally is hearing drug companies denounced as the devil. I don't like giant corporations (or, in the words of Spalding Gray, "the big indifferent machine") any more than anyone else, but I really don't like wanting to kill myself. A person who denounces psychopharmaceuticals based on a political agenda is a person who has never lain crumpled in a ball in the closet, sobbing uncontrollably, face covered in Sharpie, throat raw from induced vomiting. Accordingly, that person should be thankful and shut the hell up.

Exactly how long can you stand on a street corner showing two drug dealers your scar-tissue-induced radical penis curvature? The answer is twelve seconds. After that it feels weird.

Health is normal. The human body is a self-repairing, self-defending, self-healing marvel. Disease is relatively difficult to induce, considering the body's powerful immune system. However, this complicated and delicate machinery can be damaged if fed the wrong fuel during the formative years. ... Healthy living with nutritional excellence throughout life can slow the decline of aging. It can prevent the years and years of suffering in ill health that is so common today as people get older and become dependent on medical treatments, drugs, and surgery. Nutritional excellence is the only real fountain of youth.

We're all dreaming,” Arctor said. If the last to know he's an addict is the addict, then maybe the last to know when a man means what he says is the man himself, he reflected. He wondered how much of the garbage that Donna had overheard he had seriously meant. He wondered how much of the insanity of the day--his insanity--had been real, or just induced as a contact lunacy, by the situation. Donna, always, was a pivot point of reality for him; for her this was the basic, natural question. He wished he could answer.

Okay, I wasn't getting something, by there was nothing I could do about it. I wasn't the Buddha. I couldn't have a vision. Unless, maybe, it was drug-induced.

He points out that mystics have always worked systematically to modify their brain chemistry, whether through fasting, self-flagellation, sleeplessness, hypnotic movement, or chanting.* The brain can be made to drug itself, as seems to happen with certain placebos. We don’t merely imagine that the placebo antidepressant is working to lift our sadness or worry—the brain is actually producing extra serotonin in response to the mental prompt of swallowing a pill containing nothing but sugar and belief. What all this suggests is that the workings of consciousness are both more and less materialistic than we usually think: chemical reactions can induce thoughts, but thoughts can also induce chemical reactions.

A young psychiatrist, himself newly recovered from porn-induced sexual dysfunction,[182] pointed out that the internet porn phenomenon is only 10 or 15 years old, and way ahead of the research. He notes: Medical research works at a snail's pace. With luck we'll be addressing this in 20 or 30 years ... when half the male population is incapacitated. Drug companies can't sell any medications by someone quitting porn. We

Once we get the anticipated reward, brain dopamine firing increases well above tonic baseline, but if the reward we anticipated doesn't materialise, dopamine levels fall well below baseline. Which is to say, if we get the expected reward, we get an even bigger spike, if we don't get the expected reward, we experience an even bigger plunge. We've all experienced the letdown of unmet expectations. An expected reward that failed to materialise is worse than a reward that was never anticipated in the first place. How does cue-induced craving translate to our pleasure-pain balance? The balance tips to the side of pleasure, a dopamine mini spike, in anticipation of future reward. Immediately followed by a tip to the side of pain, a dopamine mini defecit, in the aftermath of the cue. The dopamine defecit is craving and drives drug seeking behaviour.

Today, what's normal is being redefined: from vaginal birth to surgical birth; from 'My water broke,' to 'Let's break your water;' from 'It's time' to 'It's time for the induction.' As medical anthropologist Robbie Davis-Floyd writes, 'in the early twenty-first century, we do not know what normal birth is.' Most practicing obstetricians have never witnessed an unplugged birth that wasn't an accident. Women are even beginning to deny normal birth to themselves: if 'normal' means being induced, immobilized by wires and tubes, sped up with drugs, all the while knowing that there's a good chance of surgery, well, might as well just cut to the chase, so to speak. 'Just give me a cesarean,' some are saying. And who can blame them? They want to avoid what they think of as normal birth.

The ceremonial differentiation of the dietary is best seen in the use of intoxicating beverages and narcotics. If these articles of consumption are costly, they are felt to be noble and honorific. Therefore the base classes, primarily the women, practice an enforced continence with respect to these stimulants, except in countries where they are obtainable at a very low cost. From archaic times down through all the length of the patriarchal regime it has been the office of the women to prepare and administer these luxuries, and it has been the perquisite of the men of gentle birth and breeding to consume them. Drunkenness and the other pathological consequences of the free use of stimulants therefore tend in their turn to become honorific, as being a mark, at the second remove, of the superior status of those who are able to afford the indulgence. Infirmities induced by over-indulgence are among some peoples freely recognised as manly attributes. It has even happened that the name for certain diseased conditions of the body arising from such an origin has passed into everyday speech as a synonym for "noble" or "gentle". It is only at a relatively early stage of culture that the symptoms of expensive vice are conventionally accepted as marks of a superior status, and so tend to become virtues and command the deference of the community; but the reputability that attaches to certain expensive vices long retains so much of its force as to appreciably lesson the disapprobation visited upon the men of the wealthy or noble class for any excessive indulgence. The same invidious distinction adds force to the current disapproval of any indulgence of this kind on the part of women, minors, and inferiors. This invidious traditional distinction has not lost its force even among the more advanced peoples of today. Where the example set by the leisure class retains its imperative force in the regulation of the conventionalities, it is observable that the women still in great measure practise the same traditional continence with regard to stimulants.

In spite of his pain and drug-induced haze, Scythe Faraday smiled. “Yes, your poisons. Are you my apprentice or not?” Citra couldn’t help but smile right back at him. “Yes, Your Honor, I am.

She had forced herself to learn to read – picked up bits and pieces, here and there, from the very few teachers who had been patient with her; from looking at words while out and about; from television, and from friends. And to avoid the shouting and drug-induced moaning, and the row of male visitors her mum would entertain, she would barricade herself in her room – there'd been no lock – and lose herself in books.

This is the part of the country that invokes terrible nostalgia, a morbid and phlegm-induced retrospective of parties, clubs, drugs, shows, people, and is the goiter of my Boston days. I wouldn't have a clue as to who I'd ever care to see in this town, though I've done time here. If it weren't for Daughters and company, I'd feel like a compete tourist in a ghostly, plot-less town...pulling hoods up and heads around, opposite directions, if I ever saw someone I thought I might have known. Young people feeling really cool in bathrooms, dancing to the same songs in the same clubs, with the same dropout students, artists, thugs, bullies, jocks, all game in the search for one's self and sex.

Neuroscientist David Comings drew out the larger implications of such hallucinations for the relationship between our rational and spiritual brains: The psychedelic drugs like DMT often produce a sensation of “contact,” of being in the presence of and interaction with a non-human being. Highly intelligent and sophisticated test subjects who knew these feelings were drug-induced nevertheless insisted the contact had really happened. The temporal lobe-limbic system’s emotional tape recorder sometimes cannot distinguish between externally generated real events and internally generated non-real experience thus providing a system in which the rational brain and the spiritual brain are not necessarily in conflict.

Once they drugged women, induced labor, cut them open, sewed them up. No more. No anesthetics, even. Aunt Elizabeth said it was better for the baby, but also: I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children.

Any activity that transforms the way we perceive reality is enjoyable, a fact that accounts for the attraction of “consciousness-expanding” drugs of all sorts, from magic mushrooms to alcohol to the current Pandora’s box of hallucinogenic chemicals. But consciousness cannot be expanded; all we can do is shuffle its content, which gives us the impression of having broadened it somehow. The price of most artificially induced alterations, however, is that we lose control over that very consciousness we were supposed to expand.

This is Glesca.... Any time you're confused, take a wee minute to remind yourself of that inescapable fact: this is Glesca. We don't do subtle, we don't do nuanced, we don't do conspiracy. We do pish-heid bampot bludgeoning his girlfriend to death in a fit of paranoid rage induced by forty-eight hours straight on the batter. We do coked-up neds jumping on a guy's heid outside a nightclub because he looked at them funny. We do drug-dealing gangster rockets shooting other drug-dealing gangster rockets as comeback for something almost identical a fortnight ago. We do bam-on-bam. We do tit-for-tat, score-settling, feuds, jealousy, petty revenge. We do straightforward. We do obvious. We do cannaemisswhodunit. When you hear hoofbeats on Sauchiehall Street, it's gaunny be a horse, no' a zebra...'.

A discovery is like falling in love and reaching the top of a mountain after a hard climb all in one, an ecstasy not induced by drugs but by the revelation of a face of nature that no one has seen before and that often turns out to be more subtle and wonderful than anyone had imagined.

So beware. For good or ill, a mature, enthusiastic delight is extremely contagious. This is where's God's Word cuts to the heart of the matter. Foolish companions will induce one another to try out and ultimately to 'study' foolish delights. Skateboarding and computer games come to mind. So do drugs and alcohol.

I expect a full night's sleep from you, followed by a recitation of your poisons in the morning, in order of toxicity." "My poison?" In spite of his pain and drug-induced haze, Scythe Faraday smiled. "Yes, your poisons. Are you my apprentice or not?" Citra couldn't help but smile right back at him. "Yes, Your Honor, I am.

final day of the original experiment. When the scientists examined the rats’ brains, they saw cocaine-induced changes in the rats’ reward pathways consistent with persistent cocaine sensitization. These findings show that a drug like cocaine can alter the brain forever. Similar findings have been shown with other addictive substances, from alcohol to opioids to cannabis. In my clinical work I see people who struggle with severe addiction slipping right back into compulsive use with a single exposure, even after years of abstinence. This may occur because of persistent sensitization to the drug of choice, the distant echoes of earlier drug use.

For example, the euphoria brought on by DMT helped volunteers more unflinchingly look at their lives and conflicts. These ecstatic feelings may be, in part, related to the powerful DMT-induced surge of the morphinelike brain chemical beta-endorphin. DMT also stimulated a massive rise in the brain hormones vasopressin and prolactin. Scientists believe these compounds are important in feelings of bonding, attachment, and comfort with other members of the species. Perhaps the elevations in these brain chemicals made it easier for our volunteers to trust us, relax into the drug effects, and share powerfully personal issues in ways that previously were impossible.

I’ve got something for you,” he crooned, reaching down and putting my wedding band back on my finger. The huge diamond ring sparkled in a spotlight against the familiar darkness—the darkness of the bedroom where Tristan had perpetrated so many drug-induced sex acts against me. “You forgot your finest jewelry at home. Never leave home without it.

Work is hazardous to your health, to borrow a book title. In fact, work is mass murder or genocide. Directly or indirectly, work will kill most of the people who read these words... Even if you aren't killed or crippled while actually working, you very well might be while going to work, coming from work, looking for work, or trying to forget about work. The vast majority of victims of the automobile are either doing one of these work-obligatory activities or else fall afoul of those who do them. To this augmented body-count must be added the victims of auto-industrial pollution and work-induced alcoholism and drug addiction. Both cancer and heart disease are modern afflictions normally traceable, directly, or indirectly, to work. Work, then, institutionalizes homicide as a way of life... We kill people in the six-figure range (at least) in order to sell Big Macs and Cadillacs to the survivors. Our forty or fifty thousand annual highway fatalities are victims, not martyrs. They died for nothing -- or rather, they died for work.

In the absence of any therapy, the mentally ill of the 20th century were chained, shackled, straitjacketed, kept nude, electrocuted, half-frozen, parboiled, violently hosed, wrapped in wet canvas, confined to “mummy bags”, subjected to insulin-induced hypoglycemic comas, forced into seizures with massive doses of the stimulant Metrazol, injected with camphor, drugged into three-week comas with barbiturates and tranquilizers, involuntarily sterilized, and surgically mutilated. Rape by hospital staff was common, as was humiliation and verbal abuse. One reporter noted that a state hospital patient had been restrained for so long that his skin was beginning to grow around the leather straps.

Alcohol, the drug of choice in professional life, puts us to sleep, but then we wake and can't get back to sleep. 'Do you take a nip of whisky or not? Or do you put up with it? There are penalty clauses to all of these sleep-inducers,' [Former Australian Greens Leader Bob Brown] says. I knew this from medical school. It turns on you in the middle of the night.'

But there comes a point when your partner behaves in ways that fail to meet your needs, or rather those of your ego. The feelings of fear, pain, and lack that are an intrinsic part of egoic consciousness but had been covered up by the “love relationship” now resurface. Just as with every other addiction, you are on a high when the drug is available, but invariably there comes a time when the drug no longer works for you. When those painful feelings reappear, you feel them even more strongly than before, and what is more, you now perceive your partner as the cause of those feelings. This means that you project them outward and attack the other with all the savage violence that is part of your pain. This attack may awaken the partner's own pain, and he or she may counter your attack. At this point, the ego is still unconsciously hoping that its attack or its attempts at manipulation will be sufficient punishment to induce your partner to change their behavior, so that it can use them again as a cover-up for your pain. Every addiction arises from an unconscious refusal to face and move through your own pain. Every addiction starts with pain and ends with pain. Whatever the substance you are addicted to — alcohol, food, legal or illegal drugs, or a person — you are using something or somebody to cover up your pain. That is why, after the initial euphoria has passed, there is so much unhappiness, so much pain in intimate relationships. They do not cause pain and unhappiness. They bring out the pain and unhappiness that is already in you. Every addiction does that. Every addiction reaches a point where it does not work for you anymore, and then you feel the pain more intensely than ever. This is one reason why most people are always trying to escape from the present moment and are seeking some kind of salvation in the future. The first thing that they might encounter if they focused their attention on the Now is their own pain, and this is what they fear. If they only knew how easy it is to access in the Now the power of presence that dissolves the past and its pain, the reality that dissolves the illusion. If they only knew how close they are to their own reality, how close to God.

It's a dream," Pris said. "Induced by drugs that Roy gave me." "P-pardon?" "You really think that bounty hunters exist?" "Mr. Baty said they killed your friends." "Roy Baty is as crazy as I am," Pris said. "Our trip was between a mental hospital on the East Coast and here. We're all schizophrenic, with defective emotional lives — flattening of affect, it's called. And we have group hallucinations.

Dr Stewart Wolf took the placebo effect to the limit. He took two women who were suffering with nausea and vomiting, one of them pregnant, and told them he had a treatment which would improve their symptoms. In fact he passed a tube down into their stomachs (so that they wouldn’t taste the revolting bitterness) and administered ipecac, a drug that which should actually induce nausea and vomiting. Not only did the patients’ symptoms improve, but their gastric contractions—which ipecac should worsen—were reduced. His results suggest—albeit it in a very small sample—that a drug could be made to have the opposite effect to what you would predict from the pharmacology, simply by manipulating people’s expectations. In this case, the placebo effect outgunned even the pharmacological influences. More

So does TV watching create inner space? Does it cause you to be present? Unfortunately, it does not. Although for long periods your mind may not be generating any thoughts, it has linked into the thought activity of the television show. It has linked up with the TV version of the collective mind, and is thinking its thoughts. Your mind is inactive only in the sense that it is not producing thoughts. It is, however, continuously absorbing thoughts and images that come through the TV screen. This induces a trancelike passive state of heightened susceptibility, not unlike hypnosis. That is why it lends itself to manipulation of “public opinion,” as politicians and special-interest groups as well as advertisers know and will pay millions of dollars to catch you in that state of receptive unawareness. They want their thoughts to become your thoughts, and usually they succeed. So when watching television, the tendency is for you to fall below thought, not rise above it. Television has this in common with alcohol and certain other drugs. While it provides some relief from your mind, you again pay a high price: loss of consciousness. Like those drugs, it too has a strong addictive quality. You reach for the remote control to switch off and instead find yourself going through all the channels.

Continuity could generate video images of Angie, animate them with templates compiled from her stims. Viewing them induced a mild but not unpleasant vertigo, one of the rare times she was able to directly grasp the fact of her fame. 'Public statement on your decision to go to Jamaica, praise for the methods of the clinic, the dangers of drugs, renewed enthusiasm for your work, gratitude to your audience, stock footage of the Malibu place...

In addition to localized neural networks, hallucinogenic drugs have been documented to trigger such preternatural experiences, such as the sense of floating and flying stimulated by atropine and other belladonna alkaloids. These can be found in mandrake and jimsonweed and were used by European witches and American Indian shamans, probably for this very purpose.32 Dissociative anesthetics such as the ketamines are also known to induce out-of-body experiences. Ingestion of methylenedioxyamphetamine (MDA) may bring back long-forgotten memories and produce the feeling of age regression, while dimethyltryptamine (DMT)—also known as “the spirit molecule”—causes the dissociation of the mind from the body and is the hallucinogenic substance in ayahuasca, a drug taken by South American shamans. People who have taken DMT report “I no longer have a body,” and “I am falling,” “flying,” or “lifting up.

Because who knows? Who knows anything? Who knows who’s pulling the strings? Or what is? Or how? Who knows if destiny is just how you tell yourself the story of your life? Another son might not have heard his mother’s last words as a prophecy but as drug-induced gibberish, forgotten soon after. Another girl might not have told herself a love story about a drawing her brother made. Who knows if Grandma really thought the first daffodils of spring were lucky or if she just wanted to go on walks with me through the woods? Who knows if she even believed in her bible at all or if she just preferred a world where hope and creativity and faith trump reason? Who knows if there are ghosts (sorry, Grandma) or just the living, breathing memories of your loved ones inside you, speaking to you, trying to get your attention by any means necessary? Who knows where the hell Ralph is? (Sorry, Oscar.) No one knows.

Like it has a thousand times before, the cannabis is relaxing my muscles and sharpening my analysis. And like an astronomer gazing at the constellations above, I can now draw connections that give meaning to my day, uncovering the truths that have been hiding in plain sight. I begin to write an essay, or perhaps a speech, in my mind. My fingers will not let me jot down notes on paper or my phone, so I must try to remember my drug-induced insights until the morning.

Hugging is healthy. It helps the immune system, cures depression, reduces stress and induces sleep. It’s invigorating, rejuvenating and has no unpleasant side effects. Hugging is nothing less than a miracle drug. Hugging is all natural. It is organic, naturally sweet, no artificial ingredients, nonpolluting, environmentally friendly and 100 percent wholesome. Hugging is the ideal gift. Great for any occasion, fun to give and receive, shows you care, comes with its own wrapping and, of course, fully returnable. Hugging is practically perfect. No batteries to wear out, inflation-proof, nonfattening, no monthly payments, theft-proof and nontaxable. Hugging is an underutilized resource with magical powers. When we open our hearts and arms, we encourage others to do the same. Think of the people in your life. Are there any words you’d like to say? Are there any hugs you want to share? Are you waiting and hoping someone else will ask first? Please don’t wait! Initiate!

So far, menstrual-cycle impacts have been found for antipsychotics, antihistamines and antibiotic treatments as well as heart medication.58 Some antidepressants have been found to affect women differently at different times of their cycle, meaning that dosage may be too high at some points and too low at others.59 Women are also more likely to experience drug-induced heart-rhythm abnormalities60 and the risk is highest during the first half of a woman’s cycle.61 This can, of course, be fatal.

How does stress influence the midbrain pleasure circuit (or the feeding control circuits)? The short answer is that we don't really know. However, there are some tantalizing initial clues. Recall that twenty-four hours after a single exposure to cocaine, the excitatory glutamate-using synapses recived by VTA dopamine neurons express LTP. This change, which will result in greater dopamine release in VTA target areas, could also be produced by nicotine, mophine, amphetamines, or alcohol. Amazingly, even breif exposure to stress (a rat's five-minute-long forced swim in cold water) also produced LTP of the VTA synapses that was indistinguishable from that evoked by drugs. What's more, the stress-induced LTP could be prevented by pretreatment with a corticosterone receptor blocker. This suggests that drugs and stress rewire the pleasure circuit in overlapping ways and that the stress response to trigger LTP in the VTA requires a stress hormone signaling loop from the brain to the body and back.

But the greatest human problems are not social problems, but decisions that the individual has to make alone. The most important feelings of which man is capable emphasise his separateness from other people, not his kinship with them. The feelings of a mountaineer towards a mountain emphasise his kinship with the mountain rather than with the rest of mankind. The same goes for the leap of the heart experienced by a sailor when he smells the sea, or for the astronomer’s feeling about the stars, or for the archaeologist’s love of the past. My feeling of love for my fellowmen makes me aware of my humanness; but my feeling about a mountain gives me an oddly nonhuman sensation. It would be incorrect, perhaps, to call it ‘superhuman’; but it nevertheless gives me a sense of transcending my everyday humanity. Maslow’s importance is that he has placed these experiences of ‘transcendence’ at the centre of his psychology. He sees them as the compass by which man gains a sense of the magnetic north of his existence. They bring a glimpse of ‘the source of power, meaning and purpose’ inside himself. This can be seen with great clarity in the matter of the cure of alcoholics. Alcoholism arises from what I have called ‘generalised hypertension’, a feeling of strain or anxiety about practically everything. It might be described as a ‘passively negative’ attitude towards existence. The negativity prevents proper relaxation; there is a perpetual excess of adrenalin in the bloodstream. Alcohol may produce the necessary relaxation, switch off the anxiety, allow one to feel like a real human being instead of a bundle of over-tense nerves. Recurrence of the hypertension makes the alcoholic remedy a habit, but the disadvantages soon begin to outweigh the advantage: hangovers, headaches, fatigue, guilt, general inefficiency. And, above all, passivity. The alcoholics are given mescalin or LSD, and then peak experiences are induced by means of music or poetry or colours blending on a screen. They are suddenly gripped and shaken by a sense of meaning, of just how incredibly interesting life can be for the undefeated. They also become aware of the vicious circle involved in alcoholism: misery and passivity leading to a general running-down of the vital powers, and to the lower levels of perception that are the outcome of fatigue. ‘The spirit world shuts not its gates, Your heart is dead, your senses sleep,’ says the Earth Spirit to Faust. And the senses sleep when there is not enough energy to run them efficiently. On the other hand, when the level of will and determination is high, the senses wake up. (Maslow was not particularly literary, or he might have been amused to think that Faust is suffering from exactly the same problem as the girl in the chewing gum factory (described earlier), and that he had, incidentally, solved a problem that had troubled European culture for nearly two centuries). Peak experiences are a by-product of this higher energy-drive. The alcoholic drinks because he is seeking peak experiences; (the same, of course, goes for all addicts, whether of drugs or tobacco.) In fact, he is moving away from them, like a lost traveller walking away from the inn in which he hopes to spend the night. The moment he sees with clarity what he needs to do to regain the peak experience, he does an about-face and ceases to be an alcoholic.

Some of them screamed. Some of them wept. Some of them grinned like LSD was a blast. A case officer said John Stanton hatched the idea - lets flood Cuba with this shit before we invade. Langley co-signed the brainstorm. Langley embellished it: Let's induce mass hallucinations and stage the second coming of Christ!!!! Langley found some suicidal actors. Langley dolled them up to look like J.C. Langley had them set to pre-invade Cuba concurrent with the dope saturation. Peter howled. The case officer said, 'It's not funny.' A drug-zorched peon whipped out his wang and jacked off.

This view of psychiary [as a genuine scientific activity] is premised on the idea that modern drugs are disease- or symptom-specific treatments; that they work by reversing some or all of an underlying physical pathology. It is the idea of the specificity of action that makes drug treatment appear to be a therapeutic, medical enterprise. If, in contrast, modern psychiatric treatments are not specific, if they act merely by inducing psychoactive effects that suppress or contain psychiatric distress and problematic behaviours, then psychiatry has not moved far from its historical roots as a [...] medicalized form of social control.

As a consequence of natural analgesic actions or as a result of the administration of drugs that interfere with body signaling (painkillers, anesthetics), the brain receives a distorted view of what the body state really is at the moment. We know that in situations of fear in which the brain chooses the running option rather than freezing, the brain stem disengages the part of the pain-transmission circuitry, a bit like pulling the plug. The periqueductal gray, which controls these responses, can also command the secretion of natural opioids and achieve precisely what taking an analgesic would achieve -- elimination of pain signals. In the strict sense, we are dealing here with a hallucination of the body because what the brain registers in its maps and the conscious mind feels do not correspond to the reality that might be perceived. Whenever we ingest molecules the have the power to modify the transmission or mapping of body signals, we play on this mechanism. Alcohol does it; so do analgesics and anesthetics, as well as countless drugs of abuse. It is patently clear that, other than out of curiousity, humans are drawn to such molecules because of their desire to generate feelings of well-being, feelings in which pain signals are obliterated and pleasure signals induced.

There is nothing more intrinsically criminal in the average drug user than in the average cigarette smoker or alcohol addict. The drugs they inject or inhale do not themselves induce criminal activity by their pharmacological effect, except perhaps in the way that alcohol can also fuel a person’s pent-up aggression and remove the mental inhibitions that thwart violence. Stimulant drugs may have that effect on some users, but narcotics like heroin do not; on the contrary, they tend to calm people down. It is withdrawal from opiates that makes people physically ill, irritable and more likely to act violently—mostly out of desperation to replenish their supply.

Everything I thought I understood about disease research, drug development, and the delivery of clinical care has been turned on its head. This isn’t science or medicine as I had come to know them but rather a parade of psychogenic bias, neglect, bad science, flawed public policy, and the political agendas of powerful people and institutions that have sentenced ME patients to the medical equivalent of the most squalid slum in the poorest country on earth. The political decisions taken over the last thirty years have polluted research, perverted clinical care, and shipwrecked ME patients with a life-threatening dose of stigma, disbelief and medically induced harm.

This was no coincidence. The best short stories and the most successful jokes have a lot in common. Each form relies on suggestion and economy. Characters have to be drawn in a few deft strokes. There's generally a setup, a reveal, a reversal, and a release. The structure is delicate. If one element fails, the edifice crumbles. In a novel you might get away with a loose line or two, a saggy paragraph, even a limp chapter. But in the joke and in the short story, the beginning and end are precisely anchored tent poles, and what lies between must pull so taut it twangs. I'm not sure if there is any pattern to these selections. I did not spend a lot of time with those that seemed afraid to tell stories, that handled plot as if it were a hair in the soup, unwelcome and embarrassing. I also tended not to revisit stories that seemed bleak without having earned it, where the emotional notes were false, or where the writing was tricked out or primped up with fashionable devices stressing form over content. I do know that the easiest and the first choices were the stories to which I had a physical response. I read Jennifer Egan's "Out of Body" clenched from head to toe by tension as her suicidal, drug-addled protagonist moves through the Manhattan night toward an unforgivable betrayal. I shed tears over two stories of childhood shadowed by unbearable memory: "The Hare's Mask," by Mark Slouka, with its piercing ending, and Claire Keegan's Irishinflected tale of neglect and rescue, "Foster." Elizabeth McCracken's "Property" also moved me, with its sudden perception shift along the wavering sightlines of loss and grief. Nathan Englander's "Free Fruit for Young Widows" opened with a gasp-inducing act of unexpected violence and evolved into an ethical Rubik's cube. A couple of stories made me laugh: Tom Bissell's "A Bridge Under Water," even as it foreshadows the dissolution of a marriage and probes what religion does for us, and to us; and Richard Powers's "To the Measures Fall," a deftly comic meditation on the uses of literature in the course of a life, and a lifetime. Some stories didn't call forth such a strong immediate response but had instead a lingering resonance. Of these, many dealt with love and its costs, leaving behind indelible images. In Megan Mayhew Bergman's "Housewifely Arts," a bereaved daughter drives miles to visit her dead mother's parrot because she yearns to hear the bird mimic her mother's voice. In Allegra Goodman's "La Vita Nuova," a jilted fiancée lets her art class paint all over her wedding dress. In Ehud Havazelet's spare and tender story, "Gurov in Manhattan," an ailing man and his aging dog must confront life's necessary losses. A complicated, only partly welcome romance blossoms between a Korean woman and her demented

I was surprised by what I found; moreover, because I came away with a knowledge that I had not possessed before, I was also grateful, and surprised by that as well. I had not expected the violence to be so pleasurable....This is, if you like, the answer to the hundred-dollar question: why do young males riot every Saturday? They do it for the same reason that another generation drank too much, or smoked dope, or took hallucinogenic drugs, or behaved badly or rebelliously. Violence is their antisocial kick, their mind-altering experience, an adrenaline-induced euphoria that might be all the more powerful because it is generated by the body itself, with, I was convinced, many of the same addictive qualities that characterize synthetically-produced drugs

Original Statement by Hunger Strikers to Psychiatric Association, National Alliance for the Mentally Ill and the U.S. Office of the Surgeon General 1. A Hunger Strike to Challenge International Domination by Biopsychiatry. This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to “first do no harm.” Psychiatrists are able with impunity to: Incarcerate citizens who have committed crimes against neither persons nor property. Impose diagnostic labels on people that stigmatize and defame them. Induce proven neurological damage by force and coercion with powerful psychotropic drugs. Stimulate violence and suicide with drugs promoted as able to control these activities. Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy). Employ restraint and solitary confinement—which frequently cause severe emotional trauma, humiliation, physical harm, and even death—in preference to patience and understanding. Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public.21

A hell-fire faith that uses the theatrical techniques of revivalism in order to stimulate remorse and induce the crisis of sudden conversion; a saviour cult that is for ever stirring up what St. Bernard calls the amor carnalis or fleshly love of the Avatar and personal God; a ritualistic mystery-religion that generates high feelings of awe and reverence and aesthetic ecstasy by means of its sacraments and ceremonials, its music and its incense, its numinous darknesses and sacred lights in its own special way, each one of these runs the risk of becoming a form of psychological idolatry, in which God is identified with the ego's affective attitude towards God and finally the emotion becomes an end in itself, to be eagerly sought after and worshipped, as the addicts of a drug spend life in the pursuit of their artificial paradise.

The psychosis-inducing effects of synthetics offered one last, crucial piece of evidence about the risks of cannabis. And so, in January 2017, the National Academy of Medicine examined the thirty years of research that had begun with Sven Andréasson’s paper and declared the issue settled. “The association between cannabis use and development of a psychotic disorder is supported by data synthesized in several good-quality systematic reviews,” the NAM wrote. “The magnitude of this association is moderate to large and appears to be dose-dependent . . . The primary literature reviewed by the committee confirms the conclusions of the systematic reviews.” But almost no one noticed the National Academy report. The New York Times published an online summary of its findings—in May 2018, more than a year after it appeared. It has not changed the public policy debate around marijuana in the United States or perceptions of the safety of the drug.

What neuroleptics do, then, is induce a pathological deficiency in dopamine transmission. They induce, in Deniker’s words, a “therapeutic Parkinsonism.” And once they became the standard fare in psychiatry, this is the pathology that became the face of madness in America. The image we have today of schizophrenia is not that of madness—whatever that might be—in its natural state. All of the traits that we have come to associate with schizophrenia—the awkward gait, the jerking arm movements, the vacant facial expression, the sleepiness, the lack of initiative—are symptoms due, at least in large part, to a drug-induced deficiency in dopamine transmission. Even behavior that seems contrary to that slothful image, such as the agitated pacing seen in some people with schizophrenia, often arises from neuroleptics. Our perceptions of how those ill with “schizophrenia” think, behave, and look are all perceptions of people altered by medication, and not by any natural course of a “disease.” - Mad in America, chapter 7

Flow is an extremely potent response to external events and requires an extraordinary set of signals. The process includes dopamine, which does more than tune signal-to-noise ratios. Emotionally, we feel dopamine as engagement, excitement, creativity, and a desire to investigate and make meaning out of the world. Evolutionarily, it serves a similar function. Human beings are hardwired for exploration, hardwired to push the envelope: dopamine is largely responsible for that wiring. This neurochemical is released whenever we take a risk or encounter something novel. It rewards exploratory behavior. It also helps us survive that behavior. By increasing attention, information flow, and pattern recognition in the brain, and heart rate, blood pressure, and muscle firing timing in the body, dopamine serves as a formidable skill-booster as well. Norepinephrine provides another boost. In the body, it speeds up heart rate, muscle tension, and respiration, and triggers glucose release so we have more energy. In the brain, norepinephrine increases arousal, attention, neural efficiency, and emotional control. In flow, it keeps us locked on target, holding distractions at bay. And as a pleasure-inducer, if dopamine’s drug analog is cocaine, norepinephrine’s is speed, which means this enhancement comes with a hell of a high. Endorphins, our third flow conspirator, also come with a hell of a high. These natural “endogenous” (meaning naturally internal to the body) opiates relieve pain and produce pleasure much like “exogenous” (externally added to the body) opiates like heroin. Potent too. The most commonly produced endorphin is 100 times more powerful than medical morphine. The next neurotransmitter is anandamide, which takes its name from the Sanskrit word for “bliss”—and for good reason. Anandamide is an endogenous cannabinoid, and similarly feels like the psychoactive effect found in marijuana. Known to show up in exercise-induced flow states (and suspected in other kinds), this chemical elevates mood, relieves pain, dilates blood vessels and bronchial tubes (aiding respiration), and amplifies lateral thinking (our ability to link disparate ideas together). More critically, anandamide also inhibits our ability to feel fear, even, possibly, according to research done at Duke, facilitates the extinction of long-term fear memories. Lastly, at the tail end of a flow state, it also appears (more research needs to be done) that the brain releases serotonin, the neurochemical now associated with SSRIs like Prozac. “It’s a molecule involved in helping people cope with adversity,” Oxford University’s Philip Cowen told the New York Times, “to not lose it, to keep going and try to sort everything out.” In flow, serotonin is partly responsible for the afterglow effect, and thus the cause of some confusion. “A lot of people associate serotonin directly with flow,” says high performance psychologist Michael Gervais, “but that’s backward. By the time the serotonin has arrived the state has already happened. It’s a signal things are coming to an end, not just beginning.” These five chemicals are flow’s mighty cocktail. Alone, each packs a punch, together a wallop.

The accelerated deindustrialization of North America, Europe, and Japan, and the shift of manufacturing to Asia in general and to China in particular, has been the leading reason for this reappraisal.[93] This manufacturing switch has brought changes ranging from risible to tragic. In the first category are such grotesque transactions as Canada, the country with per capita forest resources greater than in any other affluent nation, importing toothpicks and toilet paper from China, a country whose wood stocks amount to a small fraction of Canada’s enormous boreal forest patrimony.[94] But the switch has also contributed to tragedies, such as the rising midlife mortality among America’s white non-university-educated men. There can be no doubt that America’s post-2000 loss of some 7 million (formerly well-paying) manufacturing jobs—with most of that loss attributable to globalization, as most of that production moved to China—has been the principal reason of these deaths of despair, largely attributable to suicide, drug overdose, and alcohol-induced liver disease.

What if, rather than asking women to bear the burden of responsibility for our nation’s health and intelligence, governments invested money in research for better formulas that can improve health? If what we feed our babies in the first year really has that much of an impact on lifelong health, this should be a priority. Because in reality, not all babies are going to be able to be breastfed, as long as we want to live in a world where women have the freedom to decide how to use their bodies; whether to work or stay home; whether to be a primary caregiver or not. In reality, there are going to be children raised by single dads; there are going to be children raised by grandparents; there are going to be children who are adopted by parents who aren’t able to induce lactation; there are going to be children whose mothers don’t produce enough milk, or who are on drugs not compatible with breastfeeding. Rather than demanding that every mother should be able to—should want to—breastfeed, we should be demanding better research, better resources, better options. We should be demanding better.

Be all right, Nina willed silently, hoping her thoughts could somehow cut through the air, speed over the waters of the Ketterdam harbors, and reach her friend. Stay safe and whole and wait for us. Nina hadn’t been on Vellgeluk when Van Eck had taken Inej hostage. She’d still been trying to purge the parem from her body, caught in the haze of suffering that had begun on the voyage from Djerholm. She told herself to be grateful for the memory of that misery, every shaking, aching, vomiting minute of it. The shame of Matthias witnessing it all, holding back her hair, dabbing her brow, restraining her as gently as he could as she argued, cajoled, screamed at him for more parem. She made herself remember every terrible thing she’d said, every wild pleasure offered, each insult or accusation she’d hurled at him. You enjoy watching me suffer. You want me to beg, don’t you? How long have you been waiting to see me like this? Stop punishing me, Matthias. Help me. Be good to me and I’ll be good to you. He’d absorbed it all in stoic silence. She clutched tight to those memories. She needed them as vivid and bright and cringe-inducing as possible to fight her hunger for the drug. She never wanted to be like that again.

Those who govern on behalf of the rich have an incentive to persuade us we are alone in our struggle for survival, and that any attempts to solve our problems collectively – through trade unions, protest movements or even the mutual obligations of society – are illegitimate or even immoral. The strategy of political leaders such as Thatcher and Reagan was to atomize and rule. Neoliberalism leads us to believe that relying on others is a sign of weakness, that we all are, or should be, ‘self-made’ men and women. But even the briefest glance at social outcomes shows that this cannot possibly be true. If wealth were the inevitable result of hard work and enterprise, every woman in Africa would be a millionaire. The claims that the ultra-rich make for themselves – that they are possessed of unique intelligence or creativity or drive – are examples of the ‘self-attribution fallacy’.10 This means crediting yourself with outcomes for which you were not responsible. The same applies to the belief in personal failure that assails all too many at the bottom of the economic hierarchy today. From birth, this system of belief has been drummed into our heads: by government propaganda, by the billionaire media, through our educational system, by the boastful claims of the oligarchs and entrepreneurs we’re induced to worship. The doctrine has religious, quasi-Calvinist qualities: in the Kingdom of the Invisible Hand, the deserving and the undeserving are revealed through the grace bestowed upon them by the god of money. Any policy or protest that seeks to disrupt the formation of a ‘natural order’ of rich and poor is an unwarranted stay upon the divine will of the market. In school we’re taught to compete and are rewarded accordingly, yet our great social and environmental predicaments demand the opposite – the skill we most urgently need to learn is cooperation. We are set apart, and we suffer for it. A series of scientific papers suggest that social pain is processed11 by the same neural circuits as physical pain.12 This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the terms we use to denote physical pain and injury: ‘I was stung by his words’; ‘It was a massive blow’; ‘I was cut to the quick’; ‘It broke my heart’; ‘I was mortified’. In both humans and other social mammals, social contact reduces physical pain.13 This is why we hug our children when they hurt themselves: affection is a powerful analgesic.14 Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

As many speakers noted, this tool wasn’t particularly well suited for assessing outcomes of a psychiatric drug. How could a study of a neuroleptic possibly be “double-blind”? The psychiatrist would quickly see who was on the drug and who was not, and any patient given Thorazine would know he was on a medication as well. Then there was the problem of diagnosis: How would a researcher know if the patients randomized into a trial really had “schizophrenia”? The diagnostic boundaries of mental disorders were forever changing. Equally problematic, what defined a “good outcome”? Psychiatrists and hospital staff might want to see drug-induced behavioral changes that made the patient “more socially acceptable” but weren’t to the “ultimate benefit of the patient,” said one conference speaker.11 And how could outcomes be measured? In a study of a drug for a known disease, mortality rates or laboratory results could serve as objective measures of whether a treatment worked. For instance, to test whether a drug for tuberculosis was effective, an X-ray of the lung could show whether the bacillus that caused the disease was gone. What would be the measurable endpoint in a trial of a drug for schizophrenia? The problem, said NIMH physician Edward Evarts at the conference, was that “the goals of therapy in schizophrenia, short of getting the patient ‘well,’ have not been clearly defined.

The first result of this randomized trial was predictable from prior studies: in the control group, children with the short variant-i.e., the "high risk" form of the gene- were twice as likely to veer toward high-risk behaviors, including binge drinking, drug use, and sexual promiscuity as adolescents, confirming earlier studies that had suggested an increased risk within this genetic subgroup. The second result was more provocative: these very children were also the most likely to respond to the social interventions. In the intervention group, children with the high-risk allele were most strongly and rapidly "normalized"-i.e., the most drastically affected subjects were also the best responders. In a parallel study, orphaned infants with the short variant of 5HTTLRP appeared more impulsive and socially disturbed than their long-variant counterparts as baseline-but were also the most likely to benefit from placement in a more nurturing foster-care environment. In both cases, it seems, the short variant encodes a hyperactive "stress sensor" for psychic susceptibility, but also a sensor most likely to respond to an intervention that targets the susceptibility. The most brittle or fragile forms of psyche are the most likely to be distorted by trauma-inducing environments-but are also the most likely to be restored by targeted interventions. It is as if resilience itself has a genetic core: some humans are born resilient (but are less responsive to interventions), while others are born sensitive (but more likely to respond to changes in their environments.)

One of the greatest difficulties we human beings seem to have is to relinquish long-held ideas. Many of us are addicted to being right, even if facts do not support us. One fixed image we cling to, as iconic in today’s culture as the devil was in previous ages, is that of the addict as an unsavoury and shadowy character, given to criminal activity. What we don’t see is how we’ve contributed to making him a criminal. There is nothing more intrinsically criminal in the average drug user than in the average cigarette smoker or alcohol addict. The drugs they inject or inhale do not themselves induce criminal activity by their pharmacological effect, except perhaps in the way that alcohol can also fuel a person’s pent-up aggression and remove the mental inhibitions that thwart violence. Stimulant drugs may have that effect on some users, but narcotics like heroin do not; on the contrary, they tend to calm people down. It is withdrawal from opiates that makes people physically ill, irritable and more likely to act violently — mostly out of desperation to replenish their supply. The criminality associated with addiction follows directly from the need to raise money to purchase drugs at prices that are artificially inflated owing to their illegality. The addict shoplifts, steals and robs because it’s the only way she can obtain the funds to pay the dealer. History has demonstrated many times over that people will transgress laws and resist coercion when it comes to struggling for their basic needs — or what they perceive as such. Sam Sullivan, Vancouver’s quadriplegic mayor, told a conference on drug addiction once that if wheelchairs were illegal, he would do anything to get one, no matter what laws he had to break. It was an apt comparison: the hardcore addict feels equally handicapped without his substances. As we have seen, many addicts who deal in drugs do so exclusively to finance their habit. There is no profit in it for them.

Consider the life of a pregnant sow. Her incredible fertility is the source of her particular hell. While a cow will give birth to only a single calf at a time, the modern factory sow will birth, nurse, and raise an average of nearly nine piglets — a number that has been increased annually by industry breeders. She will invariably be kept pregnant as much as possible, which will prove to be the majority of her life. When she is approaching her due date, drugs to induce labor may be administered to make the timing more convenient for the farmer. After her piglets are weaned, a hormone injection makes the sow rapidly “cycle” so that she will be ready to be artificially inseminated again in only three weeks. Four out of five times a sow will spend the sixteen weeks of her pregnancy confined in a “gestation crate” so small that she will not be able to turn around. Her bone density will decrease because of the lack of movement. She will be given no bedding and often will develop quarter-sized, blackened, pus-filled sores from chafing in the crate. (In one undercover investigation in Nebraska, pregnant pigs with multiple open sores on their faces, heads, shoulders, backs, and legs — some as large as a fist — were videotaped. A worker at the farm commented, “They all have sores. . . . There’s hardly a pig in there who doesn’t have a sore.”) More serious and pervasive is the suffering caused by boredom and isolation and the thwarting of the sow’s powerful urge to prepare for her coming piglets. In nature, she would spend much of her time before giving birth foraging and ultimately would build a nest of grass, leaves, or straw. To avoid excessive weight gain and to further reduce feed costs, the crated sow will be feed restricted and often hungry. Pigs also have an inborn tendency to use separate areas for sleeping and defecating that is totally thwarted in confinement. The pregnant pigs, like most all pigs in industrial systems, must lie or step in their excrement to force it through the slatted floor. The industry defends such confinement by arguing that it helps control and manage animals better, but the system makes good welfare practices more difficult because lame and diseased animals are almost impossible to identify when no animals are allowed to move.

Cannabinoids relax the rules of cortical crowd control, but 300 micrograms of d-lysergic acid diethylamide break them completely. This is a clean sweep. This is the Renaissance after the Dark Ages. Dopamine—the fuel of desire—is only one of four major neuro modulators. Each of the neuromodulators fuels brain operations in its own particular way. But all four of them share two properties. First, they get released and used up all over the brain, not at specific locales. Second, each is produced by one specialized organ, a brain part designed to manufacture that one potent chemical (see Figure 3). Instead of watering the flowers one by one, neuromodulator release is like a sprinkler system. That’s why neuromodulators initiate changes that are global, not local. Dopamine fuels attraction, focus, approach, and especially wanting and doing. Norepinephrine fuels perceptual alertness, arousal, excitement, and attention to sensory detail. Acetylcholine energizes all mental operations, consciousness, and thought itself. But the final neuromodulator, serotonin, is more complicated in its action. Serotonin does a lot of different things in a lot of different places, because there are many kinds of serotonin receptors, and they inhabit a great variety of neural nooks, staking out an intricate network. One of serotonin’s most important jobs is to regulate information flow throughout the brain by inhibiting the firing of neurons in many places. And it’s the serotonin system that gets dynamited by LSD. Serotonin dampens, it paces, it soothes. It raises the threshold of neurons to the voltage changes induced by glutamate. Remember glutamate? That’s the main excitatory neurotransmitter that carries information from synapse to synapse throughout the brain. Serotonin cools this excitation, putting off the next axonal burst, making the receptive neuron less sensitive to the messages it receives from other neurons. Slow down! Take it easy! Don’t get carried away by every little molecule of glutamate. Serotonin soothes neurons that might otherwise fire too often, too quickly. If you want to know how it feels to get a serotonin boost, ask a depressive several days into antidepressant therapy. Paxil, Zoloft, Prozac, and all their cousins leave more serotonin in the synapses, hanging around, waiting to help out when the brain becomes too active. Which is most of the time if you feel the world is dark and threatening. Extra serotonin makes the thinking process more relaxed—a nice change for depressives, who get a chance to wallow in relative normality.

Meanwhile, scientists are studying certain drugs that may erase traumatic memories that continue to haunt and disturb us. In 2009, Dutch scientists, led by Dr. Merel Kindt, announced that they had found new uses for an old drug called propranolol, which could act like a “miracle” drug to ease the pain associated with traumatic memories. The drug did not induce amnesia that begins at a specific point in time, but it did make the pain more manageable—and in just three days, the study claimed. The discovery caused a flurry of headlines, in light of the thousands of victims who suffer from PTSD (post-traumatic stress disorder). Everyone from war veterans to victims of sexual abuse and horrific accidents could apparently find relief from their symptoms. But it also seemed to fly in the face of brain research, which shows that long-term memories are encoded not electrically, but at the level of protein molecules. Recent experiments, however, suggest that recalling memories requires both the retrieval and then the reassembly of the memory, so that the protein structure might actually be rearranged in the process. In other words, recalling a memory actually changes it. This may be the reason why the drug works: propranolol is known to interfere with adrenaline absorption, a key in creating the long-lasting, vivid memories that often result from traumatic events. “Propranolol sits on that nerve cell and blocks it. So adrenaline can be present, but it can’t do its job,” says Dr. James McGaugh of the University of California at Irvine. In other words, without adrenaline, the memory fades. Controlled tests done on individuals with traumatic memories showed very promising results. But the drug hit a brick wall when it came to the ethics of erasing memory. Some ethicists did not dispute its effectiveness, but they frowned on the very idea of a forgetfulness drug, since memories are there for a purpose: to teach us the lessons of life. Even unpleasant memories, they said, serve some larger purpose. The drug got a thumbs-down from the President’s Council on Bioethics. Its report concluded that “dulling our memory of terrible things [would] make us too comfortable with the world, unmoved by suffering, wrongdoing, or cruelty.… Can we become numb to life’s sharpest sorrows without also becoming numb to its greatest joys?” Dr. David Magus of Stanford University’s Center for Biomedical Ethics says, “Our breakups, our relationships, as painful as they are, we learn from some of those painful experiences. They make us better people.” Others disagree. Dr. Roger Pitman of Harvard University says that if a doctor encounters an accident victim who is in intense pain, “should we deprive them of morphine because we might be taking away the full emotional experience? Who would ever argue with that? Why should psychiatry be different? I think that somehow behind this argument lurks the notion that mental disorders are not the same as physical disorders.

Today, such studies are illegal. Medical scientists cannot offer inducements like pardons to persuade prisoners to take part in their studies. Although they can award small cash payments to research subjects, they are forbidden from giving anyone so much money or such tempting favors that their compensations might constitute what ethicists term an inappropriate inducement, an irresistible temptation to join the study. Now, more than eighty years after the 1918 flu, people enter studies for several reasons—to get free medical care, to get an experimental drug that, they hope, might cure them of a disease like cancer or AIDS, or to help further scientific knowledge. In theory at least, study participants are supposed to be true volunteers, taking part in research of their own free will. But in 1918, such ethical arguments were rarely considered. Instead, the justification for a risky study with human beings was that it was better to subject a few to a great danger in order to save the many. Prisoners were thought to be the ideal study subjects. They could offer up their bodies for science and, if they survived, their pardons could be justified because they gave something back to society. The Navy inmates were perfect for another reason. Thirty-nine of them had never had influenza, as far as anyone knew. So they might be uniquely susceptible to the disease. If the doctors wanted to deliberately transmit the 1918 flu, what better subjects? Was influenza really so easily transmitted? the doctors asked. Why did some people get it and others not? Why did it kill the young and healthy? Could the wartime disruptions and movements of troops explain the spread of the flu? If it was as contagious as it seemed, how was it being spread? What kind of microorganism was causing the illness? The normal way to try to answer such questions would be to study the spread of the disease in animals. Give the disease to a few cages of laboratory rats, or perhaps to some white rabbits. Isolate whatever was causing the illness. Show how it spread and test ways to protect animals—and people—against the disease. But influenza, it seemed, was a uniquely human disease. No animal was known to be susceptible to it. Medical researchers felt they had no choice but to study influenza in people. Either the Navy doctors were uncommonly persuasive or the enticement of a pardon was overwhelmingly compelling. For whatever reason, the sixty-two men agreed to be subjects in the medical experiment. And so the study began. First the sailors were transferred to a quarantine station on Gallops Island in Boston Harbor. Then the Navy doctors did their best to give the men the flu. Influenza is a respiratory disease—it is spread from person to person, presumably carried on droplets of mucus sprayed in the air when sick people cough or sneeze, or carried on their hands and spread when the sick touch the healthy. Whatever was causing the flu should be present in mucus taken from the ill. The experiments, then, were straightforward. The Navy doctors collected mucus from men who were desperately ill with the flu, gathering thick viscous secretions from their noses and throats. They sprayed mucus from flu patients into the noses and throats of some men, and dropped it into other men’s eyes. In one attempt, they swabbed mucus from the back of the nose of a man with the flu and then directly swabbed that mucus into the back of a volunteer’s nose.

This was a different kind of poor compared to the primarily drug and laziness induced poor of the US.

The benzodiazepines (especially IM lorazepam) are used to manage substance induced and psychotic agitation in the emergency department. Benzodiazepines have been used instead of amobarbital (Amytal) for drug-assisted interviewing.

of stimulating reward pathways in the brain, such as drugs, sex, aggression, and intimidating others, could become relatively more attractive and less constrained by concern about violating trusting relationships. The ability to modify behavior based on negative experiences may be impaired.30 Hard-core drug addicts, whose lives invariably began under conditions of severe stress, are all too readily triggered into a stress reaction. Not only does the stress response easily overwhelm the addict’s already-challenged capacity for rational thought when emotionally aroused, but the hormones of stress also “cross-sensitize” with addictive substances. The more one is present, the more the other is craved. Addiction is a deeply ingrained response to stress, an attempt to cope with it through self-soothing. Maladaptive in the long term, it is highly effective in the short term. Predictably, stress is a major cause of continued drug dependence. It increases opiate craving and use, enhances the reward efficacy of drugs, and provokes relapse to drug seeking and drug taking.31 “Exposure to stress is the most powerful and reliable experimental manipulation used to induce reinstatement of alcohol or drug use,” one team of researchers reports.32 “Stressful experiences,” another research group points out, “increase the vulnerability of the individual to either develop drug self-administration or relapse.”33

For instance, that pot-and-shroom-induced paranoia could be useful, if I could only get a grip on it. As I sat stoned on the couch, convinced that everyone was judging me, I felt that I could hear exactly what they were all thinking. It was like tapping into a fantastical form of empathy. If I just pushed through, I’d be able to harness the drugs’ power.

Can a person live without hope? Must a middle-aged man such as me who underwent a bevy of loss and failure aim to summon the interior moxie to watch the sunrise on each new day while wearing a faint smile of hope? Must I stoically resolve to endure bearing the weighty load of previous personal debacles? I gain nothing by wallowing in self-denunciation. Guilt and shame exact a severe tithe. I cannot lead a worthy life by tumbling into alcoholic numbness or a drug-induced pit.

She no longer felt like a separate entity, a drug- or anxiety-induced hallucination, but rather, an alter of myself that had always coexisted within me.

This all happens unconsciously. All you know is that you instantly have an overwhelming ‘need’ to view porn. It can feel like a matter of life and death, such that all your resolutions take flight. In drug addicts the cue-induced dopamine spike can be as high as the spike from actually taking the drug,[133] and this is likely true for some porn users as well. I caught a glimpse of a porn pic the other day and there was a distinct buzz in my brain, almost like a hot flash. Fortunately it freaked me out enough to get away fast.

You may be wondering how chronic overstimulation can induce two seemingly opposite effects. First, it can increase dopamine activity (sensitisation via DeltaFosB). Second, it can decrease dopamine activity (desensitisation via CREB124). The answer is that it’s mostly about timing. But it’s also about the neurological differences between wanting and liking.[135] Sensitisation leads to high spikes of dopamine in response to cues and triggers associated with use. The dopamine spikes occur before ingesting the drug or masturbating to porn, and are experienced as cravings to use. However, on exposure to the same old stimuli less dopamine (and less opioids) are released (desensitisation). This dampening of pleasure occurs during drug use or while masturbating to porn. The activity is experienced as less pleasurable, increasing cravings for more. Thus, two mechanisms once beneficial to our animal ancestors have unwanted consequences in the age of porn tube sites and omnipresent junk food. Sensitisation leads to greater wanting or more intense cravings, while desensitisation leads to less liking or a decline in overall pleasure.[136] This disparity acts as a double-edged sword that drives compulsive use: overpowering cravings to use (sensitisation) combined with less fulfilment from both everyday activities and from the problematic behaviours (desensitisation). Brain scan studies confirm that porn addicts have greater reward system activation in the craving phase (wanting), but do not like porn any more than non-addicts.

Chemically induced joy comes at a cost. That cost can be high. Very, very high. So high that you’re going to think twice after reading what science has to say about drug use. One study found that adolescents who smoke just a couple of joints of marijuana show changes in their brains. That’s not a couple of years of smoking or the decades that some adults rack up. It’s just two joints. A research team led by Dr. Gabriella Gobbi, a professor and psychiatrist at the McGill University Health Center in Montreal, discovered that teenagers using cannabis had a nearly 40% greater risk of depression and a 50% greater risk of suicidal ideation in adulthood. Dr. Gobbi stated that “given the large number of adolescents who smoke cannabis, the risk in the population becomes very big. About 7% of depression is probably linked to the use of cannabis in adolescence, which translates into more than 400,000 cases.” The research that revealed these startling numbers was not just a single study of adolescent marijuana use. It was a meta-analysis and review of 11 studies with a total of 23,317 teenage subjects followed through young adulthood. Further, Gobbi’s team only reviewed studies that provided information on depression in the subjects prior to their cannabis use. “We considered only studies that controlled for [preexisting] depression,” said Dr. Gobbi. “They were not depressed before using marijuana, so they probably weren’t using it to self-medicate.” Marijuana use preceded depression. The specific findings of Gobbi’s research include: The risk of depression associated with marijuana use in teens below age 18 is 1.4 times higher than among nonusers. The risk of suicidal thoughts is 1.5 times higher. The likelihood that teen marijuana users will attempt suicide is 3.46 times greater. In adults with prolonged marijuana use, the wiring of the brain degrades. Areas affected include the hippocampus (learning and memory), insula (compassion), and prefrontal cortex (executive functions). The authors of one study stated that “regular cannabis use is associated with gray matter volume reduction in the medial temporal cortex, temporal pole, parahippocampal gyrus, insula, and orbitofrontal cortex; these regions are rich in cannabinoid CB1 receptors and functionally associated with motivational, emotional, and affective processing. Furthermore, these changes correlate with the frequency of cannabis use . . . [while the] . . . age of onset of drug use also influences the magnitude of these changes.” A large number of studies show that cannabis use both increases anxiety and depression and leads to worse health. Key parts of your brain shrink more, based on how early you began smoking weed, and how often you smoke it. That’s a “high” price to pay.

sex is the closest feeling you’ll get to magic. Real magic. Not this cooked up, drug-induced version of it.

Premature experience, he asserts, is bad precisely because it is premature. The period of nascent yearning is meant for sublimation - in the sense of making sublime, of orientating youthful inclinations and longings towards great love, great art, great achievement. Premature experience is like the false ecstasy of drugs in that "it artificially induces the exaltation naturally attached to the completion of the greatest endeavors - victory in a just war, consummated love, artistic creation, religious devotion, and the discovery of truth." It has the effect of draining great enthusiasm and great expectations that can only be built up through sublimation, tension, and waiting.

No past or current sleeping medications on the legal (or illegal) market induce natural sleep. Don’t get me wrong—no one would claim that you are awake after taking prescription sleeping pills. But to suggest that you are experiencing natural sleep would not be a true assertion. The older sleep medications—termed “sedative hypnotics,” such as diazepam—were blunt instruments. They sedated you rather than assisting you into natural sleep. Understandably, many people mistake the former for the latter. Most of the newer sleeping pills on the market present a similar situation, though they are slightly less heavy in their sedating effects. Sleeping pills, old and new, target the same system in the brain that alcohol does—the receptors that stop your brain cells from firing—and are thus part of the same general class of drugs: sedatives. Sleeping pills effectively knock out the higher regions of your brain’s cortex.

Legend had it that this cult had acquired their name from their ruthless leader’s tactic of getting his followers stoned before encouraging them to murder top political and religious leaders with trippy, weed-induced promises of a paradise full of nubile young maidens in exotic gardens. These bloodthirsty stoners lapped it up and soon became known as the Hashish-iyun, named after their drug of choice, and giving root to the English word, assassin.

There is no doubt that the act of creation is very similar to the act of dreaming. The difference is that it includes an activity which has been difficult to analyze. It is not only the power to summon an image, but the power to compose with this image. The second faculty, the faculty of active creation, is what is missing from the use of drugs. Drugs induce passivity. Passivity, like the passivity of India induced by religion, is destructive both to human life and to art.

Beginning in 1973, Stanislav Grof, the Czech émigré psychiatrist who is one of the pioneers of LSD-assisted psychotherapy, served as scholar in residence at Esalen, but he had conducted workshops there for years before. Grof, who has guided thousands of LSD sessions, once predicted that psychedelics “would be for psychiatry what the microscope is for biology or the telescope is for astronomy. These tools make it possible to study important processes that under normal circumstances are not available for direct observation.” Hundreds came to Esalen to peer through that microscope, often in workshops Grof led for psychotherapists who wanted to incorporate psychedelics in their practices. Many if not most of the therapists and guides now doing this work underground learned their craft at the feet of Stan Grof in the Big House at Esalen. Whether such work continued at Esalen after LSD was made illegal is uncertain, but it wouldn’t be surprising: the place is perched so far out over the edge of the continent as to feel beyond the reach of federal law enforcement. But at least officially, such workshops ended when LSD became illegal. Grof began teaching instead something called Holotropic Breathwork, a technique for inducing a psychedelic state of consciousness without drugs, by means of deep, rapid, and rhythmic breathing, usually accompanied by loud drumming. Yet Esalen’s role in the history of psychedelics did not end with their prohibition. It became the place where people hoping to bring these molecules back into the culture, whether as an adjunct to therapy or a means of spiritual development, met to plot their campaigns.

Over the next couple of years, Cole and the rest of psychiatry settled on a trial design for testing psychotropic drugs. Psychiatrists and nurses would use “rating scales” to measure numerically the characteristic symptoms of the disease that was to be studied. Did a drug for schizophrenia reduce the patient’s “anxiety”? His or her “grandiosity”? “Hostility”? “Suspiciousness”? “Unusual thought content”? “Uncooperativeness”? The severity of all of those symptoms would be measured on a numerical scale and a total “symptom” score tabulated, and a drug would be deemed effective if it reduced the total score significantly more than a placebo did within a six-week period. At least in theory, psychiatry now had a way to conduct trials of psychiatric drugs that would produce an “objective” result. Yet the adoption of this assessment put psychiatry on a very particular path: The field would now see short-term reduction of symptoms as evidence of a drug’s efficacy. Much as a physician in internal medicine would prescribe an antibiotic for a bacterial infection, a psychiatrist would prescribe a pill that knocked down a “target symptom” of a “discrete disease.” The six-week “clinical trial” would prove that this was the right thing to do. However, this tool wouldn’t provide any insight into how patients were faring over the long term. Were they able to work? Were they enjoying life? Did they have friends? Were they getting married? None of those questions would be answered. This was the moment that magic-bullet medicine shaped psychiatry’s future. The use of the clinical trial would cause psychiatrists to see their therapies through a very particular prism, and even at the 1956 conference, New York State Psychiatric Institute researcher Joseph Zubin warned that when it came to evaluating a therapy for a psychiatric disorder, a six-week study induced a kind of scientific myopia. “It would be foolhardy to claim a definite advantage for a specified therapy without a two- to five-year follow-up,” he said. “A two-year follow-up would seem to be the very minimum for the long-term effects.

To erase or “de-pattern” personality traits, Cameron gave his subjects megadoses of LSD, subjected them to drug-induced “sleep therapy” for up to 65 consecutive days, and applied electroshock therapy at 75 times the usual intensity. To shape new behavior, Cameron forced them to listen to repeated recorded messages for 16-hour intervals, a technique known as “psychic driving.” —Washington Post, July 28, 1985, quoting the Congressional Record of the Senate, 99th Congress, 1st Session, Volume 131, No. 106, Part 2, p. 131, in regard to the mind-control work of psychiatrist Dr. Ewen Cameron, former President of the Canadian, American and World Psychiatric Associations, while in the employ of the CIA

The primrose path to perdition never ceases to attract. Not least among the attractions of the primrose path are drugs of abuse. This has always been so and will always be so. The temptation to obscure life’s existential difficulties, dissatis- factions, and terrors by means of chemically-induced oblivion has always been, and will always be, great, at least until the meaning of life has been found once and for all.

The primrose path to perdition never ceases to attract. Not least among the attractions of the primrose path are drugs of abuse. This has always been so and will always be so. The temptation to obscure life’s existential difficulties, dissatisfactions, and terrors by means of chemically-induced oblivion has always been, and will always be, great, at least until the meaning of life has been found once and for all.

What was most striking about these delusions was how prosaic and true-to-life they appeared. This wasn’t like LSD, where you knew the visual fireworks were induced by the drug. Meth hallucinations seemed like they were really happening.

In 1805 Goethe wrote Faust in classicist Weimar, and by poetic means perfected one of his theses, that the genesis of man is itself drug-induced: I change my brain, therefore I am.

Some lower-level criminals have been known to sniff cocaine before going out on a hold-up, to boost their nerve; in popular lore this has been transferred, very inaccurately, to the heroin addict. In fact, a shot of heroin would probably induce the mood to lie around in his pad and postpone the robbery indefinitely (or until he needs money for another fix). Similarly, cocaine abusers are often irrationally violent and attack their friends, or total strangers, without apparent motive. (This is because they know that the victim has actually been plotting against them.) Heroin addicts are about the most nonviolent citizens around outside of the Quakers.

Similarly, use of cocaine by black day laborers and other blue-collar workers was initially encouraged, as long as the use was in the service of accomplishing work tasks for whites. But then the situation changed as whites discovered that blacks, too, enjoyed cocaine recreationally for its euphoria- and confidence-inducing effects. Use by blacks was increasingly reported in a manner designed to evoke fear among the white majority. Countless articles exaggerated both the extent to which cocaine was used by blacks and the connection between their use of the drug and heinous crimes. Popular myths held that the drug made black men homicidal as well as exceptional marksmen. Perhaps the most outrageous claim was that the drug rendered this group unaffected by .32-caliber bullets. Incredibly, these ridiculous assertions were actually believed. They prompted some southern police forces to switch to a larger .38-caliber weapon in order to deal with the mythical black, cocainized superhuman.

Scheff continued, “The drugs being given to the children are toxic—they’re known to cause genetic mutation, organ failure, bone marrow death, bodily deformations, brain damage, and fatal skin disorders.15 “If the children refuse the drugs, they’re held down and force fed. If the children continue to resist, they’re taken to Columbia Presbyterian hospital, where a surgeon puts a plastic tube through their abdominal wall into their stomachs. From then on, the drugs are injected directly into their intestines.16 “In 2003, two children, ages six and twelve, had debilitating strokes due to drug toxicities. The six-year-old went blind. They both died shortly after. Another fourteen-year-old died recently. An eight-year-old boy had two plastic surgeries to remove large, fatty, drug-induced lumps from his neck.”17 “This isn’t science fiction. This is AIDS research.

The thoughts of the drug induced baby rape slipping from her mind.

A few years later, researchers at Yale University School of Medicine quantified this risk. They reviewed the records of 87,290 patients diagnosed with depression or anxiety between 1997 and 2001 and determined those treated with antidepressants converted to bipolar at the rate of 7.7 percent per year, which was three times greater than for those not exposed to the drugs.17 As a result, over longer periods, 20 to 40 percent of all patients initially diagnosed with unipolar depression today eventually convert to bipolar illness.18 Indeed, in a recent survey of members of the Depressive and Manic-Depressive Association, 60 percent of those with a bipolar diagnosis said they had initially fallen ill with major depression and had turned bipolar after exposure to an antidepressant.19 This is data that tells of a process that routinely manufactures bipolar patients. “If you create iatrogenically a bipolar patient,” explained Fred Goodwin, in a 2005 interview in Primary Psychiatry, “that patient is likely to have recurrences of bipolar illness even if the offending antidepressant is discontinued. The evidence shows that once a patient has had a manic episode, he or she is more likely to have another one, even without the antidepressant stimulation.”20 Italy’s Giovanni Fava put it this way: “Antidepressant-induced mania is not simply a temporary and fully reversible phenomenon, but may trigger complex biochemical mechanisms of illness deterioration.”21

In studies of first-episode bipolar patients, investigators at McLean Hospital, the University of Pittsburgh, and the University of Cincinnati Hospital found that at least one-third had used marijuana or some other illegal drug prior to their first manic or psychotic episode.10 This substance abuse, the University of Cincinnati investigators concluded, may “initiate progressively more severe affective responses, culminating in manic or depressive episodes, that then become self-perpetuating.”11 Even the one-third figure may be low; in 2008, researchers at Mt. Sinai Medical School reported that nearly two-thirds of the bipolar patients hospitalized at Silver Hill Hospital in Connecticut in 2005 and 2006 experienced their first bout of “mood instability” after they had abused illicit drugs.12 Stimulants, cocaine, marijuana, and hallucinogens were common culprits. In 2007, Dutch investigators reported that marijuana use “is associated with a fivefold increase in the risk of a first diagnosis of bipolar disorder” and that one-third of new bipolar cases in the Netherlands resulted from it.13 Antidepressants have also led many people into the bipolar camp, and to understand why, all we have to do is return to the discovery of this class of drugs. We see tuberculosis patients treated with iproniazid dancing in the wards, and while that magazine report was probably a bit exaggerated, it told of lethargic patients suddenly behaving in a manic way. In 1956, George Crane published the first report of antidepressant-induced mania, and this problem has remained present in the scientific literature ever since.14 In 1985, Swiss investigators tracking changes in the patient mix at Burghölzli psychiatric hospital in Zurich reported that the percentage with manic symptoms jumped dramatically following the introduction of antidepressants. “Bipolar disorders increased; more patients were admitted with frequent episodes,” they wrote.15 In a 1993 practice guide to depression, the APA confessed that “all anti-depressant treatments, including ECT [electroconvulsive therapy], may provoke manic or hypomanic episodes.”16

What's wrong with getting high? The nineteenth-century debates over euphoria, in which drug-induced pleasure became suspect or pathological, have been succeeded by a twenty-first century neuroscience in which positive mood is seen as a symptom of raised dopamine or serotonin levels.

Living without emotions was easy; it was the coming out of an induced emotional state that was hard—like an addict trying to get sober. Alcohol and drugs made me feel, and if I wasn’t careful, tonight could get bad.

She could have been in the drug induced coma for days. Months even. There just wasn’t any way to tell.

This life-enhancing, happiness-inducing miracle drug that does, in fact, ruthlessly kill its enemies—you’ve guessed it—is gratitude.

There is no evidence from anywhere in the world that harm reduction measures encourage drug use. Denying addicts humane assistance multiplies their miseries without bringing them one inch closer to recovery. There is also no contradiction between harm reduction and abstinence. The two objectives are incompatible only if we imagine that we can set the agenda for someone else’s life regardless of what he or she may choose. We cannot. Short of extreme coercion there is absolutely nothing anyone can do to induce another to give up addiction, except to provide the island of relief where contemplation and self-respect can, perhaps, take root. Those ready to choose abstinence should receive every possible support — much more support than we currently provide. But what of those who don’t choose that path? The impossibility of changing other people is not restricted to addictions. Try as we may to motivate another person to be different or to do this or not to do that, our attempts founder on a basic human trait: the drive for autonomy. “And one may choose what is contrary to one’s own interests and sometimes one positively ought,” wrote Fyodor Dostoevsky in Notes from the Underground. “What man wants is simply independent choice, whatever that independence may cost and wherever it may lead.” The issue is not whether the addict would be better off without his habit — of course he would — but whether we are going to abandon him if he is unable to give it up. Are we willing to care for human beings who suffer because of their own persistent behaviours, mindful that these behaviours stem from early life misfortunes they had no hand in creating? The harm reduction approach accepts that some people — many people — are too deeply enmeshed in substance dependence for any realistic “cure” under present circumstances. There is, for now, too much pain in their lives and too few internal and external resources available to them. In practising harm reduction we do not give up on abstinence — on the contrary, we may hope to encourage that possibility by helping people feel better, bringing them into therapeutic relationships with caregivers, offering them a sense of trust, removing judgment from our interactions with them and giving them a sense of acceptance. At the same time, we do not hold out abstinence as the Holy Grail and we do not make our valuation of addicts as worthwhile human beings dependent on their making choices that please us. Harm reduction is as much an attitude and way of being as it is a set of policies and methods.

The picture was painted before Naomi’s addiction. Drug-induced smiles aren’t real.

And then there’s physical dependence. As defined in medical terms, physical dependence is manifested when a person stops taking a substance and, due to changes in the brain and body, she experiences withdrawal symptoms. Those temporary, drug-induced changes form the basis of physical dependence. Although a feature of drug addiction, a person’s physical dependence on a substance does not necessarily imply that he is addicted to it. The withdrawal syndrome is different for each class of drug — in the case of opiates such as morphine or heroin it includes nausea, diarrhea, sweats, aches and pains and weakness, as well as severe anxiety, agitation and depressed mood. But you don’t have to be addicted to experience withdrawal — you just have to have been taking a medication for an extended period of time. As many people have discovered to their chagrin, with abrupt cessation it’s quite possible to suffer highly unpleasant withdrawal symptoms from drugs that are not addictive: the antidepressants paroxetine (Paxil) and venlafaxine (Effexor) are but two examples. Withdrawal does not mean you were addicted; for addiction, there also needs to be craving and relapse. In fact, in the case of narcotics, it turns out that the addictive, “feel good” effect of these drugs seems to act in a different part of the brain than the effects that lead to physical dependence. When morphine is infused only into the “reward” circuits of a rat’s brain, addiction-like behaviour results, but there’s no physical dependence and no withdrawal. “Dependence” can also be understood as a powerful attachment to harmful substances or behaviours, and this definition gives us a clearer picture of addiction. The addict comes to depend on the substance or behaviour in order to make himself feel momentarily calmer or more excited or less dissatisfied with his life.

In the cloudy swirl of misleading ideas surrounding public discussion of addiction, there’s one that stands out: the misconception that drug taking by itself will lead to addiction — in other words, that the cause of addiction resides in the power of the drug over the human brain. It is one of the bedrock fables sustaining the so-called “War on Drugs.” It also obscures the existence of a basic addiction process of which drugs are only one possible object, among many. Compulsive gambling, for example, is widely considered to be a form of addiction without anyone arguing that it’s caused by a deck of cards. The notion that addiction is drug-induced is often reinforced. Clearly, if drugs by themselves could cause addiction, we would not be safe offering narcotics to anyone. Medical evidence has repeatedly shown that opioids prescribed for cancer pain, even for long periods of time, do not lead to addiction except in a minority of susceptible people. During my years working on a palliative care ward I sometimes treated terminally ill cancer patients with extraordinarily high doses of narcotics — doses that my hardcore addict clients could only dream of. If the pain was alleviated by other means — for example, when patient was successfully given a nerve block for bone pain due to malignant deposits in the spine — the morphine could be rapidly discontinued. Yet if anyone had reason to seek oblivion through narcotic addiction, it would have been these terminally ill human beings. An article in the Canadian Journal of Medicine in 2006 reviewed international research covering over six thousand people who had received narcotics for chronic pain that was not cancerous in origin. There was no significant risk of addiction, a finding common to all studies that examine the relationship between addiction and the use of narcotics for pain relief. “Doubts or concerns about opioid efficacy, toxicity, tolerance, and abuse or addiction should no longer be used to justify withholding opioids,” concluded a large study of patients with chronic pain due to rheumatic disease. We can never understand addiction if we look for its sources exclusively in the actions of chemicals, no matter how powerful they are.

Some people, a relatively small minority, are at grave risk for addiction if exposed to certain substances. For this minority, exposure to drugs really will trigger addiction, and the trajectory of drug dependence, once begun, is extremely difficult to stop. In the United States opiate relapse rates of 80 per cent to more than 90 per cent have been recorded among addicts who try to quit their habit. Even after hospital treatment the re-addiction rates are over 70 per cent. Such dismal results have led to the impression that opiates themselves hold the power of addiction over human beings. Similarly, cocaine has been described in the media as “the most addictive drug on earth,” causing “instant addiction.” More recently, crystal methamphetamine (crystal meth) has gained a reputation as the most instantly powerful addiction-inducing drug — a well-deserved notoriety, so long as we keep in mind that the vast majority of people who use it do not become addicted. Statistics Canada reported in 2005, for example, that 4.6 per cent of Canadians have tried crystal meth, but only 0.5 per cent had used it in the past year. If the drug by itself induced addiction, the two figures would have been nearly identical. In one sense certain substances, like narcotics and stimulants, alcohol, nicotine and marijuana, can be said to be addictive, and it’s in that sense that I use the term. These are the drugs for which animals and humans will develop craving and which they will seek compulsively. But this is far from saying that the addiction is caused directly by access to the drug. The reasons are deeply rooted in the neurobiology and psychology of emotions.