Drug Related Quotes

What are you doing following me around the back streets of London, you little idiot?” Will demanded, giving her arm a light shake. Cecily’s eyes narrowed. “This morning it was cariad (note: Welsh endearment, like ‘darling’ or ‘love’), now it’s idiot.” “Oh, you’re using a Glamour rune. There’s one thing to declare, you are not afraid of anything when you live in the country. But this is London.” “I’m not afraid of London,” Cecily said defiantly. Will leaned closer, almost hissing in her ear *and said something very complicated in Welsh* She laughed. “No, it wouldn’t do you any good to tell me to go home. You are my brother, and I want to go with you.” Will blinked at her words. You are my brother, and I want to go with you. It was the sort of thing he was used to hearing Jem say. Although Cecily was unlike Jem in every other conceivable possible way, she did share one quality with him. Stubbornness. When Cecily said she wanted something, it did not express an idle desire, but an iron determination. “Do you even care where I’m going?” he said. “What if I were going to hell?” “I’ve always wanted to see hell,” Cecily said. “Doesn’t everyone?” “Most of us spend our time trying to stay out of it, Cecily. I’m going to an ifrit den, if you must know, to purchase drugs from vile, dissolute criminals. They may clap eyes on you, and decide to sell you.” “Wouldn’t you stop them?” “I suppose it would depend on whether they cut me a part of the profit.” She shook her head. “Jem is your parabatai,” she said. “He is your brother, given to you by the Clave, but I am your sister by blood. Why would you do anything for him, but you only want me to go home?” “How do you know the drugs are for Jem?” Will said. “I’m not an idiot, Will.” “No, more’s the pity. Jem- Jem is like the better part of me. I would not expect you to understand. I owe him. I owe him this.” “So what am I?” Cecily said. Will exhaled, too desperate to check himself. “You are my weakness.” “And Tessa is your heart,” she said, not angrily, but thoughtfully. “I am not fooled. As I told you, I’m not an idiot. And more’s the pity for you, although I suppose we all want things we can’t have.” “Oh,” said Will, “and what do you want?” “I want you to come home.” A strand of black hair was stuck to her cheek by the dampness, and Will fought the urge to pull her cloak closer about her, to make her safe as he had when she was a child. “The Institute is my home,” Will sighed, and leaned his head against the stone wall. “I can’t stand out her arguing with you all evening, Cecily. If you’re determined to follow me into hell, I can’t stop you.” “Finally,” she said provingly. “You’ve seen sense. I knew you would, you’re related to me.” Will fought the urge to shake her. “Are you ready?” She nodded, and he raised his hand to knock on the door.

Oh, my dear, relations are like drugs, - useful sometimes, and even pleasant, if taken in small quantities and seldom, but dreadfully pernicious on the whole, and the truly wise avoid them.

Everything's gonna be fine. Stay optimistic. If there's dark clouds coming, they'll leave again. They always do. The world is round. Everything is round. The biggest invention of all time, the wheel, is round. Things pass, nothing will stay the same forever. No matter how big a pile of shite you've gotten yourself into-be it drugs, financial problems, fucked up relations-you will get over it. It will go away just like the weather. The sun is round, so is the planet we live on, as are marriage rings, and our eyes through which we see the world.

One of the reasons that so many people of color and poor people are in prison is that the deindustrialization of the economy has led to the creation of new economies and the expansion of some old ones – I have already mentioned the drug trade and the market for sexual services. At the same time, though, there are any number of communities that more than welcome prisons as a source of employment. Communities even compete with one another to be the site where new prisons will be constructed because prisons create a significant number of relatively good jobs for their residents

Back and forth from Brooklyn to Manhattan. New York at night, from its bridges, is a miracle. When I first came to the city, it took all my fantasies and set them on fire, turned them into flickering constellations of light. Then it did the same with my history. As a dark speck of energy hurtling over the water toward that galaxy, I felt myself disappear. Relative to the image of infinity I was nothing, a clump of quantum matter skidding through the ether. It was as good as any drug.

It was already getting dark out, but I kept my sunglasses on. I didn't want to have to look anybody in the eye. I didn't want to relate to anybody too keenly. Plus, the fluorescent lights at the drug store were blinding. If I could have purchased my medications from a vending machine, I would have paid double for them.

Depression, somehow, is much more in line with society's notions of what women are all about: passive, sensitive, hopeless, helpless, stricken, dependent, confused, rather tiresome, and with limited aspirations. Manic states, on the other hand, seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo. Anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental. Journalists and other writers, quite understandably, have tended to focus on women and depression, rather than women and mania. This is not surprising: depression is twice as common in women as men. But manic-depressive illness occurs equally often in women and men, and, being a relatively common condition, mania ends up affecting a large number of women. They, in turn, often are misdiagnosed, receive poor, if any, psychiatric treatment, and are at high risk for suicide, alcoholism, drug abuse, and violence. But they, like men who have manic-depressive illness, also often contribute a great deal of energy, fire, enthusiasm, and imagination to the people and world around them.

The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development; they actually got negative circumstances of neglect. I don’t have a single female patient in the Downtown Eastside of Vancouver who wasn’t sexually abused, for example, as were many of the men, or abused, neglected and abandoned serially, over and over again. That’s what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.

Mother's hug- The only drug that works every time, costs nothing and has no side effects.

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.

Much of the borderline’s dramatic behavior is related to his interminable search for something to fill the emptiness that continually haunts him. Relationships and drugs are two of the mechanisms the borderline uses to combat the loneliness and to capture a sense of existing in a world that feels real. CASE

The Sackler empire is a completely integrated operation,” Blair wrote. They could develop a drug, have it clinically tested, secure favorable reports from the doctors and hospitals with which they had connections, devise an advertising campaign in their agency, publish the clinical articles and the advertisements in their own medical journals, and use their public relations muscle to place articles in newspapers and magazines.

It provides the police with something to do, and as junkies and potheads are relatively easy to apprehend because they have to take so many chances to get hold of their drugs, a heroic police can make spectacular arrests, lawyers can do a brisk business, judges can make speeches, the big pedlars can make a fortune, the tabloids can sell millions of copies. John Citizen can sit back feeling exonerated and watch evil get its deserts. That's the junk scene, man. Everyone gets something out of it except the junkie. If he's lucky he can creep round the corner and get a fix. But it wasn't the junk that made him creep.

Among the educated young there is therefore a startling and unprecedented interest in the transformation of human consciousness. All over the Western world publishers are selling millions of books dealing with Yoga, Vedanta, Zen Buddhism, and the chemical mysticism of psychedelic drugs, and I have come to believe that the whole “hip” subculture, however misguided in some of its manifestations, is the earnest and responsible effort of young people to correct the self–destroying course of industrial civilization.

Males who do extreme amounts of exercise, such as professional soccer players and runners who cover more than 40 or 50 miles a week, have less LHRH, LH, and testosterone in their circulation, smaller testes, less functional sperm. They also have higher levels of glucocorticoids in their bloodstreams, even in the absence of stress. (A similar decline in reproductive function is found in men who are addicted to opiate drugs.)

Dr. Bone Specialist came in, made me stand up and hobble across the room, checked my reflexes, and then made me lie down on the table. He bent my right knee this way and that, up and down, all the way out to the side and in. Then he did the same with my left leg. He ordered X rays then started to leave the room. I panicked. I MUST GET DRUGS. "What can I take for the pain?" I asked him before he got out the door. "You can take some over the counter ibuprofen," he suggested. "But I wouldn't take more than nine a day." I choked. Nine a day? I'd been popping forty. Nine a day? Like hell. I couldn't even go to the bathroom on my own, I hadn't slept in three weeks, and my normally sunny cheery disposition had turned into that of a very rabid dog. If I didn't get good drugs and get them now, it was straight to Shooter's World and then Walgreens pharmacy for me. "I don't think you understand," I explained. "I can't go to work. I have spent the last four days with my mother who is addicted to QVC, watching jewelry shows, doll shows and make-up shows. I almost ordered a beef-jerky maker! Give me something, or I'm going to use your calf muscles to make the first batch!" Without further ado, he hastily scribbled out a prescription for some codeine and was gone. I was happy. My mother, however, had lost the ability to speak.

A more fundamental problem with labelling human distress and deviance as mental disorder is that it reduces a complex, important, and distinct part of human life to nothing more than a biological illness or defect, not to be processed or understood, or in some cases even embraced, but to be ‘treated’ and ‘cured’ by any means possible—often with drugs that may be doing much more harm than good. This biological reductiveness, along with the stigma that it attracts, shapes the person’s interpretation and experience of his distress or deviance, and, ultimately, his relation to himself, to others, and to the world. Moreover, to call out every difference and deviance as mental disorder is also to circumscribe normality and define sanity, not as tranquillity or possibility, which are the products of the wisdom that is being denied, but as conformity, placidity, and a kind of mediocrity.

Of all the intoxicants you can find on the road (including a "national beer" for nearly every country in the world), marijuana deserves a particular mention here, primarily because it's so popular with travelers. Much of this popularity is due to the fact that marijuana is a relatively harmless diversion (again, provided you don't get caught with it) that can intensify certain impressions and sensations of travel. The problem with marijuana, however, is that it's the travel equivalent of watching television: It replaces real sensations with artificially enhanced ones. Because it doesn't force you to work for a feeling, it creates passive experiences that are only vaguely connected to the rest of your life. "The drug vision remains a sort of dream that cannot be brought over into daily life," wrote Peter Matthiessen in The Snow Leopard. "Old mists may be banished, that is true, but the alien chemical agent forms another mist, maintaining the separation of the 'I' from the true experience of the 'One.'" Moreover, chemical highs have a way of distracting you from the utterly stoning natural high of travel itself. After all, roasting a bowl might spice up a random afternoon in Dayton, Ohio, but is it really all that necessary along the Sumatran shores of Lake Toba, the mountain basins of Nepal, or the desert plateaus of Patagonia? As Salvador Dali quipped, "I never took drugs because I am drugs." With this in mind, strive to be drugs as you travel, to patiently embrace the raw, personal sensation of unmediated reality--an experience for more affecting than any intoxicant can promise.

In fact, porn can literally kill you. Since 2000, there have been at least 34 drug-related deaths among performers...

We didn't do drugs, we were the drugs

Brain-imaging studies of drug users at that stage show that viewing a film of actors pretending to use drugs activates dopamine pathways in the brain more than does watching porn films. This

When people recover from depression via psychotherapy, their attributions about recovery are likely to be different than those of people who have been treated with medication. Psychotherapy is a learning experience. Improvement is not produced by an external substance, but by changes within the person. It is like learning to read, write or ride a bicycle. Once you have learned, the skills stays with you. People no not become illiterate after they graduate from school, and if they get rusty at riding a bicycle, the skill can be acquired with relatively little practice. Furthermore, part of what a person might learn in therapy is to expect downturns in mood and to interpret them as a normal part of their life, rather than as an indication of an underlying disorder. This understanding, along with the skills that the person has learned for coping with negative moods and situations, can help to prevent a depressive relapse.

When you're reading a good noir, the shocks and twists have a way of feeling deja vu-like, as if you saw them coming, but hoped the characters would take a left turn... not answer the phone, not sleep with that woman, not sell drugs to those cops... but knew they would. It would have been wrong if they didn't, and the real surprise can be that you care about someone you know is in for hell. You relate to them, even when their hell is so much bigger than your own. But we're all going to die, and we all make mistakes. The best noir stories make you forget plot entirely by giving you characters that feel so well-realised you can't look away as they fall.

He dropped the joint in the dirt and ran inside. It wasn't his first, and wouldn't be his last. The joint, that is. Not the kid. He was pretty sure, at this point, that he would never have sexual relations with his wife again.

Anything well done has the feeling of death to me, of being finished. I don't want to "master" anything. I want to spy, and sneak, and capture things just as they are . . . record all that comes before and after the song—jokes and fights and private moments. Having an unfillable hole inside is a great catalyst. You're always trying new things to fill it. People with holes look good! Look ready for action. But then sometimes you're home alone, and there's nothing new to try, and the hole's still there. "Hey," it growls, poking you from inside, "I'm hungry." I get tired of it! We are like two living cells inside a just-dead body—doomed, terrified. She argues herself out of anything she's working on, halfway through. As I stand there in the downpour and pull the mailbox open and drop my letter down the hole, I think about how Cindy is more beautiful, intelligent, and intricate than me, but still I have the winning point: whatever I do, even when I'm wrong, I go all the way. It's dark humor, but it's rooted in something real. What you present to the world is light humor. You keep it fun and fast-paced. No one can relate to that long-term. Struggle is what makes life rich—not success.

The only happy people I know are people I don’t know well.” This observation is a one-sentence antidote to this obstacle to happiness. If all of us realized that the people with whom we negatively compare our happiness are plagued by pains and demons of which we know little or nothing, we would stop comparing our happiness with others’. Think of those people you know well, and you will realize the truth of Helen Telushkin’s comment. Most likely you know how much unhappiness everyone you know well has experienced. And even with regard to these people whom you know well, chances are that you do not know with what inner demons—emotional, psychological, economic, sexual, or related to alcohol or drugs—they have to struggle.

One day in my pharmacology class, we were discussing the possibility of legalizing marijuana. The class was pretty evenly divided between those that advocated legalizing marijuana and those that did not. The professor said he wanted to hear from a few people on both sides of the argument. A couple students had the opportunity to stand in front of the class and present their arguments. One student got up and spoke about how any kind of marijuana use was morally wrong and how nobody in the class could give him any example of someone who needed marijuana. A small girl in the back of the classroom raised her hand and said that she didn’t want to get up, but just wanted to comment that there are SOME situations in which people might need marijuana. The same boy from before spoke up and said that she needed to back up her statements and that he still stood by the fact that there wasn’t anyone who truly needed marijuana. The same girl in the back of the classroom slowly stood up. As she raised her head to look at the boy, I could physically see her calling on every drop of confidence in her body. She told us that her husband had cancer. She started to tear up, as she related how he couldn’t take any of the painkillers to deal with the radiation and chemotherapy treatments. His body was allergic and would have violent reactions to them. She told us how he had finally given in and tried marijuana. Not only did it help him to feel better, but it allowed him to have enough of an appetite to get the nutrients he so desperately needed. She started to sob as she told us that for the past month she had to meet with drug dealers to buy her husband the only medicine that would take the pain away. She struggled every day because according to society, she was a criminal, but she was willing to do anything she could to help her sick husband. Sobbing uncontrollably now, she ran out of the classroom. The whole classroom sat there in silence for a few minutes. Eventually, my professor asked, “Is there anyone that thinks this girl is doing something wrong?” Not one person raised their hand.

Today, antibiotics are as common as a cup of coffee. In the 1950s they were relatively new. Today, over-use has reduced their efficacy but in the 1950s they really were a miracle drug. Sister Monica Joan had never had penicillin before, and responded immediately.

after the war, historian Marilyn Young warned: The U.S. can destroy Iraq’s highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . We shall lose the war after we have won it.

(Time is relative, said Heraclitus a long time ago, and distance a function of velocity. Since the ultimate goal of transport technology is the annihilation of space, the compression of all Being into one pure point, it follows that six-packs help. Speed is the ultimate drug and rockets run on alcohol.

trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

Now we have hundreds of carefully engineered, designed, and marketed commercial foods filled with rapidly absorbed processed sugars that cause a burst of sensation that can’t be matched by some lowly natural food. Once, we had lives that, amid considerable privation and negatives, also offered a huge array of subtle and often hard-won pleasures. And now we have drugs that cause spasms of pleasure and dopamine a thousand-fold higher than anything stimulated in our drug-free world.

The smell of cigarette smoke in the air in a tavern that changes names often, a bar cursed because of a girl who died of a drug overdose in the basement, we put a few coins in the jukebox; chose “Angel Band” by Johnny Cash and sat down at the bar, ordered a soda, you wanted a whiskey on the rocks. We saw the coal miner who moved here from West Virginia knocking back liquor like I drink sweet tea. No one asked why he was so solemn today. It was warm. It was relatively quiet. To anyone else, this place could feel sinister. But to us, it was freedom. It was a hiding place. No one was ever here long enough to know us. And we liked it that way.

Drug addicts perplex me. They're a relatively recent development, historically speaking. Everyone has their theories - monotheists like to blame it on godlessness - but I think it was a plague that developed in the sooty petticoats of the Industrial Revolution and its concomitant division of labor. Once people specialized their labors and separated themselves from food production and the daily needs of basic survival, there was a hollow place in their lives that they did not know how to fill.

The cost savings weren’t what did the trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

Next is diet or nutrition—or as I prefer to call it, nutritional biochemistry. The third domain is sleep, which has gone underappreciated by Medicine 2.0 until relatively recently. The fourth domain encompasses a set of tools and techniques to manage and improve emotional health. Our fifth and final domain consists of the various drugs, supplements, and hormones that doctors learn about in medical school and beyond. I lump these into one bucket called exogenous molecules, meaning molecules we ingest that come from outside the body.

A black kid arrested twice for possession of marijuana may be no more of a repeat offender than a white frat boy who regularly smokes pot in his dorm room. But because of his race and his confinement to a racially segregated ghetto, the black kid has a criminal record, while the white frat boy, because of his race and relative privilege, does not. Thus, when prosecutors throw the book at black repeat offenders or when police stalk ex-offenders and subject them to regular frisks and searches on the grounds that it makes sense to “watch criminals closely,” they are often exacerbating racial disparities created by the discretionary decision to wage the War on Drugs almost exclusively in poor communities of color.

Our analyses of the FDA data showed relatively little difference between the effects of antidepressants and the effects of placebos. Indeed, the effects were so small that they did not qualify as clinically significant. The drug companies knew how small the effect of their medications were compared to placebos, and so did the FDA and other regulatory agencies. The companies found various ways to make the data seem more favorable to their products, and the FDA helped them keep their negative data secret. In fact, in some instances, the FDA urged the companies to keep negative data hidden, even when the companies wanted to reveal them. My colleagues and I hadn't really discovered anything new. We had merely revealed their 'dirty little secret'.

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.

Just the two major legal drugs, tobacco and alcohol, are together directly responsible for over 500,000 deaths a year in this country. Deaths associated with prescription drugs are an additional 100,000 a year. The combined deaths associated with all the illegal drugs, including heroin, cocaine, marijuana, methamphetamine, and PCP, may increase this total by another 5,000. In other words, if all illegal drug use were to be curtailed by some stroke of a magic wand, the drug-related deaths in the country would decrease by 1 percent. The remaining 99% remain just as dead,

published in the American Psychological Society journal, by Dianne Tice and Roy Baumeister discusses the cost of procrastination. It is related to: Depression Irrational beliefs Low self-esteem Anxiety Stress Procrastination is not innocent behavior. It’s a sign of poor self-regulation. Researchers even compare procrastination to alcohol and drug abuse. It’s serious. And I’ve experienced that for many years.

But the idea of a peace dividend could not be stifled so long as Americans were in need. Shortly after the war, historian Marilyn Young warned: The U.S. can destroy Iraq's highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . . We shall lose the war after we have won it.

Any notion that drug use among blacks is more severe or dangerous is belied by the data; white youth have about three times the number of drug-related emergency room visits as their African American counterparts.

At this point he quit, right in the middle of an important and promising piece of work. He now saw his colleagues partly as relentless, obsessive public prosecutors and security chiefs of logic, and partly as opium eaters, addicts of some strange pale drug that filled their world with visions of numbers and abstract relations. "God help me," he thought, "surely I never could have meant to spend all my life as a mathematician?

Smoke a bowl and you can do this for hours,” one of the guys says. “Just kidding. No drugs in the major leagues.” As we cut the clay, there are no bowls to smoke—though according to one sod farm worker, weed goes well with anything turf-related: “You can’t be a grass man and not be a grass man,” he says—but there is an easy intimacy among the crew, a kind of in-this-together camaraderie, and for a few minutes I feel like one of them, too.

Deng explained to his hosts that he had come to Japan for three reasons: to exchange documents ratifying the Treaty of Peace and Friendship; to express China's appreciation to Japanese friends who in recent decades had dedicated themselves to improving Sino-Japanese relations; and like Xu Fu, to find a “secret magic drug.” Japanese listeners laughed, for they were familiar with the story of Xu Fu, who, 2,200 years earlier, on behalf of Emperor Qin, had been dispatched to Japan to find a drug that would bring eternal life. Deng went on to explain that what he really meant by the “magic drug” was the secret of how to modernize. He said he wanted to learn about modern technology and management.

Mutations litter the chromosomes. In individual specimens of breast and colon cancer, between fifty to eighty genes are mutated; in pancreatic cancers, about fifty to sixty. Even brain cancers, which often develop at earlier ages and hence may be expected to accumulate fewer mutations, possess about forty to fifty mutated genes. Only a few cancers are notable exceptions to this rule, possessing relatively few mutations across the genome. One of these is an old culprit, acute lymphoblastic leukemia: only five or ten genetic alterations cross its otherwise pristine genomic landscape.* Indeed, the relative paucity of genetic aberrancy in this leukemia may be one reason that this tumor is so easily felled by cytotoxic chemotherapy. Scientists speculate that genetically simple tumors (i.e., those carrying few mutations) might inherently be more susceptible to drugs, and thus intrinsically more curable. If so, the strange discrepancy between the success of high-dose chemotherapy in curing leukemia and its failure to cure most other cancers has a deep biological explanation. The search for a “universal cure” for cancer was predicated on a tumor that, genetically speaking, is far from universal. In

The advice of etiquette experts on dealing with unwanted invitations, or overly demanding requests for favours, has always been the same: just say no. That may have been a useless mantra in the war on drugs, but in the war on relatives who want to stay for a fortnight, or colleagues trying to get you to do their work for them, the manners guru Emily Post’s formulation – ‘I’m afraid that won’t be possible’ – remains the gold standard. Excuses merely invite negotiation. The comic retort has its place (Peter Cook: ‘Oh dear, I find I’m watching television that night’), and I’m fond of the tautological non-explanation (‘I can’t, because I’m unable to’). But these are variations on a theme. The best way to say no is to say no. Then shut up.

And then—some visionary, through some accident— —accident, Mahavira?— —through some quirk of metabolism, through some drug perhaps, has his doors of perception opened for an instant and he almost sees—presque vu!—the entire being and he knows for the first time that there is a whole … other pattern here … Each moment in his life is only minutely related to the cause-and-effect chain within his little molecular world. Each moment, if he could only analyze it, reveals the entire pattern of the motion of the

. . . bush-league sex compared to L.A.; pasties here —total naked public humping in L.A. . . . Las Vegas is a society of armed masturbators/gambling is the kicker here/sex is extra/weird trip for high rollers . . . house-whores for winners, hand jobs for the bad luck crowd.

Although stigmatizing attitudes are not limited to mental illness, the public seems to disapprove persons with psychiatric disabilities significantly more than persons with related conditions such as physical illness (34-36). Severe mental illness has been likened to drug addiction, prostitution, and criminality (37,38). Unlike physical disabilities, persons with mental illness are perceived by the public to be in control of their disabilities and responsible for causing them (34,36). Furthermore, research respondents are less likely to pity persons with mental illness, instead reacting to psychiatric disability with anger and believing that help is not deserved (35,36,39)." World Psychiatry. 2002 Feb; 1(1): 16–20. PMCID: PMC1489832 Understanding the impact of stigma on people with mental illness PATRICK W CORRIGAN and AMY C WATSON

The psychoanalyst Erik H. Erikson devoted a chapter in his Pulitzer Prize—winning book, Childhood and Society, to his reflections on the American identity. “This dynamic country,” he wrote, “subjects its inhabitants to more extreme contrasts and abrupt changes during a generation than is normally the case with other great nations.” Such trends have only accelerated since Erikson made that observation in 1950. The effects of rapid social and economic shifts on the parenting environment are too well known to need detailing here. The erosion of community, the breakdown of the extended family, the pressures on marriage relationships, the harried lives of nuclear families still intact and the growing sense of insecurity even in the midst of relative wealth have all combined to create an emotional milieu in which calm, attuned parenting is becoming alarmingly difficult. The result being successive generations of children in alienation, drug use and violence — what Robert Bly has astutely described as “the rage of the unparented.” Bly notes in The Sibling Society that “in 1935 the average working man had forty hours a week free, including Saturday. By 1990, it was down to seventeen hours. The twenty-three lost hours of free time a week since 1935 are the very hours in which the father could be a nurturing father, and find some center in himself, and the very hours in which the mother could feel she actually has a husband.” These patterns characterize not only the earlyyears of parenting, but entire childhoods. “Family meals, talks, reading together no longer take place,” writes Bly. “What the young need — stability, presence, attention, advice, good psychic food, unpolluted stories — is exactly what the sibling society won’t give them.

When I introduce myself as a card-carrying Libertarian, more often than not I get the same old response: 'Oh, you're the people who want to legalize drugs.' Well, not exactly. We're the people who understand that American taxpayers are paying absurd amounts of money to accomplish goals that could be met at a fraction of the cost. We're the people who think it's ridiculous that the majority of the growth in our prison populations in this country is due to slamming people in jail just because they were caught using drugs. We're the ones who understand that so much of the crime on the streets of our country is drug-related--crime that would largely disappear if the massive profits brought on by drug criminalization were eliminated. We're the party that understands that you can reduce drug usage more efficiently, and at a lower cost, through treatment than through law enforcement.

Bud, you had to bribe the shit out of numerous Shanghai cops. There was no reason to economize here. Bud had a rich and boundless career ahead of him, vaulting up a hierarchy of extremely dangerous drug-related occupations for which decoy served as a paid audition of sorts. A start weapons system was a wise investment.

In 2012, I turned fifty-six. Hugh and his longtime girlfriend took me out to dinner. On the way home I remembered a bit of old folklore—probably you’ve heard it—about how to boil a frog. You put it in cold water, then start turning up the heat. If you do it gradually, the frog is too stupid to jump out. I don’t know if it’s true or not, but I decided it was an excellent metaphor for growing old. When I was a teenager, I looked at over-fifties with pity and unease: they walked too slow, they talked too slow, they watched TV instead of going out to movies and concerts, their idea of a great party was hotpot with the neighbors and tucked into bed after the eleven o’clock news. But—like most other fifty-, sixty-, and seventysomethings who are in relative good health—I didn’t mind it so much when my turn came. Because the brain doesn’t age, although its ideas about the world may harden and there’s a greater tendency to run off at the mouth about how things were in the good old days. (I was spared that, at least, because most of my so-called good old days had been spent as a full-bore, straight-on-for-Texas drug addict.) I think for most people, life’s deceptive deliriums begin to fall away after fifty. The days speed up, the aches multiply, and your gait slows down, but there are compensations. In calmness comes appreciation, and—in my case—a determination to be as much of a do-right-daddy as possible in the time I had left. That meant ladling out soup once a week at a homeless shelter in Boulder, and working for three or four political candidates with the radical idea that Colorado should not be paved over.

If we can figure out at the age of five which kids are going to be addicts and which ones aren’t, that tells us something fundamental about drug addiction. “Their relative maladjustment,” the study found, “precedes the initiation of drug use.” Indeed, “Problem drug use is a symptom, not a cause, of personal and social maladjustment.

In 2002, a team of researchers at the University of Washington decided to take the defenses of the drug war seriously, by subjecting the arguments to empirical testing in a major study of drug-law enforcement in a racially mixed city—Seattle.88 The study found that, contrary to the prevailing “common sense,” the high arrest rates of African Americans in drug-law enforcement could not be explained by rates of offending; nor could they be explained by other standard excuses, such as the ease and efficiency of policing open-air drug markets, citizen complaints, crime rates, or drug-related violence. The study also debunked the assumption that white drug dealers deal indoors, making their criminal activity more difficult to detect.

Educated, well-to-do Baby Boomers are disciplined in their hedonism, careful that their peccadillos don’t impede their scramble for success. For the most part, the rich have developed a relatively safe and moderate approach to drugs, and for the few who haven’t, well, there’s professional help. Decriminalization of marijuana won’t hurt the strong. But what about the weak? Kids who use marijuana regularly get lower test scores, are more likely to drop out of high school, and are less likely to go to college. And who are they? A 2011 study reports that children of parents who have not completed high school are twice as likely to smoke marijuana as children of those who have completed college. Again, new freedoms harm the vulnerable. The

Type A reactions are dose dependent, common, and related to the pharmacological effects of the drug. Type B reactions are allergic or idiosyncratic reactions; they are not dose dependent and are usually not predictable or preventable. Type C reactions are related to the cumulative dose of the medication; they are dose and time related, and they are relatively uncommon.

The UK needs a post Brexit US trade deal like a hole in the head. Given America's out-of-control opioid crisis, fuelled by prescription drug addiction, along with an obesity epidemic like the world has never seen, why on earth would the UK want to open its doors to US healthcare companies ? So that they can wreak untold havoc and destroy our National Health Service ? No thanks !

The new Anti-Drug Abuse Act authorized public housing authorities to evict any tenant who allows any form of drug-related criminal activity to occur on or near public housing premises and eliminated many federal benefits, including student loans, for anyone convicted of a drug offense. The act also expanded use of the death penalty for serious drug-related offenses and imposed new mandatory minimums for drug offenses, including a five-year mandatory minimum for simple possession of cocaine base—with no evidence of intent to sell. Remarkably, the penalty would apply to first-time offenders. The severity of this punishment was unprecedented in the federal system. Until 1988, one year of imprisonment had been the maximum for possession of any amount of any drug.

This one girl here, Devon, she’s from Detroit. She’s brand-new too. One day I was about to leave to the grocery store, which is like a ten-minute walk away. She asked me to pick up a sandwich for her (which was kind of annoying), so I was like, “Why don’t you come with me?” She was like, “I can’t, ’cause I can’t walk very far.” I was like, “It’s not even ten minutes. Come on, don’t be lazy—if anything it’ll be a mini workout.” She was like, “Ever since I got shot, it hurts when I walk uphill.” (The walk on the way back is pretty much all on an incline.) I asked her why she got shot. I thought . . . Detroit? Ghetto, right? Probably domestic abuse, or a drug-related thing. She goes, “I got in a fight over a parking space, and the guy shot me in both of my knees.

By the end of the twentieth century Interpol was ranking art crime as one of the world’s most profitable criminal activities, second only to drug smuggling and weapons dealing. The three activities were related: Drug pushers were moving stolen and smuggled art down the same pipelines they used for narcotics, and terrorists were using looted antiquities to fund their activities. This latter trend began in 1974, when the IRA stole $32 million worth of paintings by Rubens, Goya, and Vermeer. In 2001, the Taliban looted the Kabul museum and “washed” the stolen works in Switzerland. Stolen art was much more easily transportable than drugs or arms. A customs canine, after all, could hardly be expected to tell the difference between a crap Kandinksy and a credible one.

Trip Advisor: Travel the World with Haiku [D] Jerusalem, Israel Jews pray motionless and the Western Wall shakes. It's all relative. Capetown, South Africa And the coloured girls say, 'We're not Africaans, we're English.' In a total Africaans accent. Bulls Bay, Jamaica Weed, rum, guava jelly, Reggae, Marley, Red Stripe beer, O Baby, jerk that chicken. Istanbul, Turkey I asked my driver, 'Why do you believe in Allah?' He answers: 'If not, He hit me!' Cairo, Egypt Cairo International Airport, Porter drops my bags six times. Descendents of the Pharaohs, my ass. Santorini Island, Greece Greeks are like the current, They push you over and then Try to suck you in. Christiania, Denmark One thousand drug dealers, Five hundred thousand tourists. Alway$ Chri$tma$ here.*

I'm just asking you to accept that there are some people who will go to extraordinary lengths to cover up the facts that they are abusing children. What words are there to describe what happened to me, what was done to me? Some call it ritual abuse, others call it organised abuse. There are those that call it satanic. I've heard all the phrases, not just in relation to me, but also with regard to those I work with and try to help. Do you know what I think? It doesn't matter how you dress it up, it doesn't matter what label you put on it. It is abuse, pure and simple. It is adults abusing children. It is adults deciding - actually making a conscious decision, a conscious choices that what they want, what they convince themselves they need, is more important than anything else; certainly more important than the safety or feelings or sanity of a child. However, there can be differences which are layered on top of that abuse. I'm not saying that some abuse is worse than others, or that someone 'wins' the competition to have the worst abuse inflicted on them, but ritual and organised abuse is at the extreme end of the spectrum. If we try to think of a continuum where there are lots of different things imposed on children (or, for that matter, anyone who is forced into these things — and that force can take many forms, it can be threats and promises, as well as kicks and punches), then ritual and organised abuse is intense and complicated. It often involves multiple abusers of both sexes. There can be extreme violence, mind control, systematic torture and even, in some cases, a complex belief system which is sometimes described as religion. I say 'described as' religion because, to me, I think that when this aspect is involved, it is window dressing. I'm not religious. I cried many times for God to save me. I was always ignored — how could I believe? However, I think that ritual abusers who do use religious imagery or 'beliefs' are doing so to justify it all to themselves, or to confuse the victim, or to hide their activities. Ritual abuse is highly organised and, obviously, secretive. It is often linked with other major crimes such as child pornography, child prostitution, the drugs industry, trafficking, and many other illegal and heinous activities. Ritual abuse is organised sexual, physical and psychological abuse, which can be systematic and sustained over a long period of time. It involves the use of rituals - things which the abusers 'need' to do, or 'need' to have in place - but it doesn't have to have a belief system. There doesn't have to be God or the Devil, or any other deity for it to be considered 'ritual'. It involves using patterns of learning and development to keep the abuse going and to make sure the child stays quiet.

As much as they were concerned about the police, the Panthers also took seriously the threat of crime and sought to address the fears of the community they served. With this in mind, they organized Seniors Against a Fearful Environment (SAFE), an escort and bussing service in which young Black people accompanied the elderly on their business around the city. In Los Angeles, when the Party opened an office on Central Avenue, they immediately set about running the drug dealers out of the area. And in Philadelphia, neighbors reported a decrease in violent crime after the Party opened their office, and an increase after the office closed. There, the BPP paid particular attention to gang violence, organizing truces and recruiting gang members to help with the survival programs. It may be that the Panthers reduced crime by virtue of their very existence. Crime, and gang violence especially, dropped during the period of their activity, in part (in the estimate of sociologist Lewis Yablonsky) because the BPP and similar groups “channeled young black and Chicano youth who might have participated in gangbanging violence into relatively positive efforts for social change through political activities.

The neurological research shows something truly remarkable: If a person keeps taking the same substance, his or her brain keeps firing the same circuits in the same way—in effect, memorizing what the substance does. The person can easily become conditioned to the effect of a particular pill or injection from associating it with a familiar internal change from past experience. Because of this kind of conditioning, when the person then takes a placebo, the same hardwired circuits will fire as when he or she took the drug. An associative memory elicits a subconscious program that makes a connection between the pill or injection and the hormonal change in the body, and then the program automatically signals the body to make the related chemicals found in the drug. . . . Isn’t that amazing? Benedetti

The pleasure you get from task completion is powerful, but it has a short half-life. It does not linger to sustain you over the days to come. Enjoyment of task completion fades surprisingly fast, just like a drug high. That is because there is no heart in it, no warm, glowing feeling of connection to the world and other people. It is a sugar high compared to the sustaining nutrients of relational, experiential living.

Whatever the evolutionary precursors of drug use are, a permanently “drug-free” human culture has yet to be discovered. Like music, language, art, and tool use, the pursuit of altered states of consciousness is a human universal. With access to few alternatives, Siberian shamans imbibe reindeer and human urine to maximize the psychedelic yield of Amanita muscaria mushrooms (the metabolite that is excreted may be stronger than the substance initially ingested); on nearly the opposite side of the world, New Zealanders party with untested “research chemicals” synthesized by Chinese chemists. Drug use spans time and culture. It is a rare human who has never taken a drug to alter her mood; statistically, it is non-users who are abnormal. Indeed, today, around two thirds of Americans over 12 have had at least one drink in the last year, and 1 in 5 are current smokers. (In the 1940s and ’50s, a whopping 67% of men smoked.) Among people ages 21 to 25, 60% have taken an illegal drug at least once—overwhelmingly marijuana—and 20% have taken one in the past month. Moreover, around half of us could suffer from physical withdrawal symptoms if denied our daily coffee. While Americans are relatively prodigious drug users—topping the charts in the use of many substances—we are far from alone in our psychoactive predilections.

In the year 2000, wars caused the deaths of 310,000 individuals, and violent crime killed another 520,000. Each and every victim is a world destroyed, a family ruined, friends and relatives scarred for life. Yet from a macro perspective these 830,000 victims comprised only 1.5 per cent of the 56 million people who died in 2000. That year 1.26 million people died in car accidents (2.25 per cent of total mortality) and 815,000 people committed suicide (1.45 per cent).4 The figures for 2002 are even more surprising. Out of 57 million dead, only 172,000 people died in war and 569,000 died of violent crime (a total of 741,000 victims of human violence). In contrast, 873,000 people committed suicide.5 It turns out that in the year following the 9/11 attacks, despite all the talk of terrorism and war, the average person was more likely to kill himself than to be killed by a terrorist, a soldier or a drug dealer.

You’ve probably also noted the impacts of virtual distraction on your own and others’ behaviors: memory loss, inability to concentrate, being asked to repeat what you just said, miscommunication the norm, getting lost online and wasting time you don’t have, withdrawing from the real world. The list of what’s being lost is a description of our best human capacities—memory, meaning, relating, thinking, learning, caring. There is no denying the damage that’s been done to humans as technology took over—our own Progress Trap. The impact on children’s behavior is of greatest concern for its present and future implications. Dr. Nicolas Kardaras, a highly skilled physician in rehabilitation, is author of Glow Kids: How Screen Addiction Is Hijacking Our Kids—and How to Break the Trance. He describes our children’s behavior in ways that I notice in my younger grandchildren: “We see the aggressive temper tantrums when the devices are taken away and the wandering attention spans when children are not perpetually stimulated by their hyper-arousing devices. Worse, we see children who become bored, apathetic, uninteresting and uninterested when not plugged in.”17 These very disturbing behaviors are not just emotional childish reactions. Our children are behaving as addicts deprived of their drug. Brain imaging studies show that technology stimulates brains just like cocaine does.

1)    The woman has intuitive feelings that she is at risk. 2)    At the inception of the relationship, the man accelerated the pace, prematurely placing on the agenda such things as commitment, living together, and marriage. 3)    He resolves conflict with intimidation, bullying, and violence. 4)    He is verbally abusive. 5)    He uses threats and intimidation as instruments of control or abuse. This includes threats to harm physically, to defame, to embarrass, to restrict freedom, to disclose secrets, to cut off support, to abandon, and to commit suicide. 6)    He breaks or strikes things in anger. He uses symbolic violence (tearing a wedding photo, marring a face in a photo, etc.). 7)    He has battered in prior relationships. 8)    He uses alcohol or drugs with adverse affects (memory loss, hostility, cruelty). 9)    He cites alcohol or drugs as an excuse or explanation for hostile or violent conduct (“That was the booze talking, not me; I got so drunk I was crazy”). 10)   His history includes police encounters for behavioral offenses (threats, stalking, assault, battery). 11)   There has been more than one incident of violent behavior (including vandalism, breaking things, throwing things). 12)   He uses money to control the activities, purchase, and behavior of his wife/partner. 13)   He becomes jealous of anyone or anything that takes her time away from the relationship; he keeps her on a “tight leash,” requires her to account for her time. 14)   He refuses to accept rejection. 15)   He expects the relationship to go on forever, perhaps using phrases like “together for life;” “always;” “no matter what.” 16)   He projects extreme emotions onto others (hate, love, jealousy, commitment) even when there is no evidence that would lead a reasonable person to perceive them. 17)   He minimizes incidents of abuse. 18)   He spends a disproportionate amount of time talking about his wife/partner and derives much of his identity from being her husband, lover, etc. 19)   He tries to enlist his wife’s friends or relatives in a campaign to keep or recover the relationship. 20)   He has inappropriately surveilled or followed his wife/partner. 21)   He believes others are out to get him. He believes that those around his wife/partner dislike him and encourage her to leave. 22)   He resists change and is described as inflexible, unwilling to compromise. 23)   He identifies with or compares himself to violent people in films, news stories, fiction, or history. He characterizes the violence of others as justified. 24)   He suffers mood swings or is sullen, angry, or depressed. 25)   He consistently blames others for problems of his own making; he refuses to take responsibility for the results of his actions. 26)   He refers to weapons as instruments of power, control, or revenge. 27)   Weapons are a substantial part of his persona; he has a gun or he talks about, jokes about, reads about, or collects weapons. 28)   He uses “male privilege” as a justification for his conduct (treats her like a servant, makes all the big decisions, acts like the “master of the house”). 29)   He experienced or witnessed violence as a child. 30)   His wife/partner fears he will injure or kill her. She has discussed this with others or has made plans to be carried out in the event of her death (e.g., designating someone to care for children).

A system of justice does not need to pursue retribution. If the purpose of drug sentencing is to prevent harm, all we need to do is decide what to do with people who pose a genuine risk to society or cause tangible harm. There are perfectly rational ways of doing this; in fact, most societies already pursue such policies with respect to alcohol: we leave people free to drink and get inebriated, but set limits on where and when. In general, we prosecute drunk drivers, not inebriated pedestrians. In this sense, the justice system is in many respects a battleground between moral ideas and evidence concerning how to most effectively promote both individual and societal interests, liberty, health, happiness and wellbeing. Severely compromising this system, insofar as it serves to further these ideals, is our vacillation or obsession with moral responsibility, which is, in the broadest sense, an attempt to isolate the subjective element of human choice, an exercise that all too readily deteriorates into blaming and scapegoating without providing effective solutions to the actual problem. The problem with the question of moral responsibility is that it is inherently subjective and involves conjecture about an individuals’ state of mind, awareness and ability to act that can rarely if ever be proved. Thus it involves precisely the same type of conjecture that characterizes superstitious notions of possession and the influence of the devil and provides no effective means of managing conduct: the individual convicted for an offence or crime considered morally wrong is convicted based on a series of hypotheses and probabilities and not necessarily because he or she is actually morally wrong. The fairness and effectiveness of a system of justice based on such hypotheses is highly questionable particularly as a basis for preventing or reducing drug use related harm. For example, with respect to drugs, the system quite obviously fails as a deterrent and the system is not organised to ‘reform’ the offender much less to ensure that he or she has ‘learned a lesson’; moreover, the offender does not get an opportunity to make amends or even have a conversation with the alleged victim. In the case of retributive justice, the justice system is effectively mopping up after the fact. In other words, as far as deterrence is concerned, the entire exercise of justice becomes an exercise based on faith, rather than one based on evidence.

I spent the rest of the film miserable, hardly seeing it. Or, rather, I was seeing it but in a wholly different way: not the ecstatic prodigy; not the mystic, the solitary, heroically quitting the concert stage at the height of his fame to retreat into the snows of Canada - but the hypochondriac, the recluse, the isolate. The paranoiac. The pill popper. No: the drug addict. The obsessive: glove-wearing, germ-phobic, bundled year round with scarves, twitching and racked with compulsions. The hunched nocturnal weirdo so unsure how to conduct even the most basic relations with people that (in an interview which I was suddenly finding torturous) he had asked a recording engineer if they couldn't go to a lawyer and legally be declared brothers - sort of the tragic, late-genius version of Tom Cable and me pressing cut thumbs in the darkened back-yard of his house, or - even more strangely - Boris seizing my hand, bloody at the knuckles where I'd punched him on the playground, and pressing it to his own bloodied mouth.

IN THE 1960S, WHEN I became a beat cop in San Diego, manufacturing, selling, possessing, or using “dangerous drugs” or “controlled substances” were all violations of the law. But there was no “war,” per se, on drug-law violators. We made the occasional pot bust, less frequently a heroin or cocaine pinch. Drug enforcement was viewed by many of us almost as an ancillary duty. You’d stumble across an offender on a traffic stop or at a loud-party call. Mostly, you were on the prowl for non-drug-related crime: a gas station or liquor store stickup series, a burglary-fencing ring, an auto theft “chop shop” operation. Undercover narcs, of course, worked dope full time, chasing users and dealers. They played their snitches, sat on open-air markets, interrupted hand-to-hand dealing, and squeezed small-time street dealers in the climb up the chain to “Mister Big.” But because most local police forces devoted only a small percentage of personnel to French Connection–worthy cases, and because there were no “mandatory minimum” sentences (passed by Congress in 1986 to strip “soft on crime” judges of sentencing discretion on a host of drug offenses), and because street gangs fought over, well, streets—as in neighborhood turf (and cars and girlfriends)—not drug markets, most of our jails and prisons still had plenty of room for violent, predatory criminals. The point is, although they certainly did not turn their backs on drug offenses, the country’s police were not at “war” with users and dealers. And though their government-issued photos may have adorned the wall behind the police chief’s desk, a long succession of US presidents stayed out of the local picture.

The most notorious story is the Trovan antibiotic study conducted by Pfizer in Kano, Nigeria, during a meningitis epidemic. An experimental new antibiotic was compared, in a randomised trial, with a low dose of a competing antibiotic that was known to be effective. Eleven children died, roughly the same number from each group. Crucially, the participants were apparently not informed about the experimental nature of the treatments, and moreover, they were not informed that a treatment known to be effective was available, immediately, from Médecins sans Frontières next door at the very same facility. Pfizer argued in court – successfully – that there was no international norm requiring it to get informed consent for a trial involving experimental drugs in Africa, so the cases relating to the trial should be heard in Nigeria only. That’s a chilling thing to hear a company claim about experimental drug trials, and it was knocked back in 2006 when the Nigerian Ministry of Health released its report on the trial. This stated that Pfizer had violated Nigerian law, the UN Convention on the Rights of the Child and the Declaration of Helsinki.

The Undivided Wholeness of All Things Most mind-boggling of all are Bohm's fully developed ideas about wholeness. Because everything in the cosmos is made out of the seamless holographic fabric of the implicate order, he believes it is as meaningless to view the universe as composed of "parts, " as it is to view the different geysers in a fountain as separate from the water out of which they flow. An electron is not an "elementary particle. " It is just a name given to a certain aspect of the holomovement. Dividing reality up into parts and then naming those parts is always arbitrary, a product of convention, because subatomic particles, and everything else in the universe, are no more separate from one another than different patterns in an ornate carpet. This is a profound suggestion. In his general theory of relativity Einstein astounded the world when he said that space and time are not separate entities, but are smoothly linked and part of a larger whole he called the space-time continuum. Bohm takes this idea a giant step further. He says that everything in the universe is part of a continuum. Despite the apparent separateness of things at the explicate level, everything is a seamless extension of everything else, and ultimately even the implicate and explicate orders blend into each other. Take a moment to consider this. Look at your hand. Now look at the light streaming from the lamp beside you. And at the dog resting at your feet. You are not merely made of the same things. You are the same thing. One thing. Unbroken. One enormous something that has extended its uncountable arms and appendages into all the apparent objects, atoms, restless oceans, and twinkling stars in the cosmos. Bohm cautions that this does not mean the universe is a giant undifferentiated mass. Things can be part of an undivided whole and still possess their own unique qualities. To illustrate what he means he points to the little eddies and whirlpools that often form in a river. At a glance such eddies appear to be separate things and possess many individual characteristics such as size, rate, and direction of rotation, et cetera. But careful scrutiny reveals that it is impossible to determine where any given whirlpool ends and the river begins. Thus, Bohm is not suggesting that the differences between "things" is meaningless. He merely wants us to be aware constantly that dividing various aspects of the holomovement into "things" is always an abstraction, a way of making those aspects stand out in our perception by our way of thinking. In attempts to correct this, instead of calling different aspects of the holomovement "things, " he prefers to call them "relatively independent subtotalities. "10 Indeed, Bohm believes that our almost universal tendency to fragment the world and ignore the dynamic interconnectedness of all things is responsible for many of our problems, not only in science but in our lives and our society as well. For instance, we believe we can extract the valuable parts of the earth without affecting the whole. We believe it is possible to treat parts of our body and not be concerned with the whole. We believe we can deal with various problems in our society, such as crime, poverty, and drug addiction, without addressing the problems in our society as a whole, and so on. In his writings Bohm argues passionately that our current way of fragmenting the world into parts not only doesn't work, but may even lead to our extinction.

A conversation that took place between two American women describes this intimate relationship between physical and immaterial forms of dying. One of these women came to see me soon after her only child, a twenty-year-old son, died from an accidental drug overdose. We spoke of ways to help her live with this tragic loss. About two years later, this woman’s best friend found herself struggling through a very painful divorce. The first woman explained to her friend: My son is never coming back. I entertain no fantasies about this. My relationship to myself and to how I relate to the world has changed forever. But the same is true for you. Your sense of who you are, of who is there for you and who you will travel through life with, has also changed forever. You too need to grieve a death. You are thinking that you have to come to terms with this intolerable situation outside of yourself. But just as I had to allow myself to die after my son’s death, you must die to a marriage that you once had. We grieve for the passing of what we had, but also for ourselves, for our own deaths. The profound misfortune of the death of this woman’s son opened her heart to an exploration of impermanence and death that went far beyond her own personal story.

You’re just living a normal life — never been sick, never been unhealthy, and all of a sudden you are fighting for your life. And this is happening to individuals every day,” Thomas said. The infection went to her blood stream and bone marrow and caused septic shock and organ failure. After undergoing multiple surgeries including a bone-marrow transplant and a “never-ending cycle of antibiotics,” she survived the ordeal.1​➔​ Thomas survived relatively intact. Some don’t, losing limbs in a desperate bid to stop the infection from spreading and then living permanently debilitated lives. Others aren’t even that “lucky.” Denis

They are more inward looking by nature, and for them the outward movement into form is minimal. They would rather return home than go out. They have no desire to get strongly involved in or change the world. If they have any ambitions, they usually don’t go beyond finding something to do that gives them a degree of independence. Some of them find it hard to fit into this world. Some are lucky enough to find a protective niche where they can lead a relatively sheltered life, a job that provides them with a regular income or a small business of their own. Some may feel drawn toward living in a spiritual community or monastery. Others may become dropouts and live on the margins of a society they feel they have little in common with. Some turn to drugs because they find living in this world too painful. Others eventually become healers or spiritual teachers, that is to say, teachers of Being. In past ages, they would probably have been called contemplatives. There is no place for them, it seems, in our contemporary civilization. On the arising new earth, however, their role is just as vital as that of the creators, the doers, the reformers. Their function is to anchor the frequency of the new consciousness on this planet. I call them the frequency-holders. They are here to generate consciousness through the activities of daily life, through their interactions with others as well as through “just being.” In this way, they endow the seemingly insignificant with profound meaning. Their task is to bring spacious stillness into this world by being absolutely present in whatever they do. There is consciousness and therefore quality in what they do, even the simplest task. Their purpose is to do everything in a sacred manner. As each human being is an integral part of the collective human consciousness, they affect the world much more deeply than is visible on the surface of their lives.

So why did strong, modern states not emerge in Latin America as they did in Europe? If there is a single factor that explains this outcome, it is the relative absence of interstate war in the New World. We have seen how central war and preparation for war were in the creation of modern states in China, Prussia, and France. Even in the United States, state building has been driven by national security concerns throughout the twentieth century. Though Europe has been remarkably peaceful since 1945, the prior centuries were characterized by high and endemic levels of interstate violence. Over the past two centuries, the major political acts that reconfigured the map of Europe—the French Revolution and Napoleonic Wars, and the wars of unification of Italy and Germany—all involved high levels of violence, culminating in the two world wars of the twentieth century. There has been plenty of violence in Latin America, of course: today the region is infested with drug cartels, street gangs, and a few remaining guerrilla groups, all of which inflict enormous sufferings on local populations. But in comparison with Europe, Latin America has been a peaceful place in terms of interstate war. This has been a blessing for the region, but it has also left a problematic institutional legacy.

S-adenosyl-methionine (SAMe) is a natural derivative of an amino acid normally produced by the body, and it plays a role in methylation (see Chapter 5). Levels of SAMe in the body often become depleted by middle age. Multiple clinical trials have shown that SAMe provides substantial benefit for patients with depression. This effect occurs relatively quickly, unlike the requirement to build up levels in the bloodstream that accompanies some prescription drugs for depression. It is, therefore, an effective, natural, and quick-acting treatment for mild depression. Human trials have also shown benefits for strengthening the liver and for relief from osteoarthritis.

My time at Parklife got me thinking about drug users who do not have access to such drug-related services and education. The amount of money required to attend a festival, especially when entrance ticket, travel, and food costs are included, is prohibitive for most. Consequently, it is not surprising that the highest drug-related mortality rates in the United States are found in regions, including Appalachia and Oklahoma, with lower rates of university completion and greater economic distress.12 Attention-grabbing headlines claiming that opioids (or any other drug) are killing people are wrong. Ignorance and poverty are killing people, just as they have for centuries.

Though diagnosis is unquestionably critical in treatment considerations for many severe conditions with a biological substrate (for example, schizophrenia, bipolar disorders, major affective disorders, temporal lobe epilepsy, drug toxicity, organic or brain disease from toxins, degenerative causes, or infectious agents), diagnosis is often counterproductive in the everyday psychotherapy of less severely impaired patients. Why? For one thing, psychotherapy consists of a gradual unfolding process wherein the therapist attempts to know the patient as fully as possible. A diagnosis limits vision; it diminishes ability to relate to the other as a person. Once we make a diagnosis, we tend to selectively inattend to aspects of the patient that do not fit into that particular diagnosis, and correspondingly overattend to subtle features that appear to confirm an initial diagnosis. What’s more, a diagnosis may act as a self-fulfilling prophecy. Relating to a patient as a “borderline” or a “hysteric” may serve to stimulate and perpetuate those very traits. Indeed, there is a long history of iatrogenic influence on the shape of clinical entities, including the current controversy about multiple-personality disorder and repressed memories of sexual abuse. And keep in mind, too, the low reliability of the DSM personality disorder category (the very patients often engaging in longer-term psychotherapy).

Low inhibition and anxiety “There was no fear, no worry, no sense of reputation and competition, no envy, none of these things which in varying degrees have always been present in my work.” “A lowered sense of personal danger; I don’t feel threatened anymore, and there is no feeling of my reputation being at stake.” “Although doing well on these problems would be fine, failure to get ahead on them would have been threatening. However, as it turned out, on this afternoon the normal blocks in the way of progress seemed to be absent.” 2. Capacity to restructure problem in a larger context “Looking at the same problem with [psychedelic] materials, I was able to consider it in a much more basic way, because I could form and keep in mind a much broader picture.” “I could handle two or three different ideas at the same time and keep track of each.” “Normally I would overlook many more trivial points for the sake of expediency, but under the drug, time seemed unimportant. I faced every possible questionable issue square in the face.” “Ability to start from the broadest general basis in the beginning.” “I returned to the original problem…. I tried, I think consciously, to think of the problem in its totality, rather than through the devices I had used before.” 3. Enhanced fluency and flexibility of ideation “I began to work fast, almost feverishly, to keep up with the flow of ideas.” “I began to draw …my senses could not keep up with my images …my hand was not fast enough …my eyes were not keen enough…. I was impatient to record the picture (it has not faded one particle). I worked at a pace I would not have thought I was capable of.” “I was very impressed with the ease with which ideas appeared (it was virtually as if the world is made of ideas, and so it is only necessary to examine any part of the world to get an idea). I also got the feeling that creativity is an active process in which you limit yourself and have an objective, so there is a focus about which ideas can cluster and relate.” “I dismissed the original idea entirely, and started to approach the graphic problem in a radically different way. That was when things started to happen. All kinds of different possibilities came to mind….” “And the feeling during this period of profuse production was one of joy and exuberance…. It was the pure fun of doing, inventing, creating, and playing.

More than 2 million people found themselves behind bars at the turn of the twenty-first century, and millions more were relegated to the margins of mainstream society, banished to a political and social space not unlike Jim Crow, where discrimination in employment, housing, and access to education was perfectly legal, and where they could be denied the right to vote. The system functioned relatively automatically, and the prevailing system of racial meanings, identities, and ideologies already seemed natural. Ninety percent of those admitted to prison for drug offenses in many states were black or Latino, yet the mass incarceration of communities of color was explained in race-neutral terms, an adaptation to the needs and demands of the current political climate. The New Jim Crow was born.

Absinthe, or wormwood, the liquorice-flavoured, plant-based liqueur, had been popular in France throughout the 19th century. Though the drink was of Swiss origin, heavy tax on import had encouraged H.L. Pernod to start producing it commercially in France at the end of the 18th century.12 It was a tremendous success, and as the 19th century unfolded, its popularity soared. Exceedingly potent, it was closer to a soft drug than a drink. ‘The drunkenness it gives does not resemble any known drunkenness,’ bemoaned Alfred Delvau. ‘It makes you lose your footing right away […] You think you are headed towards infinity, like all great dreamers, and you are only headed towards incoherence.’13 In excess, absinthe could have a fatal effect on the nervous system, and by the time Maria started attending the bars and cafés where it was served, it had become a national curse. A favourite drink among the working classes precisely because of its relative cheapness for the effect produced, absinthe became the scapegoat for a host of social ills, not least the Commune. (...) Absinthe found a dedicated following among artists, writers and poets (including Charles Baudelaire), for whom the liquor became the entrancing ‘green fairy’. Its popularity in these circles was due primarily to its intoxicating effect, but also because its consumption was accompanied by a curious ritual which appealed to quirky individuals with a taste for the extraordinary. To counteract the drink’s inherent bitterness, a sugar lump was placed on a special spoon with a hole in it, which was held above the glass while water was poured over it, with the effect of sweetening the absinthe. Not surprisingly, absinthe flowed freely through the bars and cafés of Montmartre.

The strongest evidence yet was published in 2010. In a painstaking long-term study, much larger and more thorough than anything done previously, an international team of researchers tracked one thousand children in New Zealand from birth until the age of thirty-two. Each child’s self-control was rated in a variety of ways (through observations by researchers as well as in reports of problems from parents, teachers, and the children themselves). This produced an especially reliable measure of children’s self-control, and the researchers were able to check it against an extraordinarily wide array of outcomes through adolescence and into adulthood. The children with high self-control grew up into adults who had better physical health, including lower rates of obesity, fewer sexually transmitted diseases, and even healthier teeth. (Apparently, good self-control includes brushing and flossing.) Self-control was irrelevant to adult depression, but its lack made people more prone to alcohol and drug problems. The children with poor self-control tended to wind up poorer financially. They worked in relatively low-paying jobs, had little money in the bank, and were less likely to own a home or have money set aside for retirement. They also grew up to have more children being raised in single-parent households, presumably because they had a harder time adapting to the discipline required for a long-term relationship. The children with good self-control were much more likely to wind up in a stable marriage and raise children in a two-parent home. Last, but certainly not least, the children with poor self-control were more likely to end up in prison. Among those with the lowest levels of self-control, more than 40 percent had a criminal conviction by the age of thirty-two, compared with just 12 percent of the people who had been toward the high end of the self-control distribution in their youth.

Nobody ever talked about what a struggle this all was. I could see why women used to die in childbirth. They didn't catch some kind of microbe, or even hemorrhage. They just gave up. They knew that if they didn't die, they'd be going through it again the next year, and the next. I couldn't understand how a woman might just stop trying, like a tired swimmer, let her head go under, the water fill her lungs. I slowly massaged Yvonne's neck, her shoulders, I wouldn't let her go under. She sucked ice through threadbare white terry. If my mother were here, she'd have made Melinda meek cough up the drugs, sure enough. "Mamacita, ay," Yvonne wailed. I didn't know why she would call her mother. She hated her mother. She hadn't seen her in six years, since the day she locked Yvonne and her brother and sisters in their apartment in Burbank to go out and party, and never came back. Yvonne said she let her boyfriends run a train on her when she was eleven. I didn't even know what that meant. Gang bang, she said. And still she called out, Mama. It wasn't just Yvonne. All down the ward, they called for their mothers. ... I held onto Yvonne's hands, and I imagined my mother, seventeen years ago, giving birth to me. Did she call for her mother?...I thought of her mother, the one picture I had, the little I knew. Karin Thorvald, who may or may not have been a distant relation of King Olaf of Norway, classical actress and drunk, who could recite Shakespeare by heart while feeding the chickens and who drowned in the cow pond when my mother was thirteen. I couldn't imagine her calling out for anyone. But then I realized, they didn't mean their own mothers. Not those weak women, those victims. Drug addicts, shopaholics, cookie bakers. They didn't mean the women who let them down, who failed to help them into womanhood, women who let their boyfriends run a train on them. Bingers and purgers, women smiling into mirrors, women in girdles, women in barstools. Not those women with their complaints and their magazines, controlling women, women who asked, what's in it for me? Not the women who watched TV while they made dinner, women who dyed their hair blond behind closed doors trying to look twenty-three. They didn't mean the mothers washing dishes wishing they'd never married, the ones in the ER, saying they fell down the stairs, not the ones in prison saying loneliness is the human condition, get used to it. They wanted the real mother, the blood mother, the great womb, mother of a fierce compassion, a woman large enough to hold all the pain, to carry it away. What we needed was someone who bled, someone deep and rich as a field, a wide-hipped mother, awesome, immense, women like huge soft couches, mothers coursing with blood, mothers big enough, wide enough, for us to hide in, to sink down to the bottom of, mothers who would breathe for is when we could not breathe anymore, who would fight for us, who would kill for us, die for us. Yvonne was sitting up, holding her breath, eyes bulging out. It was the thing she should not do. "Breathe," I said in her ear. "Please, Yvonne, try." She tried to breathe, a couple of shallow inhalations, but it hurt too much. She flopped back on the narrow bed, too tired to go on. All she could do was grip my hand and cry. And I thought of the way the baby was linked to her, as she was linked to her mother, and her mother, all the way back, insider and inside, knit into a chain of disaster that brought her to this bed, this day. And not only her. I wondered what my own inheritance was going to be. "I wish I was dead," Yvonne said into the pillowcase with the flowers I'd brought from home. The baby came four hours later. A girl, born 5:32 PM.

Addicts should not be coerced into treatment, since in the long term coercion creates more problems than it solves. On the other hand, for those addicts who opt for treatment, there must be a system of publicly funded recovery facilities with clean rooms, nutritious food, and access to outdoors and nature. Well-trained professional staff need to provide medical care, counseling, skills training, and emotional support. Our current nonsystem is utterly inadequate, with its patchwork of recovery homes run on private contracts and, here and there, a few upscale addiction treatment spas for the wealthy. No matter how committed their staff and how helpful their services may be, they are a drop in comparison to the ocean of vast need. In the absence of a coordinated rehabilitation system, the efforts of individual recovery homes are limited and occur in a vacuum, with no follow-up. It may be thought that the cost of such a drug rehabilitation and treatment system would be exorbitant. No doubt the financial expenses would be great — but surely less than the funds now freely squandered on the War on Drugs, to say nothing of the savings from the cessation of drug-related criminal activity and the diminished burden on the health care system.

was my first indication that the policies of Mamaw’s “party of the working man”—the Democrats—weren’t all they were cracked up to be. Political scientists have spent millions of words trying to explain how Appalachia and the South went from staunchly Democratic to staunchly Republican in less than a generation. Some blame race relations and the Democratic Party’s embrace of the civil rights movement. Others cite religious faith and the hold that social conservatism has on evangelicals in that region. A big part of the explanation lies in the fact that many in the white working class saw precisely what I did, working at Dillman’s. As far back as the 1970s, the white working class began to turn to Richard Nixon because of a perception that, as one man put it, government was “payin’ people who are on welfare today doin’ nothin’! They’re laughin’ at our society! And we’re all hardworkin’ people and we’re gettin’ laughed at for workin’ every day!”20 At around that time, our neighbor—one of Mamaw and Papaw’s oldest friends—registered the house next to ours for Section 8. Section 8 is a government program that offers low-income residents a voucher to rent housing. Mamaw’s friend had little luck renting his property, but when he qualified his house for the Section 8 voucher, he virtually assured that would change. Mamaw saw it as a betrayal, ensuring that “bad” people would move into the neighborhood and drive down property values. Despite our efforts to draw bright lines between the working and nonworking poor, Mamaw and I recognized that we shared a lot in common with those whom we thought gave our people a bad name. Those Section 8 recipients looked a lot like us. The matriarch of the first family to move in next door was born in Kentucky but moved north at a young age as her parents sought a better life. She’d gotten involved with a couple of men, each of whom had left her with a child but no support. She was nice, and so were her kids. But the drugs and the late-night fighting revealed troubles that too many hillbilly transplants knew too well. Confronted with such a realization of her own family’s struggle, Mamaw grew frustrated and angry. From that anger sprang Bonnie Vance the social policy expert: “She’s a lazy whore, but she wouldn’t be if she was forced to get a job”; “I hate those fuckers for giving these people the money to move into our neighborhood.” She’d rant against the people we’d see in the grocery store: “I can’t understand why people who’ve worked all their lives scrape by while these deadbeats buy liquor and cell phone coverage with our tax money.

The clinical hallmark of manic-depressive illness is its recurrent, episodic nature. Byron had this in an almost textbook manner, showing frequent and pronounced fluctuations in mood, energy, sleep patterns, sexual behavior, alcohol and other drug use, and weight (Byron also exhibited extremes in dieting, obsession with his weight, eccentric eating patterns, and excessive use of epsom salts). Although these changes in mood and behavior were dramatic and disruptive when they occurred, it is important to note that Byron was clinically normal most of the time; this, too, is highly characteristic of manic-depressive illness. An inordinate amount of confusion about whether someone does or does not have manic-depressive illness stems from the popular misconception that irrationality of mood and reason are stable rather than fluctuating features of the disease. Some assume that because an individual such as Byron was sane and in impressive control of his reason most of the time, that he could not have been "mad" or have suffered from a major mental illness. Lucidity and normal functioning are, however, perfectly consistent with-indeed, characteristic of-the phasic nature of manic-depressive illness. This is in contrast to schizophrenia, which is usually a chronic and relatively unrelenting illness characterized by, among other things, an inability to reason clearly.

Outlawing drugs in order to solve drug problems is much like outlawing sex in order to win the war against AIDS. We recognize that people will continue to have sex for nonreproductive reasons despite the laws and mores. Therefore, we try to make sexual practices as safe as possible in order to minimize the spread of the AIDS viruses. In a similar way, we continually try to make our drinking water, foods, and even our pharmaceutical medicines safer. The ubiquity of chemical intoxicants in our lives is undeniable evidence of the continuing universal need for safer medicines with such applications. While use may not always be for an approved medical purpose, or prudent, or even legal, it is fulfilling the relentless drive we all have to change the way we feel, to alter our behavior and consciousness, and, yes, to intoxicate ourselves. We must recognize that intoxicants are medicines, treatments for the human condition. Then we must make them as safe and risk free and as healthy as possible. Dream with me for a moment. What would be wrong if we had perfectly safe intoxicants? I mean drugs that delivered the same effects as our most popular ones but never caused dependency, disease, dysfunction, or death. Imagine an alcohol-type substance that never caused addiction, liver disease, hangovers, impaired driving, or workplace problems. Would you care to inhale a perfumed mist that is as enjoyable as marijuana or tobacco but as harmless as clean air? How would you like a pain-killer as effective as morphine but safer than aspirin, a mood enhancer that dissolves on your tongue and is more appealing than cocaine and less harmful than caffeine, a tranquilizer less addicting than Valium and more relaxing than a martini, or a safe sleeping pill that allows you to choose to dream or not? Perhaps you would like to munch on a user friendly hallucinogen that is as brief and benign as a good movie? This is not science fiction. As described in the following pages, there are such intoxicants available right now that are far safer than the ones we currently use. If smokers can switch from tobacco cigarettes to nicotine gum, why can’t crack users chew a cocaine gum that has already been tested on animals and found to be relatively safe? Even safer substances may be just around the corner. But we must begin by recognizing that there is a legitimate place in our society for intoxication. Then we must join together in building new, perfectly safe intoxicants for a world that will be ready to discard the old ones like the junk they really are. This book is your guide to that future. It is a field guide to that silent spring of intoxicants and all the animals and peoples who have sipped its waters. We can no more stop the flow than we can prevent ourselves from drinking. But, by cleaning up the waters we can leave the morass that has been the endless war on drugs and step onto the shores of a healthy tomorrow. Use this book to find the way.

In 2012, the U.S. government estimated that 660,000 Americans were using heroin and more than 3,000 dying of it every year because Mexico was boosting the supply.22 About a quarter of all people who try heroin will become dependent on it, according to government estimates,23 and the precise appeal of methamphetamine to Mexico’s Sinaloa drug cartel was that it was “ragingly addictive,” according to the New York Times.24 Forbes reports that there is “little doubt” that the heroin that killed Philip Seymour Hoffman came from Mexico.25 These aren’t “big city” problems: They’re Mexico-is-on-our-border problems. Missouri had 18 heroin overdose deaths in 2001; ten years later, there were 245.26 Heroin deaths in Minnesota shot from 3 to 98 between 1999 and 2013.27 Michigan saw fatal heroin overdoses surge from a few dozen a year in 2002 to more than 100 a year starting in 2009.28 In just one year, heroin-related fatalities in Connecticut nearly doubled, to 257 in 2013.29 Between 2007 and 2012, heroin use in the United States is estimated to have increased by almost 80 percent.30 And that’s just heroin. More than 40,000 Americans were killed from all illegal drug use in 2010, surpassing car accidents and shootings as a cause of death.31 The addicts who die may be the lucky ones. In 2001, a seventeen-year-old boy in New Jersey who scored 700 on the math SAT took a heroin overdose that left him unable to stand, walk, or bathe himself. His mother, a globetrotting executive with Citibank, was forced to quit her job and become his full-time caretaker. After a year of hospitalization and more than a decade of therapy, he still needs his mother to carry him to the toilet. He has no recollection of taking an overdose, but packets of heroin and marijuana were found stored in a secret compartment in his bedroom.32

I lost my first patient on a Tuesday. She was an eighty-two-year-old woman, small and trim, the healthiest person on the general surgery service, where I spent a month as an intern. (At her autopsy, the pathologist would be shocked to learn her age: “She has the organs of a fifty-year-old!”) She had been admitted for constipation from a mild bowel obstruction. After six days of hoping her bowels would untangle themselves, we did a minor operation to help sort things out. Around eight P.M. Monday night, I stopped by to check on her, and she was alert, doing fine. As we talked, I pulled from my pocket my list of the day’s work and crossed off the last item (post-op check, Mrs. Harvey). It was time to go home and get some rest. Sometime after midnight, the phone rang. The patient was crashing. With the complacency of bureaucratic work suddenly torn away, I sat up in bed and spat out orders: “One liter bolus of LR, EKG, chest X-ray, stat—I’m on my way in.” I called my chief, and she told me to add labs and to call her back when I had a better sense of things. I sped to the hospital and found Mrs. Harvey struggling for air, her heart racing, her blood pressure collapsing. She wasn’t getting better no matter what I did; and as I was the only general surgery intern on call, my pager was buzzing relentlessly, with calls I could dispense with (patients needing sleep medication) and ones I couldn’t (a rupturing aortic aneurysm in the ER). I was drowning, out of my depth, pulled in a thousand directions, and Mrs. Harvey was still not improving. I arranged a transfer to the ICU, where we blasted her with drugs and fluids to keep her from dying, and I spent the next few hours running between my patient threatening to die in the ER and my patient actively dying in the ICU. By 5:45 A.M., the patient in the ER was on his way to the OR, and Mrs. Harvey was relatively stable. She’d needed twelve liters of fluid, two units of blood, a ventilator, and three different pressors to stay alive. When I finally left the hospital, at five P.M. on Tuesday evening, Mrs. Harvey wasn’t getting better—or worse. At seven P.M., the phone rang: Mrs. Harvey had coded, and the ICU team was attempting CPR. I raced back to the hospital, and once again, she pulled through. Barely. This time, instead of going home, I grabbed dinner near the hospital, just in case. At eight P.M., my phone rang: Mrs. Harvey had died. I went home to sleep.

1. Do you recall anyone drinking or taking drugs or being involved in some other behavior that you now believe could be dysfunctional? 2. Did you avoid bringing friends to your home because of drinking or some other dysfunctional behavior in the home? 3. Did one of your parents make excuses for the other parent’s drinking or other behaviors? 4. Did your parents focus on each other so much that they seemed to ignore you? 5. Did your parents or relatives argue constantly? 6. Were you drawn into arguments or disagreements and asked to choose sides with one parent or relative against another? 7. Did you try to protect your brothers or sisters against drinking or other behavior in the family? 8. As an adult, do you feel immature? Do you feel like you are a child inside? 9. As an adult, do you believe you are treated like a child when you interact with your parents? Are you continuing to live out a childhood role with the parents? 10. Do you believe that it is your responsibility to take care of your parents’ feelings or worries? Do other relatives look to you to solve their problems? 11. Do you fear authority figures and angry people? 12. Do you constantly seek approval or praise but have difficulty accepting a compliment when one comes your way? 13. Do you see most forms of criticism as a personal attack? 14. Do you over commit yourself and then feel angry when others do not appreciate what you do? 15. Do you think you are responsible for the way another person feels or behaves? 16. Do you have difficulty identifying feelings? 17. Do you focus outside yourself for love or security? 18. Do you involve yourself in the problems of others? Do you feel more alive when there is a crisis? 19. Do you equate sex with intimacy? 20. Do you confuse love and pity? 21. Have you found yourself in a relationship with a compulsive or dangerous person and wonder how you got there? 22. Do you judge yourself without mercy and guess at what is normal? 23. Do you behave one way in public and another way at home? 24. Do you think your parents had a problem with drinking or taking drugs? 25. Do you think you were affected by the drinking or other dysfunctional behavior of your parents or family? If you answered yes to three or more of these questions, you may be suffering from the effects of growing up in an alcoholic or other dysfunctional family. As The Laundry List states, you can be affected even if you did not take a drink. Please read Chapter Two to learn more about these effects.

Correlation and causality. Why is it that throughout the animal kingdom and in every human culture, males account for most aggression and violence? Well, what about testosterone and some related hormones, collectively called androgens, a term that unless otherwise noted, I will use simplistically as synonymous with testosterone. In nearly all species, males have more circulating testosterone than do females, who secrete small amounts of androgens from the adrenal glands. Moreover, male aggression is most prevalent when testosterone levels are highest; adolescence and during mating season in seasonal breeders. Thus, testosterone and aggression are linked. Furthermore, there are particularly high levels of testosterone receptors in the amygdala, in the way station by which it projects to the rest of the brain, the bed nucleus of the stria terminalis, and in its major targets, the hypothalamus, the central gray of the mid-brain, and the frontal cortex. But these are merely correlative data. Showing that testosterone causes aggression requires a subtraction plus a replacement experiment. Subtraction, castrate a male: do levels of aggression decrease? Yes, including in humans. This shows that something coming from the testes causes aggression. Is it testosterone? Replacement: give that castrated individual replacement testosterone. Do pre-castration levels of aggression return? Yes, including in humans, thus testosterone causes aggression. Time to see how wrong that is. The first hint of a complication comes after castration. When average levels of aggression plummet in every species, but crucially, not to zero, well, maybe the castration wasn't perfect, you missed some bits of testes, or maybe enough of the minor adrenal androgens are secreted to maintain the aggression. But no, even when testosterone and androgens are completely eliminated, some aggression remains, thus some male aggression is testosterone independent. This point is driven home by castration of some sexual offenders, a legal procedure in a few states. This is accomplished with chemical castration, administration of drugs that either inhibit testosterone production or block testosterone receptors. Castration decreases sexual urges in the subset of sex offenders with intense, obsessive, and pathological urges. But otherwise, castration doesn't decrease recidivism rates as stated in one meta-analysis. Hostile rapists and those who commit sex crimes motivated by power or anger are not amenable to treatment with the anti-androgenic drugs. This leads to a hugely informative point. The more experience the male had being aggressive prior to castration, the more aggression continues afterward. In otherwise, the less his being aggressive in the future requires testosterone and the more it's a function of social learning.

What, then, is addiction? In the words of a consensus statement by addiction experts in 2001, addiction is a “chronic neurobiological disease… characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.” The key features of substance addiction are the use of drugs or alcohol despite negative consequences, and relapse. I’ve heard some people shrug off their addictive tendencies by saying, for example, “I can’t be an alcoholic. I don’t drink that much…” or “I only drink at certain times.” The issue is not the quantity or even the frequency, but the impact. “An addict continues to use a drug when evidence strongly demonstrates the drug is doing significant harm…. If users show the pattern of preoccupation and compulsive use repeatedly over time with relapse, addiction can be identified.” Helpful as such definitions are, we have to take a broader view to understand addiction fully. There is a fundamental addiction process that can express itself in many ways, through many different habits. The use of substances like heroin, cocaine, nicotine and alcohol are only the most obvious examples, the most laden with the risk of physiological and medical consequences. Many behavioural, nonsubstance addictions can also be highly destructive to physical health, psychological balance, and personal and social relationships. Addiction is any repeated behaviour, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others. Addiction involves: 1. compulsive engagement with the behaviour, a preoccupation with it; 2. impaired control over the behaviour; 3. persistence or relapse, despite evidence of harm; and 4. dissatisfaction, irritability or intense craving when the object — be it a drug, activity or other goal — is not immediately available. Compulsion, impaired control, persistence, irritability, relapse and craving — these are the hallmarks of addiction — any addiction. Not all harmful compulsions are addictions, though: an obsessive-compulsive, for example, also has impaired control and persists in a ritualized and psychologically debilitating behaviour such as, say, repeated hand washing. The difference is that he has no craving for it and, unlike the addict, he gets no kick out of his compulsion. How does the addict know she has impaired control? Because she doesn’t stop the behaviour in spite of its ill effects. She makes promises to herself or others to quit, but despite pain, peril and promises, she keeps relapsing. There are exceptions, of course. Some addicts never recognize the harm their behaviours cause and never form resolutions to end them. They stay in denial and rationalization. Others openly accept the risk, resolving to live and die “my way.

He stared at it in utter disbelief while his secretary, Peters, who’d only been with him for a fortnight, muttered a silent prayer of gratitude for the break and continued scribbling as fast as he could, trying futilely to catch up with his employer’s dictation. “This,” said Ian curtly, “was sent to me either by mistake or as a joke. In either case, it’s in excruciatingly bad taste.” A memory of Elizabeth Cameron flickered across Ian’s mind-a mercenary, shallow litter flirt with a face and body that had drugged his mind. She’d been betrothed to a viscount when he’d met her. Obviously she hadn’t married her viscount-no doubt she’d jilted him in favor of someone with even better prospects. The English nobility, as he well knew, married only for prestige and money, then looked elsewhere for sexual fulfillment. Evidently Elizabeth Cameron’s relatives were putting her back on the marriage block. If so, they must be damned eager to unload her if they were willing to forsake a title for Ian’s money…That line of conjecture seemed so unlikely that Ian dismissed it. This note was obviously a stupid prank, perpetrated, no doubt, by someone who remembered the gossip that had exploded over that weekend house party-someone who thought he’d find the note amusing. Completely dismissing the prankster and Elizabeth Cameron from his mind, Ian glanced at his harassed secretary who was frantically scribbling away. “No reply is necessary,” he said. As he spoke he flipped the message across his desk toward his secretary, but the white parchment slid across the polished oak and floated to the floor. Peters made an awkward dive to catch it, but as he lurched sideways all the other correspondence that went with his dictation slid off his lap onto the floor. “I-I’m sorry, sir,” he stammered, leaping up and trying to collect the dozens of pieces of paper he’d scattered on the carpet. “Extremely sorry, Mr. Thornton,” he added, frantically snatching up contracts, invitations and letters and shoving them into a disorderly pile. His employer appeared not to hear him. He was already rapping out more instructions and passing the corresponding invitations and letters across the desk. “Decline the first three, accept the fourth, decline the fifth. Send my condolences on this one. On this one, explain that I’m going to be in Scotland, and send an invitation to join me there, along with directions to the cottage.” Clutching the papers to his chest, Peters poked his face up on the opposite side of the desk. “Yes, Mr. Thornton!” he said, trying to sound confident. But it was hard to be confident when one was on one’s knees. Harder still when one wasn’t entirely certain which instructions of the morning went with which invitation or piece of correspondence. Ian Thornton spent the rest of the afternoon closeted with Peters, heaping more dictation on the inundated clerk. He spent the evening with the Earl of Melbourne, his future father-in-law, discussing the earl’s daughter and himself. Peters spent part of his evening trying to learn from the butler which invitations his employer was likely to accept or reject.

Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class of humans around the globe. The findings of these researchers are at odds with the view that children have protected status in most families, societies, and cultures. Instead, Finkelhor reports that children are prime targets and highly vulnerable, due principally to their small size, their physical and emotional immaturity with its associated lack of control, power and resources; and their related dependency on caregivers. They are subjected to many forms of exploitation on an ongoing basis, imposed on them by individuals with greater power, strength, knowledge, and resources, many of whom are, paradoxically and tragically, responsible for their care and welfare. These traumas are interpersonal in nature and involve personal transgression, violation and exploitation of the child by those who rely on the child's lesser physical abilities, innocence, and immaturity to intimidate, bully, confuse, blackmail, exploit, or otherwise coerce. In the worst-case scenario, a parent or other significant caregiver directly and repeatedly abuses a child or does not respond to or protect a child or other vulnerable individual who is being abused and mistreated and isolates the child from others through threats or with direct violence. Consequently, such an abusive, nonprotective, or malevolently exploitative circumstance (Chefetz has coined the term "attack-ment" to describe these dynamics) has a profound impact on victim's ability to trust others. It also affects the victim's identity and self-concept, usually in negative ways that include self-hatred, low self-worth, and lack of self-confidence. As a result, both relationships, and the individual's sense of self and internal states (feelings, thoughts, and perceptions) can become sources of fear, despair, rage, or other extreme dysphoria or numbed and dissociated reactions. This state of alienation from self and others is further exacerbated when the occurrence of abuse or other victimization involves betrayal and is repeated and becomes chronic, in the process leading the victim to remain in a state of either hyperarousal/anticipation/hypervigilance or hypoarousal/numbing (or to alternate between these two states) and to develop strong protective mechanisms, such as dissociation, in order to endure recurrences. When these additional victimizations recur, they unfortunately tend to escalate in severity and intrusiveness over time, causing additional traumatization (Duckworth & Follette, 2011). In many cases of child maltreatment, emotional or psychological coercion and the use of the adult's authority and dominant power rather than physical force or violence is the fulcrum and weapon used against the child; however, force and violence are common in some settings and in some forms of abuse (sometimes in conjunction with extreme isolation and drugging of the child), as they are used to further control or terrorize the victim into submission. The use of force and violence is more commonplace and prevalent in some families, communities, religions, cultural/ethnic groups, and societies based on the views and values about adult prerogatives with children that are espoused. They may also be based on the sociopathy of the perpetrators.