Drugs and Alcohol
A Self Medication Model of Substance Use
© Isabella McKenzie Parker, 2010
Drug and alcohol abuse really do need the benefit of some form of rehab, in conjunction with some form of psychotherapy to address the underlining psychological problems that motivated people to use mind altering substances to cope with life. The Self Medication Model explores the appeal of particular drugs and alcohol, so providing some indication of areas where psychotherapy needs to target. These psychological problems and vulnerabilities generally have their origins in childhood and are mainly characterised by poor self worth and unresolved anger, due to emotional developmental needs being unmet or violated by parents (even unintentionally by parents who ‘did the best they knew how’).
How this occurs is explained more fully on the CAARP-ALIAS model of development of Self Worth, which discusses child
emotional developmental needs and parenting behaviour to meet those needs. It also discusses the consequences of needs being unmet (poor Self Worth) or violated (poor self worth plus anger). If you want to know more on this important topic which is relevant to substance abuse, check out my website:
http://www.selfesteemparenting.com.au
There is a lot of info available on alcohol and illicit drugs, the effects of addiction on the individual, destruction of the family and the costs to society. Comprehensive coverage of this info is to be found in numerous other sources. My interest here is to focus on the question of ‘why’ there is so much drug and alcohol use. What is the appeal? Why is there so much reliance on drugs and alcohol for socialising and coping with life? What is the ‘positive’ effect that users are seeking? This is something of a mystery to non-users who manage to function effectively and enjoy life without feeling any need to resort to drugs.
The term ‘recreational drug use’ is used as if to explain illicit drug use. Is the term also supposed to legitimise this use by distinguishing it from ‘workplace drug use’ or ‘career drug use’? If it is intended as an explanation for drug use, it fails. It actually throws up more questions than answers. Why would anyone need to consume mind-altering substances in order to engage in and enjoy recreational activities? Why would anyone think it is a good idea to have distorted perceptions and delusions or impaired functioning and loss of decision making ability or blacking out with no recollections or vomiting in the street and lying comatose in the gutter?
Examples of distorted perceptions and delusional thinking/beliefs can be seen commonly as supposedly humorous witticisms or slogans on souvenir items in touristy gift shops:
“For instant happy woman just add wine”.
“For instant happy man just add beer”.
“I only drink to make other people seem interesting”.
“Drink until she looks sexy”, a reference to the ‘beer goggles effect’.
In similar vein is the extract from a drinking man’s song:
“I never went to bed with a dog, But I sure woke up with a few”.
These slogans would be funny - if they were not true. But, sadly, they are true – they normalise sad behaviour, they normalise self abuse with alcohol, they normalise anti-social behaviour - and that is an indictment on society. Why do drinkers need perceptual distortion to engage in socialising with friends and strangers? Why the delusional belief that happiness can be bought in a bottle (or a tinny, or a cask, or a ‘six-pack’ or a ‘slab’)? Why the need for such detachment from reality? Why choose such self abuse as a form of recreation - and escapism?
As a starting point, we can explore what ‘positive effect’ there is by considering what neurotransmitters are implicated and what effects these neurotransmitters (or hormones) have on the Central Nervous System (CNS) and the body. In this exploration of the ‘why’ question, and in the interests of aiming to provide some clarity of understanding, the topic will be examined from different perspectives so there will be some repetition and overlap of information presented. Table 1 lists neurotransmitters (in no particular order) that are implicated in drug use, including a summary of the main effects of these neurotransmitters, and drugs linked with each neurotransmitter. Table 2 summarises effects of drugs which implicate multiple neurotransmitters.
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Table 1. Neurotransmitters (or receptors) implicated in drug and alcohol use.
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Neurotransmitter/receptor Effect on CNS Drugs
--------------------------------------------------------------------------------------------------------------------------------------------------------Dopamine Pleasure in 'pleasure centre' Alcohol and all drugs
of the brain (including nicotine)
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Adrenaline, noradrenaline Stimulant, energising Amphetamines, cocaine, ecstasy, cannabis,
also known as epinephrine, nicotine, caffeine, geranium extract, guarana
norepinephrine
------------------------------------------------------------------------------------------------------------------------------------------------------
GABA Depressant on CNS, Alcohol, cannabis
relaxant, anxiety reduction
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Serotonin Hallucinogenic, euphoria, Ecstasy, cocaine, cannabis,
distorted perceptions -> amphetamines, LSD,
confidence, risky behaviour alcohol
-----------------------------------------------------------------------------------------------------------------------------------------------------
Cannabanoid Hallucinogenic, euphoria Cannabis
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Opioids (endorphins) Analgaesic, euphoria Opiates (heroin, morphine, codeine,
oxycodone, pethidine, methadone,
poppy seed tea, alcohol, cannabis,GHB
-----------------------------------------------------------------------------------------------------------------------------------------------------
Oxytocin Bonding, 'cuddle hormone', Ecstasy
closeness
===========================================================================
Table 2. Drugs implicating multiple neurotransmitters
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Drug (Main effect) Neurotransmitter Effect
-------------------------------------------------------------------------------------------------------------------------------------------------------
Cocaine (stimulant) Dopamine Pleasure
Adrenaline/ nordrenaline Stimulant, energy, 'rush', feeling alive
Serotonin Euphoria, confidence, excitement,
risk taking
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Amphetamine (stimulant) Dopamine Pleasure
Adrenaline/noradrenaline Stimulant, increased stamina and libido
Serotonin Euphoria, well being, perceptual
distortions, feel clever and powerful
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Alcohol (depressant) Dopamine Pleasure
GABA Relaxed, impaired reactions
Serotonin Euphoria, distorted perceptions
Opioids Analgaesia, 'feel good'
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Cannabis (hallucinogen) Dopamine Pleasure
Serotonin Euphoria, perceptual distortions
GABA Depressant, relaxing
Noradrenaline Stimulant
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Ecstasy (stimulant and hallucinogen Dopamine Pleasure
or an empathogen/enactogen) Noradrenaline Stimulant
Serotonin Euphoria, perceptual distortions
Oxytocin Bonding
===============================================================================
Overcoming drug tolerance:
As tolerance develops to illicit drugs, the original effect is sought in new drug experiences achieved by adding alcohol or mixing drug cocktails or misuse of prescription medication, veterinary anaesthetics, herbal products and also by taking synthetic designer drugs that mimic effects of illicit drugs whilst not being detectable by drug tests and getting around drug laws.
Drinking alcohol in addition can enhance drug effects. Cocktails of similar-acting drugs enhances their effects - and also increases risk of death. Combining drugs with a CNS depressant or sedating effect can stop the user breathing. Two or more stimulant drugs can interfere with heart beat. Taking drugs with opposing effects sound like a traffic intersection with all lights ‘green’ - there is bound to be a crash!
Problems are being encountered with alcohol-caffeine mixes such as Jager Bomb. There is concern that these drinks lead to violence and drink-driving due largely to an erroneous belief among drinkers that the stimulant effect of caffeine counteracts the cognitive and motor skill impairment caused by the depressant action of alcohol. While the caffeine in these mixes does alleviate fatigue, it does not alleviate impaired function. Hence, these drinkers who are in fact intoxicated and functionally impaired, perceive themselves as not being drunk - police refer to them as ‘wide awake drunks’. They subsequently have a false belief in their actual capabilities and are at increased risk of driving or engaging in other risk-taking behaviour. They also tend to engage in violence – wound up by the caffeine and their social control switched off by alcohol. Dangerous practices are resorted to in order to speed up intoxicating effects and novel experiences are sought by addition of dangerous substances such as adding liquid nitrogen to an alcoholic cocktail. Another example is a dumb practice reported to be common among footballers. There is reliance on ‘uppers’ and ‘downers’ - taking stimulants such as caffeine pills before and during a game to increase alertness and reflexes, then following the match with alcohol to celebrate or drown sorrows and combinations of sleeping pills, pain killers or valium in an attempt to ‘unwind’. This is as clever as slamming a car into reverse gear whilst speeding forward! Table 3 lists some of the more common examples of drug cocktails.
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Table 3. Cocktails of drugs with similar or opposite effects.
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Cocktail Sedating/Depresssant Effect Stimulant Effect
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Cocktails of similar-acting drugs:
----------------------------------------
GHB cocktail GHB, ketamine and alcohol
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'Giggle Pills' guarana and geranium
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Cocktails of opposite-acting drugs:
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GHB cocktail GHB amphetamines
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'Goofballs' barbiturates amphetamines
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'Speedballs' heroin methamphetamines
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'Hypnotic Pills' poppy seed (morphine and guarana and geranium
codeine)
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'Jager Bomb' alcohol caffeine
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Self Medication Model
In examining drug effects from a psychological perspective, it becomes apparent that alcohol, nicotine and illicit drugs are consumed in order to cope with life by filling an 'inner void', anaesthetising unpleasant feelings or blacking out completely and compensating for psychological and social deficits. In other words, these substances are used for the purpose of ‘self medication’. Hence, I am proposing a Self Medication Model of Drug and Alcohol use. This model is examined by discussing each neurotransmitter listed in Table 1 and exploring the ‘effects’ as they apply in addressing psychological /emotional pain and cognitive/social deficits.
Summarising the neurotransmitters implicated in drug use and the psychological issues the drugs are being used to ‘self edicate’: Emotional deficits (dopamine, oxytocin), cognitive deficits (adrenaline), psychological and social deficits (serotonin, GABA) and analgaesia (opioids, cannabinoids).
** Dopamine produces feelings of pleasure.
Source: All substances discussed.
Q: Why this need?
A: Lacking validation, lacking satisfaction in life.
The role of dopamine as a mechanism in the reward aspect of validation has been discussed in the “Validation Hypothesis” (on a sepaarate page). Validation (ie, feeling valued for who you are and for what you do, having a life that is worthwhile and provides satisfaction) has been identified as a natural source of dopamine - ‘getting high on life’. In contrast, people with lives lacking these sources of natural dopamine are vulnerable to seeking and becoming dependent on the ‘quick fix’ of artificial or compensatory sources of dopamine – ie, consumption of substances (such as alcohol, drugs, tobacco, high calorie food) and engaging in activities (such as casual sex, pornography, shopping, gambling, internet, gaming) that have the potential to become addictive. The quick fix of hedonism is preferred over the effort required for validation.
** Oxytocin facilitates bonding:
Source: Ecstasy.
Q: Why this need?
A: Lack of connectedness.
Poor ‘attachment’ is common due to ‘outsourcing parenting’ and family breakdown has contributed to lack of family connection and greater disenfranchisement of youth. In spite of communication technology and cyber friends, there is a lack of any real connectedness, but instead, an exacerbation of personal alienation and social isolisation.
** Adrenaline energises:
Source: Amphetamines, cocaine, ecstasy, cannabis, nicotine, caffeine, geranium extract, guarana.
Q: Why this need?
A: Low endogenous arousal of the brain, lack of cognitive self sufficiency.
Why would anyone need or want a stimulant? To provide energy to dance all night – to loud, rhythmless, mind-numbing music and unpleasant flashing lights that can bring on a seizure for an epileptic. And why would they need or want to do that? It is as if they are racing to fill an inner void and numb unthinking minds.
Common complaints are that youth today get bored easily, need to be entertained and have a short attention span. Note: Boredom is the product of a boring mind - anyone bored with their own company will find that others find it boring, too. It is as if they lack a capacity for cognitive self-sufficiency. In understanding why and how, perhaps Hans Eysenck’s account of the extroversion/introversion personality dimension and the modern education methods might be worth a look.
Eysenck posited that the brain requires optimal level of arousal to remain alive. This arousal comes from two sources – endogenous (activation within the individual’s own brain) and exogenous (from stimulation by the external environment, including consumption of stimulants).
Extroverts have low levels of endogenous arousal so require additional external stimulation which may be provided by high energy physical activities, noisy gatherings, loud music, fun company, laughing, variety in activities and company, meeting new people, novel experiences, entertainment and being the ‘life of the party’. By contrast, Introverts have high levels of endogenous arousal so need relatively little external stimulation. Introverts have too much going on in their mind to ever become bored and may actually prefer their own company over social activities. It isn’t that they are deliberately being anti-social or don’t like people. While Introverts can enjoy the company of close friends and social activities, they experience high levels of external stimulation (eg, large crowds, noisy gatherings, loud music) that the Extrovert needs and enjoys, as unpleasant.
Boredom and the need to seek stimulation may represent brains with low endogenous arousal - not a lot of brain activity going on. But, why the high prevalence of boredom?
A possible explanation:
Socially progressive education methods are based predominantly on entertainment style, audio-visual, whizz bang technology of images and sound, key strokes, clicks and double clicks on icons and menu options. Prior to introduction of television, education consisted of auditory input from the teacher’s voice, reading text and visual images from some pictures, so consisted mainly of listening/hearing, reading and rote learning. This was regarded as outmoded by the socially progressive policy makers and advisors on education. Yet, reading text involves more complex processing than audio-visual input. Listening/hearing and reading involve cognitive processes to recognize sounds and letters, how they are grouped in words, linked together in sentences, processing of the physical aspects of the text, then interpretation. The meaning of the words and sentences is processed, discerning words that are spelt or sound the same but have different meanings. The imagination processes are activated to create images that represent the words, creating complete pictures of objects and places that have never been seen by the reader, either in real life or in pictures. For a narrative, the imagination processes create moving images. By contrast, highly stimulating, entertainment style of education utilizes less processing functions by the brain so these processes have less opportunity to develop. Audio-visual information is received just like being ‘poured into the brain using a funnel’, like being drip fed liquid nourishment that requires no digestion. Hence, these brains lack opportunity to develop specific cognitive processing abilities, resulting in development of minds that rely on pre-processed packaged information presented in entertainment format.
Research:
Reports on studies of effects of TV viewing on young children recommend that infants under two years should not watch any TV at all since passive reception of audio-visual input interferes with cognitive development and also produces over stimulation. The mothers of these children will later complain that these children are ‘too easily bored’, always in need of entertainment, lacking in imagination and creative ability to entertain themselves. What the infant brain needs for cognitive development is stimulation of interaction, two-way exchange with the mother (father and siblings), learning by doing, developing self-sufficiency in self-entertaining, actively exploring the environment (within the ‘safe zone’).
Summarising:
The pre-processed nature of audio-visual education stunts the development of specific cognitive processes and the highly stimulating nature of entertainment style education conditions the brain to be dependent on entertainment and external stimulation. Modern education methods have commonly been accused of dumbing down kids. As for the short attention span – well, with the abolition of the maligned ‘rote learning’, the capacity for sustained attention has not developed. Lacking cognitive self-sufficiency to self-entertain, they lack capacity to generate sufficient endogenous arousal, so their brains need external stimulation and are conditioned to be dependent on high levels of stimulation.
Perhaps being plugged into an iPod or an iPad or an iPhone is quite literally being plugged into an iLifeSupportSystem. This provides essential stimulation their brains are unable to produce themselves but need in order to achieve sufficient arousal to remain alive.
** Serotonin distorts perceptions:
Source: Ecstasy, cocaine,
amphetamines, LSD, alcohol, cannabis.
Q: Why this need?
A: Lack of social confidence.
The delusional quality of the altered states fosters detaching from reality and achieving a false sense of confidence and bravery based on distorted perceptions of reality. The downside is these distorted perceptions interfere with the capacity for recognising danger.
** GABA depresses CNS, relaxant:
Source: Alcohol, cannabis.
Q: Why this need?
A: Inability to relax and enjoy social situations.
Lack of cognitive capacity for natural relaxation is compensated for by the chemical quick fix, typical of modern society. Perhaps the natural ability to relax is avoided because it would reveal the lack of cognitive self-sufficiency and the boredom would take over.
** Opioids and Cannabinoids producing analgaesia:
Source: Opiates, alcohol, cannabis.
Q: Why this need?
A: Need to anaesthetise emotional pain.
There is a lot of emotional pain in society – as evidenced by impact on mental health. There is a lot of anger in society – as evidenced by the extent of violence. There are a lot of kids and adolescents in pain from parental neglect, emotional deprivation, rejection, abandonment, family breakdown, violence and sexual abuse. In spite of the facade of bravado, there are lot of kids who lack confidence, do not feel good about themselves, have poor self esteem, poor self worth. They lack emotional wellbeing, emotional security and secure family connection. Drugs dull that emotional pain.
Examples of multiple effects:
** Alcohol deserves a separate mention, due to it being the most commonly used drug and the one most associated with social problems.
There are four areas of effects that I would like to focus on: relaxation, binge drinking, sex and violence.
(i) In moderation, alcohol is enjoyable, promoting a temporary sense of wellbeing, relaxation and facilitates social harmony.
(ii) However, there is a vast difference between moderate drinking for relaxation and enjoyment and the binge drinking with the deliberate sole intention of getting drunk ASAP, vomiting in the street and lying comatose in the gutter. The process of getting drunk ASAP is speeded up by intentionally drinking on an empty stomach (eating is referred to as ‘cheating’). Another method to speed up and increase intoxication is delivery of alcohol to other internal body organs which provide quick access to the blood stream (eg, delivering alcohol into the rectum via a rubber tube, known as ‘butt chugging’, and girls inserting tampons soaked in vodka into their rectum or vagina). Three points to make here:
(a) These get-drunk-double-quick strategies are clearly not the product of mature thinking
brain processes
(b) The intention in getting drunk ASAP is clearly Self Medication in its most obvious form, for
emotional pain and coping style for
life situations – anaesthetising and blacking out as a means of avoidance and escapism
(c) The dicing-with-death aspect, like many suicide attempts, can only be regarded as a desperate cry
for help.
(iii) Alternatively, there is drinking with the intention of ‘getting laid’. This involves unwise decision making, the risk of being raped or waking up in the bed of a stranger after unprotected sex, risking pregnancy and sexually transmitted infections. There is no need to go into a discussion here on the reasons a woman with low self esteem would treat herself with such disrespect and engage in such self-abuse. Male participants exploiting this drunken vulnerability clearly have no respect for women. Clearly, they lack integrity and have no self respect, either.
(iv) The term ‘alcohol-fuelled violence’ is a misnomer. Whether repressed anger is internalised or externalised, it is more likely to be expressed violently after consumption of alcohol. This is not because the alcohol causes violence but because it removes the inhibitions that keep the anger under control. There is a range of behaviour that drinkers exhibit in response to consuming alcohol: relaxed, chatty, giggly, romantic, singing, maudlin, sleazy, loud, belligerent, abusive, aggressive and physically violent or even distorted perceptions (when drinkers think alcohol makes them witty, charming or sexy). Yet, a single substance cannot be responsible for such a diverse range of behaviour. What alcohol actually does is switch off the brain mechanism responsible for inhibition or social control. This results in revealing the true character that is hidden behind the socially desirable facade which we all present to those around us. For example, at a social function, a man with a reputation of being a ‘respectable family man, a pillar of society’ consumes several drinks, then makes crude comments and lewd suggestions to women and gropes their breasts and bottoms. Friends and associates defend his gross behaviour by claiming it is ‘so out of character’ and he ‘just had too much to drink’. Sorry to disillusion anyone or offend drinkers who use alcohol to excuse bad behaviour, but the reality is that if a man behaves like a sleaze when he is under the influence of alcohol, it is because he really is a ‘sleaze’. Likewise, anyone who becomes angry, abusive, aggressive or violent after consuming alcohol is really only expressing existing anger and an existing desire to engage in aggressive behaviour – but they keep these feelings and desires under control when they are sober. ("Anger" and "Repressed Anger" are discussed on a separate page).
** Ecstasy also deserves separate mention due to suggestions by proponents of 'utopian pharmacology' that the drug could have a therapeutic role as a cure for deficits in empathy.
Ecstasy is classed as an empathogen or enactogen. It acts simultaneously as a stimulant and as a hallucinogen and also activates oxytocin (referred to as the ‘cuddle hormone’ that facilitates ‘bonding’ in relationships) which induces feelings of connectedness to others. This closeness and altered tactile sensations produce desire for sensual and sexual experiences.
Comments on utopian pharmacology:
According to a reductionist view, all human behaviour, thoughts, attitudes and feelings can be reduced to biochemical processes (such as neurotransmitters) as if this is all the explanation that is required. Accordingly, there is a view that there is a role for‘utopian pharmacology’. Ecstasy supposedly induces feelings of 'empathy' and 'connectedness' (due to oxytocin) and also promotes feelings of confidence (due to serotonin). Ecstasy was dubbed ‘Adam’ by a proponent because he ‘believed that it returned the user to a state of primordial innocence’. Hence, there is a view that 'character deficits' can supposedly be corrected by use of psychedelic drugs such as ecstasy.
However, these biochemical processes are the mechanism only for experiencing feelings, while cognitive processes (thoughts) that give meaning to feelings are ignored as irrelevant. Psychoactive drugs alleviate symptoms of mental and affective disorders temporarily by changing mood state but do not provide a cure. They do not provide permanent change in aversive feelings or address underlying psychological
causal factors (eg, unresolved emotional issues, negative self beliefs, self defeating behaviour, dysfunctional relationship patterns). Antidepressants do not cure depression, anxiolytics do not cure anxiety, mood stabilisers do not cure bipolar disorder, psychotropics do not cure schizophrenia. Likewise, psychoactive drugs are not going to cure deficits in social competency or deficits in empathy. An artificial,
drug-induced mood state or altered consciousness will temporarily mask underlying feelings associated with negative or aversive thoughts and beliefs but will not change them so that thoughts and feelings match. There needs to be a match between thoughts and mood, in order to find meaning and make sense of feelings. Dissonance or disconnection between cognitions (thoughts, attitudes, beliefs) and feelings creates inner conflict and confusion. A feature of schizophrenia is a ‘split’ between thoughts and emotions and yet according to utopian pharmacology, it is desirable to create this schism between drug-induced emotions and underlying thoughts, beliefs and attitudes.
In a society where hedonism is valued above effort, a word of caution in assuming that pills such as ecstasy (via their action on neurotransmitters serotonin and oxytocin) can convert society into a utopia by curing mental, emotional and social ills. Supposedly, by empowering individuals with a sense of confidence and exchanging anger, hostilities and violent crime with love for fellow human beings.
However, the reality does not match the utopian vision - which is probably the delusional product of a hallucinogenic drug session. Likewise, the 'Adam delusion'. Studies show that the reality is that two days after a night on ecstasy, users change from being loving and empathetic to being irritable, unsociable and less empathetic than they before their drug binge. Couples who declared undying love (on ecstasy) are more likely to be having rows and split. Physiological tolerance to ecstasy develops and frequent users complain that the magic has faded. Research has found among volunteer users that the drug produced friendliness, playfulness and loving feelings, even among strangers, but it distorts one’s perception of others rather than producing true empathy. It also reduces capacity to recognize facial expressions of fear in other people, an effect that may be involved in the increased sociability.
Never mind that these drugs have the potential to create problems associated with addiction. In addition to the risk of potentially fatal effects while using ecstasy, repeated use may ultimately damage the cells that produce serotonin which has an important role in mood, appetite, pain, learning and memory. There is reportedly already research suggesting disruption or interference with memory. Heavy regular users may experience depression, anxiety, emotional burnout, rejection-sensitivity, paranoia and various physical symptoms.
What should also be of concern to advocates of legalising drugs and using them to correct social and mental ills and character deficits, is that the psychedelic effects of ecstasy manifest as a perceptual distortion so that fearlessness is actually due to impaired ability to read cues which signal danger. Hence, the increased 'confidence' and 'connectedness' are delusional, so rather than promoting true empathy and confidence, empathogens are agents of delusion. It is an odd contradiction that psychoactive drugs are used to treat delusions in a psychotic episode, yet a psychoactive drug is being advocated to induce delusions as a means of 'curing' social ills.
Utopian pharmacology reflects Huxley’s use of the drug soma, in his dystonian futuristic views in "Brave New World". The utopian pharmacologists need to be reminded that Huxley was not presenting a role of soma as an ideal that was benefiting individuals or society. Perhaps they need to be reminded that the purpose of the government in providing soma was not the wellbeing of the populace, but their control. And perhaps that is the true motive of proponents of utopian pharmacology – dis-empowering individuals by getting them to relinquish their personal power to addictive substances.
A Self Medication Model of drug use might appear to support a role of utopian pharmacology in therapy. However, while the model hypothesises that drugs and alcohol are used in an attempt to cope with life and compensate for cognitive and social deficits, the emphasis here is that it is only an attempt and not a successful one. Like psychotropic drugs, the illicit drugs and alcohol change or cure nothing. They merely serve to escape from problems by distorting reality, anaesthetising aversive feelings, masking inadequacies and filling the void within.
Meditation – a safe, natural alternative:
If the goal of using drugs and alcohol is to relax or experience altered states of awareness or consciousness, then why not give meditation a go? This is truly a self-empowering exercise rather than relinquishing control to a chemical substance. Meditation produces relaxation – but perhaps a state of inner calm would be too confronting for the stimulant user who has a low tolerance for a relaxed mind. Meditation clears the channel between the different levels of consciousness (subconscious, the conscious mind and the higher consciousness) – and no side effects, no developing of tolerance, no addiction. Meditation facilitates experiences of psychological insights and spiritual awareness - but that might be too confronting for users who are using psychoactive substances to escape into a drug-induced stupor – distortion and delusion (of hallucinogens), anaesthetising or blacking out (with analgaesics) or overwhelming the mind (with stimulants) - rather than explore and resolve.
Conclusion:
Perhaps we do not realise how lacking in self sufficiency we are, as a society. How dependent society is on the quick fix of a pill to dull emotional pain rather than the effort to face and address the cause. Or the hedonic experience of artificial sources of dopamine, rather than the effort of seeking satisfaction in life. As a social species, interpersonal interaction and community social events and sporting activities are an essential part of the social cohesion of society and mental and emotional wellbeing and connectedness of its members. However, dependence on these external sources of stimulation does not bring mental and emotional wellbeing. Entertainment and drugs to fill the inner void and feeding on the emotions of others to feel alive, does not bring mental and emotional wellbeing or connectedness – neither does it contribute to social cohesion. The youth of today tend to be a generation of dependency: dependent on alcohol and drugs to socialise, cope, self-medicate and feel good about themselves; dependent on communication technology and social media that fosters alienation, dependent on being ‘kept in the loop’, yet dependent on constant external stimulation from alcohol, drugs, entertainment and noise; and girls dependent on giving sex as a means of temporary validation.
Drug and alcohol abuse really do need the benefit of some form of rehab, in conjunction with some form of psychotherapy to address the underlining psychological problems that motivated people to use mind altering substances to cope with life. The Self Medication Model explores the appeal of particular drugs and alcohol, so providing some indication of areas where psychotherapy needs to target. These psychological problems and vulnerabilities generally have their origins in childhood and are mainly characterised by poor self worth and unresolved anger, due to emotional developmental needs being unmet or violated by parents (even unintentionally by parents who ‘did the best they knew how’).
How this occurs is explained more fully on the CAARP-ALIAS model of development of Self Worth, which discusses child
emotional developmental needs and parenting behaviour to meet those needs. It also discusses the consequences of needs being unmet (poor Self Worth) or violated (poor self worth plus anger). If you want to know more on this important topic which is relevant to substance abuse, check out my website:
http://www.selfesteemparenting.com.au
There is a lot of info available on alcohol and illicit drugs, the effects of addiction on the individual, destruction of the family and the costs to society. Comprehensive coverage of this info is to be found in numerous other sources. My interest here is to focus on the question of ‘why’ there is so much drug and alcohol use. What is the appeal? Why is there so much reliance on drugs and alcohol for socialising and coping with life? What is the ‘positive’ effect that users are seeking? This is something of a mystery to non-users who manage to function effectively and enjoy life without feeling any need to resort to drugs.
The term ‘recreational drug use’ is used as if to explain illicit drug use. Is the term also supposed to legitimise this use by distinguishing it from ‘workplace drug use’ or ‘career drug use’? If it is intended as an explanation for drug use, it fails. It actually throws up more questions than answers. Why would anyone need to consume mind-altering substances in order to engage in and enjoy recreational activities? Why would anyone think it is a good idea to have distorted perceptions and delusions or impaired functioning and loss of decision making ability or blacking out with no recollections or vomiting in the street and lying comatose in the gutter?
Examples of distorted perceptions and delusional thinking/beliefs can be seen commonly as supposedly humorous witticisms or slogans on souvenir items in touristy gift shops:
“For instant happy woman just add wine”.
“For instant happy man just add beer”.
“I only drink to make other people seem interesting”.
“Drink until she looks sexy”, a reference to the ‘beer goggles effect’.
In similar vein is the extract from a drinking man’s song:
“I never went to bed with a dog, But I sure woke up with a few”.
These slogans would be funny - if they were not true. But, sadly, they are true – they normalise sad behaviour, they normalise self abuse with alcohol, they normalise anti-social behaviour - and that is an indictment on society. Why do drinkers need perceptual distortion to engage in socialising with friends and strangers? Why the delusional belief that happiness can be bought in a bottle (or a tinny, or a cask, or a ‘six-pack’ or a ‘slab’)? Why the need for such detachment from reality? Why choose such self abuse as a form of recreation - and escapism?
As a starting point, we can explore what ‘positive effect’ there is by considering what neurotransmitters are implicated and what effects these neurotransmitters (or hormones) have on the Central Nervous System (CNS) and the body. In this exploration of the ‘why’ question, and in the interests of aiming to provide some clarity of understanding, the topic will be examined from different perspectives so there will be some repetition and overlap of information presented. Table 1 lists neurotransmitters (in no particular order) that are implicated in drug use, including a summary of the main effects of these neurotransmitters, and drugs linked with each neurotransmitter. Table 2 summarises effects of drugs which implicate multiple neurotransmitters.
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Table 1. Neurotransmitters (or receptors) implicated in drug and alcohol use.
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Neurotransmitter/receptor Effect on CNS Drugs
--------------------------------------------------------------------------------------------------------------------------------------------------------Dopamine Pleasure in 'pleasure centre' Alcohol and all drugs
of the brain (including nicotine)
-------------------------------------------------------------------------------------------------------------------------------------------------------
Adrenaline, noradrenaline Stimulant, energising Amphetamines, cocaine, ecstasy, cannabis,
also known as epinephrine, nicotine, caffeine, geranium extract, guarana
norepinephrine
------------------------------------------------------------------------------------------------------------------------------------------------------
GABA Depressant on CNS, Alcohol, cannabis
relaxant, anxiety reduction
------------------------------------------------------------------------------------------------------------------------------------------------------
Serotonin Hallucinogenic, euphoria, Ecstasy, cocaine, cannabis,
distorted perceptions -> amphetamines, LSD,
confidence, risky behaviour alcohol
-----------------------------------------------------------------------------------------------------------------------------------------------------
Cannabanoid Hallucinogenic, euphoria Cannabis
-----------------------------------------------------------------------------------------------------------------------------------------------------
Opioids (endorphins) Analgaesic, euphoria Opiates (heroin, morphine, codeine,
oxycodone, pethidine, methadone,
poppy seed tea, alcohol, cannabis,GHB
-----------------------------------------------------------------------------------------------------------------------------------------------------
Oxytocin Bonding, 'cuddle hormone', Ecstasy
closeness
===========================================================================
Table 2. Drugs implicating multiple neurotransmitters
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Drug (Main effect) Neurotransmitter Effect
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Cocaine (stimulant) Dopamine Pleasure
Adrenaline/ nordrenaline Stimulant, energy, 'rush', feeling alive
Serotonin Euphoria, confidence, excitement,
risk taking
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Amphetamine (stimulant) Dopamine Pleasure
Adrenaline/noradrenaline Stimulant, increased stamina and libido
Serotonin Euphoria, well being, perceptual
distortions, feel clever and powerful
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Alcohol (depressant) Dopamine Pleasure
GABA Relaxed, impaired reactions
Serotonin Euphoria, distorted perceptions
Opioids Analgaesia, 'feel good'
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Cannabis (hallucinogen) Dopamine Pleasure
Serotonin Euphoria, perceptual distortions
GABA Depressant, relaxing
Noradrenaline Stimulant
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Ecstasy (stimulant and hallucinogen Dopamine Pleasure
or an empathogen/enactogen) Noradrenaline Stimulant
Serotonin Euphoria, perceptual distortions
Oxytocin Bonding
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Overcoming drug tolerance:
As tolerance develops to illicit drugs, the original effect is sought in new drug experiences achieved by adding alcohol or mixing drug cocktails or misuse of prescription medication, veterinary anaesthetics, herbal products and also by taking synthetic designer drugs that mimic effects of illicit drugs whilst not being detectable by drug tests and getting around drug laws.
Drinking alcohol in addition can enhance drug effects. Cocktails of similar-acting drugs enhances their effects - and also increases risk of death. Combining drugs with a CNS depressant or sedating effect can stop the user breathing. Two or more stimulant drugs can interfere with heart beat. Taking drugs with opposing effects sound like a traffic intersection with all lights ‘green’ - there is bound to be a crash!
Problems are being encountered with alcohol-caffeine mixes such as Jager Bomb. There is concern that these drinks lead to violence and drink-driving due largely to an erroneous belief among drinkers that the stimulant effect of caffeine counteracts the cognitive and motor skill impairment caused by the depressant action of alcohol. While the caffeine in these mixes does alleviate fatigue, it does not alleviate impaired function. Hence, these drinkers who are in fact intoxicated and functionally impaired, perceive themselves as not being drunk - police refer to them as ‘wide awake drunks’. They subsequently have a false belief in their actual capabilities and are at increased risk of driving or engaging in other risk-taking behaviour. They also tend to engage in violence – wound up by the caffeine and their social control switched off by alcohol. Dangerous practices are resorted to in order to speed up intoxicating effects and novel experiences are sought by addition of dangerous substances such as adding liquid nitrogen to an alcoholic cocktail. Another example is a dumb practice reported to be common among footballers. There is reliance on ‘uppers’ and ‘downers’ - taking stimulants such as caffeine pills before and during a game to increase alertness and reflexes, then following the match with alcohol to celebrate or drown sorrows and combinations of sleeping pills, pain killers or valium in an attempt to ‘unwind’. This is as clever as slamming a car into reverse gear whilst speeding forward! Table 3 lists some of the more common examples of drug cocktails.
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Table 3. Cocktails of drugs with similar or opposite effects.
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Cocktail Sedating/Depresssant Effect Stimulant Effect
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Cocktails of similar-acting drugs:
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GHB cocktail GHB, ketamine and alcohol
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'Giggle Pills' guarana and geranium
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Cocktails of opposite-acting drugs:
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GHB cocktail GHB amphetamines
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'Goofballs' barbiturates amphetamines
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'Speedballs' heroin methamphetamines
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'Hypnotic Pills' poppy seed (morphine and guarana and geranium
codeine)
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'Jager Bomb' alcohol caffeine
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Self Medication Model
In examining drug effects from a psychological perspective, it becomes apparent that alcohol, nicotine and illicit drugs are consumed in order to cope with life by filling an 'inner void', anaesthetising unpleasant feelings or blacking out completely and compensating for psychological and social deficits. In other words, these substances are used for the purpose of ‘self medication’. Hence, I am proposing a Self Medication Model of Drug and Alcohol use. This model is examined by discussing each neurotransmitter listed in Table 1 and exploring the ‘effects’ as they apply in addressing psychological /emotional pain and cognitive/social deficits.
Summarising the neurotransmitters implicated in drug use and the psychological issues the drugs are being used to ‘self edicate’: Emotional deficits (dopamine, oxytocin), cognitive deficits (adrenaline), psychological and social deficits (serotonin, GABA) and analgaesia (opioids, cannabinoids).
** Dopamine produces feelings of pleasure.
Source: All substances discussed.
Q: Why this need?
A: Lacking validation, lacking satisfaction in life.
The role of dopamine as a mechanism in the reward aspect of validation has been discussed in the “Validation Hypothesis” (on a sepaarate page). Validation (ie, feeling valued for who you are and for what you do, having a life that is worthwhile and provides satisfaction) has been identified as a natural source of dopamine - ‘getting high on life’. In contrast, people with lives lacking these sources of natural dopamine are vulnerable to seeking and becoming dependent on the ‘quick fix’ of artificial or compensatory sources of dopamine – ie, consumption of substances (such as alcohol, drugs, tobacco, high calorie food) and engaging in activities (such as casual sex, pornography, shopping, gambling, internet, gaming) that have the potential to become addictive. The quick fix of hedonism is preferred over the effort required for validation.
** Oxytocin facilitates bonding:
Source: Ecstasy.
Q: Why this need?
A: Lack of connectedness.
Poor ‘attachment’ is common due to ‘outsourcing parenting’ and family breakdown has contributed to lack of family connection and greater disenfranchisement of youth. In spite of communication technology and cyber friends, there is a lack of any real connectedness, but instead, an exacerbation of personal alienation and social isolisation.
** Adrenaline energises:
Source: Amphetamines, cocaine, ecstasy, cannabis, nicotine, caffeine, geranium extract, guarana.
Q: Why this need?
A: Low endogenous arousal of the brain, lack of cognitive self sufficiency.
Why would anyone need or want a stimulant? To provide energy to dance all night – to loud, rhythmless, mind-numbing music and unpleasant flashing lights that can bring on a seizure for an epileptic. And why would they need or want to do that? It is as if they are racing to fill an inner void and numb unthinking minds.
Common complaints are that youth today get bored easily, need to be entertained and have a short attention span. Note: Boredom is the product of a boring mind - anyone bored with their own company will find that others find it boring, too. It is as if they lack a capacity for cognitive self-sufficiency. In understanding why and how, perhaps Hans Eysenck’s account of the extroversion/introversion personality dimension and the modern education methods might be worth a look.
Eysenck posited that the brain requires optimal level of arousal to remain alive. This arousal comes from two sources – endogenous (activation within the individual’s own brain) and exogenous (from stimulation by the external environment, including consumption of stimulants).
Extroverts have low levels of endogenous arousal so require additional external stimulation which may be provided by high energy physical activities, noisy gatherings, loud music, fun company, laughing, variety in activities and company, meeting new people, novel experiences, entertainment and being the ‘life of the party’. By contrast, Introverts have high levels of endogenous arousal so need relatively little external stimulation. Introverts have too much going on in their mind to ever become bored and may actually prefer their own company over social activities. It isn’t that they are deliberately being anti-social or don’t like people. While Introverts can enjoy the company of close friends and social activities, they experience high levels of external stimulation (eg, large crowds, noisy gatherings, loud music) that the Extrovert needs and enjoys, as unpleasant.
Boredom and the need to seek stimulation may represent brains with low endogenous arousal - not a lot of brain activity going on. But, why the high prevalence of boredom?
A possible explanation:
Socially progressive education methods are based predominantly on entertainment style, audio-visual, whizz bang technology of images and sound, key strokes, clicks and double clicks on icons and menu options. Prior to introduction of television, education consisted of auditory input from the teacher’s voice, reading text and visual images from some pictures, so consisted mainly of listening/hearing, reading and rote learning. This was regarded as outmoded by the socially progressive policy makers and advisors on education. Yet, reading text involves more complex processing than audio-visual input. Listening/hearing and reading involve cognitive processes to recognize sounds and letters, how they are grouped in words, linked together in sentences, processing of the physical aspects of the text, then interpretation. The meaning of the words and sentences is processed, discerning words that are spelt or sound the same but have different meanings. The imagination processes are activated to create images that represent the words, creating complete pictures of objects and places that have never been seen by the reader, either in real life or in pictures. For a narrative, the imagination processes create moving images. By contrast, highly stimulating, entertainment style of education utilizes less processing functions by the brain so these processes have less opportunity to develop. Audio-visual information is received just like being ‘poured into the brain using a funnel’, like being drip fed liquid nourishment that requires no digestion. Hence, these brains lack opportunity to develop specific cognitive processing abilities, resulting in development of minds that rely on pre-processed packaged information presented in entertainment format.
Research:
Reports on studies of effects of TV viewing on young children recommend that infants under two years should not watch any TV at all since passive reception of audio-visual input interferes with cognitive development and also produces over stimulation. The mothers of these children will later complain that these children are ‘too easily bored’, always in need of entertainment, lacking in imagination and creative ability to entertain themselves. What the infant brain needs for cognitive development is stimulation of interaction, two-way exchange with the mother (father and siblings), learning by doing, developing self-sufficiency in self-entertaining, actively exploring the environment (within the ‘safe zone’).
Summarising:
The pre-processed nature of audio-visual education stunts the development of specific cognitive processes and the highly stimulating nature of entertainment style education conditions the brain to be dependent on entertainment and external stimulation. Modern education methods have commonly been accused of dumbing down kids. As for the short attention span – well, with the abolition of the maligned ‘rote learning’, the capacity for sustained attention has not developed. Lacking cognitive self-sufficiency to self-entertain, they lack capacity to generate sufficient endogenous arousal, so their brains need external stimulation and are conditioned to be dependent on high levels of stimulation.
Perhaps being plugged into an iPod or an iPad or an iPhone is quite literally being plugged into an iLifeSupportSystem. This provides essential stimulation their brains are unable to produce themselves but need in order to achieve sufficient arousal to remain alive.
** Serotonin distorts perceptions:
Source: Ecstasy, cocaine,
amphetamines, LSD, alcohol, cannabis.
Q: Why this need?
A: Lack of social confidence.
The delusional quality of the altered states fosters detaching from reality and achieving a false sense of confidence and bravery based on distorted perceptions of reality. The downside is these distorted perceptions interfere with the capacity for recognising danger.
** GABA depresses CNS, relaxant:
Source: Alcohol, cannabis.
Q: Why this need?
A: Inability to relax and enjoy social situations.
Lack of cognitive capacity for natural relaxation is compensated for by the chemical quick fix, typical of modern society. Perhaps the natural ability to relax is avoided because it would reveal the lack of cognitive self-sufficiency and the boredom would take over.
** Opioids and Cannabinoids producing analgaesia:
Source: Opiates, alcohol, cannabis.
Q: Why this need?
A: Need to anaesthetise emotional pain.
There is a lot of emotional pain in society – as evidenced by impact on mental health. There is a lot of anger in society – as evidenced by the extent of violence. There are a lot of kids and adolescents in pain from parental neglect, emotional deprivation, rejection, abandonment, family breakdown, violence and sexual abuse. In spite of the facade of bravado, there are lot of kids who lack confidence, do not feel good about themselves, have poor self esteem, poor self worth. They lack emotional wellbeing, emotional security and secure family connection. Drugs dull that emotional pain.
Examples of multiple effects:
** Alcohol deserves a separate mention, due to it being the most commonly used drug and the one most associated with social problems.
There are four areas of effects that I would like to focus on: relaxation, binge drinking, sex and violence.
(i) In moderation, alcohol is enjoyable, promoting a temporary sense of wellbeing, relaxation and facilitates social harmony.
(ii) However, there is a vast difference between moderate drinking for relaxation and enjoyment and the binge drinking with the deliberate sole intention of getting drunk ASAP, vomiting in the street and lying comatose in the gutter. The process of getting drunk ASAP is speeded up by intentionally drinking on an empty stomach (eating is referred to as ‘cheating’). Another method to speed up and increase intoxication is delivery of alcohol to other internal body organs which provide quick access to the blood stream (eg, delivering alcohol into the rectum via a rubber tube, known as ‘butt chugging’, and girls inserting tampons soaked in vodka into their rectum or vagina). Three points to make here:
(a) These get-drunk-double-quick strategies are clearly not the product of mature thinking
brain processes
(b) The intention in getting drunk ASAP is clearly Self Medication in its most obvious form, for
emotional pain and coping style for
life situations – anaesthetising and blacking out as a means of avoidance and escapism
(c) The dicing-with-death aspect, like many suicide attempts, can only be regarded as a desperate cry
for help.
(iii) Alternatively, there is drinking with the intention of ‘getting laid’. This involves unwise decision making, the risk of being raped or waking up in the bed of a stranger after unprotected sex, risking pregnancy and sexually transmitted infections. There is no need to go into a discussion here on the reasons a woman with low self esteem would treat herself with such disrespect and engage in such self-abuse. Male participants exploiting this drunken vulnerability clearly have no respect for women. Clearly, they lack integrity and have no self respect, either.
(iv) The term ‘alcohol-fuelled violence’ is a misnomer. Whether repressed anger is internalised or externalised, it is more likely to be expressed violently after consumption of alcohol. This is not because the alcohol causes violence but because it removes the inhibitions that keep the anger under control. There is a range of behaviour that drinkers exhibit in response to consuming alcohol: relaxed, chatty, giggly, romantic, singing, maudlin, sleazy, loud, belligerent, abusive, aggressive and physically violent or even distorted perceptions (when drinkers think alcohol makes them witty, charming or sexy). Yet, a single substance cannot be responsible for such a diverse range of behaviour. What alcohol actually does is switch off the brain mechanism responsible for inhibition or social control. This results in revealing the true character that is hidden behind the socially desirable facade which we all present to those around us. For example, at a social function, a man with a reputation of being a ‘respectable family man, a pillar of society’ consumes several drinks, then makes crude comments and lewd suggestions to women and gropes their breasts and bottoms. Friends and associates defend his gross behaviour by claiming it is ‘so out of character’ and he ‘just had too much to drink’. Sorry to disillusion anyone or offend drinkers who use alcohol to excuse bad behaviour, but the reality is that if a man behaves like a sleaze when he is under the influence of alcohol, it is because he really is a ‘sleaze’. Likewise, anyone who becomes angry, abusive, aggressive or violent after consuming alcohol is really only expressing existing anger and an existing desire to engage in aggressive behaviour – but they keep these feelings and desires under control when they are sober. ("Anger" and "Repressed Anger" are discussed on a separate page).
** Ecstasy also deserves separate mention due to suggestions by proponents of 'utopian pharmacology' that the drug could have a therapeutic role as a cure for deficits in empathy.
Ecstasy is classed as an empathogen or enactogen. It acts simultaneously as a stimulant and as a hallucinogen and also activates oxytocin (referred to as the ‘cuddle hormone’ that facilitates ‘bonding’ in relationships) which induces feelings of connectedness to others. This closeness and altered tactile sensations produce desire for sensual and sexual experiences.
Comments on utopian pharmacology:
According to a reductionist view, all human behaviour, thoughts, attitudes and feelings can be reduced to biochemical processes (such as neurotransmitters) as if this is all the explanation that is required. Accordingly, there is a view that there is a role for‘utopian pharmacology’. Ecstasy supposedly induces feelings of 'empathy' and 'connectedness' (due to oxytocin) and also promotes feelings of confidence (due to serotonin). Ecstasy was dubbed ‘Adam’ by a proponent because he ‘believed that it returned the user to a state of primordial innocence’. Hence, there is a view that 'character deficits' can supposedly be corrected by use of psychedelic drugs such as ecstasy.
However, these biochemical processes are the mechanism only for experiencing feelings, while cognitive processes (thoughts) that give meaning to feelings are ignored as irrelevant. Psychoactive drugs alleviate symptoms of mental and affective disorders temporarily by changing mood state but do not provide a cure. They do not provide permanent change in aversive feelings or address underlying psychological
causal factors (eg, unresolved emotional issues, negative self beliefs, self defeating behaviour, dysfunctional relationship patterns). Antidepressants do not cure depression, anxiolytics do not cure anxiety, mood stabilisers do not cure bipolar disorder, psychotropics do not cure schizophrenia. Likewise, psychoactive drugs are not going to cure deficits in social competency or deficits in empathy. An artificial,
drug-induced mood state or altered consciousness will temporarily mask underlying feelings associated with negative or aversive thoughts and beliefs but will not change them so that thoughts and feelings match. There needs to be a match between thoughts and mood, in order to find meaning and make sense of feelings. Dissonance or disconnection between cognitions (thoughts, attitudes, beliefs) and feelings creates inner conflict and confusion. A feature of schizophrenia is a ‘split’ between thoughts and emotions and yet according to utopian pharmacology, it is desirable to create this schism between drug-induced emotions and underlying thoughts, beliefs and attitudes.
In a society where hedonism is valued above effort, a word of caution in assuming that pills such as ecstasy (via their action on neurotransmitters serotonin and oxytocin) can convert society into a utopia by curing mental, emotional and social ills. Supposedly, by empowering individuals with a sense of confidence and exchanging anger, hostilities and violent crime with love for fellow human beings.
However, the reality does not match the utopian vision - which is probably the delusional product of a hallucinogenic drug session. Likewise, the 'Adam delusion'. Studies show that the reality is that two days after a night on ecstasy, users change from being loving and empathetic to being irritable, unsociable and less empathetic than they before their drug binge. Couples who declared undying love (on ecstasy) are more likely to be having rows and split. Physiological tolerance to ecstasy develops and frequent users complain that the magic has faded. Research has found among volunteer users that the drug produced friendliness, playfulness and loving feelings, even among strangers, but it distorts one’s perception of others rather than producing true empathy. It also reduces capacity to recognize facial expressions of fear in other people, an effect that may be involved in the increased sociability.
Never mind that these drugs have the potential to create problems associated with addiction. In addition to the risk of potentially fatal effects while using ecstasy, repeated use may ultimately damage the cells that produce serotonin which has an important role in mood, appetite, pain, learning and memory. There is reportedly already research suggesting disruption or interference with memory. Heavy regular users may experience depression, anxiety, emotional burnout, rejection-sensitivity, paranoia and various physical symptoms.
What should also be of concern to advocates of legalising drugs and using them to correct social and mental ills and character deficits, is that the psychedelic effects of ecstasy manifest as a perceptual distortion so that fearlessness is actually due to impaired ability to read cues which signal danger. Hence, the increased 'confidence' and 'connectedness' are delusional, so rather than promoting true empathy and confidence, empathogens are agents of delusion. It is an odd contradiction that psychoactive drugs are used to treat delusions in a psychotic episode, yet a psychoactive drug is being advocated to induce delusions as a means of 'curing' social ills.
Utopian pharmacology reflects Huxley’s use of the drug soma, in his dystonian futuristic views in "Brave New World". The utopian pharmacologists need to be reminded that Huxley was not presenting a role of soma as an ideal that was benefiting individuals or society. Perhaps they need to be reminded that the purpose of the government in providing soma was not the wellbeing of the populace, but their control. And perhaps that is the true motive of proponents of utopian pharmacology – dis-empowering individuals by getting them to relinquish their personal power to addictive substances.
A Self Medication Model of drug use might appear to support a role of utopian pharmacology in therapy. However, while the model hypothesises that drugs and alcohol are used in an attempt to cope with life and compensate for cognitive and social deficits, the emphasis here is that it is only an attempt and not a successful one. Like psychotropic drugs, the illicit drugs and alcohol change or cure nothing. They merely serve to escape from problems by distorting reality, anaesthetising aversive feelings, masking inadequacies and filling the void within.
Meditation – a safe, natural alternative:
If the goal of using drugs and alcohol is to relax or experience altered states of awareness or consciousness, then why not give meditation a go? This is truly a self-empowering exercise rather than relinquishing control to a chemical substance. Meditation produces relaxation – but perhaps a state of inner calm would be too confronting for the stimulant user who has a low tolerance for a relaxed mind. Meditation clears the channel between the different levels of consciousness (subconscious, the conscious mind and the higher consciousness) – and no side effects, no developing of tolerance, no addiction. Meditation facilitates experiences of psychological insights and spiritual awareness - but that might be too confronting for users who are using psychoactive substances to escape into a drug-induced stupor – distortion and delusion (of hallucinogens), anaesthetising or blacking out (with analgaesics) or overwhelming the mind (with stimulants) - rather than explore and resolve.
Conclusion:
Perhaps we do not realise how lacking in self sufficiency we are, as a society. How dependent society is on the quick fix of a pill to dull emotional pain rather than the effort to face and address the cause. Or the hedonic experience of artificial sources of dopamine, rather than the effort of seeking satisfaction in life. As a social species, interpersonal interaction and community social events and sporting activities are an essential part of the social cohesion of society and mental and emotional wellbeing and connectedness of its members. However, dependence on these external sources of stimulation does not bring mental and emotional wellbeing. Entertainment and drugs to fill the inner void and feeding on the emotions of others to feel alive, does not bring mental and emotional wellbeing or connectedness – neither does it contribute to social cohesion. The youth of today tend to be a generation of dependency: dependent on alcohol and drugs to socialise, cope, self-medicate and feel good about themselves; dependent on communication technology and social media that fosters alienation, dependent on being ‘kept in the loop’, yet dependent on constant external stimulation from alcohol, drugs, entertainment and noise; and girls dependent on giving sex as a means of temporary validation.