Addictions
A great book about addictions is called Buzzed, published by W.W. Norton. It is scientifically sophisticated, factual, unbiased, and it also explains jargon and street terminology. Addictions are characterized by repetitive, compulsive use, despite causing negative consequences for the user. They usually also cause harm to nonusers, but that's not part of the rigorous definition of an addiction. Most people probably think only of drugs in this regard. However, what about gambling, shoplifting, and misusing sex (for example compulsive affairs)? There is still a debate among addiction experts about how to classify these so-called, "behavioral addictions". As for me, I consider them to be addictions. I'll be discussing them in a separate essay.
Addicted people cannot consistently control their use of their "drug of choice". They often fool themselves, because they can temporarily control their use. However, over the long haul, the fact that they are out of control is obvious to anyone but themselves. Despite what authorities or parents may tell you, using any of these drugs a few times does not mean you are addicted or that you will inevitably become addicted. Telling lies like that or other scare tactics can cause potential addicts to wrongly discount accurate information. I call such use “experimentation.”
When thinking about the various addictions, many people overlook the worst one of all in terms of health problems. I'm referring to nicotine addiction. Many addicts report that it also is the hardest drug "to kick". The negative health consequences for the population at large from nicotine dependence dwarf those of the other addicting drugs by far.
Although the following classification of my own is definitely oversimplified and abbreviated, it is easy to remember and fundamentally accurate. There are three basic categories; Stimulants (Uppers), Downers, and what I call "Spacers." The two main stimulants in the United States are cocaine and amphetamines. Downers include alcohol, opiates, and sedatives. Spacers include LSD, mushrooms, mescaline, and marijuana. Because of their unique features, I put Ecstasy by itself in a fourth group, and PCP in a fifth group by itself.
Both cocaine and amphetamines can cause death from overdose. The severity of the addiction risk from these two drugs depends on the route of administration. The routes of injection and smoking are the most likely to cause addiction. Prolonged use of high doses of these two drugs can cause paranoia, agitation, and hostility. The withdrawal symptoms from stimulants are essentially the opposite of the symptoms of intoxication. In other words the user gets depressed and has very low energy. Withdrawal from stimulants is not lethal. There is also no specific treatment for the symptoms of withdrawal. Helpful measures include good nutrition, adequate rest, and emotional support. The question of whether or not chronic use of these two drugs causes any permanent damage is still the subject of debate. Some chronic users develop prolonged paranoia, but usually it eventually resolves.
Overdoses of the Downers (including alcohol) can also be lethal. Alcohol when ingested rapidly, on an empty stomach, and in large quantity, can cause death from respiratory arrest. By the way, drinking coffee does not sober you up. You just become a "nervous drunk." An overdose of the opiates can also cause death from respiratory arrest. There are many different kinds of benzodiazepines, which are also Downers, including, Valium, Librium, Ativan, Xanax, and Klonopin to name just a few. If “Benzos” are taken by themselves in overdose, the person usually just sleeps a long time. When mixed with alcohol, the combination can be lethal. There are many other sedatives, all of which can be lethal in overdose. These include barbiturates, chloral hydrate, doriden, miltown, and Placidyl, to name just a few.
Opiates, another Downer, can be injected (for example heroine), smoked (like opium), or swallowed in pill form(Oxycontin, Vicodin, etc.) Any form of prolonged administration is associated with a high risk of addiction. Again, the withdrawal from Downers causes basically the opposite symptoms of the intoxication, i.e. agitation. If you are unhealthy, you can die from alcohol withdrawal. It can and should be treated with safe drugs. Contrary to common believe, people cannot die from opiate withdrawal. They just wish that they would die. Moreover, there are prescription drugs which can lessen the severity of the withdrawal symptoms.
All the drugs that I've discussed so far are associated with tolerance. This means that if you continue to take the drug, it takes a higher and higher dose to cause the same effects. Moreover, the enjoyable part of the intoxication, usually decreases with chronic use. As I've already mentioned, the above drugs also have symptoms when chronic use is discontinued, called withdrawal. "Spacers" don't have these two characteristics, (Withdrawal and Tolerance).However, they are definitely used addictively in the sense that many users divert much of their time and energy into finding and using these drugs, and conversely they stop putting their energy into parenting, working, healthy hobbies, et cetera. Chronic use of these various drugs makes it difficult for a person to "be who they really are" in their life. These behavioral changes are the defining characteristics of Addiction., from a modern point of view. Previously, Tolerance and Withdrawal were considered to be the essential diagnostic criteria.
As I said, the hallucinogens include LSD, mescaline, psilocybin, and also Marijuana, and when in a concentrated form (like hashish). I'm not going to discuss the issues of medical marijuana and legalization of drugs in this essay. Obviously, not all people always have bad reactions, all the time, to these drugs. However, some people clearly have temporary paranoia or severe anxiety reactions caused by Hallucinogens. Others become socially awkward and very ill at ease. Others become nonproductive in their lives, at least from a conventional point of view, ( for example the so called, " amotivational syndrome"- caused by chronic use of marijuana). Bad trips and flashbacks can also occur, and it's not possible to predict who will get such reactions or how long they will last.
I put PCP in a class by itself, because of the severity of the intoxication, that occurs sometimes for some people. People can experience temporary psychosis (i.e. becoming crazy or
being out of touch with reality) from a single dose. There also can be relatively long-lasting psychosis. Other people experience dangerous, irrational, and even very aggressive behavior, or self injurious behavior.
Ecstasy (MDMA) also deserves its own class. Many users of ecstasy report having experienced new and permanent insights about life that they greatly value. They sometimes experience great empathy and decreased fear and openness to life, which they find valuable. Unfortunately there is an unresolved question about whether or not this drug causes permanent brain damage. Let me make clear that I have no vested interest in whether or not anybody uses ecstasy. I have followed the scientific literature about Ecstasy for almost 2 decades, and based on my reading, the question is still not answered. For me it's not worth the risk. However, I know other people who feel differently.
That leaves a few additional considerations. If you buy your drugs on the street, you can't really know what you are purchasing. Lots of street drugs have been cut with other drugs. You may have purchased a mixture. There may be harmful impurities. I'm not trying to frighten you. These facts are simply true. Cheaper drugs which cause similar symptoms can be substituted. You also can't know the potency of what you have purchased. This can have deadly consequences. Every time a higher potency form of heroine becomes available on the street, many addicts die of accidental overdose. In addition all the above drugs impair a person's ability to drive, with the exception of cigarettes. Even people who definitely know the identity of the drugs they are using may kill themselves by mixing drugs in a way that is dangerous.
I hope that this oversimplified discussion proves useful. I can't say enough about the book, Buzzed, if you are interested in more information. It's one of the most informative, no bullshit, and yet enjoyable books that I've ever read.