Executive Director's Column
I work at the Maple Ridge Treatment Centre, a large residential facility for men suffering from substance addictions. My clients and their families come to us looking for answers, and perhaps their most common question is: Why would anyone use alcohol and drugs if they lead to severe suffering?
It’s a perplexing question. Mainstream addiction experts provide several answers. Counselors with a Freudian bent have popularized the idea that addicts are in ‘denial’ of their problem. Others appeal to neurobiology: the addict’s brain has adapted to drug use and must have the drug to prevent withdrawal. Some believe that the use of drugs is a maladaptive coping skill to deal with stress or that it is rooted in the addict’s doomed attempt to deal with trauma. And there has been a recent movement suggesting that all addicts have co-occurring mental health issues, and this condition gives rise to drug use (see, eg, Minkoff, 2000).
Valid as these answers may be, at least in part, they reduce the drug experience to a mere symptom, of no more importance than a runny nose that accompanies a cold. Clinically, we define addiction as continued use of the substance despite knowing that its use will bring suffering. There must be something remarkable about the drug-induced altered-state-of-consciousness that addicts are willing to suffer the inevitable pain that follows.
Difficulties in understanding the drug experience
What is the drug experience? Frankly, we haven’t done a very good job understanding it. In his book, Altered States of Consciousness (1990), Charles T. Tart provides a brief historical explanation for this omission. In the first half of the 20th Century, psychologists had little interest in the subject. A few thinkers had previously examined the drug experience-writer Thomas De Quincey (Confessions of an English Opium Eater, 1821), poet Charles Baudelaire (Artificial Paradises, 1860/1996), and philosopher-psychologist William James (The Varieties of Religious Experience, 1902/1999) come to mind – but psychology was preoccupied with two approaches to the study of human beings: behaviorism and Freudian-based psychoanalysis. Psychologists hoped to understand the nature of the human being by focusing on survival and security needs, and they found inspiration by studying the difficulties of those who suffered from mental disorders.
In response to these two powerful approaches, a third approach arose in the latter half of the century. Called ‘humanism’, it was interested in human growth potential, the inner urge within the individual to ‘self-actualize’. This interest led naturally to teasing out the qualities that healthy people displayed rather than study only those with disorders, and it put the focus on the individual person. Abraham Maslow, humanism’s early exponent, argued that survival and basic psychological security needs were only the foundation for a natural human tendency for personal growth.
With its focus on inner growth, humanism sparked new interest in altered-states-of-consciousness. Perhaps what we called ‘normal’ was, in reality, an arbitrary limitation of our natural potential. Psychologists began studying Zen meditation, religious mysticism, hypnosis, and so on.
Obviously, a drug-induced altered-state-of-consciousness soon emerged as a topic for study. Researchers wrote papers on various drugs, but the most famous were studies on LSD. In the 1950s, LSD was seen both as therapeutic agent and as an aid to achieve personal growth. British psychiatrist Humphrey Osmond provided alcoholics in Weyburn, Saskatchewan, Canada, with LSD in the hope of helping them recover (even Bill Wilson, the driving force behind Alcoholics Anonymous, experimented with hallucinogens as a means of aiding his personal recovery from alcoholism). Soon after, researchers, such as Crockett, et al. (1963) and Sherwood, et al. (1962), published papers on the use of LSD as a therapeutic agent. The most famous document on the use of hallucinogens to achieve personal growth was Aldous Huxley’s (1956/1990) The Doors of Perception, a description of the mind-awakening qualities of being high on the hallucinogen mescaline.
In the mid-1960s and later, however, public fears of drug use curtailed research. And under the so-called US ‘war on drugs’, many researchers were understandably worried that their funds would evaporate if they pursued this study. Because of the threat, many researchers, such as Hastings (1990), wrote anonymously, while others, such as Lensen (1999), did not publish until a more favorable political climate was in place.
Let me emphasize that most of this early research studied the use of drugs that was not addictive and lamented the terrible suffering of excessive drug use. Charles Tart, in the third edition of Altered States of Consciousness (1990), openly speaks of his “strongly ambivalent feelings” (p. 389) on including drug chapters in the later edition because of the terrible suffering from excessive drug use in the 1970s and 1980s.
The essential motivation for using drugs: an altered-state-of-consciousness
In spite of Tart’s regret, it is important to appreciate the obvious: the urge for an altered-state-of-consciousness is the essential motivation for the use of drugs.
This idea is worth repeating because so much publicized today about addictive drug use comes from pharmacological, neuroscience, cognitive-behavioral, enforcement, and drug policy perspectives. Happily, a growing number of researchers are studying the experience from the addict’s perspective. And what we are discovering is that at the heart of drug use is the craving for a positive emotional experience.
To reinforce this idea, I point out that clients do not come to the Maple Ridge Treatment Centre because, for instance, they smoke a pack of cigarettes a day. Even though the Government of Canada regularly targets nicotine as the number one drug of abuse, tobacco’s effect is not powerful enough to justify a large treatment facility. And if I were to try to convince my clients that smoking a cigarette is similar to smoking cocaine, they would laugh at me. Similarly, caffeine and sugar are not potent enough to bring people to our center. Treatment facilities are built only for those who succumb to drugs that provide a dramatically-altered state-of-consciousness.
Elements of a drug-induced altered-state-of-consciousness
With the caveat that we still lack a deep psychological understanding of why people select one drug over another, what the experience of the drug high is like, the appeal of the drug high, and so on, let’s have a look at some descriptions of the high.
I have on my desk an eclectic collection of works that describe the drug experience: Thomas De Quincey’s (1821/1986) Confessions of an English Opium Eater, William James’ (1902/1999) The Varieties of Religious Experience, Eugene O’Neill’s (1941) Long Day’s Journey into Night, Gerald Le Dain’s (1971) Interim Report of the Royal Commission on the Use of Non-medical Drugs in Canada, Paddy Chayefsky’s (1978) Altered States, Charles Bukowski’s (1984) Barfly, Solomon Snyder’s (1986) Drugs and the Brain, Jack Kerouac’s (1993) Visions of Cody, two issues on addiction from Janus Head (2003) magazine, and some qualitative papers from various scholarly journals.
Taken together, these works tell us is that the drug high is not a single experience but many: the accounts comprise a pool of inconsistencies and contradictions. Euphoria, depression, pleasant and unpleasant hallucinations, feelings of connection with the universe, out of body experiences, peacefulness and relaxation, paranoia, freedom from stereotypical thinking, discovering hidden connections between things, time speeding up and slowing down, and so on. There is nothing odd in this. Early studies of the LSD high soon convinced experts that the experience depends at least as much on the psychology of the user as it does on the chemical effects of the drug on the brain (Tart, 1990).
But common threads weave through the descriptions. There are, of course, the negative states associated with long-term drug use, such as depression, lethargy, terrifying hallucinations, and paranoia. Still, the positive effects remain: ecstasy, freedom from conventional thinking, loss of self-consciousness, dissociation from the sober boring self, and so on. Stimulant addicts who have developed ‘cocaine psychosis’ or ‘methamphetamine psychosis’, for instance, willingly continue to use these drugs despite the paranoia because of the positive emotional effects.
Examples of the drug experience
Forget for a moment ideas of cravings and poor coping skills and listen to the appeal of drugs:
From Thomas De Quincey (1821/1986), on opium:
“I was necessarily ignorant of the whole art and mystery of opium taking…but I took it;–and in an hour, oh! Heavens! what a revulsion! what an upheaving, from its lowest depths, of the inner spirit! What an apocalypse of the world within me! That my [stomach] pains had vanished, was now a trifle in my eyes:–this negative effect was swallowed up in the immensity of those positive effects which had opened before me-in the abyss of divine enjoyment thus suddenly revealed. Here was a panacea…for all human woes: here was the secret of happiness….” (p. 70-71)
From William James (1902/1999), on alcohol:
“The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties of human nature usually crushed to earth by the cold facts and dry criticism of the sober hour. Sobriety diminishes, discriminates and says no; drunkenness expands, unites, and says yes. It is in fact the great exciter of the Yes function in man. It brings its votary from the chill periphery of things to the radiant core. It makes him for the moment one with truth.” (p. 421)
From Eugene O’Neill (1941/1989), on alcohol:
“I became drunk with the beauty and singing rhythm of [the sea], and for a moment I lost myself-actually lost my life. I was set free! I dissolved in the sea, became white sails and flying spray, became beauty and rhythm, became moonlight and the ship and the high dim-starred sky! I belonged, without past or future, within peace and unity and a wild joy, within something greater than my own life or the life of Man, to Life itself! To God, if you want to put it that way.” (p. 153)
From Gerald Le Dain (1971), on the appeal of illicit drug use:
“Modern drug use would definitely seem to be related in some measure to the collapse of religious values-the ability to find a religious meaning of life. The positive values that young people claim to find in the drug experience bear a striking similarity to traditional religious values, including the concern with the soul, or inner self. The spirit of renunciation, the emphasis on openness and the closely knit community, are part of it, but there is definitely the sense of identification with something larger, something to which one belongs as part of the human race.” (para. 331)
From Jack Kerouac (1993), on describing a cloudy day under the influence of marijuana:
“That kind of day, that’ll only know a rosy cloud at sundown when the sun will find its tortured way through masses and battles of fevered darkening matter-raw, dank, the wind going like a gong through your coat and also through your body-the wild wooly clouds hurrying no faster in the heavens above than the steam from the railyards hurrying over the fence and up the street into town-fantastic, noisy….” (p. 85)
From a cocaine addict (cited in Trujillo, 2003), on crack cocaine:
“It’s like the whole world, life is beautiful. I feel great. I have a lot of ideas. My mind just opens tremendously. My mind is like really fast and I think better. I feel good. I feel life is wonderful. I can do anything.” (p. 171)
Again, I emphasize that I am not promoting drug use. I would invite anyone who thinks that drugs are a good way to transcend their sober world to attend an open twelve-step meeting. They will soon appreciate the depths of suffering that inevitably accompanies addictive drug use.
But I am hoping that readers will sense some of that mystery and appeal of the drug experience that these quotations describe. Ponder the language: feelings of transcendence, of wonder, of belonging, of focus on details, of the mystical, of total absorption in the high. And, with the exception of Kerouac’s deliberate attempt to highlight how details come alive under the influence of marijuana, this is no mild experience. Feelings are raised to the level of ecstasy: “here was the secret of happiness,” “I belonged…within peace and unity and a wild joy,” “I can do anything.” To borrow from O’Neill, the drug experience satisfies the urge to transcend the sober self-conscious self and feel a deep and profound sense of being at one with the cosmos.
How different such descriptions are from the mainstream professional treatment descriptions of drug use as pathological: the defective personality trait of denial, warped neurobiology, and maladaptive coping skills. More and more I see thoughtful observers meditate on the drug experience. For instance, a documentary on this theme is Gambling, Gods and LSD, which won the prize for best documentary at the 2003 Canadian Genie Awards. After spending 10 years working on the project, director Peter Mettler examines addicts, who, Mettler argues, have chosen drugs to embark on a spiritual quest to discover who they are and their place in the universe.
A growing number of researchers and clinicians are convinced that an approach that appreciates the drug experience itself (among other things) will lead to better treatment for addicts. We seem preoccupied with our pharmacological and cognitive-behavioral perspectives, developing drugs to help addicts recover and teaching them new coping skills. But success rates from such treatment are not particularly inspiring, and it is likely that this poor success is linked directly to our neglecting the ‘spirituality’ factor.
Meaning conference 2006
Thus our upcoming conference on Addiction, Meaning & Spirituality. Drug use arises, in large part, from a need to satisfy ‘spiritual’ yearnings. Our conference will help clinicians, researchers, and those interested in humanistic-existential-transpersonal approaches discover the possibilities for easing the suffering that drugs inflict on addicts, their families, and society.
Baudelaire, C. (1860/1996). Artificial Paradises. Sacramento, CA: Citadel Press.
Bukowski, C. (1984). Barfly. Santa Barbara, CA: The Paget Press.
Chayefsky, P. (1978). Altered states. New York: Harper & Row.
Crockett, R., Sandison, R., & Walk, A. (Eds.). (1963). Hallucinogenic drugs and their psychotherapeutic use. London: J.Q. Lewis.
De Quincey, T. (1821/1986). Confessions of an English opium eater. Toronto: Penguin.
Hastings, A.C. (1990). The effects of marijuana on consciousness. In Tart, C.T. (Ed.). (1990). Altered states of consciousness, revised and updated. New York: HarperCollins, p. 407-432.
Huxley, A. (1956/1990). The doors of perception and Heaven and hell. Toronto, ON: HarperCollins.
James, W. (1902/1999). The varieties of religious experience. New York: Random House.
Kerouac, J. (1993). Visions of Cody. New York: Penguin.
Le Dain, G. (1971). Interim Report of the Royal Commission on the Use of Non-medical Drugs in Canada. Ottawa, ON: Government of Canada.
Lensen, D. (1999). On drugs. Minneapolis, MN: University of Minnesota Press.
Minkoff, K. (2000). An integrated model for the management of co-occurring psychiatric and substance disorders in managed care systems. Disease Management & Health Outcomes, 8, 250-257
O’Neill, E. (1941/1989). Long day’s journey into night. Newhaven, CT: Yale University Press.
Sherwood, J., Stolaroff, M., & Harman, W. (1962). The psycheldelic experience: A new concept in psychotherapy. Journal of Neuropsychiatry, 4, 69-80.
Snyder, S. (1986). Drugs and the Brain. New York: W.H. Freeman.
Tart, C.T. (Ed.). (1990). Altered states of consciousness, Revised and updated. New York: HarperCollins.
Trujillo, J. (2003). An existential-phenomenology of crack cocaine abuse. Janus Head 7(1), 167-187.