Saturday, January 17, 2009

DrugMonkey Asks; Decriminalization: What would happen? Part 2

Or Why I am studying to become an Addiction Researcher......

So now I am going to talk about the drug users, both current and potential. But I am probably not going to get to the decriminalization/legalization aspect of the discussion until we get a ways into this. First I would like to discuss addiction, overt dependence and what I see as the failure of our current addiction paradigm.

I think it is important to make the distinction between addiction and overt dependence. I think a very good way of expressing this is to identify two different types of heroin junkies. You have most heroin junkies, who even after they detox from opiates, still have a driving need to use more heroin. Then you have a much rarer type of heroin junkie, the junkie who after detox, will have absolutely no desire to even look at heroin again, much less still want to use it.

Overt dependence (OD) is the specific chemical mechanism that is very different from substance to substance. It is what makes heroin detox very different from detoxing from crack, or meth from alcohol. Using a particular drug will cause specific changes in one's neurochemistry. While some of these mechanisms might be somewhat similar, they each have their own unique patterns, that are nonetheless going to be common to other people who have OD on the same substance.

Addiction on the other hand, has some common characteristics, no matter what the addiction in question. These are characteristics that you will find with heroin addiction, alcohol addiction and shopping addiction or sex addiction. It would be way oversimplifying and completely inaccurate to claim that this is the whole story, but there are factors that are common to all addictions, something you just won't find with OD.

The known neurological common denominator in addiction is one that I am personally very familiar with, dopamine. This is why substance abuse is so very common with people who have ADHD. We are always on the lookout for better ways of getting our dopamine fix, as one aspect of ADHD is a dopamine deficit. At the same time, I suspect that this very trait is what provides most people with ADHD, some immunity to OD.

I suspect that there are more common neurological threads, that wind their way through addiction, which is why I am going in the educational direction I am. Not to say that I am limiting myself to neuropsych. I am going to work my way through clinical psychology on the road to my goal, because I think that there is a great deal of value to be had by approaching this from multiple directions. But ultimately, I want to study the common elements of addiction and the human brain. At the same time, I also want to find some of the uncommon neurological elements. Because I suspect that in the quest for both, lies a better answer, or a better paradigm for treating addiction.

So what do I mean by uncommon elements? Let me use my own addiction to tobacco as an example. Nicotine dependency is but a tiny aspect of my addiction to cigarettes. As is my dopamine fix (though that is by no means negligible, as I suspect that the OD on nicotine really is). What is far more important to my driving need to smoke cigarettes, is what smoking means to me.

When I was fairly young, I left home and then left the state to wander the U.S. and even some outside the U.S. I hitchhiked nearly every state. During those years, I slept outside far more often than I slept in. I lost absolutely everything I had on multiple occasions, starting completely over - mind you all I had at any given point was what I could carry on my back. The only consistency I had in my life, was cigarettes and coffee. The only things that were absolutes in my life. Next to that, I almost always had marijuana and a copy of Huxley's Brave New World.

Of the things I've listed, the only elements that are still critical components of my life are cigarettes and trying to hang onto a copy of Brave New World. I usually drink the coffee, but at times I feel the need to detox. And I have for a few reasons, found it necessary to quit smoking or otherwise use marijuana. So smoking is a huge issue for me, because it is one of the very last threads that tie in important aspects of my life.

On top of that, I have made smoking more than just a fix. I really enjoy smoking. I enjoy trying new tobaccos and blends. I like how it tastes and because of the quality of tobacco I smoke, I actually like the way that it smells. So defeating my addiction to cigarettes, is going to take a lot of effort on my part.

I did warn you that it would take us a minute to get to my hypotheses to answer DM's question, didn't I? If you're still with me, take heart, because we're there baby! Kind of, sort of....

Here's the problem. I honestly doubt that with our current addiction paradigm, as addiction pertains to drug users, our society would look much different than it does now. This is accepting that many of the changes I detailed in part 1 would make some rather significant changes to society. But as far as drug users go, things don't really look a whole lot different.

The exception to that, is that I do believe that we would see a temporary spike in drug use and with it, a spike in addiction rates - also temporary. This is not to say that the addictions accrued during this time would be any more temporary than addictions are now, just that as use dropped back down, so would the rates of new addicts.

I suspect though, that in the long term, overall use of most drugs would ultimately drop below the levels we have now. Because I believe rather strongly that legalization would foster an environment that encourages us to explore new addiction paradigms and that it would also foster new approaches to prevention/education.

I am honestly not that sure about what a new addiction paradigm should encompass. But I certainly have some ideas. First and foremost, I would love to see our society gain a much better picture of what addiction really is and accept that while addiction can be and all too often is a very ugly existence, addiction can not only be benign, but can even be an unmitigated positive. That it is ok to tell a drug addict that they are always likely to be an addict, with the caveat that they need not always manifest their addiction in the use of harmful substances or destructive behaviors.

I have mentioned that I have ADHD. Not only do I have ADHD, I have very severe ADHD. I have also been diagnosed with bipolar disorder and have been an insomniac since birth (seriously, I slept less than ten of my first twenty-four hours outside the womb - it was downhill from there). I know about dopamine deficiencies and have spent a rather large percentage of my life trying to compensate. When I was younger, that led me to using a lot of different substances for such compensation, but it also led me in other, unexpected directions.

I love to write and perform music. Performance in itself isn't the key though, what really gets the dopamine squirting, is when I am effectively influencing the emotions of my audience, making them feel what I feel or want them to feel. The stronger the effect I have on someones emotional state, the more intense the experience is for me. Given my Christian upbringing, this made the next step in my musical addiction a natural; writing worship music and leading worship. Because this brought the emotional intensity to a whole new level, making the effect could garner so much more intense.

I am not going to go into the interchange that brought me to that place right now, though I may address it another time. Suffice to say that in this process, I managed to do what a lot of addicts do. I lied to myself to make me believe this was ok, and by extension lied to others. That in itself isn't the worse, my addiction led me to stick with it after I had realized the lies I had told myself. To be sure, I was encouraged by some folks in the church who knew where I was at, for a variety of reasons, but when it came down to it, I stuck with it because of what it did for me. Because of my addiction.

The thing is, it could have been and has become an honest, benign addiction again. I stick to writing music that I believe in and while I'm not performing now, I know that when I am able to share my music with others, it will affect them. No lying and no harming anyone - least of all myself. Yet addiction it most certainly remains. The act of creating beauty with one of my favorite mediums, words, gets the dopamine moving. Even sitting here right now, putting these words on this page is making it happen. It's an addiction, but quite arguably a very positive one. After all, I believe what I am saying. I believe it strongly enough, that I want to direct my education so that I can either prove it, or discover that I am wrong - either of which is fine with me, because either result will still be a step in the right direction. That direction being furthering our understanding of the world, specifically addiction.

And if I can convince others that I might well be right, that may encourage them in a positive way. Or this may encourage people to challenge me and maybe even make a cohesive argument that encourages me to change my position. Or their challenge may encourage me to think more and develop a more cohesive position of my own. Hell, their challenge may be so ridiculous that it fills me with righteous indignation. Any and all of these possible results, will produce yet more dopamine spikes and feed my addiction even more. All without me resorting to the use of destructive chemicals or other destructive behaviors.

There is a lot more I could say and maybe I will. But I think I have provided about as much a overview as I can for now. I realize that much of this seems quite tangential to the issue of what decriminalization or legalization might look like, but it's all interconnected - or should be. I think that it is quite reasonable to say that both the prohibition and war on drugs have been abysmal failures. But that is not the only failure. Our entire drug paradigm is an absolute, categorical failure. Our entire addiction paradigm is an absolute, categorical failure.

Therefore, I think it is rather unreasonable to attempt to discuss any of these in a vacuum.


JLK said...

Isn't it so difficult to try to write a paper or do some other assignment when you could be writing a blog about the things you LOVE to talk about? I'm so grateful for the break I have for the next 6-7 months or so before starting grad school to give me a chance to refocus myself on the things that led me on that path in the first place.

A fantastic post, DuWayne. Now I am off to read the one below it.

And good luck with your paper!

DuWayne Brayton said...

Actually, I really don't mind the writing of papers on other topics. There aren't a lot of topics I am likely to have to write about that I won't enjoy, because I have a very diverse set of interests. Basically I love to talk, love to learn new things. So I think it will be tough to find papers I don't like and I figure there's no reason I can't turn around and use a lot of them as blog posts.

OTOH, this is my easy-peasy semester (it's my first time in school in sixteen years). This summer will be too. Right now I'm at fourteen credits and they won't let me take more than eighteen in the summer. But come this fall, I am ramping it up to at least twenty, if not twenty four. At that point I might start hating life and the fucking papers.

JLK said...

I went through the same thing when I went back to school. (It was a 6yr gap for me as opposed to your 16) I was so excited and happy to be back that I loved every assignment. I had 19 credits when I went back, so we were in similar situations.

My advice to you - build up to larger #s of credits gradually. I started with 6 in the summer, then went to 12, then to 15. I was working full-time during all of this though, so your situation may make it much easier to take more credits.

I remember thinking to myself, "Holy shit! How did I not take like 8 classes per semester when I was a full-time undergrad at 17?? I didn't have to WORK!"

But you've got kids and I don't, so I feel like going back to school as a nontrad for both of us is remarkably similar in terms of outside time committments. Just make sure you don't burn yourself out! Remember that exams and papers often have the same or similar deadlines, and the more classes you have the more you'll be cramming ungodly amounts of work into small time periods.