Posts Tagged ‘ Drugs, Herbs, Medicines, Poisons ’

Rob Ford is not an Addict; Rob Ford is a Monster

Insightfully missing the point in a recent article titled “Rob Ford: a dubious grasp on recovery fundamentals,” Jim Coyle of the Toronto Star examined our illustrious mayor’s behaviour and statements on his return from rehab, and found them to be inconsistent with the narrative of an addict in recovery.

Says Coyle: “About his experience in rehab, the mayor recited only bromides and generics. This was unusual. Virtually all rehab grads have moments of clarity, small epiphanies, those times when they get it. These are usually heart-scalding. And hardly a rehab grad speech is made without a man or woman telling of an instance deeply meaningful to them. Ford has had nothing of the kind to say. Likewise, he had almost nothing specific to say about the behavioural changes that will be necessary to live sober — the mundane nuts and bolts in which rehabs specialize. … The most screaming silence of all, of course, was his failure to specifically mention his children or wife — who, if they are like most every other family to have walked this path, will have suffered most from his addiction. Most every parent who goes into rehab has a searing moment when they realize just how much pain they’ve caused loved ones. It causes our greatest grief. It inspires our greatest determination to get well and get it right. Most every parent coming out of rehab dedicates themselves, above all, to being better fathers or mothers.”

Long story short, Rob Ford’s recovering addict performance was unconvincing. Coyle seems to think that Ford is addicted, but not recovered. I suspect, however, that it goes deeper than that: Rob Ford, though a problem drinker, was never truly addicted in the first place. The defining feature of addiction is akrasia: using against one’s better judgement. Wanting to stop, but being unable to stop. It is not the same as merely having a drug/alcohol problem, as drugs and alcohol can cause serious problems even in the absence of an addiction, and, indeed, one can be addicted without having suffered any dramatic harm (and most users of every popular drug are not addicted and will never be seriously harmed by their use). Rob Ford was not constantly drunk, but was prone to binges, and in his excess frequently got himself into trouble. The claim that he has an addiction, as far as I can tell, was never substantiated, but was taken for granted since the news first came out about the crack video. There was, at that time, some debate about whether the allegations about using crack were correct. There was, however, no debate about what crack use signifies.

Did someone said crackIn the white middle/upper class imagination, crack has long provided a convenient transfer point by which the responsibility for racial inequities could be shifted from white society (racism) to black people themselves, via the proxy of a drug. Crack thus inherited the legacies of slavery and systematic discrimination. Faithful to these roots, its criminal prosecution has brought terrible violence against already severely marginalised people. In the United States, prior to the Obama administration, crack cocaine was punishable 100 times as severely as powdered cocaine (under Obama, that ratio was lessened to 18 to 1), even though crack and powder cocaine are literally the same drug, different only in means of ingestion (and therefore in rate of absorption). Powdered cocaine, however, is associated with rich whites, and crack cocaine is associated with poor blacks. As those incarcerated in the United States are required to work, often under threat of increased sentences or even solitary confinement, disproportionate prosecution of the War on Drugs against young black males has ensured a steady supply of slave labour for American manufacturing. To justify these practices, crack has been repeatedly vilified, its harms conflated with those of endemic poverty and malnutrition. Discrimination is covered up by medicalisation, turning a moral problem into personal problem, poverty into criminality and then into disease. Rob Ford, however, is not black, nor is his family poor. To the gentrifiers who dominate this city, for a white mayor to be a crack user was incomprehensible — it didn’t match the script for either mayors or crack users. Much of the ensuing scandal revolved around race, with Ford casting himself as white saviour while simultaneously uttering bigoted comments, repeatedly accused of racism but also of having inappropriately appeared in photographs with people whose appearance marks them as outsiders to be avoided. He got high with people from whom he was supposed to be hiding, and it blew everyone’s minds.

Should we have been so surprised? While “a whopping 85 percent of those sentenced for crack cocaine offenses were black … the majority of users of the drug were white.” (Hart, 2014) Most of what most of us think we know about crack is completely untrue. For example, there never was a crack baby epidemic. It’s not that crack is totally safe; there can be significant health effects from regular crack smoking, but they’ve been vastly overstated in drug war propaganda, and so the public has a very distorted image of its effects and users. One of the lies we’ve been told is that crack is instantaneously addictive: try it once and you’ll become mindless, incapable of making rational choices, forever consumed by the hunger for crack. To see if this were actually the case, psychologist Carl Hart performed an experiment in which crack users were given the choice of crack now, or a monetary reward some hours later. If the mindless-crackhead model were accurate, no amount of money would have been enough to outweigh the option of getting high right now — but, in the experiment, $20 was a sufficient reward for every single crack user to delay gratification. If only $5 was offered, sometimes they’d choose the crack, provided there was enough of it. This makes it clear that crack users can rationally consider their options and refrain from using if there’s a better option available. Moreover, most people who use crack do not become addicted to it, and even if they end up struggling with addiction, they can still weigh options and choose appropriately. Addiction is a conflict of values, where the good parts about getting high, though outweighed by the bad parts, are still serving an important function which cannot be so easily released, and this conflict can expand and take over entire lives, or even entire communities. Rob Ford, however, is not even addicted — or, at least, there’s no evidence that he is. We simply found out that he’s used crack and immediately assumed he must be addicted, because we’ve been lied to for decades in the hopes that the slavery of black people might thrive uncontested.

I don't always smoke crack

Rob Ford’s behaviour has been problematic, to say the least. His comments and actions have been homophobic, racist, abusive and reckless, and his drinking has surely played a central role in that. There is much about him many of us we would like very much to sweep under the rug, and the narrative of addiction provides a convenient way of doing exactly that. By calling him an “addict,” we strip his actions of authenticity. If he was addicted, that means he was going against his own will, and so the struggling human can be separated from its body’s actions. This also functions collectively: by marking certain behaviours as “those of an addict,” we can place them outside of our collective self-concept (we’re not like that; he’s just sick). The realities that a great many people actually want to have an ignorant bigot for mayor, and that someone with power might actually like to get high (and not be conflicted and contrite about it), are harder to swallow than the old story that sometimes people go down bad paths in their lives and do awful things in spite of themselves. “Addiction” is, among other things, a script we can assume he’s following if we want to ignore what he actually is. And what is he?

A monster is a creature which exists across categories, which cannot be accounted for under the dominant system of thought, and which therefore threatens destabilisation, provoking a reaction of fear and hatred. It comes from the Latin verb for “to remind”: monsters demonstrate. In colloquial English, it also means an unredeemable villain, one guilty of cruelty and identified with the grotesque. A monster is the unthinkable and inescapable. For an addict to have made errors only to find a path to recovery and redemption would put everything in its proper place and reaffirm the social order — the gentrification of Rob Ford, defusing his potency. The definitional requirement of addiction, however, is simply absent: political manoeuvring aside, there was never any indication that Rob Ford actually wanted to stop but found himself unable to; I posit that he never wanted to stop at all: he simply likes getting drunk and high. Thus, he is a monster, haphazardly crossing the lines of race and class, revelling unreflexively in the violation of every Torontonian taboo.

frankeinford

Does he seem like he’s recovering? To quote again from Jim Coyle, “There was nothing of the vitality and enthusiasm that most rehab grads have on release, the gratitude for a new lease on life, the eagerness to get on with showcasing the new and improved us. He seemed like someone who had just lost his best friend. … he seemed still to be grieving.” We must now consider the possibility that Rob Ford was able to sustain his exuberance and civic engagement in the face of constant and vicious attacks not in spite of but because of his substance use. What seemed like a politically expedient move — admitting to a non-existent addiction so as to follow a simple narrative and regain public trust — has now failed. His recovery was a lie, and he has been made weaker by the effort. It may be that without the stimulating secret to his powers he will simply fade away. More likely, however, is that we have not yet born witness to the great and terrible fruition of his monstrosity, and he will soon return to shock us all once more. I can only hope that he will not do so in a way that is materially damaging to this fair city, and that he will not regain power in the upcoming election. Vote Sketchy.

If the purpose of a monster is to show unrealised possibilities for greater understanding hidden in the cracks between categories, what promises lie hidden within the ample flesh of our notorious mayor? The (well founded) accusations of racism on his part, combined with condemnation expressed towards him for associating with poor black people, perhaps, hold the key. By indulging wilfully in what we wrongly assumed was reserved for the underclass, he has crossed a boundary, forcibly inserting black poverty and drug use into the branding of a “post racial” city in the throes of gentrification. Here, as elsewhere, race continues to inform practices of marginalisation.  We have supported policies of genocide against First Nations, and we have allowed the descendants of slavery to be enslaved once again under completely false pretences, blamed for the problems endemic in their communities, problems which stem from structural forces which meanwhile buoy the status of middle and upper class white Americans and Canadians such as Rob Ford. Perhaps, instead of constantly falling over ourselves to express disingenuous sympathy for Rob Ford’s “condition,” we should work to change the systemic factors responsible for establishing the narrative by which we have misjudged his conduct. Addressing endemic poverty among marginalised populations is a daunting problem and will not be simple, nor will it happen without resistance, yet it is necessary. Allow me therefore to close with two concrete suggestions for how to move forward:

1) Abolish the prison system, and pay reparations to those who’ve borne its abuses.

2) Design and implement a mincome-type system to eliminate poverty.

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What does marijuana do? It rebalances everything

[see also: “Can we please stop assuming that marijuana is harmful to young people?“]

The “simplest” accurate description of the effects of marijuana in humans is that it modulates the regulation of homeostasis. Homeostasis is what Goldilocks seeks in the children’s story: not too hot; not too cold; just right. More than just heat and cold, the human body contains many systems which must be held in relative balance. The balance between inhibition and excitation, bone formation and resorption, inflammatory/anti-inflammatory signalling, fat storage and release, blood sugar, blood pressure, hormone levels; all these systems are held in balance by the endocannabinoid system. This system, though involved in maintaining nearly every biological process in all humans, has only received scientific study for roughly the past 20 years, and it was discovered because it’s the site of action for marijuana.

Marijuana does not simply activate (agonise) this system. In addition to full cannabinoid agonists (chemicals which stimulate — agonise; antonym: antagonise — receptors), it also contains partial agonists, antagonists (Thomas, 2007), reuptake and transport inhibitors, enzyme modulators and much else besides, (Russo, 2011) including an assortment of terpenoids  and flavinoids responsible for the odour of the flowers; how a marijuana strain smells indicates what mix of chemicals (all of which appear to be pharmacologically active in humans) are present, beyond the most famous two, neither of which have an odour: THC and CBD. The most studied receptors in the endocannabinoid system are called CB1 and CB2, both of which inhibit the other (Callén et al 2012), and both of which are stimulated by THC (a partial agonist at both and other sites) and antagonised by CBD (Thomas et al, 2007). There are also believed to be numerous other receptors involved (Petrocellis, 2009), and their scientific study is yet only preliminary and largely speculative. Far from a single chemical with a single mode of action, marijuana has an entourage effect: many chemicals working together to produce effects not reducible to the action of only one or two of its constituents. One chemical it often contains in relatively large quantities, for example, is caryophyllene, a selective full CB2 agonist which is also found in cloves, rosemary, hops and eucalyptus. Other plants which work on cannabinoid receptors include hot pepper and vanilla. Through their presence in the diet of some marijuana users, these (and other) plants participate in the entourage effects of marijuana in modulating the regulation of homeostasis.

Summary: it rebalances almost every system in the body through multiple inter-related effects which move in several directions at once and which compensate for each other’s effects (confused yet?)

vanilla-planifolia

But what does it all DO?

Research into the effects of marijuana has been aided by intense and widespread public interest, but hindered in recent decades by efforts by various parties to suppress any investigation into possible benefits and to spread claims of possible harms (no matter how tenuous), as part of the “war on drugs.” As an ethnographer working with young drug users in person and on the internet, as well as having read widely on the subject, these are the effects I have most often found credibly attributed to marijuana:

Increased appetite, change in the perception of time, relief from pain, intensified awareness (both inside and outside the body), relaxation, euphoria, increased heart rate, lower blood pressure, emotional release, increased vigor, lethargy, inhibited memory, increased creativity, intense introspection, reveries, flights of fancy, lower body temperature, increased sexual pleasure, reduced sexual desire, relief from nausea, greater aesthetic appreciation, magical thinking, heightened interest in spiritual phenomena, and both increased and decreased anxiety (presumably different types of anxiety).

Reported medically relevant effects of marijuana also include bronchodilation, decreased intracranial and intraocular pressure, glucagon release, reduction in insulin tolerance, lymphocyte suppression, antimicrobial, anticonvulsant, antipsychotic, psychotomimetic, anti-inflammatory, antiemetic, antinociceptive and anticarcinogenic effects.

Occasionally marijuana causes many strange and idiosyncratic effects not here described. Some of these may sometimes be labelled as psychotic or spiritual, but these effects are typically short-lived; they do not last and often cannot be produced reliably or consistently, making them difficult, if fascinating, to study.

Many of marijuana’s effects appear to be highly context- and dose-dependent. In small and occasional doses, it is often more stimulating, boosting appetite and providing relief from depression, whereas in very large and frequently repeated doses, these effects may reverse, with less appetite and relative inactivity. While it influences every organ system, its direct effects are largely confined to the maintenance of homeostasis, which it pushes not just in one direction but in several, counteracting and balancing out its own effects. Even a massive overdose will generally have a negligible impact on long term health, though it may be disorienting until it wears off.

The stimulating effects of THC typically last 2-3 hours, whereas the half-life of CBD, which is more relaxing, is 9 hours. Thus, the first dose of marijuana after a period of abstinence will tend to be far more stimulating than subsequent doses, which must compete with the relaxing effects of previous doses, because the relaxation both persists much longer and shares many of the same pathways as the stimulation. Regular ingestion of THC also leads to increased tolerance to its stimulating effects, but not to its relaxing effects, with very heavy use associated with a reversible 20% reduction in CB1 receptor density in some areas of the brain (Hirvonen et al, 2012); THC itself provides a longer term mild relaxing effect than the immediate boost. As cannabinoid activity can produce anxiety, it may well be that developing tolerance to the drug may itself protect against anxiety on a longer time scale; in a sense, by getting high you can get your anxiety out of the way while also benefiting from a variety of relaxing and euphoric effects to counteract it, rather than having to deal with constant, unremitting anxiety. Notably, Hirvonen et al only found the reduction in receptor density in only some areas, so this long term down-tuning does not affect all of the processes influenced by THC, but only some of them. In any case, we need to consider not just the immediate high, but also its persisting effects, if we are to understand the consequences of its use in humans.

Summary: it does lots of things, and sometimes also the opposite. (maybe this will be easier if we go system by system…)

Homeostasis 2

 

Marijuana in the Brain

The brain’s major inhibitory neurotransmitter is GABA, and the major excitatory neurotransmitter is glutamate; the endocannabinoid system regulates the levels of each of these by selectively suppressing them as called for, hopefully maintaining an appropriate balance. THC temporarily boosts this process, suppressing both inhibition and excitation. With GABA suppressed, a wide variety of effects and processes which would otherwise have been inhibited become more free to play themselves out. This explains the sensory enhancements commonly experienced by marijuana users, with increased sensitivity to smell, sight, sound, texture and much besides, including sexual pleasure. This is probably also the best scientific explanation for its occasionally outlandish effects, from the merely weird to the deeply spiritual to the profoundly unsettling: the mind, unleashed and uncontained, for better or for worse. Glutamate, though itself excitatory, excites neural networks which inhibit various behaviours, and so its suppression may contribute not only to relaxation but also to some of marijuana’s behavioural effects, such as indulgence in magical thinking and the wild dancing. Importantly, glutamate can also damage brain cells (excitotoxicity), and so suppressing it provides some protection brain damage as it occurs in head injury, epilepsy, hypoglycaemia, stroke, alcohol or benzodiazapine withdrawal and a variety of neurodegenerative conditions including multiple sclerosis, Parkinson’s Disease, Alzheimer’s Disease and Huntington’s Disease, among other conditions. Cannabinoid receptors on glial cells are involved in memory storage, recall, and forgetting (Lane et al, 2005), as well as the extinction of conditioned place preferences more specifically (Parker et al, 2004), suggesting that marijuana use may make it easier to adapt to new contexts and to forget old habits. It fundamentally changes how we experience the passage of time; in Hindu mythology, Lord Shiva, poisoned by time, takes marijuana which relieves his anxiety so that he begins to dance, and through his dance the poison is neutralised, thus saving the universe from being destroyed by an imbalance between space and time. Many experiments have shown that marijuana use impairs performance at certain memory tasks, but that this effect disappears after a period of abstinence, and so cannot be described as damage. Rather than merely the absence of remembering, forgetting is an active process by which we let go of extraneous or harmful memories (White, 2001; Pollan, 2002); by boosting forgetting functions through its effects on glial cells, marijuana may provide relief from traumatic memories. (Marcisano, 2001) The creative benefit most commonly cited by artists who use marijuana is in improvisation, getting into the flow so that strange new rhythms can emerge, fascinate and delight. (Fachner, 2003) More research is necessary, but I suspect that increased forgetting and increased improvisation are linked, and that a good description of marijuana’s creative effects might be less rote repetition and more novel recombination; whether that will be desirable or harmful will depend on the task at hand.

Marijuana is very popular among people with ADHD, for whom it may be synergistic with their tendency to hyperfocus, sometimes used to push past ennui into full dynamic engagement (the term for which in the cognitive sciences is “flow”), though it also tends to increase restlessness and can make them even more distractable, especially in larger doses, and so ADHD people often find very small doses to be the most helpful. (Loflin, 2014) One physiological description of ADHD is impaired dopamine transporter function, and the most common pharmaceutical interventions for ADHD are psychostimulants such as amphetamines which stimulate dopamine release directly. Marijuana, on the other hand, does not increase dopamine signalling, but modulates salience through other pathways. For this reason, many ADHD people find that marijuana feels more “natural,” ebbing and flowing with the context, whereas amphetamines often feel forced or artificial. Another difference is that amphetamines often make it very difficult to eat and sleep, whereas marijuana boosts appetite and, for many of its users, provides unusually restful and easy sleep. This is extremely important, because poor sleep and poor diet are major sources of harm among people with ADHD.

Some autistic people have also found marijuana to be of benefit in relieving the overstimulation-related emotional anxiety and tension which can inhibit their behaviour. Recent evidence has emerged that autism may in part be caused by abnormalities in cannabinoid signalling (Földy, 2013), so it seems that the rebalancing effect of marijuana directly interacts with some of the underlying causes of autism. One physiological description of autism is too much glutamate and not enough GABA; by suppressing both glutamate and GABA, marijuana may essentially level the playing field, so that a stoned neurotypical and a stoned autistic person end up on roughly the same level.

In neither ADHD nor autism does marijuana merely suppress symptoms and make a person “normal”; far from it. What it does is to rebalance many metabolic, attentional and neural systems, reconfiguring any problematic balance which may be in place, and producing a new state of consciousness unlike either neurotypical consciousness or the typical expression of either ADHD or autism. That is, it may normalise homeostasis, but to do so is not necessarily normative, in the anthropological sense.

In summary, marijuana rebalances excitation and inhibition in ways which are sometimes highly valued, and which may correct for or prevent imbalances in attentional and cognitive systems.

Marijuana benefits and risks

Marijuana, Neuroprotection and Brain Damage

In addition to preventing glutamate excitotoxicity and neuroinflammation, marijuana also reduces the volume of fluid in the head following head injury, lowers brain temperature (trivia: the popular fever reducer sold as Tylenol works partially by breaking down into  a cannabinoid reuptake inhibitor, and therefore shares a pathway with marijuana (Bertolini, 2006)) and prevents prion accumulation (Dirikoc et al, 2007), all of which are ways by which it’s known marijuana can protect against brain damage. It also reduces risk of such neurodegenerative conditions as Parkinson’s Disease and Alzheimer’s Disease through other mechanisms besides. (Ramirez et al, 2005Eubanks et al, 2006) However, because of the pressure from the US government to publish (or fabricate) harms from marijuana, several widely publicised studies have been used to claim that marijuana causes brain damage. In every case, these studies either suggested nothing of the kind when properly interpreted, or were confounded enough to be worthless, and there is, at time of writing, absolutely no credible evidence of any form of brain damage from marijuana use in humans. In a classic example, one team of researchers forced rhesus monkeys to inhale large volumes of smoke, depriving them of oxygen in the process, and attributed their mental decline to marijuana rather than to oxygen deprivation. (Heath et al, 1980) Not surprisingly, subsequent studies failed to reproduce their finding. (Slikker et al, 1990; Paule et al 1992) Other studies have shown mental deficits and brain abnormalities in some young heavy marijuana smokers (Meier, 2012; Smith, 2013, Gilman et al 2014), but it’s highly likely that both the observed deficits and the marijuana use were caused by the same factor, rather than the deficits being caused by the marijuana use, as the deficits are only found in a minority of teenagers who use marijuana, and because there are a variety of sources of deficit which also predict marijuana use. (Tims, 2002) Post traumatic stress disorder (PTSD; often a product of child abuse) is a likely candidate, because it predicts both cognitive deficits (Moradi et al, 2013) as well as adolescent drug use (Maté, 2008Dube, 2003), including heavy cannabis use. (Cornelius et al, 2009) For people with PTSD, marijuana may correct a chronically dysfunctional stress response (Heim et al, 2000) and make it easier to forget painful memories (Ganon-Elazer 2012; Patel et al, 2004Marcisano et al, 2001). Regrettably, in none of the studies in which deficits were shown to be correlated with heavy early-onset marijuana use did researchers attempt to control for the enormous confound of past trauma. In light of the indications that marijuana is useful in the treatment of PTSD, to attribute the harms of trauma to a plant being used to alleviate it is particularly bothersome. There has also been a disturbing tendency in news coverage report all findings of alteration as “damage,” even where no deficits, and indeed some potential benefits, were shown. Given the ongoing drug war and propaganda efforts by various governments, the utmost skepticism is warranted in interpreting claims of marijuana-induced brain damage, none of which (to date) survive careful scrutiny grounded in the appropriate scientific literature. Given what we’ve learned about marijuana’s effects the dire claims seem ever more preposterous, especially given the many marijuana users who have distinguished themselves in scientific and artistic communities alike.

Rather than simply accusing hemp flowers of harming teenagers, a more sensible approach might be to listen to teenagers who are heavy marijuana users, to understand why they’re using it and what they’re getting out of it, bearing in mind that they may well be survivors of abuse, which agents of the legal, medical and educational systems may have directly participated in rather than alleviating. Stigma, theft of medicine, segregation and punishment are unacceptable responses to observed suffering.

In summary: marijuana rebalances and soothes a variety of neural processes and can protect against numerous potential sources of damage. No form of brain damage has been demonstrated to have resulted from its use.

Sagan High

Marijuana and Metabolism

The endocrine system consists of glands throughout the body which regulate everything from energy levels to metabolism to sex drive. CB1 receptors can be found throughout this system and influence the release of many hormones. One function of this system is to produce excitation in response to stress. This is necessary for survival, but when it gets out of hand it can be a major source of harm, especially in a fast paced modern economy where stress may be relentless. One effect of marijuana in the endocrine system seems to be to protect against this, by reducing susceptibility to stress-induced activation in the hypothalamus-pituitary-adrenal axis. (Patel et al, 2004) The details of how it does this, as well as all of its other diverse and complex effects throughout the endocrine system, however, remain murky, but are becoming clearer and will likely continue to do so over the coming years.

Marijuana’s ability to boost appetite is well known, and it is used to treat anorexia as well as diet problems resulting from other drug therapies, such as in patients with AIDS or cancer. Part of this effect on appetite may be because GABA suppression increases the rewarding stimulation from food; another part is its ability to block nausea, including the nausea induced by chemotherapy drugs. While there is a stereotype of getting high and then gorging on lots of delicious food, many of my respondents have informed me that they actually prefer to get high after their meal, finding it to improve their digestion and settle their stomach. It’s also common for “the munchies” to not set in until around 45 minutes after dosing, and it’s here that the endocrine effects, specifically in the pancreas, are explanatory. The pancreas secretes the pair of hormones glucagon and insulin to regulate blood sugar by signalling the liver to break down fat into sugar (glucagon) or to store sugar as fat (insulin). These hormones work as a pair to maintain homeostasis, and they stimulate the release of each other through a complex feedback mechanism. In 2008, it was determined that CB1 activation triggers glucagon release and that CB2 activation lowers glucose-dependent insulin release. (Bermudez-Silva et al, 2008) This helps to explain why marijuana users tend to eat more calories but do not gain any extra weight, have less obesity and lower rates of type II diabetes than non-users (Rodondi et al, 2006Le Strat, 2011Rajavashisth et al, 2012), and why some diabetics find that marijuana makes it easier to manage their blood sugar, as marijuana rebalances the relative levels of glucagon and insulin, although anti-inflammatory effects are also relevant.  Type II diabetics (whose pancreas still functions) tend to have very high levels of insulin, but the liver is unable to use it, and so blood sugar stays high, and the pancreas damages itself by trying to continually produce more and more insulin, eventually leading to organ failure if the diabetes is unmanaged. By boosting glucagon release and lowering insulin resistance, marijuana may alleviate or prevent the progression of type II diabetes and restore balance to the system.  The endocannabinoid system is also separately involved in fat storage (Cota, 2003Osei-Hyiaman et al, 2005) (interestingly, THC is also fat soluble, and so it seems to be storing itself through this process, and is released back into the bloodstream during exercise (Wong et al, 2013)), and some studies have found marijuana users to have more fat in visceral tissue. (Hézode et al, 2008Muniyappa, 2013) Cannabinoid antagonists have also been shown to reduce obesity, and not only do rodents given these drugs eat less, they also lose more weight than their reduced feeding can account for. (Pagotto et al, 2006) What exactly this means for users of marijuana (which contains both cannabinoid agonists and antagonists) remains unclear (more fat storage through one mechanism, and less fat storage through another), but the findings of lower rates of obesity and diabetes among marijuana users — despite correlations between marijuana use and a variety of life-style risk factors, including heavier eating — are very promising. Marijuana use is certainly not a major source of harm in this system, and may be of benefit in a variety of (very common) circumstances.

Cannabinoid signalling is also involved in many reproductive functions in both males and females, including in foetal development, and there are even CB receptors on sperm themselves. While the effects of marijuana on sperm and reproductive functions are not well understood, it appears that regular marijuana use may moderately reduce both menses and sperm production, and that therefore while many marijuana users can still conceive, it may be prudent for couples having difficulty conceiving to refrain from using marijuana. On the other hand, many find marijuana to improve their experience of sex, and it even allows for orgasm in some otherwise anorgasmic women. Not enough is known about its effects on pregnancy to be confident as to when it may be of benefit or harm to the foetus, (Pagotto et al, 2006) but it is commonly used to alleviate the nausea associated with morning sickness.

A stereotype of marijuana users is that they are lazy and that the drug makes them inactive. Traditional Hindu practices assume that this is the case, and discourage its use by home-owners, while allowing it to ascetics in the process of renouncing worldly attachments. (Morningstar, 1985) Some marijuana users certainly seem drawn to renunciation, and may show little interest in material advancement, especially when using heavily. Many others, however report that its effects are stimulating, and there have been many elite athletes who used marijuana, including martial arts legend Bruce Lee, basketball legend Kareem Abdul-Jabbar, Olympic gold medallists Michael Phelps and Ross Rebagliati, and more than half of the Oregon Ducks football team. Clearly, its effects are not disastrous to fitness or to the ability to exercise. Noted astronomer Carl Sagan and physicist Richard Feynman both used marijuana to stimulate visionary states and the flow of ideas; a great many other musicians, writers, scientists and artists have admitted to doing so as well. Many of the same have admitted at other times that marijuana can interfere with their performance or leave them distracted and tired. Its effects can be very inconsistent, and depend on the user’s metabolism, dosing strategy and the chemical composition of the strain being used.

In summary, marijuana rebalances energy levels, fat storage, reproductive functions, appetite and metabolism, and can correct for imbalances such as in type II diabetes, anorexia and a variety of stress-related disorders.

abdul-jabbar-608

Marijuana and Mental Health

The use of marijuana is often seen in people who suffer from a wide variety of mental health problems (Wittchen et al 2007), for which it is often used to self-medicate, for better or for worse. It  is known to sometimes relieve depression (Denson, 2006), emotional anxiety (Fusar-Poli et al, 2010) and intense stress (Ganon-Elazer, 2012). However, through its powerful and pervasive effects, it  may well trigger an episode of any number of conditions, such as underlying psychoses. Some use marijuana precisely to provoke an inexplicable or extreme mental state, which may be interpreted as either spiritual or psychotic, or to produce greater and longer lasting states of elation and activity (mania), and many religious and shamanic groups have employed it to facilitate communication with spirits, to transport the user to heaven, to destroy karma, to deepen a trance, and much else besides. Marijuana surely is a drug favoured by lunatics and maniacs, not only to end their lunacy or mania but sometimes to provoke it. Does that make it dangerous to people who do not want these effects? Especially, perhaps if they despise the moon?

Much has been made of the association between cannabis use and schizophrenia. Schizophrenia (literally: broken mind) is a diagnostic category which consists of an unknown number of poorly understood mental types, characterised by positive symptoms such as delusions, hallucinations and disordered thinking, and negative symptoms such as not finding pleasure in anything and not being interested in talking to the other humans. Best estimates suggest that around 1 in 100 people will be exhibit schizophrenia at some point during their life, or 1.4 in 100 people who have ever used marijuana. (Zammit, 2007) This makes it a moderate risk factor, but less severe than being a first or second generation immigrant, having a father over the age of 55 at the time of birth, being raised in an urban area, or infection with Toxoplasma gondii, a parasite common among cat owners. (Bourque et al, 2011Torrey et al, 2012) All of the above effects are dwarfed by familial predisposition, and Proal et al recently found that schizophrenic marijuana users are just as likely to have schizophrenic relatives as schizophrenics who do not use marijuana, suggesting that marijuana is not a cause of schizophrenia at all, but it’s just that schizophrenics are more likely than non-schizophrenics to use marijuana. (Proal et al, 2014) If we wish to reduce risk factors for schizophrenia, we may be better served by banning cats. Other research has suggested that “cannabis induced psychosis,” most characterised by paranoia, is at least partially a direct result of legitimate paranoia occasioned by the war on drugs, rather than the plant itself. (Hamilton et al 2014) There is some evidence that marijuana users with psychosis display more positive symptoms (such as paranoia) and less negative symptoms (such as anhedonia) (Zammit, 2008); this is especially interesting because mainstream psychiatry lacks an effective treatment for the negative symptoms, and it may be that many people are self medicating with marijuana for precisely this reason. Not only do people with psychosis use more marijuana than people without psychosis, but Giuffrida et al found that the body may be responding to schizophrenia by increasing endocannabinoid expression, and that this was associated with a reduction in symptom severity. (Giuffrida et al, 2004) Should we be surprised that some schizophrenics are drawn to a plant which mimics some of the body’s defence mechanisms against their symptoms? Lastly, while THC may occasionally produce psychotomimetic effects (that is, very stoned people may appear to be psychotic until they sober up), CBD appears to be anti-psychotic, (Zuardi et al, 2006) and so modulating the endocannabinoid system, for example with a high-CBD strain of marijuana, may be clinically useful in managing the positive symptoms of psychosis as well as the negative ones. In short, the evidence does not support the claim that using marijuana puts you at greater risk for harms from psychosis; perhaps even the opposite is the case, but more research is necessary. Indeed, prohibition is, itself, undeniably a far greater source of harm, for example by severely exacerbating such problems as racial oppression. (Fellner, 2000) Whether the same would be true for the prohibition of cats remains to be tested.

Among people living under the description of bipolar disorder, marijuana is the number one drug of choice, and those who use marijuana have less depression and more mania than those who do not. (Leweke, 2008) This is not surprising, given marijuana’s potential to increase positive symptoms and decrease negative ones. As there are strong cultural forces which value the creativity and charisma of mania and demonise depression, and because people living under the description of bipolar disorder typically identify with their hypomanic self rather than with a sober baseline, (Martin, 2007) marijuana is often used to improve mood and productivity, as well as to deal with stress in highly demanding contexts, with occasionally destabilising or dangerous consequences. To understand its effects in bipolar disorder, therefore, it is necessary to compare its users to others facing similar contexual pressures — for example, are university students (or entrepreneurs) more or less likely to “burn out” if they use marijuana? It’s also important to remember that marijuana has anti-depressant effects and is used to produce stimulation among people who do not have bipolar disorder, as well as by those who do. It’s not surprising that people with bipolar tendencies use it for the same reasons that others use it, even knowing it may increase the likelihood or intensity of a manic episode. Such people would do well to monitor their use (or to recruit friends and family to help monitor their use), and to consider refraining from using if they have a history of making dangerous decisions while manic.

In summary, marijuana rebalances mood, anxiety and attention in ways which may correct for or prevent certain forms of imbalance, but which may also upset a tenuous balance.

Sadhu

Marijuana in the Heart and Lungs

Much attention has been paid to the effects on the lungs of smoking marijuana, because of the severe and well known harms from smoking tobacco. Marijuana smoke contains many of the same carcinogens as tobacco smoke, and some in far higher concentrations (Moir et al, 2008), and so it was expected that it would be a cause of lung disease, as those chemicals are believed to cause cancer and emphysema in tobacco smokers. This however turns out not to be the case; marijuana smokers do not have elevated rates of lung cancer or emphysema, the two main debilitating effects of chronic tobacco smoking, and none of its long term effects on lung function are of clear clinical significance. (Tashkin, 2013) The analogy therefore can be rejected: marijuana is not dangerous in the ways that tobacco is dangerous. In fact, tobacco smokers who also smoke marijuana have lower rates of cancer and emphysema than do tobacco smokers who do not smoke marijuana, (Aldington, 2007) suggestive of the medicinal and/or protective effects of the flower vapours. Some marijuana smokers experience significant irritation and pain in the lungs which worsens over years of smoking, which may lead to a severe cough, and which is consistent with chronic bronchitis, but this often disappears if they switch from smoking to vaporising, even after decades of heavy smoking (vaporising is a method in which the plant matter is heated enough to convert the active compounds into a gaseous form, but below a temperature which would burn the plant matter, thereby avoiding the toxic byproducts of combustion). The lack of association between marijuana smoking and cancer, despite the well documented ample presence of known carcinogens, is strong evidence of its anti-carcinogenic effects; the chemicals it contains seem to compensate for the harmful effects of smoke inhalation (this is far from the only evidence of anti-carcinogenic effects (Ligresti et al, 2006), but it is suggestive as to their extent and efficacy in the wild). Marijuana, as a bronchodilator and an anti-inflammatory, has also been used in the treatment of asthma, and many asthmatic marijuana users have reported that their symptoms reduced during their period of use. (Williams, 1976)

Another major cause of death in tobacco smokers is heart disease, and, like the lung effects, there’s no evidence of elevated levels of coronary disease in marijuana smokers, despite the presence of various toxins in marijuana smoke. In the heart, the effects of marijuana are quite clear: decreased blood pressure, increased heart rate, often by as much as 30% , with CB1 and CB2 receptors as elsewhere working in opposite directions to control blood vessel dilation and other aspects of cardiovascular function. For most users this is not an appreciable concern, although it’s not uncommon for marijuana users to abort exercise because of strange feelings in their heart, or specifically because they feel that their heart is pumping too quickly or strongly. Some people with chronically low blood pressure find that they react badly to marijuana, and it is common for people under the acute influence of alcohol — which also lowers blood pressure — to become dizzy or nauseous if they proceed to smoke marijuana. Doing so may result in “the spins,” a very uncomfortable feeling where the world appears to be spinning and only spins faster if one closes one’s eyes. It is highly advisable therefore not to smoke marijuana while already drinking, especially if one is not a regular marijuana user and may be taken by surprise by the blood pressure crash. Smoking and then drinking does not appear to be nearly so dangerous, partly due to relative ease of dose control (you can sip your drink, but you cannot unsmoke a joint).

In people at elevated risk, a heart rate boost of 30% can trigger a heart attack. It has been estimated that marijuana smoking may increase risk for the next hour of myocardial infarction (heart attack) by a similar extent to having sex or exercising. Therefore, if your doctor has told you to abstain from sex due to the danger to your heart, you should consider also abstaining from marijuana. However, just because it’s more likely for a heart attack to take place during that window doesn’t mean it increases the risk of a heart attack happening at all. Indeed, a study of 3886 people who had already had at least one heart attack found no statistically significant association between marijuana use and death over an 18 year period (Frost et al, 2012), so there’s no great cause for worry. Instead, it seems to be the case that, if someone was going to have a heart attack anyway, it’s liable to happen within an hour of getting high, because of marijuana’s circulatory effects. CB1 activation has also been shown to worsen the damage from repurfusion (the shock caused by oxygen returning to cells temporarily deprived of it due to a heart attack), whereas CB2 protects against this damage, as well as against plaque instability and inflammation, such as in atherosclerosis (remember, THC activates both CB1 and CB2, so it both helps and hinders at the same time). CBD, meanwhile, has other non-cannabinoid receptor mediated cardioprotective effects. A high-CBD strain of marijuana may therefore be more beneficial for people at risk for heart attack than a high-THC strain. (Russo, 2006) For those concerned about heart and lung effects, vapourising or eating marijuana may be preferable to smoking it, as that will greatly reduce exposure to a variety of toxins. That said, the appropriate level of concern for smoking marijuana is probably more comparable to the dangers of toasting bread instead of eating it raw than it is to smoking tobacco, and many users will continue to consider this an acceptable trade-off for the convenience and ease of dose-control which come from smoking. (Montecucco, 2012)

In summary, marijuana rebalances dilation and contractility in the heart and lungs and may correct for or prevent such imbalances as usually result from smoke inhalation.

marijuana-heart

Marijuana in the Bones, Muscles and Joints

Unlike the many hard objects we encounter outside the body, our bones are constantly being broken down and remade. In young people there is typically more growth than break-down; this levels off and then reverses with age, and, as bone formation is driven by estrogen, post-menopausal women, women who have had their ovaries removed, or others who have very low estrogen, are at increased risk of bone loss and fracture. Cannabinoids regulate this system, stimulating bone formation via CB1 activation and slowing the rate of break-down via CB2 activation, and so marijuana may compensate for factors which could otherwise drive osteoporosis. (Scutt, 2007; Bab, 2009) As an anti-inflammatory and muscle relaxant, marijuana can also improve flexibility and provide relief for everything from soreness after exercise to certain types of arthritis. Indeed, endocannabinoid activation has been found to occur naturally following exertion, and is believed to allow for longer periods of exertion in what’s known as the “runner’s high.” (Sparling et al, 2003) I have observed marijuana use in the wild stimulating the user to begin exercising or facilitating continuation of exercise despite fatigue. I have also seen the opposite: half hearted attempts at exercise followed immediately by cessation. On the one hand, it may be that marijuana makes it easier to continue doing what one was already doing, such as either running or lying on the couch. On the other hand, it sometimes triggers a reversal, from low energy to high energy or vice versa. Like the endogenous runner’s high, using marijuana when fatigued may produce a “second wind” and allow the user to continue. The cardio-pulmonary dilation, discussed above, is also relevant, as it may improve oxygen availability during exercise.

In summary, marijuana rebalances bone growth, muscle fatigue and inflammation in ways which may correct for or prevent certain forms of imbalance, such as age related bone loss and pain after exercise

I-love-yoga-image-smaller

 

Marijuana and the Immune System

THC has been experimentally shown to inhibit certain immune functions — in particular, lymphocyte activity — and to augment others, (Cabral, 2001) and marijuana also contains a variety of antimicrobial agents. (Nissen, et al, 2010) These immunological effects can protect against numerous auto-immune disorders, increase healing and down-tune immune responses. It is likely the case that marijuana can protect against certain kinds of infections under certain conditions, and that it can increase vulnerability to other infections under other conditions. Cannabis oil, especially applied topically, may be an effective treatment for acne, psoriasis (Wilkinson 2007), contact dermatitis (Karsak et al, 2007) as well as a variety of other inflammatory or allergic responses, and against certain infections because of its direct anti-microbial effects.

In summary, marijuana rebalances inflammation and other immune responses and may correct for or prevent certain forms of imbalance, such as autoimmune disorders.

Conclusion:

Marijuana has very complicated effects throughout the body. Many of these effects are often highly valued and sought for a wide variety of reasons. Some of these effects can in some situations can be undesirable, and THC by itself has been implicated in a variety of potential harms, including anxiety, psychosis-like mental effects, heart attack and immune suppression. It is necessary therefore to emphasise the importance of using cannabis flowers instead of isolated chemicals such as pure THC, because of the ways in which the other chemicals in the flowers compensate for, counteract, or amplify the effects of THC. (Russo, 2011) Whether marijuana will boost or inhibit each bodily system depends on the state of the body at the time of use, the chemical makeup of the marijuana being used, and the dosing strategy. Smoking one small hit one evening per week may well have the opposite effect of consuming cannabis oil throughout the day every day; the former may be primarily stimulating whereas the latter may lead to a generalised relaxation and slowing of metabolism. As either/both may be desired by each user, preferences in plant variety and dosage strategy vary accordingly. Some people react badly to the plant, whether for mental, cognitive, hormonal or ideological reasons, and some are allergic to it; for many others, it can be profoundly helpful, providing a way by which to take some conscious control over the regulation of homeostasis and to seek a balance which will work for us.

flower
The above is my best understanding of what marijuana does. Although I have here leaned mostly upon scientific journal articles, which I have tried both to understand and to interpret, I am not in fact an advanced specialist in every relevant discipline — nor, I suspect, is anyone else; my academic background is as an ethnographer, and so I consider my primary responsibility to be towards the humans using the plant, for whatever reasons, and with whatever consequences, and I engage with the scientific literature in order to better understand and interpret the observations I have made in the wild, the many curious things I have been told in interviews both formal and informal. I am absolutely certain that there is very important information about the effects of this plant which I do not understand or which I have not yet seen. If you know of anything useful, or suspect that something I have said is inaccurate, incomplete or in other ways merits revision, I would be happy to hear your suggestions. May my best endeavours to faithfully convey my observations be useful to you.

Happy 420!
Can you smell the flowers?

Funding:
None. Some years ago I took a vow never to sell any drugs about which I expected to write, so as to avoid conflict of interest. I am, however, almost completely out of money, and would be very appreciative of donations and/or job offers so that I can continue to live, buy groceries, learn and write. (no paypal; can accept email money transfers to michaelvipperman@gmail.com, or food offerings in Toronto area only)

Donations received as of 8:45 PM, May 2, 2014: $10.

Acknowledgements:
Proof reading provided by James Birch, Lav Dimitrije and A.C. Patterson.

I own the rights to none of the images.

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Do Psychedelics Encourage False Belief?

During a psychedelic experience, it’s common to have many new ideas. Are they always good ideas?  Trippers generally think so, and many of them may well be. To people who don’t trip, however, the idea that a drug could be a font of pure wisdom is totally ludicrous. This article approaches the issue partially from the perspective of social psychology and cognitive biases (much of what I explain here comes from a paper by Daniel Gilbert, which I highly recommend). Could tripping cause us to believe things we would otherwise — even ought to — reject?

To begin with, there’s the notion that comprehension entails belief. In the words of William James, “all propositions, whether attributive or existential, are believed through the very act of being conceived.” This may sound strange, but there’s actually a lot of evidence for it, and if it weren’t the case it’d be very difficult to get around and do things. Another way of thinking about this is that it takes more effort to doubt something than it does to accept it: first we represent an idea, and only later can we reject it.

Compare two hypothetical mental systems. In one, truth and falseness are assumed to be equally likely, and so everything needs to be evaluated carefully to determine its veracity. In the other, truth is assumed to be far more likely, and everything will by default be accepted as true, unless a compelling argument against it becomes obvious. Look around your room and see which of the two you’re using: all the objects you see, are they approximately, functionally, what they appear to be? Do you need to carefully test each bit of floor to ensure that you won’t fall to your doom through what’s merely an illusion in the shape of floor?

We constantly process large volumes of information, nearly all of which is accurate enough to trust. There are lies and illusions, yes, but they’re relatively rare, so it actually makes sense to be fairly credulous most of the time. And, as it turns out, we are. Our primary way of sorting information is to ignore the vast majority and accept the rest, disregarding whatever isn’t commensurable with our extant mental frameworks. If what you’re seeing doesn’t make sense, it’s probably an illusion. If it does make sense, it’s probably accurate enough to treat it as “real.” This is useful and important, but it means that determining whether information is “correct” or not isn’t even something we’re trying to do most of the time, let alone something we succeed at reliably. We don’t need to: pattern recognition alone is sufficient to effectively navigate and make decisions. This has important implications for drugs which boost pattern recognition: more things can be understood, and therefore more things will be believed.

Another important ramification of the primacy of truth is that the more overloaded we are, the more likely we are to accept things without question. Because accepting an idea happens before we have a chance to reject it (upon remembering some bit of information that contradicts it, or upon applying it to something and seeing that its consequences are absurd, for example), our ability to evaluate something for accuracy depends upon having the time and resources to do so. The fewer available resources, the more we’ll accept things as true.

An example of something that might take away some of those cognitive resources, of course, is other salient information. Why think long and hard about one question, when there are other, really exciting things to pay attention to? For those not familiar, “salience” is the technical term for the property of “standing out,” being interesting or notable. Increasing salience is also one of the main effects of psychedelics: things that you didn’t notice before become interesting, and things that were already interesting become larger than life. This is, of course, one of the major benefits of psychedelics for insight formation, because they get you to look at things in new ways, paying attention to that which you might otherwise have ignored. In some situations this may be a two-edged sword: simple illusions may be easier to spot (nothing can hide in plain sight), but the sheer volume of information you’re processing can make parsing concepts like “absolute truth” difficult, while crowding out your ability to reflect or carefully consider, increasing the proportion of ideas you’ll believe.

It’s worth remembering that LSD has been explored for its potential as a brainwashing agent, with dismal results. As it turns out, if government agents give you acid and try to convince you of things, their success rate is going to be very low. During my series of interviews last year, I asked each respondent whether they had ever had a “false epiphany” while tripping, and the results were nearly* unanimous: no. Interestingly, it’s far more common for people to come up and realise that their sober ideas were wrong than the other way around. This is especially true for mystical or metaphysical notions, as it’s very common for such matters to be concretely experienced when tripping, when they were merely hypothetical and abstract when sober. Thus, the puerility of what once made sense becomes obvious. They also tend to make us more sensitive to underlying motivations, so it may be very obvious if somebody is trying to trick us into something.

That said, psychedelics have been famously used by a variety of religious or “cult” leaders to indoctrinate new members. If psychedelics make it easier to spot bullshit, and if the CIA was unable to use them as brainwashing agents, how could this be? One explanation is that the religious leaders weren’t actually tricking the people into believing false things, or even transmitting information, but merely presenting generalities which could then be filled in with legitimate insights by each. Effective indoctrination into a religious or magical group does not require uniformity of beliefs, but merely a sense by the inductee that the leader has access to spiritual truth.  This is especially the case in a situation where the inductee formerly had little interest in or exposure to mystical understandings. Through having their first ever personal realisations of spiritual truth in the context of taking psychedelics with somebody, it becomes easy to associate truth with that person. Once the appetite for spiritual insight has been whet, pursuing group membership in the hopes of further insights becomes a distinct possibility, all without having had any “false epiphanies” or delusions.

Getting back to the point I introduced above — that comprehension entails belief — psychedelics make it easier to conceive of new ideas by lowering the filters on our perception and supercharging our gestalt pattern matching facility. They also jack up the salience of everything, including those ideas, so they will not only be understood (and therefore automatically accepted), but also experienced as very important. They also tend to occasion not just one idea, but many, many ideas in a very short period, so remaining focused on any particular one for long enough to fully evaluate it may be unlikely. That means it’s extremely likely for the ideas we have while tripping to be accepted as true, especially if they have a spiritual feel to them and we’ve been primed to expect mystical truths. Especially during very intense trips, it’s common to come out of them dumbstruck, feeling that all the secrets of the universe had been revealed (not just the one secret of everything, but thousands of distinct truths), but being unable to remember all but the vaguest of generalities.

The experience of my respondents does not suggest that asinine or false ideas are likely to be accepted because of a trip. One particularly interesting comparison is often made between the “hit rates” of ideas occasioned between cannabis and classic psychedelics: on cannabis, people often have many ideas, a few of which are great but many of which just sound stupid after sobering up. On mushrooms or acid, however, the ideas didn’t just seem good at the time but actually were considered to have lasting value. This often surprises regular pot-smokers when they first take a classic psychedelic: they’re used to having epiphanies, but not ones which actually still hold water the next day and the next week. Further research is necessary to adequately explain this difference and to determine its extent. Your mileage may vary.

If you want to have a trip geared toward the generation and honing of insights (as opposed to Mystical union, or experience of Communion and interconnection), here are some guidelines which take into account the above discussion:

  • Be somewhere not too distracting or overwhelming. Raves and the like can work for a Communion experience, but Insight requires time, quiet and privacy to think things over.
  • Give yourself lots of extra time after your expected comedown before you need to be anywhere, so you can reflect while sober.
  • Audio record your session, and/or take notes! Make sure to get permission if anyone else appears on the recording. Listening to a recording of your conversation afterword can be extremely useful.
  • Take a small or moderate dose of something with a medium duration. Short, strong trips are great for Entheogenesis or Mysticism, but could be an information overload, and past a certain duration or intensity there may be diminishing returns.
  • Don’t expect to remember or keep everything, or for everything to make sense. If you get one or two interesting ideas out of a trip, great! Stressing over completion will just get in the way

“Though Truth and Falsehood bee neare twins, yet Truth a little elder is” – John Dunne

* A rare example of a “false epiphany” comes from Heru (a cultural engineer). For approximately one year, he believed himself to be Christ. “I believe that everything that we’re shown is in some sense true, in that it relates to the nature of our mind. But in my experience I found myself falling into quite delusional states, because I was attempting to project these truths into another level of experience. … We generally seem to exist on a relative level where there is a dualism between subject and object. … And if we experience a non-dual state like ‘I am the Christos’ or ‘I am Buddha-nature,’ … when we go back to the relative world … it appears to us that ‘I am the One, but no-one else is.’ So we objectify and reify the idea. And in that sense it can lead to Messianic complexes, which I went through… and yes, technically, we can save the world. We are here to do that. But it’s very easy for the ego to take that and twist it around and simply use it as another thing to propagate its own belief in its own independent existence.”

Inebriation: change for change’s sake

I have elsewhere described three broad categories of drug use: inebriation, enhancement and psychedelia. Of these, inebriation is simultaneously the most basic and the most reviled. Whereas the cultural struggle for acceptance of psychedelia revolves around acknowledgement that it exists at all, inebriation is typically taken to be self-evident, and self-evidently distasteful. I do not share this opinion. In excess, inebriation can certainly be very dangerous (or just plain ugly), but I believe that it has its own time and place, its own legitimacy and its own benefits.

The Basics:

Inebriation is fancy-speak for getting fucked up. The feeling is that normal, sober existence is too frustrating, stressful or just plain boring, and that if we can just do something — anything — to change how we’re feeling, things will be better. Pretty much any drug can accomplish this, as can practices such as fasting, eating, holding your breath, meditating or masturbating.

Of course, you can’t simply have your consciousness be arbitrarily different: depending on what technique of consciousness alteration you use, you’re going to get a particular cluster of effects, with widely varying degrees of predictability. The classic psychedelics, for example, are extremely unpredictable, and can do just about anything. That makes them sound appealing to somebody who’s bored and wants a change, but the change could easily be a lot more dramatic than had been intended: just because you want reality to be altered doesn’t mean you want it to be destroyed completely. Careful practices like meditation on the other hand may come with a host of other benefits and be well worth pursuing, but require a good deal of motivation, effort and discipline, likely to be lacking when we’re in the uncomfortable place of craving an alteration.

A prototypical inebriant therefore will reliably turn down the volume on neurotic self-consciousness, and not do too much else. Despite various well documented adverse effects, alcohol is by far the most popular drug for this purpose, and for good reason: it’s effective, predictable and general in its effects, providing readily scaling levels of inebriation from a slight fuzziness to total annihilation. Cannabis is also highly popular as an inebriant, and is generally safer than alcohol, but is far less predictable.

Why would anybody seek impairment?

Getting “fucked up” sounds like an entirely bad thing. Society highly values lucidity, which it associates with sobriety, so anything which alters consciousness in a way that’s not obviously and directly beneficial is seen by some as categorically unacceptable. This line of thinking is common among high achievers and religious puritans, but may also be informed by experience with problematic drug use such as alcoholism, or for other reasons. It typically comes down to the fear of lost possibilities, the idea that when you drink, you could have done something else instead, like read a book or make a painting. This is generally not actually the case. Those who reject the legitimacy of consciousness alteration generally do so from a privileged position in which consciousness is stable, manageable and positive. Even a common phenomena like stress (experienced very differently by different people) is sufficient to undermine this, let alone variation in life situation or psychological makeup.

Maybe you’ve been working hard all day, or maybe you’re really worried about something, and you just need a break from it all. Obviously, if you get fucked up all the time that’s just going to make things worse if you never take care of whatever problem was stressing you out in the first place, but if you’re past the point of being able to do something about the problem right this minute and can’t get it off our mind, doing something to take the stress off makes total sense, and might actually lead to more productivity or clearer thinking later. A nice bath, a massage or a good orgasm are generally healthier options than getting wasted, but there’s nothing wrong with taking something to help you kick back and relax, as long as you’re reasonably safe about it and get things done at other times. For a lot of people, smoking a joint serves as a great adjunct to a bath, massage or orgasm! Learn how you react to things (both at the time and in the days to follow), and do what seems to produce the most benefit with the least negative effects.

Alterity and Breaking from the Everyday

In speaking of change, we assume a conception of “normality,” a sober “baseline” against which alterations can be compared, and to which we can return. This is, of course, merely a convenient fiction: like history, consciousness does not repeat itself (though it may often rhyme). Further, identifying with the state of consciousness you find most familiar tends to exaggerate the illusion of yourself as static and separate from the Other, an illusion which inebriation may subvert by highlighting variability and hinting at the tenuousness of control. Promoting variety of experience can therefore be inherently useful, a way of “playtesting” reality, allowing for what I have described as “psychic triangulation:” considering a single topic, concept or image in various states of consciousness and comparing the results to get a more robust, multifaceted understanding of it than any one state of consciousness alone could provide. This also relates to our capacity to empathise with a greater diversity of people, and it renders our identity constructs more fluid, revealing their arbitrariness and dynamism, working to disentangle Self from the Everyday.

This break from the everyday is not exclusively about variety: it is also central to the capacity of religion to unite practitioners through the production of sacred space and sacred time. Although they frequently have other meanings as well, religious rituals tend to consist of elements which alter consciousness. Incense, chanting, unusual acoustics or lighting conditions, special clothing and sounds all contribute to the production of an “axis mundi” in which the divine can be experienced. This, I would argue, is essentially the same as entering into a group drug experience, and explains the use of drugs to mark special occasions, such as holidays, graduations or marriages. Through the act of ritually consuming a similar amount of the same drug, collective feeling within the group is established, fostering intimacy and unity. Alcohol and cannabis both to serve in this capacity: cheering commences convivial conversation, connoting comaraderie and cooperation. When a joint is passed around a circle of friends, they share in each other’s spirit and enter into a sacred space together, qualitatively separate from the Everyday that came before. Cannabis may have additional spiritual benefits, but inebriation is all that is required for this type of ritual to function.

To conclude: 

Inebriation describes any drug use where the change in consciousness the drug produces is the objective of its use. Whereas enhancement pertains to some sort of connection between subject and object, and whereas psychedelia seeks the discovery of potentially lasting insights, inebriation is about the experience itself: a desire for something out of the ordinary. This has significant ritual and psychological applications which ought not to be casually dismissed.

To me, the point of consciousness manipulation is to find a dynamic balance. Experimentation is crucial to the process of self discovery, and having tools with which to break out of complacency and ennui can be very valuable.  That said, as we try to break out of our patterns it’s easy to end up creating new, more toxic patterns. That is the meaning of addiction: becoming stuck in one way of experiencing reality, and being unable to flow easily through others. Experiencing inebriation occasionally may be highly beneficial, but do so too often and things might get really bad, really fast.

Embrace variety; don’t get stuck.

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ADDENDUM:
After publishing this, I received  two criticisms almost simultaneously. One was that I talked too much about death, and the other was that I didn’t talk enough about danger. Seems death isn’t the point for the one person, and danger is the point for the other. Inspired by these diametrically opposed critiques, I sat down and refined my model. I now have Inebriation as consisting of three subcategories: Disinhibition, Sedation and Variation (Disinhibition bleeds into the Enhancement subcategory of Ability, and Variation bleeds into the Psychedelic category of Insight). Disinhibition is the one about “danger” (and freedom, and shenanigans) which I didn’t adequately cover in this article. This addendum is to note the theoretical alteration, and to point out that danger/disinhibition is important even though I didn’t get into it much above. This will be more fully addressed in a subsequent article.

Sex and Drugs

Drugs provide powerful tools for altering consciousness; so does sex. What about combining the two? For many, sex and drugs are separately the most pleasurable experiences they know, and in combination they can be even more powerful. This article explores a few of the reasons why the two are sometimes combined and a discussion of various advantages and disadvantages.

Psychedelic Sex Blast

Inebriation

A lot of us are really conflicted when it comes to sex. Sometimes because of guilt or past traumas and associations we want to do something on one level but on some other level we’ve got a mental block that keeps us from following through with it. People in this situation may turn to an inebriant to help “loosen up” and do what they secretly want, or to overcome social anxieties, making it easier to find a partner. For a lot of people this can be an important part of getting sex to happen at all, but it comes with a tradeoff: if you’re fucked up, chances are your performance is going to be impaired.

Alcohol’s the obvious case study here. Some people find a glass or two of wine makes them tingly and sensitive, but drink too much and it impairs motor control and dulls sensation, so drunk sex usually doesn’t feel nearly as good as sober sex. It can also make consent even more complicated than usual. You may be drinking to loosen up, but what do you do when someone is pushing your limits and you’re too drunk or high to know how to respond? Make sure you think about your limits beforehand: what are you okay with doing, and with whom? It may be good to have a friend who knows your limits watching out for you so that you don’t end up doing something you’ll regret. Also remember that some people may give booze or other drugs to make you more likely to sleep with them. Avoid bad situations, watch how much you take, and don’t tolerate this kind of douchey behaviour; if your friend tries to get someone drunk so they’ll “consent,” call them on it. Not cool.

Note that within this is the implication that inebriation can be used to surge past limits into experiences of wild abandon. Just remember that Dionysus is god of wine and orgies, but he’s also insane.

Enhancement

Enhancement has two sides:  improving your performance and improving your experience. Exactly what it is you feel needs improving and what you would consider to be an improvement will change what is appropriate here, such that two things that can separately be seen as improvements might be antithetical. For example, hashish might help you make intimately connected, passionate love, whereas amphetamines might help you fuck the shit out of each other. Which is it you want, if either? (I don’t mean to imply a dichotomy here, by the way! Just that you should consider your intentions carefully)

Stimulants like coke and crystal can lead to really intense, hard fucking, as you’ll be energetic, impatient and won’t get tired as easily. As hot as that can be, the harder you fuck, the more likely that you’ll hurt yourself or your partner. Cuts and tears make it much more likely to transmit infections like HIV, and coming down hard at the wrong angle can literally break a penis! Use lots of lube, and change condoms if it’s taking a long time. Getting your heart rate up too high can lead to a heart attack or stroke, especially if you also took Viagra — and many drugs can make it hard (hehe) to get an erection or to achieve orgasm, even if it feels great. Remember, there’s nothing wrong with taking a breather and drinking some water, and if you can’t cum, that’s fine: don’t force it

Cannabis, on the other hand, makes sensations more intense, and causes us to get really into whatever it is we happen to be doing. So if we’re running, running becomes more pleasurable and we can keep going longer, or if we’re sitting around on the couch it can be hard to be motivated to do anything. Applied to sex, that means we usually have less desire to initiate sex if stoned — so it’s not true that pot is an aphrodisiac. However, if sex is initiated, it can make it much more intense, so we get really into it and stay into it for longer — just like how it effects us when we go running. Unlike stimulants which make us fuck harder, pot will often make slow fucking feel that much better. Many women have reported that they’re only able to orgasm when stoned!

Psychedelia

Sex by itself can be psychedelic: soul revealing, ego-destroying and triggering of deep insight. Mixing sex and psychedelic drugs can amplify both and be one of the most unbelievably intense things imaginable. If you Google around you’ll find many awesome stories of experiences so profound that you’ll probably be envious and want to try them yourself. Don’t!

Taking a powerful psychedelic with a lover and having sex sounds like an awesome plan on paper, but in practice it can be incredibly awkward, because once you come up, who knows how you’ll be feeling… these drugs are so powerful that they can easily overwhelm us and make it so that sex simply isn’t on our minds at all, whatever our intentions may have been. What’s worse, because of the way they can activate and amplify latent psychological processes, a bad sexual experience while tripping could be incredibly traumatising, and in the moment you might be completely incapable of expressing to your partner what it is you’re going through.

The truth is that sex on psychedelics can be totally amazing: ego boundaries dissolve and you fuse into one another, transformed into archetypal, primal energies, transpersonal divine beings of infinite beauty and love, pleasures upon pleasures unfolding into secrets of Ultimate Reality. If you ever get into that sort of space with somebody, count yourselves profoundly blessed. But do not expect it, or plan for it. What happens, happens, and that’s okay. 

On any drug, you may end up being too high to go searching for condoms and lube, so if you think you might have sex later (whether or not you’re planning to), be sure to already have everything you need with you before you get high, and don’t forget to have to take care of yourself! Make sure to eat and drink.

Addendum on aphrodisiacs:
The idea of an aphrodisiac is a drug which produces sexual desire where it wasn’t already. Many plants and drugs are claimed to be aphrodisiacs, but few truly occasion new feelings (damiana and bremelanotide are notable exceptions). My approach to aphrodisiacs is to recognise that if we’re unable to get horny, there’s often a somatic problem at the root of it, such as a headache, low energy levels, anxiety or indigestion. Better (and effective!) to treat these problems directly, rather than skipping ahead to a substance specific to getting you to have sex. My favourite aphrodisiac, therefore, is ginseng, which is primarily a stimulating “adaptogen.” Lots of people get randy after taking some… personally it makes me want to dance more than anything, so I usually have some when I go to a party. Energy can be used for lots of things! Ginseng is good for you; it’ll make your headache go away, it’ll help you think more clearly, and, yes, it may help you have more and better sex.