Further Reading

Are psychedelics good for you and is marijuana addictive?

I was favorably impressed with your insights in The Meaning of Addiction. I wonder what you think about addiction in relation to psychedelics. Do they harm? help? Are they addictive?


In general, (a) psychedelics don't lend themselves to the regularity and predictability of repetitive drug addictions, (b) but that nonetheless anything people can find to remove them from the current press of life and the anxieties it produces may serve as an addiction for some. I discuss whether the opening of realms of perception may also have positive effects in Love and Addiction.

The ongoing debate about marijuana is an example of the question of addiction to a (mild) psychedelic. From Love and Addiction I have described marijuana as offering addictive possibilities (citing the case of Malcolm X, who declared himself a former marijuana addict in his autobiography). Recent research announcing marijuana shares some routes to the brain with drugs like heroin and cocaine reintroduces this question.

Of course, this is totally the wrong way to pursue the issue. Finding a mechanism that explains that marijuana is addictive avoids completely the true questions of how (often), when, and why it is such. It is as though they found that AIDS is a virus that attacks the immune system and so they decided that it was deadly. This is completely the wrong way around in science -- the question of addiction to marijuana requires that we find what marijuana's effects typically are and the range of reactions to the drug. Most use of marijuana is quite controlled -- as it is with cocaine and heroin. So finding an addictive route to the brain with any of these substances tells us that this route will not explain addiction.

Sincerely, Stanton


I'm sure you're getting pummeled on the latest greatest marijuana thing. So -- aside from this aside to say that, yes, I think the interpretations proffered are shot through with dubious assumptions that will likely encourage certain people to take unfortunate leaps (see AM Rosenthal in today's NY Times already, *sigh*) -- I'll be as brief as possible.

It seems to me that these results actually give strong validation to arguments that you've made wrt addiction.

First, the dopamine thing is one more piece of evidence tying together hedonistic acts. It certainly applies to a number of other drugs (I find the alcohol part especially interesting from a public policy perspective), as well as sex. I don't know, but wonder about other thrill-seeking behaviors like sky-diving, rock-climbing, and how about gambling.

Second, increased CRF is hardly something unique to drug withdrawal -- it is associated with lots of things we think of as dysphoric, especially STRESS.

Together, these suggest to me that, yes in fact people probably use marijuana, and other drugs, and do other nutty things to excess to alleviate symptoms of dysphoria.

Here's my question. If this is all true, and, as seems somewhat more likely to me than identifying an alcoholism gene, it is possible to identify key brain regions and neurochemicals involved in the dysphoria that addicts are trying to alleviate, might it in fact turn out to be the case that there COULD in fact be a medical (i.e. biological) treatment for addictions?

I look forward to hearing your thoughts.

Steve Helms Tillery

Dear Steve:

I found you discussion of the generality of the biological effects now being attributed to marijuana use excellent. But you need to follow this logic through -- if virtually every activity has some impact on the systems in question, yet only a few people create addictions around these involvements, then how discriminating are the systems in question? That a drug known to produce mild effects in most users and that infrequently leads to compulsive behaviors (marijuana) implicates the same neurochemical system as drugs like cocaine, heroin, et al. (a) tells us that this system does not distinguish drugs in terms of abuse potential, so that something else must be critical in the addictive formula, (b) leads us to re-examine the epidemiology of cocaine and heroin use for the purpose of rediscovering that most users of these drugs in fact do not become addicted, (c) fails to tell us why even heavy/addicted users usually retrack their usage patterns to escape the supposed biological lock-in to which they have been exposed. Moreover, the very generality of these biological effects argues against any specific drug-biological system-addiction linkages which can be addressed through some medical therapy. As you point out, the Science discovery is actually highly supportive of my views of addiction and strikingly refutes the notion that a biological system creates addiction.