In his book, In The Realm of Hungry Ghosts, Dr. Gabor Maté, the world-renowned addiction specialist, discusses the prevalence of addiction across society, referencing a Bible quote to illustrate how susceptible us humans are to addictive behaviors: “We all have idols of the heart.”
Dr. Maté has worked with countless addicts over a decades-long career in some of the roughest neighborhoods in Vancouver, Canada. He’s in recovery. He knows addiction.
He writes convincingly on a trend amongst addicts, identifying trauma as a common denominator, which impairs childhood brain development, leading to life-long dopamine imbalances. The result is addiction and mental health conditions such as attention deficit and compulsion disorders.
Dr. Maté is intentionally unclear on the definition of trauma, pointing out that what is traumatic will be specific to each individual. In one case, it may be physical abuse, in another, it may be verbal. But the outcome is the same, dopamine imbalances that affect life-long decision-making.
“What we call personality is often a jumble of genuine traits and adopted coping styles that do not reflect our true self at all but the loss of it,” writes Dr. Maté.
WHAT IS ADDICTION?
Dr. Anna Lembke has also worked with addicts over a long career, and in her new book, Dopamine Nation, she demonstrates how dopamine deficits are the driving force behind addictive behaviors. She defines addiction as a “narrowing of the things that bring pleasure.”
In this interview with Joe Rogan, she describes how she’s noticed these days “everyone is addicted to something.” She blames the conflict between our over-stimulated environment and what she refers to as the monotony of “cubicle life.” She’s not surprised so many people want to self-medicate at the end of each day.
Rogan suggests that part of the problem is people don’t have enough “friction” in their lives, and Dr. Lembke agrees. In her practice, she sees people addicted to everything from pills, cocaine and porn to video games, weed, sex, and work. She says, people rotate their vices, Monday booze, Tuesday coke, Wednesday grass, etc., and tell themselves they’re not addicted to anything.
The problem is we’re all living in a “dopamine deficit,” she says, which she equates to a state of clinical depression. This begins a vicious circle. In order to reset the dopamine threshold and restore balance or homeostasis, the brain will crave more of the substance or behaviour to eliminate the pain of the dopamine deficit.
WHAT IS DOPAMINE?
Interestingly, Dr. Lembke says, the same brain mechanisms that drive the kind of focus needed for success also drive addictive behavior – in effect, Naomi Osaka is addicted to tennis. She identifies “tenacity” as the character trait addicts have in common and explains how this works by defining dopamine as the modulator of the brain’s pleasure/pain centre.
This is an over-simplification of the process but illustrates it well: think of the pleasure/pain axis as a seesaw and when there’s a pleasure influx, the pain side shoots up. And in order to get it back down to level, it’s necessary to load onto the pain side, usually twice the amount of pain to restore balance. But people don’t do that.
Instead, they seek out more pleasure to offset the pain not realizing the more they shoot for pleasure, the higher the dopamine deficit. Dr. Lembke explains that once a person has been addicted to one substance or behaviour and those neural pathways are set in place, the result is a heightened vulnerability to addiction in general.
Rogan’s hack for this is to set himself weekly endurance challenges in his workouts, effectively piling onto the pain side of the seesaw, causing a spike in pleasure. This type of physical exertion is something Dr. Lembke advocates for in her treatment plans. In her experience, the path to successful management of addiction is voluntary “self-binding protocols” i.e. putting restrictions in place.
CANNABIS AND ADDICTION
Unlike Dr. Maté, Dr. Lembke is not interested in the why of the situation; she’s looking for ways to manage the condition. But she’s noticed other traits that are unique to the addicted community, in particular, how much they want to talk about both their addiction and later, their recovery.
She says that addicts are wired for big highs and big lows, an overall more intense life experience. They’re deeper, and need the kind of relationships and intimacy that comes from exposing self, warts and all. Russell Brand, arguably, one of the most famous recovering addicts in the world, is a good example of this. For a long time, cannabis was his drug of choice.
In this episode of his Youtube podcast, he discusses the rise in global labour shortages due to large numbers of people testing positive for cannabis post-Covid. The response from the corporate world is to end drug testing. Brand doesn’t see this move as progress, but rather a sign that so many people are so miserable at work they need to be high to get through the day.
How does the likes of Rogan fit into this frame? Is he an addict? According to Dr. Lembke’s definition, that depends on how many things are the sources of pleasure in his life. Rogan clearly has a busy life, so it’s unlikely he has tons of time to sit for hours, playing video games and getting blazed. When he does, he enjoys it more.
This is true for many cannabis users who use weed to enhance rather than create pleasurable experiences. Rogan is candid about his marijuana use, saying he smokes three to four times a week, usually when he writes. This is an example of a self-binding protocol in action. But what happens when restraint isn’t possible.
I know cannabis users who have used weed for years but are not users of any other substance. If anything, they’ve used cannabis to eliminate more damaging vices and live healthier lives. I also know users who spark up when they wake up and sidestep their lives to be stoned all day, every day.
CANNABIS AND TRAUMA
There are some of us who have the power to adhere to self-binding protocols, and some of us who spit on them. I hover somewhere in the middle, and so can speak from both sides of the fence. Like Rogan, I use cannabis primarily to write and never get stoned before certain activities like working out or professional meetings. I do, however, write every day.
I know writers who praise the focus they can achieve with cannabis, and have heard coders, bankers and doctors praise it for the same reason. However, in recent years, I’ve noticed a key shift in my use. In 2019, I had a breakdown due to hormonal imbalances and malnutrition (long story, another post), forcing me to embark on a journey of healing and confront past trauma.
This changed my relationship to cannabis, the most significant difference being I now prefer to write when I’m not stoned, as I find the process easier, more fluid. It’s only on those days when I’m agitated that I find myself reaching for an old balm. However, a caveat, if I’m writing fiction, and really stuck, the one thing I know will unglue me and get the ideas flowing is a joint.
I can only talk from my experience but to date, there’s no room to talk about my experience because if there’s one word you’ll never hear the emerging canna-industry use it’s “addiction.” Yet, in a 2021 report by New Frontiers Data on trends amongst contemporary cannabis users, 67% cite relaxation is their primary reason for use. Relaxation is the primary reason for use across all demographics.
Isn’t relaxation another word for pleasure? To bring cannabis use into the mainstream and not talk about addiction is only telling half the story. But as Dr. Lembke pointed out, addicts love to share their story, and as we move towards a world of legal weed, there’s no question it’s a story that needs to be told and a story that cannabis users are dying to tell.