Understanding Drug Addiction and Psilocybin
Many of us were adamantly forewarned about taking drugs from an early age. Someone told us, either sipping coffee, drinking wine, or popping a Benadryl, “Do not take the hard stuff— you’ll get addicted, and it’ll ruin your life.” At eight years old, many of us wondered, “why would they tell me this? Of course, I’ll never take that stuff!” After all, most of us knew or heard of someone called a “drug addict” who, by implication, sabotaged their life and the well-being of those around them. But is this correct?
Neurophysiology of Addiction
Addiction structurally is the consequence of a disrupted pain and pleasure balance. When we experience pleasure and then remove or come down from what caused us this feeling, we will almost always experience a form of displeasure. More accurately, pleasure in this context is synonymous with reward, and displeasure can be summed up as the felt absence of that reward. The larger the tip to one side, the more significant the fall to the other before our balance shifts again to homeostasis. And this fall or decline away from reward is the gap between ‘what could be’ and ‘what is,’ leading to a craving for the positive emotion associated with 'what could be.’ This, as described, is not addiction exactly but the origin or the attraction site from which addiction begins.
Addiction is the constant pursuit of something (typically a positive emotion) that reaches beyond homeostasis or, as earlier described, toward ‘what could be.’ This craving for reward produces dopamine in the midbrain to the striatum, controlling the basal ganglia's signaling functions, mainly craving and neuronal connectivity associated with repetition. This wiring for repetition can form habits and addiction. And the constant pursuit, as earlier described, paired with biology's need to adapt for survival, almost always modifies the strength of the stimuli so that we become more immune or tolerant of the same dose. With repeated exposure, metabolizing enzymes become more active, degrading cell receptor uptake and affinity known as desensitization and endocytosis (the engulfing of a cell).
In short, addiction is not a moral failing but biological dependence. Two regular caffeine consumers can differ in their dependency and withdrawal from caffeine. The same goes for morphine and just about every substance. And although the neurotransmitter dopamine can explain a lot, further factors determine the likeliness of addiction and dependence, which could loosely be described psychologically.
Psychology of Addiction
Some interpretations of mice studies suggest that addiction emanates most strongly from a lack of a fulfilling social environment. That addictive behavior attempts to satisfy or fulfill the ‘lack thereof.’ Although this idea holds some truth, it is nevertheless misleading and, at best, incomplete because we define a fulfilling social environment from our awareness without considering variations in human perception. Variations in awareness can lead to different behaviors, propensities, and impulses for experiences. And the provocation or incitement for drug use can be fostered by a need to deviate from an environment that expresses density and hostility towards drugs.
Such an explanation does not suffice when considering the vast variation in human perception and genetics. Family history of addiction, genes (predispositions), environmental pressure, and emotions such as stress, anxiety, depression, and even happiness are all factors that can contribute to substance use and abuse. Of course, many of us have experienced these risk factors but have not considered taking drugs to soothe or tolerate our existence. What accounts for this distinction? Why is it that some resort to drugs and others don’t? In a data retrieval study by Harriet de Wit, having high impulsivity was correlated to having a strong affinity toward drug use. From my data analysis, impulsivity paired with high trait openness or neuroticism would predispose an even stronger bond for drug use. Pair these traits with overwhelming emotion and the means to access drugs easily, and you can determine the likeliness of drug use with much higher certainty.
Moreover, it is undeniable that highly conscientious and rational people have also taken drugs. What largely accounts for drug use in this category is conscientiousness paired with trait openness. In the absence or disinclination toward impulsivity, what is required is a reason relevant enough to justify taking drugs. Consider this conviction, “the benefit of taking drug x is larger than the risk associated with taking drug x.” If you work 12-hour days and the community around you takes cocaine to get ahead, that might also encourage you. Or, if you did your research and discovered that the therapeutic and spiritual benefit of taking mushrooms far outweighs the risk or addictive aspect of taking it, this might, for a rational and risk-tolerant person, be enough to take psychedelic mushrooms. All that is required for the conscientious and less impulsive type is a convincing reason and the willingness to act upon their convictions.
On the whole, whatever the characteristics are, there must be receptiveness to some degree, and the reasons for why someone is receptive, although overlapping, are slightly different for every person. And these slight variations also play a role in whether someone gets addicted. But despite poor or sound reasoning and resilience or lack thereof, some drugs are unlikely or less likely to cause addiction or compulsive use, while others might. For instance, some drugs have been clinically tested to improve feelings of stress, anxiety, and depression, while others have done the opposite. Some drugs have provided meaning to many who lost it— too many who experience cynicism, worthlessness, and nihilism, while others have plunged them further. Some have connected people, while others caused division. Not all drugs are the same! If used responsibly, some could even help the progression of moving through trauma, self-care, and appreciation for the things around you.
But could drugs be used responsibly, or do all drugs with these purported benefits eventually have a high probability of dependence and addiction? It was earlier discussed what may lead to addiction, but what within the context of drug use, dopamine expression, and reward circuitry leads to a lack of addiction? One such non-addictive inclination is the desire not to experience something physically and mentally challenging, even in conditions of dopamine secretion. Psilocybin, for example, is one such drug, which is why it is often the case that many who have purported to take psychedelic mushrooms generally don’t care to take it the next day.
Furthermore, this anti-addictive effect is compounded by the long-lasting positive effects on emotion months after a single dose of mushrooms. The positive persisting emotions after administration and a demanding experience make returning to that experience far less desirable. And often, those who repeat the experience shortly afterward don’t receive nearly as much added benefit unless the initial experience was unsatisfactory. But even then, a bad experience is not the kind of experience that encourages addiction. Instead, what encourages dependence is a drug that is supportive of frequent use. But even if psilocybin doesn’t usually promote addiction, can it influence a user to gravitate toward drugs that do?
To put it another way, is it a gateway to the world of addictive drugs? From the research, there appears to be little insight into this topic. So instead, let's examine what psilocybin does to our brain and expand from there.
Psilocybin and the Brain
In clinical settings, psilocybin has demonstrated positive results in resolving depressive symptoms for some time. One such positive result was found in a recent study by Nature that concluded, “psilocybin seems to increase the brain’s ability to visit a broader state-space both acutely and after psilocybin therapy in patients who are depressed.”
They found that a high dose of psilocybin restores functional connectivity within the brain's default network. This means that psilocybin strengthened the relationship between brain regions at a resting state, making communication between the brain more fluid for many months after treatment. In other words, it may regulate dysregulation, as seen in depression. And depression may manifest itself by heightening connectivity in the amygdala, which can induce emotions such as fear, anxiety, and aggression and cause an overactive HPA axis, resulting in lower connectivity and neuronal degradation in the hippocampus and prefrontal cortex, which ultimately disrupts learning and emotional brain network.
Moreover, fascinating observations show that this connectivity induced by psychedelic therapy doesn’t just affect depression and emotions. Instead, this increase in functional connectivity has notable effects in clinical trials to reduce alcoholism, smoking, opioid dependence, and PTSD. Alcoholism, smoking, and opioid addiction, for example, are estimated to kill over 600,000 men and women yearly in the U.S., not to mention the countless millions dependent on these drugs. PTSD is estimated to affect 12 million in the U.S., many of whom struggle to make constructive progress. Meanwhile, MDMA or psilocybin paired with psychotherapy has been demonstrated to help people more effectively move through that trauma— to move more functionally through life.
Psilocybin and the Brain Psychology
Whether psilocybin can influence users to gravitate toward more addictive substances is perhaps independent of the drug itself. Those looking to remediate a condition, affliction, or negative emotion through a carefully arranged plan using psychedelics responsibly are far less likely to gravitate toward addictive substances and be addicted to the substance than those who took psychedelics to fit within a comfortable social framework. The first category is the type that wants to work on themselves and is generally more informed. Though the second category may also derive benefits, they are nevertheless inclined to relay their experience externally, making the experience more superficially euphoric or distracting. This feeling with less perceived depth might not only cause the user to use psychedelics more regularly but also may cause the user to consent to an environment that promotes other hard drugs.
This type of behavioral development, as seen when someone starts smoking Cannabis, then ingesting Psilocybin, LSD, and finally taking Cocaine, is not always the fault of the drugs prior. Indeed, many people who have been or are addicted to cocaine or methamphetamines did start with marijuana, but multiple factors contribute to this correlation. Chiefly, marijuana is (generally) not highly addictive, legal, and accessible, making most cautious and risk-averse users start with marijuana. In short, THC is comfortably stationed as the first psychoactive drug of choice. Whether or not someone progresses from there (which many don’t) largely depends on the user's psychology and environment. And the best way to understand someone's space of perception is to ask.
However, understanding someone's reasoning or lack thereof beyond the perfunctory or superficial facts requires the listener to set aside their convictions, conventions, and self-admiring identity and search within to feel, experience, and relate to whom they’re trying to understand. In this way, the listener expands their self-identity through a shared narrative. How one experiences and relates to others arises from the profundity of one's internal state. This understanding of other people is wired in human neurobiology and is partly explained by what scientists call sensory feedback and mirror neurons. When we compare self-generating actions with observed actions, we create a “database" of sensory feedback in the cerebellum. This can later be extracted to predict and perform someone else's action. Although one's perception or predisposition further taints this extraction.
For example, someone who likes to smoke may think the reason for someone entering a drugstore is to buy cigarettes. While someone who knows that every weekend the drug store has a 10% sale may think someone is entering the drug store to take advantage of the 10% sale. Indeed, it can mean both or something entirely different. Still, we infer the actions and movements of others from our projections and scope of experience and not from the experience of others. Therefore, it may be the case that to understand someone; it may be necessary to ask, listen, and find relatability.
Important to Note
Just about anything can lead to dependence, and whether drug use becomes an addiction depends on the environment, the reoccurrence of the drug, human psychology, and the predetermining factors associated with drug use susceptibility. One such predetermining factor is dopamine expression, and scientists have empirically observed (through brain imaging) the high relevancy of dopamine for understanding drug addiction in the form of reward, motivation, and craving. And the magnitude of this relevancy becomes further emphasized in dopamine-deficient mice who refuse activity, food, and reward-seeking behavior.
However, as also observed and further discussed, reward circuitry is not the only predictor of drug use. Social pressure, anxiety, impulsivity, openness, neuroticism, reasoning, emotions, other hormones, and genes are all possible elements that fit into the structure of addiction. Why someone gets addicted hardly ever manifests, presents, or flows from one of these elements but always emerges from a unity of multiple elements, making understanding addiction and the inclination for some to use drugs more challenging.
Yet, despite the present challenges, science has made many advancements in understanding and treating certain types of addiction. For example, nicotine, opioid, and alcohol dependence can be attenuated and treated through a few sessions of psilocybin treatment. The treatment is conducted under the supervision of two qualified therapists who set an environment (through lighting, shades, playlist, etc.) to enrich the internal experience. In this way, the participant is less able to project his experience through external distractions calibrating the environment for a more impactful inner experience. Combine this impactful internal experience with positive emotions partly associated with functional connectivity, often disrupted in those with depression, and we can begin to outline why psilocybin has such marvelous benefits. However, the mapping is incomplete, so heed caution.
Although psilocybin has benefited many, that doesn’t mean it will work for you. Those with paranoia or neurotic tendencies might further the severity of their conditions by taking a hallucinogenic. Also, many closed off from a divergent, uniquely fluid experience might find its progression unsettling and concerning, creating a flimsy internal framework that can easily coil into an inescapable knot of negative or conflicting emotions. This dismaying experience is known as a bad trip. However, it is generally the case that the more understanding and open someone is to a diversity of experiences, the more likely they’re to interpret a ‘negative experience’ as a constructive one. What is viewed as a negative experience for someone can be positive for another. What accounts for this difference can be found within the scope of acceptance, desire for change, or an experience that fits into a narrative. Regardless, it is important to note that individual predispositions don’t guarantee a bad or good experience. But in a clinical setting, under participants who were open to taking psilocybin, it appears to benefit many more than it does harm. More long-term research needs to be done to ascertain the safety of this drug.
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