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There is a natural force that motivates the pursuit of intoxication.
This biological force has found expression throughout history. It pushed all the animals from Noah’s Ark into patterns of drug-seeking and drug-using behavior. It has been the basso continuo in our own behavior since long before we were civilized primates. It has led to the discovery of many intoxicants, natural and artificial, and to demonstrations of its irrepressible drive. It was responsible for Annie Meyers’ invention of the “Cocaine Dance.”
The time was 1894. Annie C. Meyers, Chicago socialite, patron of the arts, congressional appointee to the World’s Columbian Exposition, and recent widow of a distinguished naval officer, had a bad cold. Her lawyer advised her to try Birney’s Catarrh Remedy, a popular over-the-counter cold powder containing cocaine. Soon she found herself sniffing cocaine day and night. A month’s supply of cocaine cost only 50 cents, but Annie’s runaway habit totaled $10 a day, a hefty sum that forced her to forge checks and steal.
Annie was caught shoplifting in the Marshall Field store in Chicago. She had concealed several costly silks and expensive pocketbooks in her clothing and was now confronted by the store detective and manager. “If we let you go, will you keep out of the store?” asked the manager.
“Gentlemen, excuse me while I take a blow of my cocaine,” answered the always polite Mrs. Meyers, who now needed a dose every five minutes. The men were fascinated by this little lady and her white powder. They asked her to show them how it was done. Then they asked to see it again. And again. Eventually they decided to let this “unfortunate” woman go. But a few days later they stopped her in the store just as she was trying to steal a pair of fur gloves.
“Have you any more goods on you?” snapped the detective.
“Search me!” invited Annie as she threw up her hands and stepped toward him.
“Don’t come near me,” begged the detective. “I am a married man.”
He let her go again. Annie still had about $25 worth of goods on her, part of the thousands she would eventually take from that store. She resold the items on the black market.
All the money went for cocaine. After stealing a valuable diamond, she tried to sell it for 10 cents, the amount she was short for another bottle of Birney’s. She would pet the bottles and speak to them as “my baby” and “my only friend.” The only time she would leave the house was when her cocaine supply was exhausted and she had to go out to the store to buy some more. Detectives were following her everywhere, or so she imagined. Once, in the midst of a drug-induced paranoid episode, she fled to the roof of a house and refused to come down until the police passed her some cocaine via a string she lowered to them. She talked her way out of that arrest, too.
The unstoppable Mrs. Meyers used aliases and disguises, worked in different cities, and learned how to do the “Cocaine Dance”—a dance she would perform at public gatherings, then take up a collection to support her “baby.” Late one night, alone with no one to dance for, she took a pair of scissors and pried loose one of her gold teeth. With blood streaming down her face and drenching her clothes, she pawned the tooth for 80 cents. Her baby was very hungry that night.
Throughout it all, Annie was aware of a powerful force that was directing her drive for cocaine. No other experience in her life had made such a pleasing impression on her brain. During the eight years she spent under the influence, she was aware that her pursuit involved many social and psychological problems, but cocaine also stirred something deep inside her that was soothing, enlivening, vitalizing. It seemed to Annie that she was satisfying a natural, biological urge. Like the grizzly bear on the mountain ledge, it was a precarious but magnificent natural feeling.
Calling an event natural is sometimes just reporting that it happens. Over the centuries, people have sought—and drugs have offered—a wide variety of effects, including pleasure, relief from pain, mystical revelations, stimulation, relaxation, joy, ecstasy, self-understanding, escape, altered states of consciousness, or just a different feeling. These statements of motives, of what people say they seek with drugs—and there could be an endless catalogue of such motives—is also what they say they seek without drugs. They are the same internal urges, wishes, wants, and aspirations that give rise to much of our behavior. Plant drugs and other psychoactive substances have been employed as natural tools for satisfying such motives.
The motivation to use drugs to achieve these effects is not innate but acquired. The major primary drives, those associated with survival needs and part of the organism’s innate equipment, include the drives of hunger, thirst, and sex. These drives are a function of the organism satisfying certain primary biological needs. We are not born with acquired motivations yet they are not unnatural—they are simply an expression of what we strive to be. The pursuit of intoxication is no more abnormal than the pursuit of love, social attachments, thrills, power, or any number of other acquired motives. Man’s primary biological needs may be body-bound, but his acquired addictions soar beyond these needs.
Acquired motives such as intoxication can be as powerful as innate ones. As we have seen, animals will die in pursuit of cocaine with the same absolute determination that drives them in their quest for food or water. Additionally, many of the naturally occurring plant drugs and their derivatives produce effects that directly or indirectly address the needs of hunger, thirst, or sex, thereby increasing their value to the organism. Unlike other acquired motives, intoxication functions with the strength of a primary drive in its ability to steer the behavior of individuals, societies, and species. Like sex, hunger, and thirst, the fourth drive, to pursue intoxication, can never be repressed. It is biologically inevitable.
Annie’s dance to the power of this feeling was done in the footsteps and tracks of people and animals who have been inspired by the same driving beat throughout history. It began with Daniel’s Datura hop through the woods, along a path strewn with accidental encounters. It was where Kaldi’s goats pranced with coffee while livestock staggered on range poisons or galloped in addicting circles for locoweed. There were cats who leaped and turned for catnip while creatures everywhere twitched, shook, flipped, and rolled to a symphony of hallucinogens. Almost everyone caroused and reeled with alcohol or glided on opium. Mice jumped to the tune of morphine withdrawal. Grasshoppers did it awkwardly with marijuana resin. Llamas stepped assuredly with coca, and rats couldn’t stop with cocaine. And primates, great and small, selected a variety of chemical partners, from tobacco to ergot, so they could dance with their ancestors and gods.
We have seen that intoxication with plant drugs and other psychoactive substances has occurred in almost every species throughout history. There is a pattern of drug-seeking and drug-taking behavior that is consistent across time and species. This behavior is similar for many animals because it has been shaped and guided by the same evolution and environment, the same plants and pressures. In considering an evolutionary explanation of the phenomenon, we might ask if intoxication is in some way beneficial to the species. After all, the pursuit of intoxication with drugs has no apparent survival value and in some situations has certainly contributed to many deaths. The condition is so obviously disadvantageous for some animals, such as insect pollinators, that natural selection acted strongly to eliminate it or helped animals to coevolve adaptive mechanisms. Yet the laws of evolution, even with help from the prohibitive laws of Homo sapiens, have not prevented it from surfacing in every age and in every culture.
What then could be the evolutionary value of such a condition? One possibility is that the pursuit of intoxication is a side effect of a beneficial gene or genes. Intoxication with drugs is widespread in animals, especially mammals, and it seems plausible that in order to appear in so extensive a range of genetic contexts it was inextricably associated with something else that was of survival value. The universal pursuit of intoxication implies the existence of direct connections between the molecular chemistry of the drugs and the chemistry of the central nervous system, such as opiate receptors in the mammalian brain, a biological investment that is difficult to think of as arising by accident. We are organisms with chemical brains and drives that pit the chemistry of the individual against that of the environment. We have survived these interactions and learned to thrive on them.
Intoxication, like the syndrome of food poisoning, has adaptive evolutionary value. All species must have been under continual evolutionary pressure to develop protection against chemicals that are true toxins. The intoxication can produce sensory or physiological disturbances that so shake up the individual, they cause ingested food to be rejected by emesis. Recognizing bitter tastes, bad feelings, or other disturbances may also help the individual to learn to avoid future ingestions. These defenses provide an ideal warning system for detecting the early central effects of toxins. The emetic responses or learned taste aversions are highly advantageous for animals accidentally feeding on plant toxins.
Exposure to intoxicants can also produce pleasant experiences, thereby attracting us and forming the familiar “love-hate” fascination described by so many addicts. Annie Meyers described her passion for cocaine as an expression of motherly love and her intoxications were pure enjoyment; yet the cyclical withdrawal was hell. Her nonstop use prevented the agony of withdrawal, except when she was periodically arrested. These occasional unpleasant episodes only strengthened her determination to avoid them by staying “full of cocaine” all the time. The benefits of staying high on cocaine overshadowed the costs of stopping; use continued according to the same economic equation governing other types of intoxications.
This principle of positive effects outweighing negative effects can be illustrated by dizziness, a major drug effect that is triggered by disturbances in sensory input or motor control. When dizziness is accompanied by nausea, as in food poisoning or motion sickness, it is generally unpleasant. Animals as well as people usually reject drugs such as locoweed that produce intense dizziness. But when unaccompanied by nausea or severe physiological disturbances, the dizziness can become a desired state of intoxication, and inebriating amounts of such substances as alcohol will be sought after. Thus dizziness can be a pleasant or an unpleasant experience, and one that we seek almost as often as we avoid it. It is perhaps the most primitive form of intoxication and, aside from sleep and dreams, one of the oldest altered states of consciousness known to our species.
In the initiation rites of the !Kung Bushmen of the Kalahari Desert (the “!” denotes a click sound in their language), the men dance in a circular rut, stamping around and around, hour after hour. The dancing can generate a dizziness so extreme that it induces a trance state marked by visions. In the Umbanda rituals in Brazil, participants create an identical trance by spinning around rapidly as their heads and chests jerk back and forth in opposing directions. The whirling Sufi dervishes dance and spin like tops to achieve a similar altered state of consciousness.
Dizziness is not only an ancient and adult form of intoxication, it is one of the first to be discovered by children. It is common to find three-and four-year-olds whirling and twirling themselves into delirious stupors. Many children have discovered that a good way to induce dizziness is to wind up a swing and let it unwind while they are sitting on it. The “witch’s cradle,” a U.S. adaptation of the swinging basket once used by witches in the Middle Ages, is a more certain way to swing into a trance. The cradle is actually a metal swing in which a blindfolded rider stands upright. The swing hangs like a pendulum and moves the rider in rotating and horizontal planes in response to the slightest body movements. Typically, a trance is induced in a few minutes, giving the rider visions comparable to those produced by hallucinogens. Many amusement-park rides are designed to induce other thrilling experiences through dizziness. For example, “tilt-a-whirls” move riders in vertical and horizontal planes while spinning them around.
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As they grow up, these children, who score high on psychological tests measuring their propensity to seek new sensations, sometimes experiment with household drugs that promise similar experiences. Intoxication from sniffing glue, gasoline, paint, or any number of other deliriants have been utilized by children too old to twirl yet too young to have access to other drugs, New Age Tom Sawyers who have found something else to do with the paint besides put it on the fence.
Adults were offered the opportunity to enjoy these “school-boy pleasures” in London theaters of the eighteenth century. The theaters provided “ladies and gentlemen of the first respectability” with the “chemical recreation” of nitrous oxide. People laughed and sang and danced. The gas was celebrated in songs, poems, and plays. And use continued in the nineteenth century. Philosopher William James believed that the intoxication revealed the uniqueness of our species to contemplate the hidden meaning behind language and thought. Writer Oscar Wilde once said that with the gas “I knew everything,” although he was surprised to learn that the little pink man he was watching on a distant stage was really his dentist who had just pulled a tooth. Throughout all these recreations and revelations, the people reported an intoxication marked by dizziness, delirium, and delight. A few had to be restrained from hurting themselves or others. Many became sick with symptoms resembling motion sickness.
Experiences with dizziness-provoking drugs like nitrous oxide are illustrative of intoxications in general, which cannot be easily separated into distinctive pleasant and unpleasant feelings. The initial encounters with many drugs are unpleasant and the reported effects for opiates, barbiturates, alcohol, and nicotine include nausea, vomiting, sweating, dysphoria, emotional lability, aggression, drowsiness, and lethargy. There may also be impairments in concentration, thinking, comprehension, memory, and judgment. William James didn’t vomit with nitrous oxide but his nonsensical statement that he was experiencing nausea “what’s nausea but a kind of -ausea? Sober, drunk, -unk, astonishment” leaves us with a little of our own astonishment at the cognitive dysfunction of this great thinker while under the influence. As a rule, some negative effects are accompanied by some positive effects. Why bother pursuing such a chancy condition?
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Part of the answer may be found in the study of the self-administration of drugs that continually recycle the user through addiction and withdrawal. As we have seen, animals self-administer the same drugs we use. The behaviors of these animals have told us much about effects such as tolerance and breaking points. Yet with the exception of the pigeons and monkeys that were trained to report their hallucinations, few animal experiments tell us about the internal feelings that motivate use. And so we turn to human subjects for answers about their subjective sensations.
Many addicting drugs such as cocaine or heroin produce a rush of intense pleasure, especially if rapidly delivered through injection or smoking, followed by mild discomfort as the drug loses its euphoric effect through metabolic destruction. The discomfort is both physiological and psychological. Cocaine leaves the user with lethargy and fatigue. Heroin’s discomfort can be seen in the user’s runny eyes and nose, abdominal pains, clammy skin, and muscular malaise. Psychologically, both drugs create a craving, an aversive state that animals and people will seek to avoid by repeated self-administration of the drug. The aversive state will go away on its own, but the heightened contrast between the previous euphoria and the craving creates a universal impatience.
The important elements of this behavior are the changes in affect. The initial intoxication has a different emotional quality from the subsequent withdrawal. Cocaine’s first few doses, for example, produce an initial state of excitement and intense euphoria. The onset of the drug action is the reinforcer. But after the drug effect dissipates, the second state, the unpleasant withdrawal phase, begins. Withdrawal finally disappears with time or another dose. Therefore, both the onset of the drug effect and the removal of the withdrawal effect acquire the capability of reinforcing or rewarding behavior; both can motivate the continued use of the drug. This can be easily illustrated by cocaine addicts like Mrs. Meyers who continue to use the drug despite the fact that they no longer feel any pleasure or high from the intoxication. They have generated tolerance to the initial euphoric state, yet drug use is maintained because repeated doses act to block or remove the withdrawal effect.
Psychologist Richard Solomon has proposed a model to account for these events. It is known as the opponent-process theory and it is helpful in explaining a wide variety of acquired motivations, from addiction to Zen, from rock climbing to free-fall parachuting. According to the model, most organisms behave in the direction of restoring bodily functions to a normal state. Solomon explains that “the brains of all mammals are organized to oppose or suppress many types of emotional arousals or hedonic processes, whether they are pleasurable or aversive, whether they have been generated by positive or negative reinforcers.” The opposing processes are automatically set in motion by events that induce disturbances in physiological or psychological systems. These disturbances, in turn, elicit counterreactions that function to correct the imbalances.
For example, the first few doses of heroin produce a rush of euphoria followed by a state of craving. The rush is the positive reinforcer and the craving is the negative one. After many doses the rush is greatly diminished and euphoria is often absent. However, the withdrawal state of craving becomes longer and more intense. While the positive reinforcer (the rush) has lost most of its power, the negative reinforcer (the craving) has gained strength. It has acquired sufficient power to motivate behavior. The user may have become tolerant to the drug, but the intolerance to drug termination or absence drives him on.
The opponent-process model can also account for situations in which the rush is aversive and the withdrawal is positive. For example, a para-chutist experiences terror during his first free-fall jump. Studies of military parachutists have found that even the bravest men show an initial fear reaction: eyes bulge, lips retract, and the men yell with anxiety. Once they have landed safely, they appear too stunned to talk. Then they experience relief and begin a lively chatter with other jumpers. After many parachute jumps, the fear reaction is undetectable, and affective habituation is said to have occurred. This allows the positive aftereffects of withdrawal—the removal of the anxiety upon landing and the subsequent relief—to reinforce further jumps. Now the parachutists look eager before the jump and report a thrill during the free fall. The landing is followed by a long-lasting feeling of exhilaration.
These concepts help to explain how some drug-induced intoxications can be rewarding despite the occurrence of negative effects. The most unusual and “negative” drug taken by both monkeys and people is phencyclidine (PCP), a compound that produces negative effects in 100 percent of the intoxications and positive effects only 60 percent of the time. It defies convenient classification and has mixed excitatory, sedative, anesthetic, and hallucinatory properties. The intoxications are predictably unpredictable and almost everyone reports bad trips. In a sense, the persistent use and abuse of a drug like PCP seems to be a paradox. Yet the fourth drive is not just motivating people to feel good or bad—it is a desire to feel different, to achieve a rapid change in one’s state. The direction of change, up or down, good or bad, is of secondary importance. If we can understand this nature of PCP’s attraction, then we can understand how almost any intoxicant can satisfy the fourth drive.
Before PCP reached nonmedical users it was called Sernyl and was used as a surgical anesthetic for humans. The drug did not perform well in clinical tests. Patients were oblivious to the surgery but, in the recovery room, they awoke in the midst of a lingering and confusing delirium resembling schizophrenia. While some patients felt years younger—almost as if they were “born again”—others had a stormy emergence that required constant supervision because they could become violent. Therefore, PCP was restricted to use as an immobilizing agent for animals since veterinarians were generally less concerned about the psychological aftermath in their patients. However, because it was relatively cheap and easy to manufacture and the effects of sub-anesthetic doses mimicked those of many illegal hallucinogens, PCP began to appear as an adulterant in street drugs. Familiarity bred experimentation. People started to experiment with pure PCP itself and gradually acquired a liking for the drug experience.
PCP is typically smoked, although it can be used in a number of ways, and the symptoms start to appear within a few minutes. Users report peak effects within fifteen to thirty minutes, followed by a prolonged intoxication of several hours. Recovery may take many more hours, even days. The experience is triggered by PCP’s direct action on the brain, arousing the user’s body and elevating mood. Heart rate and blood pressure increase. The mood turns euphoric. But as the extremities are numbed, motor behavior becomes uncoordinated and the user acts in a drunken manner. Further doses produce bizarre and inappropriate motor movements.
Under PCP’s influence Luther R. cut off his own penis and swallowed it. The paramedics found him lying on the kitchen floor in a pool of blood. As they attempted to stop the bleeding, Luther regurgitated his penis. He never felt the pain. At similar points of intoxication users might not be able to feel a surgeon’s knife or a blow from a police baton, yet sensory impulses in grossly distorted form do reach the brain.
Seventeen-year-old Martin L. had just finished smoking a PCP cigarette when he started breaking store windows with karate kicks as he walked along the street. When the police arrived, Martin flashed a butcher knife and attacked. The police were unable to subdue him, even after multiple baton blows, and Martin, making no sound whatsoever, was showing no signs of fatigue or pain. Additional officers were called to the scene, six in all, and eventually they restrained and handcuffed the “super-human” Martin. The handcuffs held, although other people under the influence of PCP have mustered the 550 pounds of pressure necessary to snap them. Martin’s first words came in the form of a song he sang in the hospital, words that suggested some vague, albeit distorted, awareness of the preceding events: “I’m strong to the finish ’cause I eats my spinach, I’m Popeye the sailorman!”
What is so attractive about the state of PCP intoxication? When users like Martin are examined in the hospital, they do not look as though they should be singing. Flushed, feverish, and dripping with sweat, the users seem consumed by discomfort. There may be excessive salivation and tearing. Speech is slurred and difficult. A blank stare comes over the face. Unable to stand or walk properly, they start shivering, but it’s actually preseizure muscle activity. Touch them and their muscles may become tense and rigid. However, the users remain largely detached from these physical discomforts and focus on the subjective experiences. They are so unaware of physical sensations that they often have the sensation of floating clear out of their bodies.
It is precisely this dissociation, not unlike the trance from dizziness or anesthesia from nitrous oxide, that is so attractive to many users. They have dreamlike experiences in which they feel as though they were in a different place, in a different time. A common sensation is the feeling that one is watching oneself from a distance. When we think of the last time we went swimming in the ocean, we might see a mental image of ourselves running along the beach and into the water. This is an entirely fictitious memory. We couldn’t possibly have seen ourselves. Yet memory images often contain fleeting glimpses of oneself. PCP users have similar dissociated or out-of-body perspectives but while events are taking place. In such an altered state, PCP users report a generalized feeling of well-being and a detachment from worldly tensions and anxieties. In other words, their affect is changed. For many, there is ambivalence or a blanding of affect; users claim even this can be euphoric in light of preexisting depression or unhappiness. Others experience a negativism and hostility, sometimes coupled with feelings of “sheer nothingness” and thoughts about death. This, too, can be rewarding for individuals who can find escape from the stimulus overload of their normal lives and feel stronger after surviving a powerful psychological experience.
The names given to PCP by users tell of these varying stimulus properties: Angel Dust, Devil’s Dust, Embalming Fluid, Goon, Peace, Rocket Fuel, Whack, Wobble Weed, and Zombie. Other street names suggest that PCP intoxication can also recapitulate phylogeny, at least experientially: Amoeba, Worm, Busy Bee, Dog, Hog, Pig Killer, Horse Tranquilizer, Elephant Tranquilizer, Monkey Dust, and Gorilla Tab.
According to the Los Angeles Police Department, Lenny B. turned into one of these animals after smoking a tobacco cigarette that had been dipped in liquid PCP. In his mind, Lenny was flying over a duck farm. But in his house he walked like a duck, quacked like a duck, and announced to the startled guests that he was Donald Duck. Then he savagely stabbed a man to death. He was found waddling in a puddle on the sidewalk. Lenny was unaware of these events, and later told me he enjoyed the high and would take PCP again.
Elsewhere, Linda, one of my research subjects who had taken PCP in a controlled environment, had a quiet introspective experience. She reported seeing images of God and heaven: “I was flying with the angels. When I started coming down, I felt sad that I was leaving such a lovely place. I think I even cried. I hadn’t done that in years. But most of all I remember the peace and tranquility. Everything was good. I want to be there always.”
PCP will not automatically deliver a devilish or angelic experience. Many of the horror stories retold in the media are true, but the unsung tales of beatific paradises experienced by users like Linda are much more common. As with most mind-altering drugs, the intoxication from PCP is shaped and guided by both pharmacological and behavioral variables. Individual health and personality, the size of the dose, route of administration, and frequency of dosing are a few of the more obvious factors. And so are the set (expectations) of the user and the setting (environment) for the intoxication. Less apparent, but more important, are the patterns of use in which the pursuit of intoxication finds expression. These patterns are the most critical determinants of abuse. In other words, whether or not a drug will get an individual into trouble is often a question of whether an individual gets into a trouble-some pattern of use with the drug.
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If use is motivated by a desire to achieve a specific drug effect that is helpful in coping with a particular condition, the pattern of use is called circumstantial or situational. This category includes long-distance truck drivers who have relied on stimulants to provide extended alertness and endurance, as did the Apollo astronauts who used amphetamine before reentry into the Earth’s atmosphere. Both the truck drivers and the astronauts were medicating themselves in order to obtain a certain self-prescribed effect, like the baboons who treated despair with tobacco and alcohol. The same pattern is seen in the case of a student who takes caffeine pills to stay awake, an overweight woman who takes cocaine to lose a few pounds, or a worker who relaxes with an afterwork drink. The pattern is the same although the choices of drugs may not always be prudent or legal. One of the greatest dangers of this pattern is that the user will become accustomed to having the drug in similar circumstances and will be unable to exercise the control that usually accompanies medically prescribed and supervised use. Mrs. Meyers may have felt that cocaine, in addition to helping her cold, also tempered the loneliness of her recent widowhood. It was undoubtedly tempting to use the drug well after her cold was over. She quickly moved into the next pattern: intensified use.When a person perceives a need to achieve persistent effects or maintain such effects, a daily or intensified pattern of drug use may occur. In the case of many drugs, this recurrent drug taking will escalate to states of psychological or physical addiction. Intensified users include the American housewife who regularly consumes tranquilizers, the coca-chewing Bolivian miner, the daily marijuana-smoking laborer in Jamaica, and the opium-munching water buffalo in Vietnam. In these instances the pattern of drug use has become a normal and customary activity of everyday life. Daily PCP users, who are often innercity youths suffering from a high rate of unemployment, frequently cite a need to achieve constant relief from persistent unpleasant internal and external environments. A young secretary who reported that she was using cocaine a few times each day “to white-out” the depression of her recent divorce was also an intensified user who ran the risk of escalating to still greater amounts.
Escalation is common for daily cocaine or heroin users. They use at high-frequency and high-intensity levels, the mark of the compulsive pattern of drug taking. They cannot discontinue use without experiencing some physiological discomfort or psychological disruption. Mrs. Meyers was so afraid of withdrawal that she would tear her hair out and throw a temper tantrum whenever she was arrested. The strategy worked; her jailers would take pity on her and sneak her some cocaine. A characteristic of these compulsive users is that they become preoccupied with drug seeking and drug taking, often to the exclusion of other behaviors. Compulsive users are not only the prototypical street junkies, they also include alcohol-dependent white-collar workers and white rats, opiate-dependent physicians and research monkeys, and chain-smokers everywhere. The eight-year cocaine career of socialite Annie Meyers was no different from that of the skid-row alcoholic she was often mistaken for.
Some drugs offer greater risks of developing compulsive patterns than others. Because hallucinogens like LSD stop working when taken daily due to tolerance, intensified and compulsive patterns of use do not develop with these drugs. The tolerance can be so complete that even superdoses have no effect if the person has been taking the drug too often. Therefore, most LSD users will adopt experimental patterns and take the drug no more than ten times over the course of their entire lives. Conversely, cocaine has an extremely short duration of action. It doesn’t last long and, coupled with tolerance, can cause even social users to escalate short runs or binges into long-term compulsive patterns. Compulsive cocaine smokers may take hits as frequently as ten times per hour.
In a sense, the escalating patterns of drug use, from experimental to compulsive, can be viewed as points on a continuum. The different patterns cannot be separated easily, and individuals move along this continuum at speeds governed largely by the amount of the drug that is fueling the drive. For example, large and frequent experimental dosages of morphine delivered during a binge may catapult the user directly into compulsive patterns. Conversely, small measured doses can maintain intensified patterns for years without difficulty.
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These dynamics of the fourth drive are best illustrated by the history of cocaine. The experiences of Annie Meyers came at a turning point in that history, at a time when the dosages of cocaine preparations had recently changed. Before her time, people were prevented from developing runaway compulsive habits because only coca preparations were available.
A widely held belief in Western medicine was that most physical and mental diseases were caused by brain exhaustion and the best way to cure these conditions was to wake up the brain with a stimulating coca tonic. Physicians, pharmacists, and chemists recommended daily doses of coca extracts or wines that delivered an amount of cocaine equivalent to that obtained from chewing the leaves. While intensified dosage patterns were normally prescribed, abuse was held in check by the highly diluted preparations. Most coca wines contained only 10 milligrams of cocaine per fluid ounce, equivalent to one piece of the Coca-Peps gum used in the monkey studies.
Other patterns of use were encouraged by the commercial marketing of coca products. Coca was promoted as a wonder drug not only for medicine but also for social and recreational purposes. To make it more attractive, an assortment of coca preparations were sold, including tonics, gum, cigarettes, and soft drinks. Coca-Cola, originally promoted as a brain tonic for the elderly, was made with a coca extract. It reportedly contained slightly less than 60 milligrams of cocaine per eight-ounce serving, the amount found in a modern intranasal dose.
The tonics of Mrs. Meyers’s day were much more potent; cocaine had been recently isolated from the leaf, and the manufacturers substituted it for the coca extracts. Large amounts of cocaine alkaloids or salts could now be readily dissolved in almost any tonic or packed into any powder. Whereas coca products were treated as roughly equivalent to the chewing of the leaves, cocaine was advertised as two hundred times stronger. And it was. Just as the chimps on North and South Island had discovered, coca was not cocaine, and the golden age of coca medicine was in for some lackluster years.
Physicians started increasing the daily dosages to as much as 1,200 milligrams—a lethal dose for most people if taken into the body all at once. The effects of increased doses of cocaine were further complicated by the popularity of the highly efficient intranasal and injection routes of administration. By the time Mrs. Meyers bought her first bottle of Birney’s, many snuffs were pure cocaine and patients were instructed to take them as needed. Mrs. Meyers’s perceived needs went beyond the bounds of treating her cold and her pattern of use became compulsive.
When Annie Meyers was arrested for the last time, while trying to blow open a safe, she looked awful and she knew it: “My hair was mostly out. A part of my upper jawbone had rotted away. My teeth were entirely gone. My face and my entire body were a mass of putrefying cocaine ulcers. I weighed only about eighty pounds and it would be hard to conceive of a more repulsive sight.” Not hard at all. One need only examine more recent cases where users, faced with plentiful supplies of cheap cocaine, danced faster and harder than Mrs. Meyers ever could with her Birney’s.
During the early 1970s when cocaine once again became a social-recreational drug of choice for North Americans, the case of Annie Meyers seemed like a historical oddity. Studies of intranasal users during this period revealed that the daily intake averaged only 150 milligrams. But by the end of the decade, many social users had climbed the ladder to more concentrated patterns of use. Sniffing as much as 1,000 milligrams (1 gram) in a single dose, Kenny D. suffered severe nasal erosion. Once when he blew his nose, out came a large glob, thick as a cigar, that stretched across his palm. He displayed it to his amazed wife, who named it “Stillborn.” The glob was cartilage tissue. Kenny’s nose had collapsed. Cocaine seemed to dull the constant pain and Kenny continued his daily use even after another discharge, “Baby Sparrow,” was born.
Many cocaine users became concerned about the risks of such nasal damage and switched to smoking cocaine free base. Some users smoked as much as 85,000 milligrams a day! They were unaware that although their noses might be saved, their bodies and lives would be ruled by compulsive patterns of use.
Mitch R. couldn’t afford all the cocaine he wanted to smoke. When his supply was exhausted, he often searched the floors and carpet fibers for specks of cocaine to smoke. Like many cocaine smokers, Mitch had a hacking cough with a black, bloody expectorate. One day he “free-based” his black sputum and smoked it. He decided it was “a good hit” and continued the practice whenever supplies were low. Terry B. had a special glass waterpipe he named “Old Faithful.” He had been a super-stitious cocaine smoker for several years and never changed the water in the pipe. The pipe itself was wrapped in aluminum foil to prevent anyone from seeing what was growing in the stagnant, cocaine-saturated water. When Terry was out of cocaine, a swig from “Old Faithful” kept him going until he could replenish his supply.
These users had the same pale, cadaverous features that caused Annie Meyers to describe herself as repulsive. To prove her point, Mrs. Meyers included pictures of herself in her autobiographical book, Eight Years in Cocaine Hell, the first drug confession written by a woman and the first confession from a cocaine abuser. Those pictures showed the sunken eyes and emaciated look that was characteristic of Terry B. and so many other compulsive users, including the Michigan monkeys who injected themselves with cocaine. Annie’s ulcers were not shown, but a photograph of Terry’s leg, full of open sores that he picked while looking for “cocaine bugs,” was featured in a Time magazine cover story. Time decided not to use photographs of another patient who tried to remove the hallucinatory bugs from his body with a scalpel and forceps. When that effort failed, the patient attempted to burn them out with a propane torch: the pictures showed second-and third-degree burns covering his thighs and testicles.
Until the advent of the modern cocaine abuser, the odd horror tales associated with other drugs were exactly that: rare examples of highly idiosyncratic reactions to intoxications. There were cases of PCP abusers who had gouged out their own eyes; others had sat quietly while engulfed in flames; some had pulled out their teeth with pliers, and one woman had put her own baby in a caldron of steaming water. But cocaine users provided the quintessential examples of the fourth drive’s relentless power. Hit in the eye by a piece of cocaine-encrusted glass from an exploding waterpipe, one user described it as the best hit she ever had. She didn’t stop. After clumsily burning his hands with a lighter, a cocaine smoker took to wearing fireproof gloves. He solved the problem of constantly grinding his teeth by wearing a plastic mouth guard. He didn’t stop. Faced with increasing expenses for cocaine, a mother adjusted her budget by selling her baby on the black market. She didn’t stop.
Arrest finally stopped Annie Meyers from doing her Cocaine Dance. Her treatment consisted of a long stay in a sanitarium coupled with the religious and moral lectures that were popular in her day. Traditionally, society still tries to hold the drive in check through legal and moral controls that employ penalties for use, treatment for users, and preventive education for nonusers. Although these methods haven’t worked, our response in the face of such unstoppable examples of the drive as the modern cocaine abuser has been to intensify the controls. Accordingly, punishments escalate, involuntary testing programs for the detection of drug use become more widespread, treatment becomes mandatory, and educational campaigns tend to deliver more hyperbole than honest information, resulting in the recurrent message that “drugs will destroy your brain.”
Recently, there have been attempts to quiet the underlying drive itself. Psychiatrists try to block it with isolation, physical and chemical restraints, even electric shock. When all else fails, neurosurgeons in South America have severed the neural pathways in the brains of young cocaine users who refuse to stop. It seems as though the healing profession is stepping in to fulfill the promise that drugs will destroy your brain. In Annie Meyers’s time those in the healing arts also panicked. Dr. Albrecht Erlenmeyer, a famous nineteenth-century drug expert, saw so many unstoppable addicts like Mrs. Meyers that he proclaimed cocaine to be “the third scourge of mankind,” after opium and alcohol. It was really only the fourth drive, a drive our species had always danced to and always would.
Intoxication...
Ronald K. Siegel
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