Some Things You May Not Know About Substance Abuse, Part 16: You don’t have to use drugs to use drugs

A recovering alcoholic goes to a party in which there’s alcohol being poured. He’s determined to stay sober, but he doesn’t want to stop going to parties. All his friends are going to be there. They’ll be watching the big game on the big screen. It’s bound to be a great time.

He does all the things to ensure that he’ll stay sober at that party. He has good reasons to stay sober. They’re all written down on a laminated index card he keeps in his pocket. He brings someone who will support his sobriety. He has an alternative beverage. He has some lines worked out in his head to say if someone offers him a drink and some more lines if they persist. He parks his car so he can make a quick getaway if he has to.

Chances are, that person is going be successful at staying sober at that party. But, chances are, two days later, he’ll relapse when the pressure is off and he has no reason whatsoever to drink. I’ve seen it happen a hundred times.

What is going on?

Drinking alcohol got in his head. Not the alcohol, itself, but the idea of it. A lot of times, that’s all you need.

A recovering drug addict drives to meet a prospective customer on the far side of the city. On the way, he passes by the abandoned building where he used to score dope. He’s not going there to get dope, he’s just driving by. He has no interest in getting high. He’s been there before and doesn’t want it again. Things have gotten much better for him since he began his recovery. He has this job, for one. He’s back with his old lady. His kids are talking to him. Using drugs again would be just crazy.

But then, as he drives by the old drug house, he gets this funny feeling. Something tightens up in his chest. His stomach goes queasy. You know what? He gets a little high. He hasn’t done anything more than drive by the old drug house, but that’s all he needs to do. He doesn’t get as high as in the old days. It’s not like that; but the excitement is still there.

You know what he does? He goes on to his meeting. If he tells anyone about his drive past the old drug house, he tells them about how he was able to pass by, without relapsing. His old lady congratulates him on his success. He’s feeling pretty good about himself.

A week later, he drives by again. This time, it’s not really on his way. The same thing happens. He gets a little high; and, just like before, that’s enough.

A week after that, he drives by again. This time, he pulls over and has that feeling a little longer. You guessed what happens eventually. As they say in the meetings, if you keep going to the barbershop, one of these days you’ll get a haircut.

This is what’s known as a contact high: the high you get when you’re in the vicinity of your drug. The term is sometimes mistakenly used for the high you get when you imbibe second hand smoke or handle a drug with your hands so that it passes through your skin. You can get high by imbibing secondhand smoke and handling drugs with your bare hands, but that’s not properly called a contact high. A contact high occurs psychologically, not physiologically. It’s all in your mind.

We shouldn’t be surprised by this. It’s related to the placebo effect. When scientists are researching a new medication and want to test it, they will give the new medication to a group of people and study the effects. They’ll take a second group of people and give them a pill that looks just like the new medication. They will tell them it is the new medication, but it’s really just a sugar pill. The sugar pill is called a placebo. Then they’ll study the effect of the placebo.

Placebos always are effective to some degree. For instance, when they conducted the trials for Prozac, a popular and important anti-depressant, the placebo was effective in about half the cases. Prozac was effective in about two thirds of the cases. That’s not a huge difference, but I guess it was enough to say that Prozac works. Still, when Prozac works, it’s a pretty good chance that it works because the patient believes it will work, rather than because of some physiological effect.

People who believe that everything comes down to cells and chemicals are mystified by the placebo effect, but the phenomenon has been used and abused by both healers and charlatans, for good and ill, for centuries.

Words are the most powerful drugs used by mankind. Kipling

I once had a client who was very anxious. Nothing seemed to help her and the medicine she was taking for it was actually harming her. Her doctor hatched a scheme. He told her they had discovered a new, very powerful medicine. He would put it on her and discontinue her old medicine. The new medicine was a placebo, but he went through the usual song and dance doctors go through, describing all the side effects. He was making them up, but he needed to make it believable. She took the new medicine.

A couple weeks later, she saw her doctor again. All her symptoms of anxiety had disappeared, just like he said they would, but she was also getting all the side effects. She couldn’t tolerate the side effects, in fact. She refused to take any more of the medicine.
Here’s another story. I once worked nights selling drinks at a teenager’s nightclub. We had no alcohol there, of course; it was all just sodas and juice; but, one week the owner had gotten a couple cases of non-alcoholic beer.

A few of the kids were pretty excited to see the beer. They either didn’t hear or didn’t understand that it was non-alcoholic. It looked like beer. It tasted like beer. They started drinking it, pounding it, really; just as hard as their big brothers might at a frat party. You know what? They got just as drunk as if they had been drinking real alcohol. They would have passed a breathalyzer test, but wouldn’t be able to drive real well. We actually talked them into surrendering their keys and calling their parents. Boy were the parents mad when they thought we had been giving beer to their children.

So, you see, it is not necessary to actually use a drug to be effected by a drug, and it’s possible to relapse without ever actually touching the stuff.

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