Wednesday, 24 April 2024 ------------------------ Hello. All is well. Finishing chapter four, we discuss drugs, hypnosis, and meditation. Drug use becomes an issue when one consumes more than intended, continuing to increase intake despite adverse effects. Our drug use becomes disorderly. We develop a drug use disorder. Increased drug usage is typically the result of drug tolerance. Our body becomes tolerant of drugs we continually consume, requiring higher amounts to achieve the same previously experienced effects of a drug. At high doses, many drugs can cause complications, from antisocial behavior to loss of life. When halting one's drug use, one may experience unpleasant effects, known as experiencing withdrawal. While some drugs cause minor unpleasantness, other drugs' withdrawal effects can pose serious life risks, requiring a careful and controlled phaseout. There are four major drug categories: stimulants, depressants, opiates, and hallucinogens. Stimulants are drugs that increase overall activity in the brain. Typically, agonists for the dopamine neurotransmitter system. Stimulants include cocaine, amphetamine, methamphetamine, MDMA. They increase alertness and can have a euphoric effect, therefore have a high abuse liability. Stimulants are used to treat ADHD, as increased brain activity, specifically in the prefrontal cortex and basal ganglia, will improve capacity for inhibition or impulse control, counterintuitively reducing hyperactivity and inattention. Depressants are a bit like the opposite of stimulants. They'll reduce brain activity by acting as an agonist for the gamma-aminobutyric acid (GABA) neurotransmitter system, inhibiting neural activity. Hence, they have a sedative effect, producing a sense of relaxation and reduction of behavioral control. Depressants include alcohol, barbiturates, and benzodiazepines. They have a high abuse liability and can also have severe withdrawal effects. Medically, they're used for treating insomnia and anxiety. Opiates are used for pain management. They have analgesic properties, causing pain relief. Opiates mimic the opioid compounds we naturally produce, binding to receptors in our endogenous opioid neurotransmitter system. Opiates are natural opioids derived from opium, whereas opioids are synthetic compounds, usually with greater potency. Opioids include heroin, fentanyl, morphine, oxycodone, vicodin, and methadone. They have an extremely high level of abuse liability, in line with the opioid crisis that has affected most people in some form in the USA. Hallucinogens vary more in their effects on the brain and its neurotransmitters. They're generally less addictive and have a low abuse liability. They include marijuana, LSD, peyote, mescaline, DMT, ketamine, and PCP. They're known for their effects on our perception, causing perceptual changes while they're active. Drugs are one way to alter the state of our consciousness. Hypnosis and meditation are practices that induce changes in our state of mind. I've never heard much about hypnosis, but the book piqued my interest. What I understood is that hypnosis takes advantage of our social function to influence us, having dissociative effects by using our need to fulfill social expectations. This makes me less skeptical of hypnosis, as I have a sense of how powerful our social function is to override or control our thinking and behavior. I imagine simply being a part of a group and caving to peer pressure is a form of hypnosis. When I'm outside, it's usually not the lone person I'm afraid of but the group of people. As I've experienced many times how, in a group, one increasingly shifts into a senseless state. That makes sense, as we are social beings. A group of people forms a social system with the emergence of new thought patterns and behavioral patterns. I believe this is why I have great difficulty in groups. I notice how it seamlessly changes people, but I have to make a conscious effort to match them. However, I do have some changes. I think it comes down to having a meltdown as I get overloaded with information I cannot process in time, becoming mutely puppet-like or loudly wild-like. Meditation is typically a practice where one focuses on a single target, such as the breath, thus allowing practice alone. Like hypnosis, in a medical context, its primary use is as a tool for stress, anxiety, and pain management. Meditation has been a good tool for me. However, it's important to understand its purpose and appropriate context; otherwise, I believe it can lead to disserving disassociation from life. If it's used to process trauma, I think one must be careful. Meditation can trigger unpleasant states, where one must be sufficiently prepared to productively observe and pass through states of turmoil. Going back to drugs, I take 50mg of lisdexamfetamine in the morning. I've tried all recommended doses, a maximum of 70mg. I think the sweet spot is when you experience a calm, flow-prone state. When it feels okay to be in the present moment. Not miserable, not ecstatic, just all right. If the experience is euphoric or has a dulling effect, the dose is probably too high. For now, I refuse the instant release form, dextroamphetamine, as a booster, including methylphenidate. With those, there's a roughness to it. You sense a noticeable difference, where I feel use is more prone to be disorderly. I greatly appreciate the creation of prodrugs as they stabilize the experience. It makes all the difference for me. The main burden for me is bureaucracy. On average, I pay £150 per month. It's acceptable for me. Bureaucracy, the process of obtaining the medication, is the deal breaker. It's why I've wanted to be free from taking them. It's a nuanced situation, of course, and all in all, I think it may be a net benefit that access is complicated to avoid abuse with the larger population in mind. Taking my luck into account, If I couldn't access private healthcare, I'm not sure I'd be content with the current state. I have a hunch that better treatment of ADHD in the working population would increase output and, overall, reduce spending in the medical system and the judicial system. In terms of detrimental outcomes, I believe depressants and opioids are far more risky. I think people may overestimate the effects of pharmaceutical stimulants. Take this with a grain of salt, as I'm largely basing this on my own anecdotal experiences. I'm more concerned with our relationship to sugar and alcohol. A few thoughts came about as I wrote this that I'll briefly mention. In a society, what's the ideal balance between rights and obligations? Rights are freedoms to the individual, and obligations are responsibilities to the collective. Do rights include entitlement to benefits? What's the right way to enforce prosocial order? By force or by nudging? If people are free to make unhealthy choices, should they be entitled to free healthcare? Why do people make unhealthy decisions? It seems largely a result of their environment. Who's responsible for creating the environment, and why may their incentives be misaligned with the common good of the people? Could a person's own incentives be misaligned with their own interests? How do you enforce compliance when incentives are misaligned? How do you avoid misalignment in the first place? It's hard to pinpoint what exactly should be the purpose. You can't really say. Many things we find horrible could be seen as minor flukes in a functioning, healthy system. It could be interesting to try and experience different ways of social order.