She answered the door, halfway between a gurn and a smile; and her skin was the wrong colour.
Amy had called me up, a few months previous. The morning after the night before – the night before being a Eurovision party, which if anything is proof that high camp respects no borders. She’d been introduced, she told me, to the wonderful world of speed. Careening though conversation, I listened, wary. She’d always said she was going to steer clear of anything but weed. She had too little self control, she said, and she knew it.
People do drugs all the time with no serious long term consequences to their lives or health. I can rattle off the reasons speed and related drugs are bad for your brain – the synapses which die, the strange new ones which grow, the signalling pathways which warp. I can do the same for alcohol (a neurologically messy drug if ever there was one). I can even begin to describe the circuits which get hijacked in addiction, the strange loop-de-loop loom of dopamine and glutamate and GABA, threading delicately out and back through the brain, turning impulsion into compulsion; discreet indiscretions, through habit, to obsession.
But I can’t begin to tell you why, or why it strikes who. People do drugs all the time with no serious long term consequences. But some people aren’t so lucky; the drugs grab them, pull on threads inside their heads and throughout their life.
Her skin was the wrong colour. She’d called and invited me ’round, I’d not seen her in a while. I knocked at the door and she answered, halfway between a gurn and a smile. Her eyes too wide, her body too thin. Invited me in.
I had a cider. Everyone was playing cards, although I can’t remember what because I don’t play cards. I sat, and joined in to join in. Lines did the rounds as I wondered what had happened to my friend. And I wondered what to do.
I spent so long wondering what to do, that year, that I did nothing. But what can you do?
We had a laugh. It was always tinged with guilt and fear, for me; but we had a laugh. I’d turn up, she hadn’t slept for days. We’d watch Buffy and dance and dress up stupid and fall apart in giggles and smoke and sci fi. And she was doing lines to stay awake and dropping vallium to fall asleep and it showed, it always shows, around the eyes and in the skin, the way clothes hang looser.
And we had a laugh, amidst thick smoke and cider and badly scripted porn. And I never said. I never said anything to Amy but to laugh with her, and bitch with her, and worry that if I said anything she’d push me away. Better to be laughing by someone’s side with half an eye on the future, than turning your back. I figured. I guessed.
I still don’t know.
There’s a comic that people share with me every now and then, nudge-nudge on the in joke that I know a bit of neuro so will enjoy it. Dopamine and serotonin – the only things you really enjoy. God, what a load of crap. People love reducing, for some reason. They love the simplicity of distilling human experience to a few tractable chemicals and pretending, like love potions in bad farce, that they explain it all. Dopamine and serotonin. Because once you’ve got the basics sorted, what more do you need?
Serotonin, everyone one knows from depression. Modern antidepressant drugs meddle with this system – my own SSRIs, ‘selective serotonin reuptake inhibitors’, act to increase the amount of serotonin available. What they do after that, or as well as that, or if serotonin is really that important – no one knows. No one really knows that much about neuroscience. If they tell you different, they’re either lying or a fool.
Ecstasy also acts on serotonin – even acts on the same part of the system that SSRIs do. It also acts on dopamine, and if people have heard of dopamine it’s probably in the realm of addiction. Maybe the dopamine system makes you feel good, maybe not. It gets fired up when you fuck, or when you eat, or when you snort a line of coke. But also when you get stressed, when something nasty happens. There’s all sorts of theories about what dopamine is doing, but really we don’t know. Like I say. No one really knows that much about neuroscience.
Within the brain, circuits thread from an area called the striatum, up to the cortex, and back down again, then up again, backwards, feeding a loop back over the striatum and up from your prefrontal, frontal cortex to your primary motor cortex. Dopamine feeds into and modulates these circuits. Strengthening them. Your frontal cortex is involved in all sorts of interesting, complicated stuff – attaching emotional significance to events, long term goal selection, planning. As you move back, toward the motor cortex, this becomes simplified. Rarefied. Faster processing, less thought.
An aside. I’m ten. I have keyboard lessons, private tuition with a warm, wonderful woman. The room is festooned with pictures her students have drawn for her. It’s my third lesson. And I honestly can’t see the point of scales.
You have to do them the right way you see? You can’t just hit the right notes. You have to hit the right notes with the right fingers. There’s a poetry in the way your fingers need to flow across the keys, and of course at first it’s all stops and starts, and frustration.
“You’ll get it”, she says, kind. Patient. “One day soon, you’ll stop thinking about it, and you’ll suddenly realise you’ve done it”
And one day, I do. I’m so surprised, my fingers fall over themselves the next time. But eventually I realise I’m so much better if I just left my hands do it, stop thinking about it so much. Falling off a log.
Circuits, first dominated from frontal areas, amplified by dopamine to move activity patterns further towards the primary motor cortex. So with practice, you can stop thinking about playing, and just play; practice long enough and motivation becomes habit. Amphetamines and related drugs act directly on this circuitry, providing a massive signal boost to the transformations that shift activity from frontal, violational areas to the posterior, habitual areas.
That’s one theory, anyway. Or one part of one theory. Simple, eh? The basics sorted. What more do you need?
So why Amy, and not everyone else? People do drugs all the time.
Addiction is messy; it’s to do with people and personalities and societies, so it’s messy, like people and personality and society. I don’t like the term – everyone has their own idea of what addiction is, and it’s such an either / or.
“Problematic drug use” covers a much wider range of sins, allows a fuller spectrum of human behaviour. People will balk at being told they have an addiction problem; will be more likely to accept, on reflection, that they’ve got problems around their drug use. Taking more than you intended, for longer than you meant. Spending too much time trying to get high, getting high; spending too little time on friends, work, hobbies. Neglecting sex, food, sleep.
More than intended. Too much. Too little. No strict, set quantities; addiction’s different for every drug, for every person, for every life. Slowly (or sometimes not so slowly) the drug overshadows the life, the highs and the comedowns overshadow the person; but where exactly dusk turns to night, you can’t spot. You just know it’s happening.
Of course, if you’re using the drug, you’re probably too distracted to notice; consumed in the hunt to get high, in getting high, in the only two things you really enjoy.
I’ve watched too many times. I wish I’d learned what to do but you know, I still have no clue. No clue how to feel, no clue how to react, no clue what to say when you watch someone’s life being taken over. So I do nothing, still. What can you do?
I can make a cockeyed attempt at explaining what changes in the brain of someone going from occasional use to addiction. Just as I can wave my hands and shout off a few theories about what’s happening neurologically in depression. It doesn’t help. None of it helps, none of it tells you anything useful because none of it answers the only questions you really want answered. The why and the who. How to spot it, how to stop it. Because people aren’t just brains, and drugs aren’t just chemicals, and your feelings and desires and self are reducible to nothing beyond your feelings, your desires, your self. So I don’t know why Amy, or why anyone else. Or why not so many others. Why some people continue to fall of that log, and others catch themselves, or are caught, and manage – eventually – to carry on walking.
Amy’s fine now. She’s got a boyfriend and a dog. We still watch Buffy and sci fi, through thick smoke.
Have a laugh.
Names and details shuffled, obviously