“The problem with illicit substances is their efficiency.”
Problem Statement: The goals of the substance user, compared to others seeking a shift in perceived mood and/or mental state, are the same. The universal nature of this goal normalizes the intention as an improved sense of wellbeing, regardless of the tool used to achieve the resulting altered state. In fact, substance misuse is considered superior in that it is absolutely efficient at achieving its aims. Once society accepts universal intent, only then will we be able to address stigma and prejudice.
Seeking An Altered State
Typically, the expression, ‘An altered state consciousness,’ refers to any change, or shift, in mental state where the person is typically aware and wakeful. This includes mental states during hypnosis, meditation, or hallucination cause by the use of substances (LSD), etc.
For purposes of this article, we are shifting our definition away from that of consciousness, towards that of mood and emotional wellbeing. Therefore, an altered state of mood and/or emotional wellbeing, refers to a change of one mood/anxiety state, to another. Altered states in mood and emotional wellbeing come in both adaptive and maladaptive forms. However, both are considered functional, in that they achieve the goal to shift from one state to another.
The best example of adaptive altered states is seen in the long distance running community. There are numerous anecdotal accounts of runners entering the sport for the profound improvements experienced in mood and anxiety (an altered/shifted state, resulting from adaptive behaviour).
Rob Krar, an elite ultra runner originating from Canada, opened up about his struggles with clinical depression in 2014. He often speaks about the effects of running on his mood, and the strength it gives him, knowing that any pain he experiences during an event, is familiar to him; he knows that he can push through to the other side of his pain.
Following is a video where Rob describes his own experience with depression, and the relationship he has with long distance running:
The Substance Misuser
Alcohol and drugs produce desired effects on perceived wellbeing. From this perspective, substance misuse is considered effective, and efficient, in achieving the desired altered state. However, while effective, it is also understood as maladaptive in nature; the tool works, but is accompanied by profound biopsychosocial consequences.
Those struggling with the negative consequences of substance misuse talk, almost universally, about the intention to decrease anxiety and feel happier. There is no doubt that substance use of any kind achieves these aims, at least for the short-term.
Some individuals discover this connection after living many years with a pre-morbid diagnosis of Major Depressive Disorder. For others, ongoing substance misuse has caused regular states of dysphoria and anxiety between use episodes. Both are equally effected by substance use behaviour – Things improve, at least temporarily.
The desire for an altered state in runners, and that of those misusing substances, is no different. Each is attempting to improve their overall experience in living. We all have a desire to be happy. Whether happiness is achieved in the short-term, or long-term, is irrelevant. All of us are willing to accept feelings of happiness regardless of duration.
However, there are a set of differences between adaptive and maladaptive approaches to wellbeing that should be noted:
- Adaptive approaches are less likely to have profound negative consequences on physical health.
- Maladaptive approaches have shorter affect cycles. In other words, you have to return to the method more often for repeated short-term gains.
- Adaptive approaches towards creating altered states of wellbeing, have positive effects on multiple areas in our lives. This includes positive physical outcomes, anxiety management at work, and relationships at home.
- Maladaptive approaches reinforce quick gratification as an outcome reward. Adaptive approaches tend to reinforce delay of gratification, or working hard towards a long-term reward. It can be argued that much of what matters in life results from mastering the art of working over time towards a gratifying goal, with little short-term gain (finishing a long race, completing education, etc.).
The Problem With Judgement
It is critical that each of us recognize the universal desire found in both adaptive and maladaptive strategies for achieving an altered state towards wellbeing. While there are different consequences for adaptive and maladaptive approaches, it is important to understand the desire for feeling better.
When individuals in society pair morality and substance misuse behaviour, the end result is stigma and alienation. Harm reduction depends on viewing the consequences of behaviour through a public health and human rights lens. Whether you are a practitioner, or a family member living with someone misusing substances, in the end, we all are attempting the same thing – Feeling better. Active use of personal judgement about morality, denies this connection, often resulting undesirable consequences.
Acceptance Promotes Change
The first step in promoting change in individuals is understanding your own bias. The second step is accepting those around you, regardless of where they are at in life, or the choices they make. Universal acceptance is the most powerful tool in being an effective care provider, partner, parent, or teacher. Others will experience your non-judgmental approach, and seek you out when ready. Your job is to simply be with them along the way, while recognizing that you both seek the same thing.