Love is a Drug; Let’s not be Junkies

Tonyyyyyyyy! Tonyyyyyyyy! Open the door! I need you! A woman cries and screams as she repeatedly kicks the door and beats on it with her fists. It’s 3 am on a school night during my sophomore year of university, and I’m in bed trying to sleep. That’s not going to happen with the ongoing assault on our apartment door. Tony’s out and I’m too scared of this woman to open up the door and talk to her. Either my frat boy roommate has started selling crack from our apartment in the Berkeley Hills or he’s dumped yet another girlfriend.

Plenty of poets and songwriters have noted the similarities between romantic love and the high that comes from recreational drugs. In the last  several decades, a growing body of scientific research has demonstrated that the connection is more than a poetic analogy – there are, in fact, deep similarities at the biochemical level between the highs associated with cocaine and other drugs and the early euphoric stages of romantic love.

I wish I was related to the anthropologist Helen Fisher because her research is really cool. Perhaps most famous for her work Anatomy of Love: A Natural History of Mating, Marriage, and Why We Stray, Fisher has written extensively about the biology and culture of human mating, and is probably the world’s foremost authority on these subjects. In one famous study, she and several colleagues did fMRI (functional magnetic resonance imaging) of a number of subjects in the giddy early stages of romantic relationships. They found that the subjects exhibited brain activity very similar to people high on cocaine, including heightened activity in the dopamine (pleasure-reward) and norepinephrine (excitement) pathways.

The role of the brain’s reward center (the dopamine pathway) is particularly important in the physiology of addiction. To simplify it as much as possible, both in anticipation of and during a pleasurable activity dopamine is released by neurons in the pleasure center of the brain and attaches to receptors on another neuron, creating a feeling of pleasure. The pleasure then subsides with the reuptake of dopamine into the neurons. Cocaine works by blocking the reuptake of dopamine, and as a result it builds up in the synapses between neurons and creates a feeling of euphoria. Over time though, regular users develop tolerance for the drug. Essentially, the body has gotten better at metabolizing the drug. Also, the brain’s pleasure center has become habituated to the higher level of dopamine, and as a result more cocaine is needed to attain the same high. This is cocaine addiction.

What about sex? As with other pleasurable activities, dopamine is released before and during sexual activity. Here there is of course no actual drug that blocks the reuptake of dopamine. However, in the brains of people who regularly engage in compulsive sexual behavior, neurons in the pleasure center become increasingly primed for dopamine. They crave dopamine and the addict craves sex. As with cocaine, the individual becomes habituated to elevated dopamine and, as a result, increasingly more dopamine is needed to create the same feeling of pleasure, leading to more sex and/or increasingly elaborate and risky behavior. This is sex addiction.

Both cocaine and sex can cause addiction because of the potential to short-circuit the brain’s reward system, causing the addict to seek more of the drug/sexual activity to attain the same level of pleasure.

In early studies of the effects of cocaine on rats beginning in the 1960s, the animals were given two bottles, one with only water and one with cocaine mixed in. Almost all of them became addicted to the cocaine water and drank it until they died. Several years ago, while living in Bangkok, I read with interest and amusement that the Thai authorities had banned over the counter sale of Viagra to foreigners because a number of elderly expats and tourists had died of heart attacks while having sex with local women. Laboratory rats dying from too much cocaine. Old white men dying from too much sex. Does anyone see a connection? And, by the way, Happy Valentines Day!

The American Psychiatric Association (APA) maintains and periodically updates a bible of mental disorders called the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent version recognizes only gambling addiction as a behavioral addiction for therapeutic purposes, and concludes that there is insufficient evidence to include compulsive sex, gaming, internet and other behaviors as addictions. I think that most of us realize though that these behaviors, if done in extreme and compulsive ways, are addictive and potentially dangerous. There are of course plenty of sex, video game, internet and other behavioral addicts and a growing industry of treatment options. And, to my mind, so many people are effectively addicted to their smart phones that it’s socially difficult to label this as a disorder. And yet a growing body of research shows that excessive use is bad for our mental health.

The temptations that fuel addictions of all types are often created with a financial motive. The longer the world spins on its axis, the more people find ingenious and devious ways to distill, concentrate and re-package pleasure for profit.

Take cocaine, for example. The coca plant is native to the Andes Mountains of western South America. Natives of this region traditionally chewed the leaves of the plant, which has a mild stimulant effect, and can reduce hunger, pain and fatigue. Traces of the plant have been found in mummified human remains from this area as old as 3,000 years. Coca leaves consumed in this form are not addictive (and have even been used to treat cocaine addiction).

Cocaine was first isolated from the coca leaf in 1860 and was initially used in a variety of medicines and health tonics. Concern about abuse of the drug began in the early decades of the 20th century and it was increasingly banned after that. Official prohibitions notwithstanding, the plant’s march from innocuous leaf to dangerously addictive and wildly profitable substance continued.

With freebase cocaine, which was first used recreationally in the mid 1970s, the hydrochloride additive normally found in cocaine powder is removed. This is a purer form of cocaine, and is more addictive and dangerous than ordinary powder cocaine.

The dangerous elixir of addictive pleasure and profit motive continued with the spread of crack cocaine use in the 1980s. Crack is made by cooking a mixture of cocaine and baking powder, which results in a rocklike form that’s broken into small pieces and smoked. Because of its concentration, the way it’s delivered and how quickly it affects the brain, crack is said to be 100 times more addictive than ordinary powder cocaine (which is of course itself highly addictive).

As with cocaine, people have found ways to take sex and make it more intense, potentially addictive and profitable.

From Genesis Chapter 2, perhaps the most famous sex prohibition in western culture:

15 And the Lord God took the man, and put him into the garden of Eden to dress it and to keep it.

16 And the Lord God commanded the man, saying, Of every tree of the garden thou mayest freely eat:

17 But of the tree of the knowledge of good and evil, thou shalt not eat of it: for in the day that thou eatest thereof thou shalt surely die.

18 And the Lord God said, It is not good that the man should be alone; I will make him an help meet for him.

….

21 And the Lord God caused a deep sleep to fall upon Adam, and he slept: and he took one of his ribs, and closed up the flesh instead thereof;

22 And the rib, which the Lord God had taken from man, made he a woman, and brought her unto the man.

23 And Adam said, This is now bone of my bones, and flesh of my flesh: she shall be called Woman, because she was taken out of Man.

24 Therefore shall a man leave his father and his mother, and shall cleave unto his wife: and they shall be one flesh.

25 And they were both naked, the man and his wife, and were not ashamed.

If God had been in a hurry and needed to get to the point more quickly, he might have gone with, Yo, guys, listen up! Enjoy the fruits and the flowers. Just don’t fuck! 

In the here and now of the early 21st century, an ordinary taboo on sex feels rather quaint. The world’s oldest professional has been a global market for well over a generation. Porn is easily the biggest single category of internet content and has already arrived on virtual reality headsets. Hookups are readily available day or night on smartphone apps like Tinder, Blendr and Grindr. 

As with the coca plant, commerce has increasingly concentrated and commodified sexual pleasure and offered it in ever more addictive forms (and  I think a similar argument could be made with many other recreational drugs and behavioral addictions, from opiates to excessive mobile phone use). As I’ve noted in other posts, the dopamine pathway evolved to reward activities that were good for our survival or reproduction (eating, sex, spending time with family etc.). With addictions, the brain’s healthy reward pathways have been hijacked for pleasure and profit. The drug addict doesn’t need to socialize in a healthy way if he can just get high. The sex addict doesn’t need a healthy relationship if he gets the same pleasure from porn. Teenage girls don’t need to talk to their friends at lunch when Snapchat provides constant stimulation. 

Of course, a critical difference between cocaine and romantic love is that, while the former is something nobody should ever touch, the latter is part of most people’s lives. Isn’t that interesting? That something that is potentially addictive in the same way as cocaine would be part of the lives of most adult humans. In an article in Discover magazine entitled “In the Brain, Romantic Love Is Basically an Addiction,” Helen Fisher refers to love and sex as a “positive addiction.”

And yet we know that people in relationships sometimes do dangerous and destructive things – to themselves, to their partner, to their lives – just as people high on cocaine and other drugs do. Of course, either gender can be a victim or a perpetrator of domestic violence, and abuse can occur in both straight and gay relationships, but the statistics for male on female violence are particularly alarming. 1 in 3 women have been victims of domestic violence at some time in their lives. Of female homicide victims worldwide, 38% are killed by an intimate partner.

And of course we all know people who have done crazy or destructive things in the name of love, from the relatively benign (compulsively checking for new messages) to the destructive (perpetrated or been the victim of abuse). And most of us know people who stay in unhappy, destructive relationships. Like someone addicted to drugs, they know on an intellectual level that this behavior is bad for them, but they can’t seem to break free. Growing up, one of my most vivid memories is of visiting my best friend, and hearing his mother alone in her bedroom or bathroom, wailing in emotional pain. For years and years, she came back to her abusive husband the way a crack addict comes back to her pipe.

So love and sex are potentially addictive and destructive and yet are important parts of most adult lives. Other than joining a monastery or nunnery, what are we to do? Is there a way to enjoy the benefits and avoid or at least mitigate the risks?

Over the last few years I read a pair of books by the always entertaining journalist Neil Strauss that, taken together, suggests one solution. Strauss was somewhat well known as a writer for Rolling Stone magazine and as a biographer of rock stars and porn stars and other fucked up and famous people. But he was propelled to literary and pop cultural superstardom by his book The Game about the secret subculture of pickup artists, men who spend most of their free time picking up women (and sometimes make a living by teaching other men their techniques).

While he initially approached this subject with normal journalistic detachment, Strauss was increasingly drawn in as an active participant and eventually became the world’s top rated pickup artist (apparently they have rankings in internet forums). He ends up moving into a sort of pickup artist commune in Hollywood, which reads like a cross between a 24 hours-a-day swingers club and a mental institution for over-sexed twenty something males with no adult or medical supervision. Think of it as a crack house for sex addicts.

Strauss’s follow up work, The Truth: An Uncomfortable Book About Relationships, begins with him engaging in increasingly risky and destructive behavior (having sex with friends of his girlfriend etc.) and checking into an inpatient rehab center for sex addiction (which Strauss ironically notes he was able to pay for because of the fortune he made on his #1 best selling book about sex addicts). The overly harsh and abstinence focused center doesn’t work for him, and he checks out before completing the program. He then embarks on a variety of experiments in different polyamorous lifestyles, from swingers groups to living in a love commune with his three paramours.

Perhaps it’s predictable that there are a lot of problems – most people work hard just to create a balanced and happy relationship with one person and it’s easy to imagine conflict with the more unconventional arrangements Strauss tries. Also, while non-fiction, this is after all a story by a best-selling author and happily ever after is a pretty boring read! From constant conflict between the women in his personal love nest to almost getting hacked to death by a machete-wielding jealous boyfriend at a swingers club, nothing goes smoothly. In the end, he realizes that the solution is a committed relationship and succeeds in winning back the girlfriend he hurt so badly at the beginning of the book.

So are long term monogamous relationships the answer? I think there’s absolutely no question that people in happy marriages or other long term relationships are less likely to engage in dangerous and destructive behavior in pursuit of love or sex. If you’re in a happy marriage or other long-term relationship, congratulations! You’ve won the lottery. What about the rest of us?

I think the rat experiments I mentioned earlier provide one promising idea. The experiments in which most of the rats became addicted to cocaine and died are only the first part of the story. In those early experiments, the rats were alone in small lab cages, without companionship or anything to occupy themselves. In other words, they were forced to live in a way that is unnatural for rats, and they almost certainly experienced a great deal of stress as a result. In this context, it’s hardly a surprise that they became addicted to the readily available cocaine.

In the late 1970s the psychologist Bruce Alexander hypothesized that it was the rats’ stressful living conditions that led to addiction, not the drug itself. In a famous study known as Rat Park, Alexander and his colleagues created an elaborate home for 16-20 rats of both sexes that was 200 times larger than the typical laboratory rat cage. Rat Park included balls and wheels for play, and the rats were able to mate freely. While a control group of rats in ordinary laboratory cages showed a strong preference for the drug, the rats in Rat Park preferred ordinary water.

Rats and mice are used in biomedical experiments because their physiology is closer to humans than most people imagine. Of course, it’s not the same though and we can’t simply apply conclusions from animal studies to people. Nonetheless, I think the Rat Park experiments offer some promising ideas.

Perhaps a compelling way to stay out of trouble – whether substance abuse, or behavioral addictions like sex or gambling or spending too much time on the internet – is to maintain a well balanced life. Being in a happy long term relationship is at least partly out of our control, but with strong family relationships and a good group of friends, along with a stimulating mix of professional and leisure activities, I think there’s no question we’re less likely to get into trouble of various kinds.

On a personal level, I know that there’s no way I could write this blog (or keep up with meditation or exercise or travel three months a year or any other rewarding pastime) if I were on heroin or in one of the crazy love communes Strauss writes about. And, along with healthy social relationships, these activities definitely help keep me closer to the coca leaf chewing end of the spectrum and away from the crack whore one.

 

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