Mankind has always been either moving toward pleasure or away from some form of pain. It’s in our nature, embedded in the fight or flight response, i.e. running away from the pain of being eaten. From the desire for survival to the sex drive, we do it because it feels good, not because of some biological clock marking the fertility window as “open” for conception. We as mammals have the bonus of the joy of sex without the burden of conception. Meditation is sometimes described as an emotional experience of joy and peace with an intensity likened to sexual pleasure. Then there is the runner’s high. Actually, it’s another part of the fight or flight response to help us feel less pain during the escape from that saber-toothed tiger. It has an element of a euphoric high that some seek, driving their bodies to the point of exhaustion to “get dat feelin'”. I have treated several persons who rationalized this behavior, despite the time, effort and physical/emotional cost, to get a “natural high”. In their mind, it’s not an addiction with the usual negative consequences. Yet, they experienced the same issue of traditional abusers—the high kept getting harder to duplicate in intensity. It required more exercise, not less, to start and sustain the effect, pushing the body to unhealthy extremes. So, here we have folks experiencing euphoric changes via “internal” strategies such as meditation and exercise, and others using “external” strategies, with compounds such as cannabis, to drive these responses. What’s the connection?
Research shows us that, for either of these strategies to work, there must be an internal system responding to the internal and external actions. The good news is that there is such a system. Our brain has specific receptors for internally produced molecules similar in shape to those of opiates prescribed for pain control—those same ones often abused. The same is true for cannabis. We‘ll come back to cannabis later. For illustration purposes I’ll use the opiate system. We have an unsophisticated way of naming things in medicine. We piece together meaningful parts of words to make a new meaningful word. In the case of the internal or “endogenous” morphine [opiate] agents, we call them “endorphins.” Many of our early discoveries about the brain involved first finding an agent such as morphine, having pain reduction and euphoric benefits, then later discovering how it works. And still later, finding there was already an internal agent made by the brain that morphine was mimicking in action. Morphine and subsequently heroin, Percodan, Dilaudid, oxycodone, and codeine all acted by causing the existing brain receptors for endorphins to respond to them too. Grossly similar to a lock and key, except the receptor lock can also be a channel for crossing the nerve cell membrane or a surface receptor like a satellite dish. The problem is that receptors are not exclusively responsive to the internal nerve transmitter molecule. The outside agents can get a response that is even more intense and long-lasting than nature had planned! There are various mechanisms, but the bottom line is that the drugs or compounds drive the system to intense levels of activity, and abnormal excitation or suppression of nervous system activity, especially in the centers that allow us to experience emotion. So, by driving the system beyond normal functioning limits, we experience the “euphoria” of the high. That may be an “up, excited” or “down, relaxed” experience, depending on the compound and the individual. I have had patients tell me marijuana makes them motivated to get things done, while others say it’s relaxing and allows them to kick back and be introspective. Either way, the person is making their nervous system toxic to some degree in order to experience the euphoria he or she seeks.
Next time “the bad news”…
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