The Fix. Damian Thompson

They produce different rewards – and different punishments. You don’t have to take them to know that; you just have to observe the behaviour of their users. It’s a bit like visiting the zoo.

      Coke-heads and speed freaks gabble excitedly as they are swept along on a tide of dopamine. When that tide pulls out, they experience a particular sort of come-down. ‘Coke is the drug we save for the time after we get back from clubbing,’ says Olly, 27, a graphic designer. ‘It runs out pretty quickly. Presuming we don’t order more, by 4 a.m. everyone is getting jittery and anxious. You see people’s eyes flicking around the room wondering if anyone’s got any left. A group of four chatty and gobby friends suddenly becomes four individuals chewing the insides of their cheeks. The next morning we go for brunch to cure our hangovers but everyone’s coming down off the coke, snapping at each other. Some people feel blue for days.’

      Heroin users don’t inflict logorrhea on their friends: their drug is forcing the brain to over-produce endorphins, those natural euphoria-inducing and painkilling neurotransmitters. Heroin suppresses neurotransmission in the central nervous system, which can produce an exquisitely calm feeling, particularly if your nerves were shot to pieces in the first place. This can take people to the gates of paradise, but also to hell: the come-down is long and usually profoundly depressing, because the nucleus accumbens is extremely sensitive to opioid withdrawal.9

      Also, the brain’s self-regulatory process means that junkies quickly need to increase their doses to slow down neurotransmission; in severe cases, they inject themselves hourly in order to maintain a state of mental paralysis. William Burroughs, writing about his last year of addiction in North Africa, said he could look at the end of his shoe for eight hours. And if a friend had visited him and died on the spot, ‘I would have sat there looking at my shoe waiting to go through his pockets’.10

      Ecstasy releases serotonin, a neurotransmitter associated with happiness; hence its users’ indiscriminate declarations of affection. ‘One of the reasons I don’t do pills is seeing how fucking annoying people are when they’re “loved up”,’ says Ollie. ‘MDMA [a purer form of Ecstasy] is even worse. You see groups of heterosexual men hugging and kissing each other. There’s this idiotic bear hugging that goes on for hours, and I’m afraid it makes me laugh when I see them at work on Monday, looking sheepish and sad.’ The sheepishness is self-explanatory; the sadness is pure dopamine deprivation.

      Alcohol, meanwhile, has been called the most ruthless of all brain-hijackers. Looking back on my drinking, I now have some idea of what was happening to my body; I just wish I’d known at the time, if only to avoid some hangovers of apocalyptic proportions.

      Alcohol molecules are quite unlike those of other addicting drugs. They have the ability to speed up the transmission of chemicals that excite us and also, later, those that relax us, sometimes to the point of stupor. We’re talking about a fiendishly complicated neurochemical dance that releases inhibitions and twists moods over the course of an evening. I reckon my own dopamine would peak around the third glass of red wine, which was the moment when – if I was on form – I was most fun to be around. By the third bottle the flow of mood-enhancing chemicals would have slowed down and the inhibitory neurotransmitter GABA would be in the ascendant. My voice would become slurred and my thoughts confused – but I’d be chasing the vanishing high by drinking even faster. And my friends, sensibly, would have made their excuses and left.

      As for the hangovers – well, if ever I feel like going back on the sauce after 18 years I have only to cast my mind back to any of the thousand or so I inflicted on myself. Perhaps it was the ability of the alcohol molecule to insinuate itself into so many different functions of the brain that produced such all-encompassing misery. But, as we’ll see later, I eventually discovered an effective but fabulously stupid pharmaceutical remedy for those feelings.

      All intoxicating experiences involve a cocktail of brain chemicals that are mixed quite differently depending on the nature of the behaviour. But dopamine is still the master drug that, in the words of the research psychiatrist Morten Kringelbach, ‘appears to encode desire’ and can make us chase after something long after we’ve ceased to derive much pleasure from it.11 To quote Dirk Hansen, ‘dopamine is part of the reason why we remember how much we liked getting high yesterday’.12

      As this suggests, it’s good at fastening on to cues. One sensible piece of advice that 12-step groups dole out to their members is to avoid ‘people, places and things’ that were part of their old habits. ‘If you hang around barbers’ shops, sooner or later you’re going to get a haircut,’ is an AA saying – meaning, of course, that sitting around drinking orange juice in the pub is risky for an alcoholic. The more addicted you become to something, the more sensitive you become to these cues – even after years of abstinence. Significantly, these cues are often the ‘things’ that have come to replace people in your life.

      But the link between cues and desire isn’t confined to addicts. It’s part of everyday existence for people situated all along the addictive spectrum – that is, all human beings.

      You don’t need to ingest any substance at all to experience a rush of dopamine: the cue is enough. The smell or even just the sight of food increases dopamine in the nucleus accumbens, the region of the brain involved in reward and motivation. It’s why our mouths water. As the psychology professors Harvey Milkman and Stanley Sunderwirth explain, this is the same type of neurochemical response that occurs when a cocaine addict sees a video of people snorting a fat line of white powder: ‘The dopamine messenger impels the organism to action, an impulse that sheer willpower cannot easily overcome.’13

      I know what they mean. For some reason, watching characters drink red wine on television is more tempting for me than seeing them do it in real life; it makes me long to nip to the supermarket for a bottle of Rioja. (I don’t, I hasten to add.) Why this should be I don’t know, but in AA meetings I quite often heard speakers complain of the same thing. Some people even ‘had a slip’, to use 12-step terminology, thanks to things they had seen on screen. Cues can be made more powerful by being detached from everyday networks. This is why many slips happen when alcoholics are on holiday, away from the company of people who know they have a problem, where the booze is presented in an exotic setting that somehow detoxifies it. One businessman I know found himself – to his own astonishment – accepting a rum and coke from a stewardess on a plane flight. ‘We were so high up that it didn’t seem to count,’ he said. And thus ended the decade of abstinence of which he’d been so proud.

      Milkman and Sunderwirth have produced a list of activities that boost dopamine in the nucleus accumbens. They are: crime, eating, gambling, risk-taking, sex … and hugging your loved ones. With the possible exception of hugging, there’s an addiction (or, more accurately, a huge range of addictions) lurking in all of them.