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Thus, the motives for use are not very different. Similar effects are to a large degree attributed to other intoxicants.
The popular idea is that any feeling and all kinds of behavior may be attributed to drugs of abuse. Not surprisingly, wishful thinking is prominent: Any feeling and behavior that people may desire is attributed to intoxicants.8
There are many metaphorical descriptions of pleasurable experiences during intoxication (chapter 7). In most cases, the descriptions have an "as-if"-character:
- as if I saw the world in a clearer light
- as if the music was more beautiful and the colors stronger
- as if I were present and at the same time not present
Can widely different chemical substances really have such similar effects? Can chemical substances have so many, specific, marvelous, and even supernatural, effects?
Drugs are, of course, used in psychiatric treatment, because research has established that these drugs have beneficial effects on certain symptoms. But the effects are rather non-specific and do not influence such specific dimensions as self-confidence and inhibitions.
Knowledge of psychiatric drugs leads to skepticism towards the apparent effects of intoxicants. Intoxicant effects appear to represent true magic. A psychologist labeled his lecture on popular belief about alcohol effects: "Alcohol - the Magic Elixir.".9
Medical doctors have traditionally said that intoxicants induce "euphoria". The word means a good mood and a pleasant feeling. At first sight, this labeling seems convincing. But the research supporting this theory is lacking. Medical doctors were expected to explain why people choose to use harmful drugs. The explanation was a word - euphoria - which apparently provided an adequate explanation.
But popular opinion is ambiguous. A survey in Norway concluded that10
- 45 % of adults believe alcohol produces a good mood
- 55 % do not believe that alcohol produces a good mood
The figures indicate that among those that have personal experience with alcohol use, the popular opinion is divided almost down the middle. Who is right?
For psychological and behavioral effects of drugs, drawing conclusions from animals to humans is not so simple. But several experiments on animals and intoxicants have been carried out.
Do animals appreciate the effects of intoxicants?
The answer is largely negative. As a rule, animals avoid intoxicants. Some experiments which really have succeeded in making animals choose intoxicant use, have usually placed the animals in very artificial situations. By isolating the animals from social life and for a period forcing them to take intoxicants, it has sometimes been possible to make them prefer intoxicants.
But when animals are allowed to choose different social activities which can give some satisfaction, they seldom care about intoxicants. Here is a characteristic experiment:11
Rats were allowed to choose between two solutions with almost identical taste. One of them contained morphine.Even a psychiatrist who is known to seek biological explanations for drug use, concludes:12For the first 8 hours, the animals drank equal amounts of the two solutions. For the rest of the 19 days which the experiment lasted, they avoided the morphine almost completely.
This means that the rats avoided morphine when they got to know the effects of morphine and learned which container it was in.
"most animals cannot be made into addicts ... Although the pharmacological effects of addictive substances injected into animals are quite similar to those seen in human beings, animals generally avoid such drugs when they are given a choice."The least difficult is to make animals choose stimulants and the most difficult is to make them choose alcohol and hallucinogenic drugs. Opiates are in the middle position.13
But these conclusions from animal experiments cannot be applied directly to human beings. How are, for example, researchers supposed to assess mood and disinhibition in rodents?
In order to evaluate which research methods can be applied in experiments with humans, we must look at the mechanisms which may be involved in all the alleged pychological and behavioral effects in humans.
The first alternative is, of course, that enthusiastic users are right: The intoxicant stimulates a center of joy in the brain, relieves anxiety, enhances self-confidence etc. If these are pharmacological effects, the effects should be observed in all groups of users, regardless of the users' previous learning about the effects.
The second alternative is that psychological and behavioral effects take place as a result of social learning. In that case, these effects will only occur among those users who have learned about these psychological effects.
Learned effects may be a matter of either expectancy effects or of learned interpretations. Because these phenomena are less well-known, we shall take a closer look at them.
Several years later, this viewpoint was confirmed in an experiment which has become a classic in social psychology.15 The researchers gave the participants epinephrine, a hormone which makes the heart beat faster and gives a feeling of excitement. When we experience strong feelings, we usually have an increased production of epinephrine.
Some participants were placed in amusement-inducing situations, others in anger-inducing situations. Some participants were informed of the effects of epinephrine, while others were not informed.A non-specific reaction has to be interpreted in order to be meaningful. Those who did not know the effects of epinephrine, were unconsciously reasoning: "I have a strange feeling of being different. My heart is beating and I'm feeling restless. I presume this is because I'm very amused/angry."
Those who had been given information about epinephrine's effects, had little change in behavior and feelings during the experiment.
But those who were ignorant of the effects of epinephrine, showed more amusement in the funny situation and more anger in the anger-situation. They interpreted the bodily reactions as an evidence of strong feelings. A non-specific influence was interpreted as a distinct feeling.
The conclusion was: "Given a state of physiological arousal for which an individual has no immediate explanation, he will "label" this state and describe his feelings in terms of the cognitions available to him. ..."
The researches presumed that the effects of epinephrine might also be interpreted as feelings other than amusement and anger, dependant on the situation:
When a shady type directs his knife towards you, saying "I'll take either your money or your life", you interpret the epinephrine's effects as fear. When your loved one reaches out for you after a long period of absence, you interpret the effects as love and affection.The individual notices internal cues which in themselves are neither pleasant nor unpleasant. The cues may be interpreted as delightful or nasty, based on the explanations that are available in the situation.
The researchers assumed that the same phenomenon could apply to other bodily conditions, such as the influence of intoxicants. In this area, they could refer to research which had been performed by others.
After a while, most users were able to feel reactions which they attributed to marijuana. They largely felt physical effects. But most beginners felt the effects were unpleasant. Many thought the effects were frightening and became frightened. Experienced users calmed them down, telling them their reaction was normal. They taught the novice to regard the ambiguous experiences, initially considered unpleasant, as enjoyable:
"The same thing happened to me. You'll get to like that after awhile."Those who do not have experience with marijuana smoking, will recognize the description from their first time use of alcohol and tobacco. In the words of Becker's report, "enjoyment is introduced by the favorable definition of the experience that one acquires from others."
Becker's well-known conclusion was this:
"Marihuana-produced sensations are not automatically or necessarily pleasurable. The taste for such experience is a socially acquired one, not different in kind from acquired tastes for oysters or dry martinis. The user feels dizzy, thirsty, his scalp tingles, he misjudges time and distances; and so on. Are these things pleasurable? He isn't sure. If he is to continue marihuana use, he must decide that they are. Otherwise, getting high, while a real enough experience, will be an unpleasant one he would rather avoid."Becker is here describing how psychological "effects" which the drug in itself does not produce, may occur as learned interpretation of a "feeling-different"-sensation.
Later on, a Scandinavian study presented similar results to Becker's.17
Expectancy effects occur when the individual has been taught that a drug has certain effects, and then takes the drug (or believes he takes the drug). Well-known examples are the substantial effects of "sugar pills" or injections of physiological saline solutions in a patient who is expecting such effects.
In medicine, this is labeled "placebo effect" and the pharmacologically inactive drug is labeled a "placebo". Placebo drugs may lessen pain and other symptoms and may also produce side-effects.18 Until this century, most effects of medical doctor's prescriptions were based on placebos. In our time, suggestion still plays an important role in medical treatment. Expectations are powerful factors. A group of researchers administered a drug while instructing the participants that the drug would either be stimulating or depressing.19 The instructions were not only reflected in the participants' feelings and behavior, but also on measurement of heart rate and blood pressure. Addiction to placebo drugs has also been reported.20
If we want the hard facts about drug effects, separating learned effects from pharmacological effects is a crucial issue. A method often used is blind tests, in which one half of the participants are given the drug to be tested and the other half are given a placebo.
In blind tests, a potential source of error is the conscious identification of the active drug because of side effects, which reveal that the drug is no "sugar pill". In order to avoid this trap, researchers sometimes use an "active placebo" which is a drug with certain effects (often one which resembles the drug to be tested).
If anticipated psychological effects do not occur in blind tests, then this indicates that these effects are learned.
If anticipated psychological effects do occur, then we face two possible interpretations. It may be due to true chemical effects. But it may also be caused by the errors due to the participants' previous learning about the intoxicant.
Firstly, there is a risk that the substance may be recognized. Unfortunately, all blind tests with alcohol have employed alcohol drinkers as participants. This also applies to most of the blind tests with marijuana and several with other intoxicants. The risk of recognition is obvious. Taste and appearance may be concealed or camouflaged. But on noticing the bodily effects, learned associations may provoke learned psychological effects.
Secondly, learned interpretations may occur without consciously recognizing the intoxicant. Although the participants do not overtly recognize which substance they have ingested, internal cues may be interpreted as the feelings they have become associated with: "I do, of course, understand that I have not been drinking alcohol, but what I'm feeling is exactly the same ..."
Thirdly, even non-users of an intoxicant may have learned expectations to the substance. At all the experiments, the researchers have felt obliged to inform the participants: "You may perhaps get alcohol" or "perhaps you will be given marijuana". When a drug produces noticeable effects, the participant may conclude that he has ingested the active substance (not a placebo). He may then associate these bodily effects with the psychological and behavioral effects he has heard of.
Thus, learned effects may occur even in blind tests which technically seem successful.
The conclusion is:
If the anticipated psychological effects do not occur in blind tests, then this weighs against considering it as pharmacological effects.
If anticipated effects do occur in blind tests, the outcome must be
controlled by another method: Only studies using people who have not
learned the anticipated effects of the intoxicant, may definitely discriminate
all learned effects from the real pharmacological effects.
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