by Jenny Molloy
My mate said he didn’t want any part of this, and left.
I took out my knife and stabbed the thieving junkie bastard in the leg. He screamed and I punched him in the face again. I saw the blood and the mess he was in and it felt good. I yelled at him for a while and hit him some more, then turned and walked out. I kicked out the pane of glass in his door and walked down the stairwell and into the street. No one stopped me, no one saw me. If you have the guts, you can get away with anything in this town, I thought.
I had a girlfriend for a while. I don’t know what she saw in me. She had dark hair, was a couple of years younger and from Denmark. Etta was her name. She came on to me. We had sex. It wasn’t much good. But she liked heroin, too, and we could talk shit together and that was good. I got a job working for Dave, a dealer who lived in Mornington Crescent. He bought large weights and needed some psychos to make sure everyone who owed paid up and that no one tried to rip him off. He lived in a council block in his own flat and was loaded. The money was good and, as long as I made sure I was able to stand up when he needed me, he was happy with my work.
I didn’t really have friends but Dave the dealer was the closest I got. He was ten years older than me, from Newcastle, and loved motorbikes. He had a huge motorbike that he’d ride up and down Camden and it sounded like hell had come to town every time he pulled up anywhere. We’d drink, do drugs and fight together. People were scared and got out of our way and I liked that.
So I hit, stabbed, burned and battered many people and I got a reputation. The violence came easy. I understood it, and pain, if someone managed to fight back and hit me, did nothing to stop me. I liked physical pain. It blocked out all the shit. But eventually I didn’t have to do much of the beating up. Everyone just paid, if they knew what was good for them.
Dave was doing a big deal in a car park off the Finchley Road. His usual supplier had just lost a big consignment and so we needed to hook up with some other people in another part of town. I had my knife and a metal pipe. My head was shaved, I was six feet tall, twenty-three years old and had fists like a large pair of iron balls. I wore steel toecaps and dressed all in black. Everything about me said, ‘Don’t fuck with this guy: fucking with this guy would be a serious mistake that you would regret for the rest of your life.’
They fucked with us. Two cars. Theirs and ours. And a van that we never thought of checking, parked a little ways off. Men came out of it. They wanted Dave’s money. Fuck them. I hit the man nearest to me as hard as I could and he went down cold. My hand was broken. When you face overwhelming odds, the secret of victory is to take them out quick and with deadly force. I kicked the guy in the head. Definitely out for the count. The next guy was Turkish-looking and didn’t give me a chance to pull out my knife, so I sidestepped him and kicked him in the knee with my steel toecap and when he went down I was able to grab my knife and I stabbed him in the shoulder, twisting the blade. Then they were on me. I went rolling, down with men on me.
No escape.
Arms being held. Legs being held.
At some point, I understand that there will be pain. I spit and swear and tell them to get on with it, the chickenshits. Explosions start to take place. My knees, my balls, my chest and everything goes very bright and I stop breathing. I clench my teeth and feel my jaw is broken. Pain shoots everywhere in my body, from my skull to my little toe. I can’t see what they’re doing any more, I can’t open my eyes. The pain is so great that I am in the moment, and am not conscious of anything else. I cry with happiness. The pain does not ease. It eats me up. I pray to no one and no thing. I take it, I take it all, until every last cell in me is screaming but all I can do is endure. No one individual moment is unbearable. I live moment to moment. Then weights and pressures are lifted and I am pushed, rolled down an embankment and everything goes black.
Part Two
WHAT’S LOVE GOT TO DO WITH IT?
THE LOVE ADDICTION
The stories in this book are shocking and unpleasant, which sometimes makes understanding and sympathising with the people telling them difficult. It is hard to understand how people can make disastrous life choices, such as turning to drugs and alcohol or falling in love with people who cause incredible emotional and physical pain.
Before we conclude the stories from Part One, it is worth considering the process that lies behind addiction as well as misdirected and destructive behaviour.
Most people don’t understand addiction, even the addicts themselves. Addicts do not choose to become addicts. Addiction is the result of many complex processes involving biological, chemical, neurological, psychological and – vitally – social and emotional factors (and this is supported by decades of scientific research). But the key thing to remember is that addiction is extremely complex – and we should not judge drug addicts (even though this is sometimes impossible).
Drug addiction involves:
1. Compulsion and preoccupation with the drug/s of choice.
2. A lack of behavioural control.
3. Persistence, even when serious physical, emotional and social harm might result.
4. An extreme craving for the drug when it is not immediately available, which grows in intensity.
5. Promises to quit but quick relapses.
These are the key factors in any addiction (besides drugs, people can also be addicted to eating or having sex). Some never recognise their problem, while others do and accept the fact that their addiction will kill them unless they do something about it.
The first thing to understand is that drugs don’t cause addiction. Addiction resides in the person who takes drugs – otherwise doctors wouldn’t be able to offer drugs such as antidepressants and certain painkillers to anyone. Some people do become addicted to certain drugs after taking them just a few times but they are in the minority. Exposure to a mind-altering chemical does not make a person an addict. The person is already at risk. And once this person takes a certain drug, their descent into addiction is incredibly hard to stop as their tolerance quickly increases, and thereby their dependence. Tolerance is when an addict needs to use greater amounts of a drug to achieve the same high (and therefore spend considerably more money, often requiring more and more anti-social behaviours such as theft and prostitution to support the habit). You know you’re dependent on drugs when you can’t get hold of them, perhaps don’t have enough money and, due to chemical changes in the brain, you start to suffer from withdrawal. It is dependency that starts to destroy you. About 80 per cent of opiate users relapse when they try to stop using.
Lack of control (powerlessness), lack of emotional interaction (love) and stress are the key factors that create the neurobiology required to kick-start addiction in people.
Recent advances in the knowledge of human brain chemistry have revealed the link between love and addiction. We know that the number of dopamine receptors is reduced in the brains of long-term drug users. Brain receptor molecules sit on the surfaces of cells where they receive a variety of chemical messages which instruct the cells how to behave. This interaction is necessary for our brain cells (and therefore our brains) to work normally.
Cocaine, along with other similar stimulants, leads to huge and sudden increases in dopamine – a chemical that makes the brain feel really, really good. It’s this that leads the coke user’s brain to produce wondrous feelings of untold possibility accompanied by superhuman exhilaration.
A key thing to remember is that a person with fewer dopamine receptors will really feel the high – as their brain welcomes something it feels has been missing for all of its existence.
Dopamine is also important in getting us out of bed in the morning – to motivate us to go and do something we believe in. People with lower numbers of dopamine receptors have less ‘get-up-and-go’ and are especially prone to addiction, particularly as more coke use leads to the loss of dopamine receptors and therefore more coke is needed for the next hit to reach the same levels of good feelings. This is because the brai
n, knocked off kilter by the drugs, is trying to regain its balance, and does this by reducing dopamine activity. Reduced dopamine activity (i.e. tolerance) adds to the pain of withdrawal, which involves fatigue, depression, feelings of paranoia and alienation, and it is this that leads to dependence. This happens with all common drugs: heroin, morphine, amphetamine, crack, alcohol, caffeine and nicotine.
Dopamine is a neurotransmitter. It crosses the gaps between the brain’s synapses (the branches of brain cells that transmit information, known as the synaptic gap), sending messages to other brain cells. Once it has delivered its message, each dopamine molecule is taken back up into the cell from which it came, ready to be used again to carry its next message. Drugs like cocaine block the re-uptake of dopamine back into the cells from which they were originally released. They hover in the synaptic gap and it is this that creates the sense of joy and exhilaration. Natural activities that lead to an increased number of dopamine molecules in the synaptic gap include sex and eating.
Having sex doubles the amount of dopamine molecules but this is nothing compared to drugs like cocaine, which increases dopamine activity in the synaptic gap by 1200 per cent. After each use, the number of dopamine receptors will be reduced, so each time the user takes a mind-altering substance the brain has to work harder to get to the same high. Most drugs like cocaine provide a short high, only sticking around the receptor sites for a few minutes; as the buzz fades, the urge to take more is redoubled.
This change in the brain’s state leads to drastic changes in the user’s emotions and their everyday existence. This makes it extremely hard for the user to recover. The brain has to want to heal, to go back to normal, before the person can attempt to give up their dependency on a drug. The worse the addiction, the harder it is for the person to reach a decision that would be beneficial for their long-term health.
Opioid brain receptors that receive endorphins (a chemical which soothes emotional and physical pain – the word is derived from morphine), also welcome the presence of opiates such as heroin. Endorphins influence our mood (emotions), physical activity and immune system, and help regulate internal organs, including our heart. They play a key role in creating the emotional bond between mother and baby. Remove their opioid receptors and babies fail to connect emotionally with their mothers (this phenomenon has been observed in a number of animal experiments). Babies kept apart from their mothers start to suffer from separation anxiety. They can be soothed by being given opiates (again, this has been borne out through the study of animals).
When you think of, or experience, something sad, endorphins decrease in activity. Think of something happy and their activity increases. Similarly, when people think of relief (for example, are in pain but expect their pain to be relieved through the use of ibuprofen), endorphin activity increases in the opioid receptors, and the pain eases (known as the placebo effect).
Nurturing mothers experience major endorphin highs when they interact lovingly with their babies. These highs are designed to reinforce positive behaviour – the more positive behaviour, the more highs. To stop mothers from growing tolerant to these highs, their bodies produce a hormone called oxytocin (sometimes known as ‘the love hormone’), which increases the sensitivity of the brain’s opioid systems to endorphins. This way the brain doesn’t try to restore a balance by reducing endorphin production. This is a key part of the mother-baby relationship. Without the wonderful feelings that come from providing everything their babies need, mothers would struggle with the otherwise unrewarding and exhausting task of parenting. Thanks to oxytocin, mothers are safely addicted to their babies.
Addicts who use opiates like heroin are messing with the brain system in charge of the most powerful dynamic in human existence: the attachment instinct.
Or, to give it another word: love.
It is important to note that opiates do not do away with pain. As effective as they may be, all they do is reduce our conscious awareness of it. Pain messages arrive in one part of the brain (the thalamus) which signals the anterior cingulate cortex (ACC), where we consciously become aware of it. Opiates work on the ACC by reducing the emotional impact of pain, rather than the pain itself. They dull the message.
In the real world, a baby may wake because she is in pain from teething, so her ACC receives a bunch of urgent and repeated messages from her thalamus. The emotions associated with the suffering of pain lead the baby to cry and the mother comes running. The appearance and soothing behaviour of the mother will lead the baby’s brain to release endorphins, easing her emotional pain, just like an opiate would.
If the mother doesn’t come, then the baby’s brain won’t release endorphins and she will try to find another way of coping – which will be ineffective, as only the release of endorphins will help. Some babies try to soothe themselves, others may suck their thumbs or rock back and forth. Children whose mothers rarely or never come running at these moments have a far higher chance of developing an opiate addiction as they approach adulthood and the opportunities for opiate use increase (at parties and nightclubs, or through their peers).
The number of opiate receptors, along with endorphin production, will decrease through underuse throughout infancy and childhood. The less endorphin activity, the greater the desire for narcotics such as heroin and cocaine – and alcohol. In essence, the more impoverished the brain’s emotional centres, the greater the desire for chemical relief.
Because the life-foundational opioid love/pleasure/pain relief apparatus provides the entry point for narcotic substances into our brains, addicts most often express their first experience in terms of emotion. The drug ‘hugs’, ‘comforts’ and ‘caresses’ them; it ‘lifts them up in its arms’, it even ‘loves’ them.
Just to demonstrate how powerful the centres at which narcotics make their way into the brain are, consider the ventral tegmental area (VTA), which sits in the midbrain. When activated, it creates feelings of elation or desire. The VTA also triggers the release of dopamine in the nucleus accumbens (NA) at the front of the brain. These two brain components make up a system known as the incentive-motivation apparatus. It responds to reinforcement. All it takes for the NA to start firing off dopamine is a cue, something associated with a pleasurable experience one has had in the past. For drug users, those cues are people (fellow drug users), paraphernalia (the sight of a fresh needle or a crack pipe) and places (the dealer’s house, street corner or pub). These triggers are so powerful that they often cause addicts who are trying to quit to relapse. Addicts often say how much they miss the process of getting high, from scoring the drugs to preparing the hit and, as hard as it is to believe, find these processes almost as hard to give up as the drugs themselves.
The processes described so far are all key parts of our limbic system, the emotional centre of our brain. They process emotions like anger, fear, happiness and love. Emotions are supposed to be able to help our survival. They tell us when to flee or fight and when to love or help a loved one. We are drawn to positives (love, food and water) and repelled by negatives (physical attack and poisons). For most people it runs perfectly, allowing beneficial social interaction, helping us to fall in love and protecting us from those who would do us harm. If the limbic system is damaged in some way then our emotions will do us more harm than good. Addiction is one of the most common and disastrous results of a damaged limbic system.
The prefrontal cortex (PFC), is one of the higher brain centres that deals with all of the intelligence processed by the rest of the brain and makes the decisions as to what we should do next. One of the key parts of this decision-making process is to reject all the bad decisions, i.e. inhibit inappropriate responses. The failure to recognise one bad choice can prove disastrous. People with damaged PFCs are unable to control their impulses and will act childishly and bizarrely.
Scientific studies have tied addiction to the orbitofrontal cortex (OFC), near the eye socket, which is closely and powerfully connected to the limbic system. The OFC decid
es moment-to-moment how we should respond, based on the emotional intelligence sent from the limbic system, to people and situations. It tells us whether to respond with love and is constantly assessing our relationships with other people – whether we should show them love or anger, for example. The OFC helps us inhibit harmful impulses (verbal or physical violence) and helps us balance short-term needs against long-term consequences. Many neuro-imaging studies (which record blood flow, activation and energy consumption) have shown that the OFC fails to do its job in the brains of drug addicts. Drug addicts are well known to accept short-term gains (getting high) over the risk of long-term pain (illness, damage to relationships, prison, their own career and financial stability). Addicts who say they cannot stop taking a drug, even though it has been a long time since it held any pleasure for them, are subject to the commands of the OFC, based on experiences the user can no longer consciously remember. The OFC has by this time been conditioned to create an irresistible urge to use, thanks to the creation of extremely robust neural networks, and it releases dopamine, increasing the addict’s desire to use, displacing thoughts of unpleasant consequences.
So, as the brain develops, it is influenced by circumstances and events over which the child has had no control. In the case of children starved of love, their emotional brain never matures, so as adults they still respond like children in certain situations – with aggression and shouting. The same goes for their impulse control – it never develops. Brains like these are overwhelmed by narcotics, which are as close to a thing called love these people have ever known, and, before they know it, they are overcome by addiction.