Why People Take Drugs by Walter Ling, MD • California

Why People Take Drugs
by Walter Ling, MD • California

Why do people take drugs in the first place? Alan Leshner, former director of the National Institute on Drug Abuse, puts it simply: “People take drugs to feel good or to feel better.” In other words, people take drugs because they like how the drugs make them feel. Since we all want to feel good, and we all want to feel better when we do not feel good, what’s wrong with that?

Nothing, really. There’s nothing wrong with wanting to feel good and be happy. After all, America’s founding fathers put the pursuit of happiness, along with life and liberty, into the Declaration of Independence as one of our inalienable rights. What’s the big fuss if people take drugs in pursuit of happiness?

Well, a few things. One is that the “good time” from drugs can become addicting, and being addicted is not a happy place. An addict doesn’t do drugs to “pursue happiness,” but out of compulsion. Further, and more importantly, the “happiness” people feel on drugs isn’t the “happiness” that the founding fathers were talking about. The “happiness” referred to in the Declaration of Independence is related to “virtue.” It’s the kind of happiness you experience by becoming the person you want to be and by engaging in meaningful, productive activities that help others. In other words, the founding fathers meant the satisfaction of a successful life, feeling good from having done good, not pursuing personal pleasure for its own sake.

These two types of happiness are entirely different. They have different names, involve different brain mechanisms, and have very different effects on our health. Pleasure for its own sake — “having a good time” without any other meaning or purpose and benefiting only oneself — is called hedonia. This type of happiness creates a physiological response that is similar to when the body is under stress: Excitement is accompanied by increases in blood pressure and respiration, by increases in blood sugar and stress hormones, and by a decrease in immune responses. Which is to say, as with stress, too much of this kind of happiness can make you sick — which is the price you pay for the good time.

The other kind of happiness — feeling good from personal satisfaction and from helping others and one’s community through meaningful actions — is called eudemonia. The physiological responses that accompany this feeling are the opposite of hedonia’s: Blood pressure, respiration, blood sugar, and stress hormones all decrease, and immuneresponse hormones increase — in other words, you get healthier.

You may not be surprised to learn that these two types of happiness involve different parts of our brain. Hedonia, or personal pleasure, is antithetical to reflection; as we’ve discussed, the limbic brain’s reward centers overwhelm the rational cortical brain — the part of our brain that makes us uniquely human. On the other hand, eudemonia emerges from self-reflection and self-awareness, and it requires the highest level of cortical brain function. In a way, with eudemonia we feel good about precisely what makes us uniquely human — like being a good worker, a good friend, or a good parent. That is what feeling good about yourself is all about.

Think back on specific times when you have felt happy. When have you felt hedonia, or personal pleasure, and when have you felt eudemonia, or happiness because of who you are? It’s been said that eudemonia is the kind of happiness you want to tell your grandchildren about. What moments of happiness in your life would you want to share with your grandchildren?

Why do people do drugs? They seek hedonia, to feel good, and if they become addicted, they get stuck seeking hedonia and pay dearly for it, for addiction undermines feelings of eudemonia, or feeling good about the person you are.

Walter Ling, MD Mastering the Addicted Brain by Walter Ling, MD

Walter Ling, MD, author of Mastering the Addicted Brain, is Professor Emeritus of Psychiatry and the founding director of the Integrated Substance Abuse Programs (ISAP) at the University of California, Los Angeles. With board certifications in neurology and psychiatry, Ling has conducted clinical trials of psychiatric medications, acted as a consultant to the World Health Organization, and run a private practice listed in the “Best Doctors in America” directory.