The Anesthetic Highs

The Anesthetic Highs are the final stage in the downward progression of addiction. When we think of anesthetics, we think of pain killing drugs. That is not precisely how I am using this word when describing this final stage of addiction. Take a look at the post on Maslow's Pyramid. The bottom level of Maslow's Pyramid is the level of Physical Needs (food, water, oxygen). A person dieing of hunger is in pain, hunger pain. A person dieing of asphyxiation is in pain too, and so is someone dieing of thirst. These are the types of pain that motivate addicts to seek an Anesthetic High.

An alcoholic is a man dieing of thirst. Water will not quench his thirst. Neither will alcohol but, the alcoholic thinks it will, if he drinks enough. A drug addict is a woman starving for a drug. Her hunger is insatiable but, she nevertheless uses more and more drugs in a vain attempt to satiate it. These people feel empty and desperate. They use alcohol and or drugs hoping for any brief respite from their torment. Of course they are only feeding their addiction, not themselves, and so they are doomed.

Denial evaporates at this stage of addiction. The trouble is now it is too late to quit! The addict can no longer face life without her drug, even though she knows her drug is destroying her life. Way back during the Arrogant Highs or even during the Performance Highs the addict told himself he would quit if it ever got this bad. The trouble is, once it gets this bad, he can no longer quit! The addict at this stage is reduced to utter hopelessness. He is a candidate for suicide. She may just give up and drink herself to death.

How long does it take to descend from the top of the Lowarchy of Highs to the bottom? To go from the euphoria of the Arrogant Highs to the desperation of the Anesthetic Highs? The answer is, it depends. It depends on the person's vulnerability to addiction. It depends on the drug or drugs he is using. It depends on the age she started using. To some extent it depends on gender.

Some  people are more vulnerable to addiction than others. They may become addicted very rapidly. Some drugs are more addictive than others. People using narcotics get addicted really fast. Children and adolescents get addicted much faster than adults. And unfortunately for women they get addicted quicker than men. So a young girl using heroin would become addicted faster than anyone I guess. The truth is the process of addiction is subtle but fast. People become hopelessly addicted before they know it. It may take years or, could only take months, either way it happens to them in a subtle sneaky way they fail to fully comprehend until it is too late.

Fortunately there is a way out, it is not easy though. More about this later.





Russell P. Mai, LCDC, AAC

The Protective Highs

Last time I ended the post on the Acceptance Highs, (after quoting my two examples who both said, "I'll quit if it gets worse,") with the negative assurance that it gets worse. Which brings us to this posting on what I call the "Protective Highs." Before talking about them it might be good to look back at Maslow's Pyramid. The highs we have been looking at so far (Arrogant Highs, Performance Highs and Acceptance Highs) correspond to the three upper levels of Maslow's Pyramid (Belonging, Esteem and Self Actualization Needs). So far we have looked at how drug or alcohol induced highs replace these needs. The addict is no longer meeting his Self Actualization, Esteem or Belonging Needs. This is bad but, the next two levels of needs on Maslow's Pyramid are survival needs. The highs we are going to look at now displace survival needs. When the addict uses to get these highs she begins to ignore her survival needs in favor of getting high. This does not mean that the person using for an Arrogant High cannot accidentally overdose himself or crash his car into tree. That kind of stuff happens a lot. What it does mean is that now the addict's use routinely interferes with her ability to meet her survival needs.

The Protective Highs correspond to the Safety and Shelter Needs on Maslow's Pyramid. The addict pursues these highs at the expense of meeting his Safety and Shelter Needs. The Protective High gives a feeling of safety while in reality placing the addict in greater danger. Is it safer to be drunk or to be sober? Is it safer to be high or to not be high? The alcoholic feels safer when she's drunk but she's really at more risk. I once worked with a guy who used to say that when he got home from work he was going to open a bottle of Scotch and "turn into another lump in the sofa." When a person drinks to get that drunk they are using to reach a state of oblivion. When I taught the repeat offenders class to people with multiple DWI's every single one of them had thought everything was going to be okay when they again drove drunk, they were oblivious to the danger. Oblivion is a Protective High. It is the type of Protective High that comes from using sedative drugs like alcohol, tranquilizers, narcotics or even marijuana. There is whole other type of Protective High which comes from using stimulants like crack, cocaine or methamphetamine.

The Protective High in stimulants has to do with sustaining the high. Once the crack addict is high she is afraid of coming down and she keeps on using to Protect herself from coming down. She starts out by going to her ATM withdrawing enough money to buy a "rock" of cocaine. Then she drives to meet her crack dealer and buys a rock. Then she goes back to her apartment and smokes it. She decides that rock wan't enough. She goes back to the ATM, back to the crack man, back to her apartment, smokes it, back to her ATM, back to the crack man, back home, smokes it, back to the ATM.... On and on it goes all night long on an eighth of a tank of gas until her bank account is empty! Why? Because she is afraid of coming down!

I once worked with a homeless man who had been expelled from the only shelter available to him on Galveston Island. He told me that if he had to spend the night on the streets of downtown Galveston he was going to get drunk. I asked him if he was more likely to get rolled (robbed while passed out) drunk or sober? He replied, "drunk." I asked him if he was more likely to be severely beaten by one of youth gangs looking for victims if drunk or if sober? He replied, "drunk." I asked him if did not make more sense to stay sober than it did to get drunk? He replied, "I can't face it out there sober!" adding "If I got to spend the night on the street I am getting drunk." In other words he would prefer the illusion of safety provided by a Protective High to actual safety!

During the Protective Highs stage of addiction the Safety and Shelter Needs are neglected. They fall by the wayside. The addict smokes up his rent money. The alcoholic drinks up her insurance payment. Taking care of Safety and Shelter Needs is ignored in favor of the desperate search for a Protective High. Family and friends often enable the addict by lending him money to pay bills or rent. The addict gets high instead. The addict's parents let her move back home, now she does not have to even consider her Safety and Shelter Needs and can spend all of her and all of their money on getting loaded!

Ask the person using for Protective High about their drug or alcohol use and he might blow his stack! She might cuss you out! The alcoholic does this because he feels threatened by the query. She knows that sooner or later something terrible is bound to happen if she does not stop! On the other hand the very thought of stopping scares him to death! He needs to quit before it's too late but he can't face life without it. The addict is a scared, angry and confused mess at this point in her addiction. More and more he alienates all those around him. She resents people butting into her affairs but is desperately lonely and afraid.

Still this is the next to last stage of addiction not the last, when it comes to addiction things can always get worse. We will see how much worse next time.








Russell P. Mai, LCDC, AAC

The Acceptance Highs

Once the Performance Highs are gone (like the Arrogant Highs which preceded them) they are replaced by another set of highs. Recall that the Arrogant Highs displaced Self Actualization Needs, needs the user may not have actually experienced yet, and the Performance Highs displaced Esteem Needs. This means getting high replaced these needs. Getting high to meet needs ultimately fails. After some period of time the person using for a Performance High loses the esteem of others, eventually they lose their self-esteem.

The next level on the progression downward in the Lowarchy of Highs (Figure 2. above) is the Acceptance Highs. These highs displace the Belonging Needs on Maslow's Pyramid. They are called the Acceptance Highs because the person using for an Acceptance High feels more acceptable to others when they are high or talking about getting high than when they are not. Their actual ability to maintain healthy relationships with others actually goes away during this stage of the addiction process. Some examples may help in making the point.

At one time in my career I frequently dealt with people who were walk-in clients of a large private nonprofit agency. I described one of those sessions previously in the post on Arrogant Highs. Well that was not the only mother and son duo I have dealt with. Some years later a mom and her 15-year-old son had a session with me. The son had been using marijuana regularly since he was age 11. His mother confessed she had actually introduced her son this drug but, she had quit using about one year previous to our session. She felt guilty for leading her son into marijuana use and, she hoped that because he had followed her bad example, he might just follow her good one and quit too. He did not.

They told me that when the boy was 11 years old and first started smoking weed, he was a straight "A" student, a pitcher on his little league team and a member of the school band. When I met them he was age  15, smoked weed daily, was a "C" student, played no sports (in fact he skipped P.E. most days and smoked weed with his friends), and was not engaged in any extracurricular activities. His mother left the session so the boy and I could talk in private.

I asked the boy, "Do you think marijuana could be holding you back?" He responded, "I am sure that it is." (This response surprised me!) I next queried, "Why don't you stop" (using marijuana). He said, "Because I feel like I would be a nerd." "Oh," I said, "you feel like your friends would put you down if you quit?" He replied, "No I think my friends would be proud of me if I quit." (I was confused!) Again I asked, "So why don't you quit?" And again he replied, "Because I feel like I would be nerd." (I paused and pondered his words.) Then I said, "Oh I get it! You feel like you would be a nerd, if you quit smoking weed!" He said, "Yeah I feel like I would be a nerd." I asked him if he thought he was addicted to smoking marijuana and he responded, "I don't know, maybe."

Around that same time I was also an instructor of the Texas DWI Intervention Course (repeat offenders program). One of my students was a gentleman in his 70's. This fellow had collected a bunch of DWI's from various states including one in Texas. Once Texas discovered all his previous DWI convictions the state ordered him into the repeat offender program. This course is cleverly designed to gradually convince students they have a serious alcohol problem (they all met criteria of alcohol dependence). Right on schedule this elderly gentleman confided to me, "I think I might have  a drinking problem." (He did have one.) I replied, "What do you want to do about it?" He explained that every day he played cards with some buddies of his, that as they played they drank beer. He then asked me, "What are they going to think of me if I won't have a beer with them?" I remembered what the 15-year-old had said a couple of days before and said, "Maybe your friends will be glad for you, maybe they'll be proud of you for not drinking!" The old man replied, "Yeah maybe but, it just wouldn't feel right if wasn't drinking with them."

During the Acceptance Highs stage of addiction the alcoholic's or drug addict's behavior actually becomes increasingly less acceptable to others. The alcoholic may make long rambling emotional phone calls in the middle of the night which she is unable to recall later (this tends to alienate people). The drug addict may be unreasonably jealous or completely untrustworthy (often both). Acquaintances drift away, but close friends and family offer constant reassurance of their loyalty. They don't want the addict to feel insecure. These wrong headed efforts ultimately fail.

The elderly man and the adolescent boy, described above, were using for an Acceptance High. The boy did not want to "feel like a nerd" (unacceptable) and the older man said that not drinking with his buddies "just wouldn't feel right" (unacceptable). Both were concerned they may have a substance disorder, the boy answered, "maybe" when asked if he was addicted and the old guy thought he "might have a drinking problem." I asked the older man and the teenage boy the same question, "What are you willing to do about it?" Even though these were separate conversations, they both gave the exact same answer, "I'll quit if it gets worse."  We know what happens, it does get worse. More about this in the next post.










Russell P. Mai, LCDC, AAC

The Performance Highs

The Arrogant Highs fade away and are replaced by the slightly less euphoric Performance Highs. The Performance Highs are so named because these highs do seem to enhance performance. They are not to be confused with physiological effects of certain performance enhancing drugs such as steroids, human growth hormone or erectile dysfunction medications. These Performance Highs come from psychotropic drugs.

We all know of musicians who have used drugs to enhance their performance or creativity. We have heard of athletes using cocaine, writers using alcohol, artists using various substances believing that their talent and skill were enhanced through using. Perhaps for a time this was true. Eventually the musicians lost their creativity. The athletes lost their ability. The writers and artists no longer produced. Too many talented people eventually lost their lives.

You do not have to be an artist, musician or athlete to use for a performance high. Anyone is who needs a few drinks before they are willing to dance is using for a performance high. The same is true for those who need something (psychoactive) in their system in order to chat up a member of the opposite sex. If need to smoke weed in order to enjoy a concert this is also a sort of performance high. Obviously students abusing stimulants in order to prepare for a test are using for a performance high. So are workers who use drugs on the job in order to get through the day.

During the Performance High stage of the addiction process a person's actual performance gradually declines. This is because as they come to rely (remember that word from the 1/12/13 post?) more and more on the drug(s) for their performance they put less and less effort into the kinds of things that help real performance. In other words the musician ignores practice, so does the athlete, the lover depends on a drug and loses his charm, the student ignores her studies, the worker  becomes less reliable as he relies on drugs more.

Friends and family are not much help. Because they care about the drug user they are loathe to hurt his feelings. Instead they try to bolster her pride (to meet her Esteem Needs for her) by telling her she is doing a good job. Family tells the drinker he is a great dad despite his declining ability to fulfill the role of a good father. His wife makes excuses. Her coworkers take up her slack. They do this because they don't want to be jerks. Friends, family, coworkers make excuses, take up slack, and offer encouraging words up to a point. This the point when they can no longer make excuses, are unable to take up any more slack. Some reach that point sooner than others, some take a long, long time. Eventually the Performance Highs fade.

Before they fade the people using for a performance high will demonstrate denial concerning their substance disorder. Denial at this stage in the Lowarchy of Highs is slightly different than at the previous stage. In the Arrogant High stage of addiction denial was absolute. Now denial takes the form of rationalization. People using for a performance high rationalize about their substance use. They believe it is an asset. The will explain how their use of drugs or alcohol enhances their life in some important way. They rationalize a deficit into an asset, it's a kind of like they are cooking the books and embezzling from their esteem account (the esteem of others and their own self-esteem).

The Performance Highs like the Arrogant Highs which preceded them are also replaced by another set of highs. These next highs are not as rewarding but, they correspond to more basic needs on Maslow's Pyramid so, they are much harder to do without. They are more addictive.







Russell P. Mai, LCDC, AAC