IN THE MAGAZINE

NEW FRONTIERS OF SOBRIETY

Being Anti-High Feels Anti-Good

Published August, 2009
(Page 3 of 3)

At the Chinatown needle exchange, where I am apparently a regular. Photo by Jess Williamson

ANTI-HEROIN: NALTREXONE
DOSE: 200 MG

There are drugs called opioid antagonists, which do the opposite of recreational opioids like heroin. When paramedics treat heroin overdoses, they inject an opioid antagonist called naloxone into the body. On a molecular level, naloxone races into your brain, jumps ahead of the heroin molecules occupying your opioid receptors, and pushes them aside. Once the naloxone molecule is in place, heroin is unable to suppress your breathing and the overdoser rapidly regains consciousness. Naloxone has saved countless lives.

Researchers realized they could use a similar opioid antagonist called naltrexone to stop junkies from feeling the effects of heroin. A device was developed that is surgically implanted under the skin and releases a continuous supply of naltrexone into the body for several months at a time. Although some addicts have benefited from naltrexone implants, the results are usually disastrous. When you give a junkie naltrexone it not only prevents them from feeling heroin, it causes them to go into instantaneous accelerated withdrawal, exponentially worse than natural opiate withdrawal. Some people have killed themselves to escape the pain after getting naltrexone implants; others perform home surgery and cut the implants out of their body.

In the same way that rimonabant blocks endocannabinoids, naltrexone blocks natural opioids called endorphins. Endorphins are pleasure chemicals commonly associated with sex and exercise, but they’re also important regulatory factors in our daily mood and immune function. Even if you’re not a junkie, taking an opioid antagonist has a profound effect on your neurochemistry. For that reason, naltrexone has been shown to be an effective treatment for pedophilia and kleptomania. The natural opioid rush from acting on these compulsions is blocked, so fondling a child or stealing an iPod loses its euphoric rush.

I decide to take a dose of naltrexone four times higher than the daily dose used to treat opioid dependence. After taking the pills, I get on the train to Manhattan. I’m sort of giddy. I can’t quite describe the feeling but it’s not necessarily bad. The best anti-high thus far. I get off at Canal Street and I’m filled with tension amid all the shouting, sweaty, glistening tourists. At the same time I have this strange sensory enhancement that is not totally unpleasant. Vaguely erotic. I can feel each and every hair on my scrotum moving as I walk. Since I went to the bong store on rimonabant, I think it would only be appropriate for me to go to the needle exchange today. I walk inside and I’m immediately depressed and confused by my decision. As I’m filling out forms to get my needles, the woman looks at me and says my name is already in the computer—what? This twilight-zone moment makes me incredibly tense and paranoid. Why am I in the computer at the needle exchange? Why am I at the needle exchange? Why am I on naltrexone? I walk outside holding a paper bag full of needles and bleach and feel like I’m about to cry.

I’m totally absorbed in frantic and confused thoughts. I wish I understood addiction. I have read so many books, known so many addicts, but nothing makes sense to me. I don’t want to say addiction is a disease, because diseases are excuses. Diseases are permission slips for being sick. If I’m addicted to Valium, that’s a conscious choice I make each time I swallow a Valium tablet. But how can I say that? I feel guilty. I’m so confused. Thomas Szasz said, “If the desire to read Ulysses cannot be cured with an anti-Ulysses pill, then neither can the desire to use alcohol, heroin, or any other drug or food be cured by counterdrugs.” But is he right? My trance is broken when someone offers me a flyer for “mad mojitos.”

I get on the train to Union Square and find myself spontaneously breaking into song, then running full speed until I lose my breath. After running, my body is assaulted with sharp aches and pains. Is this what it feels like to be old? I almost step on a sparrow pecking at a muffin crumb and scream at the top of my lungs. Wow, am I on edge! When you meet new people, instead of shaking hands, both parties should scream at the top of their lungs. That would be the custom in a naltrexone alternate universe. As the day wears on, my muscles are starting to freeze up into terrible wooden knots. All my internal organs have been replaced with beef jerky. I have to keep stretching—continuously—to avoid hardening into a solid block of wood. I can’t wait for this sensation to pass. O sobriety, how I long for thee!

CONCLUSION

There are so many anti-highs I have neglected to experience, but some are seriously dangerous. Drugs with the opposite action of ketamine are potent neurotoxins, and drugs that do the opposite of alcohol and benzodiazepines are known to cause seizures. Scientists are still mapping the gelatinous landscape of our brains, and as new drugs are discovered, new anti-drugs will also be found. Who knows what kind of chemical misery the future might hold! Although I must admit, after a week of enduring these anti-highs I feel incredible. The neurochemical floodgates have opened and there is unimaginable rebound euphoria. All night I walk down the street, peaceful and optimistic, ready to high-five strangers. Ready to high-five the moon! Hey moon, what up!

All that is loved is loved by contrast. We love intoxication because we know sobriety; to love sobriety we should know anti-intoxication. We can’t know the high without the low, and after a week of getting low I’m feeling pretty high. I think the only thing we have to fear is the middle.

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