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In the 1950s and 60s a cross-section of psychologists, writers and artists in America, partly inspired by Aldous Huxley’s essay The Doors of Perception published in 1954, experimented with hallucinogenics like LSD, mescaline, mushrooms, and hashish to venture into new realms of experience, seeking the “hidden” reality of the self and the world and probing into the meaning of art to locate their inner vision.

The post How A. K. Ramanujan mirrored Aldous Huxley appeared first on OUPblog.

In the 1950s and 60s a cross-section of psychologists, writers and artists in America, partly inspired by Aldous Huxley’s essay The Doors of Perception published in 1954, experimented with hallucinogenics like LSD, mescaline, mushrooms, and hashish to venture into new realms of experience, seeking the “hidden” reality of the self and the world and probing into the meaning of art to locate their inner vision.

The post How A. K. Ramanujan mirrored Aldous Huxley appeared first on OUPblog.

What happens when medication doesn’t bring your condition under control? Usually, it’s not just one single issue but various factors that contribute to the problem. Your doctor will work to figure out why–and from there, create a new plan of attack. Finding the right combination of medications may require some trial and error.

The post Seven reasons why your medications are not working properly appeared first on OUPblog.

Bill W., the co-founder of Alcoholics Anonymous, took an acid trip in late 1950s that reportedly allowed him to revisit the mental and spiritual condition that had inspired him to swear off booze in the first place. Although AA has no religious affiliation, the numerous references to God throughout the twelve steps make its emphasis on interior discovery and redemption an indispensable part of the program.

The post Finding a new perspective on psychedelics appeared first on OUPblog.

Reports of a Russian state doping programme are jarring reminders of times when victorious athletes were offered as evidence for the superiority of political ideologies. The allegations have certainly complicated aspirations to keep drugs out of the Olympics. If your state colludes in your doping then you have only to arrange to be clean around the dates of competition.

The post We must try harder to stop the drug cheats appeared first on OUPblog.

Ten students at two visitors at Wesleyan University have been hospitalized after overdosing on the recreational drug Ecstasy, the result of having received a "bad batch." The incident elicited a conventional statement from the President of the University: “Please, please stay away from illegal substances the use of which can put you in extreme danger."

The post America’s irrational drug policies appeared first on OUPblog.

Ten years ago Don Winslow wrote the thriller of the decade. The Power of the Dog was an epic thriller that detailed America’s thirty year war on drugs on both sides of the U.S.-Mexican border. Ten years later he has done it again. Winslow blows The Power of the Dog away detailing the next ten […]

The discovery and development of drugs was not always a straight path. Many times, the drugs that are well-known today -- both hallucinogenic and medicinal -- were discovered by mistake or originally developed for a much different purpose. How well do you know the history of some of the most common drugs? Take this quiz to find out if you can match the drug to its origin.

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It’s easy to assume that we know what pain is. We’ve all experienced pain, from scraped knees and toothaches to migraines and heart attacks. When people suffer around us, or we witness a loved one in pain, we can also begin to ‘feel’ with them. But is this the end of the story?

In the three videos below Joanna Bourke, author of The Story of Pain: From Prayer to Painkillers, talks about her fascination with pain from a historical perspective. She argues that the ways in which people respond to what they describe as ‘painful’ have changed drastically since the eighteenth century, moving from a belief that it served a specific (and positive) function to seeing pain as an unremitting evil to be ‘fought’. She also looks at the interesting attitudes towards women and pain relief, and how they still exist today.

On the history of pain

Click here to view the embedded video.

How have our attitudes to pain changed?

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On women and pain relief

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Joanna Bourke is Professor of History at Birkbeck College, University of London. She is the prize-winning author of nine books, including histories of modern warfare, military medicine, psychology and psychiatry, the emotions, and rape. Her book An Intimate History of Killing (1999) won the Wolfson Prize and the Fraenkel Prize, and ‘Eyewitness’. She is also a frequent contributor to TV and radio shows, and a regular newspaper correspondent. Her latest book is The Story of Pain: From Prayer to Painkillers.

The post Does pain have a history? appeared first on OUPblog.

        

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By Robert Morrison

In The Metaphysics of Morals (1797), Immanuel Kant gives the standard eighteenth-century line on opium. Its “dreamy euphoria,” he declares, makes one “taciturn, withdrawn, and uncommunicative,” and it is “therefore… permitted only as a medicine.” Eighty-five years later, in The Gay Science (1882), Friedrich Nietzsche too discusses drugs, but he has a very different story to tell. “Who will ever relate the whole history of narcotica?” he asks pointedly. “It is almost the history of ‘culture’, of so-called high culture.” What caused this seismic shift in attitude? How did opium, in less than a century, pass from a drug understood primarily as a medicine to a drug used and abused recreationally, not just in “high culture”, but across the social strata?

The short answer is Thomas De Quincey. In his Confessions of an English Opium-Eater, first published in the London Magazine for September and October 1821, he transformed our perception of drugs. De Quincey invented recreational drug-taking, not because he was the first to swallow opiates for non-medical reasons (he was hardly that), but because he was the first to commemorate his drug experience in a compelling narrative that was consciously aimed at — and consumed by — a broad commercial audience. Further, in knitting together intellectualism, unconventionality, drugs, and the city, De Quincey mapped in the counter-cultural figure of the bohemian. He was also the first flâneur, high and anonymous, graceful and detached, strolling through crowded urban sprawls trying to decipher the spectacles, faces, and memories that reside there. Most strikingly, as the self-proclaimed “Pope” of “the true church on the subject of opium,” he initiated the tradition of the literature of intoxication with his portrait of the addict as a young man. De Quincey is the first modern artist, at once prophet and exile, riven by a drug that both inspired and eviscerated him.

The Confessions warned some early readers off opium, as De Quincey claimed he intended. “Better, a thousand times better, die than have anything to do with such a Devil’s own drug!” Thomas Carlyle commented after reading the work, while De Quincey’s erstwhile friend and fellow opium addict Samuel Taylor Coleridge insisted that he read the Confessions with “unutterable sorrow…The writer with morbid vanity, makes a boast of what was my misfortune.” But for many other readers, De Quincey’s account of opium was an invitation to experimentation — his drugged highs almost irresistible, and the gothic gloom of his lows even more so. Within months of publication, John Wilson, De Quincey’s closest friend and the lead writer for the powerful Blackwood’s Magazine, heard alarming reports of people recklessly attempting to emulate De Quincey’s drug experiences. “Pray, is it true…that your Confessions have caused about fifty unintentional suicides?” he inquires in a flamboyant Blackwood’s sketch. “I should think not,” the Opium Eater replies indignantly. “I have read of six only; and they rested on no solid foundation.”

Others, however, did not find the situation funny. One doctor recorded a sharp increase in the number of people overdosing on opium “in consequence of a little book that has been published by a man of literature.” The authors of The Family Oracle of Health (1824) were even angrier. “The use of opium has been recently much increased by a wild, absurd, and romancing production, called the Confessions of an English Opium-Eater,” they declared. “We observe, that at some late inquests this wicked book has been severely censured, as the source of misery and torment, and even of suicide itself, to those who have been seduced to take opium by its lying stories about celestial dreams, and similar nonsense.”

De Quincey was characteristically divided on the influence of his Confessions. In the work itself he states that his primary objective is to reveal the powers of the drug: opium is “the true hero of the tale,” and “the legitimate centre on which the interest revolves.” Yet in Suspiria de Profundis (1845), the sequel to the Confessions, he maintains that its “true hero” is, not opium, but the powers of his imaginative — and especially of his dreaming — mind. Elsewhere, De Quincey denied the charges that his writings had encouraged drug abuse: “Teach opium-eating! – Did I teach wine drinking? Did I reveal the mystery of sleeping? Did I inaugurate the infirmity of laughter? . . . My faith is – that no man is likely to adopt opium or to lay it aside in consequence of anything he may read in a book.” In still other instances De Quincey regarded his drug habit as a source of amusement. “Since leaving off opium,” he noted wryly, “I take a great deal too much of it for my health.” More commonly, though, he was horrified by the damage it was inflicting. “It is as if ivory carvings and elaborate fretwork and fair enamelling should be found with worms and ashes amongst coffins and the wrecks of some forgotten life,” he wrote in the midst of one of his many attempts to abjure the drug.

De Quincey’s account of his opiated experiences has left on indelible print on the literature of addiction, and modern commentators continue to grapple with his legacy, though there is no agreement on whether he should be blamed, or absolved, or lauded. In Romancing Opiates (2006), Theodore Dalrymple lambasts him. “In modern society the main cause of drug addiction…is a literary tradition of romantic claptrap, started by Coleridge and De Quincey, and continued without serious interruption ever since,” he asserts. “This claptrap is the main source of popular and medical misconceptions on the subject.” Will Self, however, argues vigorously against such a view. “The truth is that books like…De Quincey’s Confessions no more create drug addicts than video nasties engender prepubescent murderers,” he declares in Junk Mail (1995). “Rather, culture, in this wider sense, is a hall of mirrors in which cause and effect endlessly reciprocate one another in a diminuendo that tends ineluctably towards the trivial.”

Ann Marlowe takes yet another position on the “brilliant, unsurpassed Confessions.” “Ever since I read De Quincey in my early teens,” she writes in How to Stop Time (1999), “I’d planned to try opium,” a far more direct account of “cause and effect” than Self’s halls of opium smoke and mirrors. Yet Marlowe and Self agree that they were both drawn to the drug because of its close association with intellectualism and insight, for both “hoped to pass through the portals of dope” into the “honoured company” of Coleridge and De Quincey. Such reasoning, Marlowe recognizes later, is “the sorriest cliche,” or what Dalrymple would call “claptrap”. But these accounts make plain that De Quincey’s potent memorialization of his drug experience has proven at least as seductive as the drug itself. His Confessions loosed the recreational genies from the medicine bottle and made opiates for the masses. De Quincey was lucky. The drug battered him, but it never finally defeated his creativity or his resolve. Many have not been that fortunate. Diagnosed at aged twenty with an opiate addiction, Self was “appalled to discover that I was not a famous underground writer. Indeed, far from being a writer at all, I was simply underground.”

Robert Morrison is Queen’s National Scholar at Queen’s University in Kingston, Ontario, where he maintains the Thomas De Quincey homepage. For Oxford World’s Classics, he has edited (with Chris Baldick) The Vampyre and Other Tales of the Macabre, as well as Thomas De Quincey’s Confessions of an English Opium-Eater and Other Writings, and three essays On Murder. Morrison is the author of The English Opium-Eater: A Biography of Thomas De Quincey, which was a finalist for the James Black Memorial Prize. His annotated edition of Jane Austen’s Persuasion was published by Harvard University Press. For Palgrave, he edited (with Daniel Sanjiv Roberts) a collection of essays entitled Romanticism and Blackwood’s Magazine: ‘An Unprecedented Phenomenon’. Read his previous blog posts: “De Quincey’s fine art” and “Vampyre Rising.”

For over 100 years Oxford World’s Classics has made available the broadest spectrum of literature from around the globe. Each affordable volume reflects Oxford’s commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, voluminous notes to clarify the text, up-to-date bibliographies for further study, and much more. You can follow Oxford World’s Classics on Twitter and Facebook.

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Image Credits: (1) Thomas de Quincey – Project Gutenberg eText 19222 via Wikimedia Commons. (2) “A New Vice: Opium Dens in France”, cover of Le Petit Journal, 5 July 1903. via Wikimedia Commons. (3) Cropped screenshot from the film trailer Confessions of an Opium Eater (1962) via Wikimedia Commons

The post De Quincey’s wicked book appeared first on OUPblog.

By Mark S. Gold, MD

Public health officials and academics identified cigarette smoking and related disease as the nation’s number one killer and foremost driver of health costs in the 1980s. At that time overeating and obesity were not major problems, yet they may soon cause more disease, deaths, and health care costs than cigarettes. Food addiction, which may explain part of the epidemic, is slowly and finally  “catching on”. It’s been controversial, with some scientists dismissing it out of hand, so like any hypothesis, it needs additional tests.

If overeating is due to food acquiring drug-like or tobacco-like brain reinforcement properties, then the current globesity and overeating-related health crisis might have lessons to learn from tobacco. For example, taxes on tobacco products have been the single most important prevention tool in reducing smoking. Based on food addiction hypothesis, higher prices might also reduce soda consumption. A review suggested that for every 10% increase in price, consumption decreases by 7.8%. An industry trade publication reported even larger reductions; as prices of carbonated soft drinks increased by 6.8%, sales dropped by 7.8%, and as Coca-Cola prices increased by 12%, sales dropped by 14.6%. It follows that a tax on sweetened beverages might help consumers switch to water or more healthful beverages. Such a switch would lead to reduced caloric intake, and less weight gain.

Changing the attitudes and behaviors of the public combined to reduce smoking and smoking-related health care costs and suffering. Changing access to cigarettes by elimination of cigarette vending machines, raising the price per pack to decrease numbers of cigarettes or packs/day smoked, crafting PSAs to reduce smoking initiation, and training medical professionals to intervene and not look the other way, all helped reduce smoking.

Age of onset and exposure can change genes, and make use and addiction more likely. We know that early exposure to tobacco via second-hand-smoke, either in utero or in early life greatly increases the risk of life-long tobacco use and addiction. In the 1990s, children’s intake of sweetened beverages surpassed that of milk. In the past decade, per capita intake of calories from sugar/HFCS-sweetened beverages has increased by nearly 30%. Beverages now account for 10–15% of the calories consumed by children and adolescents. It is likely that food addiction models can be used to explain early exposure and changes in preference becoming fixed and persistent for life.  An extra can or glass of sugar or HFCS sweetened beverage consumed per day increases the likelihood of a child’s becoming obese increases by 60%.

Our efforts to manage and treat overeating and obesity might benefit from addiction methods and experience. We could develop realistic food addiction models and test new treatments. Would animals self-administer food or food constituents, avidly, with bingeing and loss of control? Yes. Our work (and Bart Hoebel’ s before) clearly demonstrates that sucrose and fructose corn syrup are self-administered as if they were drugs and that an opiate-like abstinence syndrome could be produced by detoxification or antagonist administration. Sugar stimulates its own taking  causes craving, wanting, withdrawal, and can motivate and change our behavior.. If the food addiction hypothesis were relevant to the human condition, these animal models could be used to test new medications. New treatments developed for overeating and obesity were previously shown to be effective in addiction medicine.

These new treatments approved by the FDA include phentermine plus topiramate and bupropion plus naltrexone. Topiramate has been used with success in alcohol dependence, bupropion in nicotine dependence, and naltrexone in opiate and also alcohol dependence. While early, these treatments are important tests of the addiction hypothesis and harbingers of more progress in the future. With addiction medicine and food addiction model systems, we may develop treatments which change food preference and not just appetite.

Food addiction may explain some, but certainly not all obesity. The Yale Food Addiction Scale may be used to screen patients for addiction-like pharmacological and psychological interventions. Medically-assisted smoking cessation efforts were enhanced once treatment advanced from simple nicotine replacement or detoxification, to the brain and the neurobehavioral attachment to cigarettes. With an addiction hypothesis that included dopamine, we discovered the efficacy of bupropion and then Chantix. Thus, rather than a successful short term treatment rate of less than 20%, we routinely helped 30% of smokers. Still, addiction-inspired public health measures rather than medically-assisted treatment were responsible for most of the successful cessation efforts, early intervention, and prevention.

Smoking-related disease caused 400,000 deaths per year in the USA plus an additional 40,000 deaths due to second-hand smoke. Until recently little effort was directed at preventing smoking or treating smokers, although we treated the lung cancers, stroke, erectile dysfunction and other diseases caused by smoking. With all this progress, all of the health savings related to smoking cessation will soon be replaced by obesity-related costs. Are these two events related? As smoking and addiction is associated with decreases in eating and weight, a nation detoxifying from smoking addiction should be expected to become overweight. Until recently, with the scientific support provided by food and addiction models, we have not applied the same lessons learned from tobacco to overeating and obesity.

Proposals for food taxes have been made and calculations formulated of revenue-benefits based on our experiences with tobacco taxation. Even when these fail, the public and health experts have to think through the idea that fruits and vegetables are more costly than fatty, sweet, fast foods. Using taxes on ingredients such as added sugar and fructose corn syrup would decrease exposure according to addiction models. This might make Coca-Cola and other sodas return to sucrose as in Mexican or Kosher Coke. Reducing portion size, while supported by cigarette experience with numbers of cigarettes per pack and purchase limits, is a weaker intervention than other approaches. Now we see food labels and calorie postings. This educates everyone as they consider is it worth the calories and do they have the time and energy to exercise away the calories ingested. Exercise is important, and promotes health, but is not a stand-alone obesity treatment or management strategy. Stigmatizing the overweight with added health premiums and workplace incentives has not worked well in the past. Blaming the patient, creating shame and guilt, doesn’t do much to inspire treatment efficacy.

Obesity has changed the width of the seats in airplanes, dress, and trouser sizes. It has also made high cholesterol, high blood pressure, high blood sugars, knee and joint pain, and other obesity-related problems routine in medical practice and treatment. Over the past three decades, rates of obesity have increased in the United States and elsewhere, so that now more people are obese and in need of treatment than ever. New approaches, evidence-based approaches, like those that have been used successfully to develop novel public health and treatment approaches for tobacco, alcohol, and other addictions are needed.

Mark S. Gold, MD is the co-editor of Food and Addiction: A Comprehensive Handbook with Kelly D. Brownell. He is the Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry at the University of Florida. Dr Gold is a teacher of the year, researcher and inventor who has focused for much of his career on the development of models for understanding the effects of tobacco, cocaine, opiates, other drugs, and also food, on the brain and behavior. He began his work on the relationship between food and drug addictions while at Yale working with addicts in withdrawal. He has worked for 30+ years trying to understand how to change food preferences, make eating and drugs of abuse less interesting or reinforcing at the brain’s dopamine and other reinforcement sites. Kelly D. Brownell, PhD is professor of psychology, epidemiology, and public health at Yale University and is director of Yale’s Rudd Center for Food Policy & Obesity. Dr. Brownell does work at the intersection of science and public policy. The Rudd Center assesses, critiques and strives to improve practices and policies related to nutrition and obesity so as to inform the public and to maximize the impact on public health.

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Image credits: (1) Young mother and her baby, sleeping in bed. Photo by SvetlanaFedoseeva, iStockphoto. (2) Shrimp cocktail elegantly served in a martini glass accompanied by a glass of white wine. Photo by sbossert, iStockphoto.

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Edgy  is how Jayne Mendius describes her husband Chris’s latest novel, SPOONFUL.  Mendius takes his readers on a journey through the sordid world of addiction.  So why is addiction coming to Bowllan’s Blog? And what does it have to do with YA? Well, our world is filled various forms of addictions – some hidden – some not.  Students hear about the elephant in the room – drugs – only when a celebrity dies from an overdose. When else? Should we discuss this issue with our young people? My vote is yes.
Watch part 1 of my at-home, Face Time interview with the Mendius family.