On the urging of a close friend I’ve been listening to and really enjoying the TrueAnon podcast. This past weekend I listened to an episode from Back in April (sorry the embedding is so weird here, I can’t just link it):
with Erik Davis, author of High Weirdness: Drugs, Esoterica, and Visionary Experiences in the Seventies and the Blotter: The Untold Story of an Acid Medium. It’s actually a two-parter but I think the second part may be paywalled.
There’s a discussion in the first part of the episode about drugs and their “eras” — LSD in the 60s — although I learned that blotter art wasn’t really a part of LSD culture until it went deep underground in the later 70s and 80s — cocaine in the 80s, and so on. The conversation of course goes to the drug of the moment in America today, Mizz Katie or ketamine. It’s easy to speculate, as the hosts and guests do, about what it says about our culture today that a “dissociative anesthetic hallucinogen” is the drug of choice — the isolation of the Covid years, the bleakness and brutality of life today, that we’re constantly engaging with dissociated versions of ourselves via social media. There’s also a passive reference to a Mark Fisher bit about people going to the club to take Xanax and black out which I can’t track down — if anyone knows where to find this bit, please let me know! (There’s tons of interesting digressive bits in the episode, I highly recommend you go listen to it!)
Mark Fisher’s Capitalist Realism is as good an entry point as any to what the episode got me thinking about. Writing in 2009:
It is not an exaggeration to say that being a teenager in late capitalist Britain is now close to being reclassified as a sickness. This pathologization already forecloses any possibility of politicization. By privatizing these problems – treating them as if they were caused only by chemical imbalances in the individual’s neurology and/or by their family background – any question of social systemic causation is ruled out.
Which drugs correspond to which eras is a question of how social and individual suffering (psychic and spiritual) are constructed and articulated in a particular era. This is, of course, heavily influenced first by a prevailing understanding of mind-body dualism in modern medicine (all forms of suffering have a physiological/biochemical basis in the body and can be “corrected” at that level) and second, more importantly, by the profit-seeking incentives of pharmaceutical companies. Take the social and pharmaco-economic construction of the concept of chronic pain through the 1990s. Take the now-closed American Pain Society’s “Pain as the Fifth Vital Sign” campaign, launched the same year (1996) that Purdue Pharma began marketing oxycontin. I’m not trying to make any big sweeping statements here, but there’s a way in which this articulation of suffering (physical, psychic, social, spiritual) was completely “somatized” into something that could be aggressively treated with high-dose opioids.
Ketamine, obviously, is a dissociative drug. Dissociation is a popular concept today — a popular articulation of, particularly, psychic and mental suffering. People who have been around for awhile (like my old ass) are likely to be a little surprised at the sudden popularity of ketamine as a therapeutic and recreational drug — the ketamine entries on Erowid were always the ones that freaked me out the most as a junior psychonaut — but it makes sense. Dissociation is probably a bit overused in the TikTok-ified clinical sense (you probably aren’t literally “dissociating” at the Thanksgiving dinner table, but hey, maybe you are), but it does, per the discussion on TrueAnon, speak to a deeper experiential truth of the moment.
What’s freaky is how thoroughly medicalized our cultural articulations of mental suffering are now, or are becoming. This is very clear when viewed through the prism of the “psychedelic renaissance.” Ketamine therapy for major depressive disorder was starting to pick up steam pre-pandemic, but it really exploded after the declaration of the Public Health Emergency for COVID-19 and a March 2020 DEA regulation permitting remote/telemedicine prescribing of controlled substances. (Though the federal Public Health Emergency has ended, this telemed regulation was just extended for another year.) This has been a game changer in a positive sense for things like buprenorphine and methadone, which a new HHS rule now allow to be prescribed via telehealth indefinitely. This also resulted in the efflorescence of online Instagram-ad mail-order ketamine clinics; these clinics (whether online or in-person) are starting to close, and the emerging consensus is that many tried to “scale” too fast to cash in on the hurricane of VC cash coalescing in a jagged spiral around medicalized psychedelic healing.
Medicalization of suffering, in a system of privatized capitalist health care such as our own, opens the door directly to pharmaceutical market-making. Now ketamine, now MDMA, now psilocybin, now DMT. HealingFromHealing’s Adam Aronovich has spoken and written extensively about this weird interface between psychedelic culture and market-oriented wellness; what particularly interests me are the challenges of “integration” that seekers of psychedelic healing often report — they travel to the South American jungle, take ayahuasca with a guide or shaman, talk about it with a healing/sharing circle afterwards, then come back to their lonely, atomized lives in Global North countries where the insights they gained through the experience of taking the compound and connecting with other people don’t make sense and have no place, and the lucrative cycle of suffering continues.
It’s doubly lucrative, because there are pharmacological fixes for alienation and deviance just as much as psychedelics and dissociatives are becoming marketable for suffering (often spiritual suffering or the excavating childhood or otherwise embodied trauma, for instance). Ketamine is but one drug of our era; the other would have to be stimulants of all kinds. These are prescribed in staggering quantities to treat ADHD. ADHD is not an identifiable somatic or neurochemical problem, but it can be understood (one way it can be understood, I am making a particular point here and not a general statement about what ADHD is or is not) as a medicalized articulation of social deviance. Stimulants work — they make almost everybody feel better, they make almost everybody more productive and better-behaved. As an aside, I always hear that stimulant drugs have the “opposite effect” on people with ADHD. This is false. A stimulant is a stimulant; if you’re not grinding your teeth or talking a mile a minute it’s probably because you’re taking a well-titrated dose under competent medical supervision, not because you’re a neurochemical unicorn. There was an explosion in diagnosis and prescription of stimulants for ADHD when I was a kid, in the 1990s. We seem to be in another, and even bigger boom right now. (I would like to do a more thoroughly-researched deep dive into this and cite some actual research figures. I’ve looked up a couple that support my claims here but haven’t done a comprehensive overview.) The medications for ADHD are basically all stimulants (which also have a long and fascinating social history that I would like to dig into) and like all psychiatric drugs, we don’t know exactly how they work, because we don’t know of any actual underlying neurochemical mechanism by which the disease entity “ADHD” manifests. But they do work at what they’re supposed to work at, which is making you better-behaved in school, more focused, more productive, and more normal by our modern standards of what normal is.
A friend of mine has a book chapter forthcoming (is it out yet? If you’re reading this, let me know) about how individual psychotherapy — much like drugs, in particular drugs in their medicalized guise as “treatments” for such-and-such clinical constructions of mental and social suffering — functions to construct an interior “subject” that can get by within (or that conforms to) the confines and dictates of 21st-century globalized capitalism. To this friend’s credit, they recognize that sometimes, this bringing-into-alignment is what relieves suffering. If you can’t sit still for Zoom class but you still have to go to Zoom class, or if your executive function starts to deteriorate when you spend endless, repetitive, identical days by yourself at home (something that I noticed happening to me in 2022-2023, which made me start to wonder about the complexities of mental and psychic disorders and how they manifest out of a complicated social interplay between individual psyche and the world), amphetamines will help you — you’ll be able to pay attention, open your mail, stop losing track of what you’re doing, or fussing endlessly over little minute details of your home environment (this latter one is me) and do what you need to do to get through it.
Ketamine and speed paint an interesting picture of how we’re suffering today — needing to be, alternately, artificially jacked in and ruthlessly optimized to a soul-killing system of exploitation and social control, or totally dissociating from grim, lonely, and increasingly blue-lighted digital reality. All of it articulated and legitimized via medicalization and clinical diagnosis, which is, of course, another avatar of social control. I’ll give a small and quiet endorsement of non-medical use of psychedelic drugs, like LSD, for fun. The TrueAnon episode discusses a few things that are true to my experience of LSD: the empty epiphany and the silly quest, the yin-yang of sacred and profane. For as much mind-manifesting as I’ve done via LSD, I’ve done an equal (or greater) amount of laughing my ass off watching local news and infomercials. If I endorse psychedelics at all, which I certainly don’t across the board, it’s not to optimize or to “heal.” Just — though this is a concept in scarcer supply than Vyvanse these days — for fun.