The current movement to legalize marijuana brings to mind the obvious question why people use drugs. This is not a simple question, but it’s worth trying to answer since it is now estimated that, according to the National Institute on Drug Abuse, about 50% of Americans are either mildly or severely abusing some drug, be it alcohol, sedatives, narcotics, stimulants or marijuana.

In fact, there has been a growing global epidemic of drug abuse that began in the Fifties and has been gaining speed ever since. Aldous Huxley’s “Brave New World” was written in 1932 and predicted a future where we all would be mandated to take “Soma,” a magic hangover-free opiate that would remove all our anxiety, stress and unrest.

My patients, who are largely athletes, often seek out drugs in an effort to calm their anxiety, manage their pain or suppress their depressing disappointments. Both research and my clinical experience suggest that there has not been a single drug invented, with the exception of caffeine, that helps an athlete’s performance.

Let us spend a little time understanding why it is that so many Americans take drugs. The psychoanalyst Heinz Kohut noted that drug addiction is the result of a defective self which creates huge problems in affect control. He suggests that drug users go through a typical vicious cycle that endlessly repeats itself.

Initially there is some sort of crisis caused by unreasonable expectations. I have seen athletes get depressed following a big win and remark to me: “Is that all there is?” One reason vacationers get depressed either on or following a vacation is because they had harbored an unrealistic vision of how glorious it would be. These disappointments can be felt as severe and so painful that the person immediately turns to drugs to escape the flood of anger and despair.

This cycle repeats itself over and over and little is learned about why they harbor such great but unrealistic expectations. The drug offers temporary relief or euphoria, but there is no growth or psychological learning that takes place as to what the depression is about. All that is achieved is short-term relief from the crisis. The formula is simple. Unconscious defects in the self will force unrealistic expectations, which lead to inevitable disappointment and then drug use to sooth the pain.

The cure for all this is psychotherapy, but no one believes that anymore. The pharmaceutical industry uses well-produced, well-written and extremely persuasive commercials that encourage a belief in drugs, drugs, drugs. You cannot watch a show on television without seeing another drug ad.

Psychoanalysis has had a bad name for years as moribund, irrelevant and overly lengthy, but the question is what else works and the answer is that nothing else works. Behavior modification does not work, rehab often does not work and other drugs to treat drug use typically fail as well. As an example, the promise that methadone could cure heroin addiction was an impressive failure.

Athletes and the many others who are addicted to one drug or another tend to externalize the answer and believe that the answers are found outside of the self. But the fact is that most of our unrest comes from within and the only way to figure that out is to look inside. Madison Avenue has done a splendid job of convincing us that the answer to all our problems can be purchased at the local CVS or nowadays at the local marijuana dispensary.

Aldous Huxley predicted all of this 90 years ago. But just like in his book, some people realized that life can never be nor does it have to be a bowl of perfect cherries.
People need lots of help in seeing how good they are,  but it seems that more and more people are less and less convinced of that. We’ve been overexposed to images of Brad Pitt, Michael Jordan, Tiger Woods, Angelina Jolie, Madonna and Taylor Swift. And if we don’t look like them, act like them and vacation where they vacation that means we feel like losers.

That shame is a nasty feeling and accounts for why so many people are angry and do their best to drown their rage and shame with meds or booze or pot. It’s a brave new world for sure and there is plenty of Soma to go around.