Cravings

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"I had left my San Francisco postdoctoral position disillusioned by the whole concept of craving. Some addicts certainly reported drug craving: there was no doubt about that. But it didn’t really predict whether they relapsed, according to the majority of research. Sometimes people would report severe craving but not use drugs; other times, they’d use drugs in situations where they said they’d experienced no craving at all. It seemed to me that it would be much more useful to study people’s actual decisions about whether to take drugs, rather than focus so much on what they said about what they wanted or craved in some hypothetical future."

—High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society, Dr. Carl Hart

I hate cravings.  I hate how, even after 14 years, certain drug dreams can send me into a total tailspin.  My skin feels wrong, tingling and crawling like all the hairs are sticking up on end. And my back and neck and shoulders tense up.  There’s a real obsessive/compulsive quality and my thoughts start spinning in on themselves, and I can’t focus on anything else.  If there were a well-studied treatment (with established risks and benefits), I would seriously consider it.  I think a lot of what I now experience as drug cravings existed before I ever did any drugs, but at that point, was focused on wanting to cut and hit myself and peel off my skin.  And was probably related to a lot of my drinking and random hook ups my first couple years at college.

But, no, there’s not a one to one relationship between cravings and getting high. (Did the researchers actually believe that? I guess so.)  For me, trying to get heroin was a long game, involving cultivating relationships with people with drug connections, trying to avoid getting lectured and guilt tripped but also trying to avoid being constantly surrounded by drugs, trying to give myself more control over when I used.  So by the time I actually got my hands on the drugs, there was never a simple path between the craving and the high.  And I think, after I first got the idea of doing heroin into my head, there was pretty much never a time when I didn’t want to do it, just times when it seemed like a better or worse idea.

Coke was different because I didn’t like it (and never craved it) but if people offered it for free, I didn’t say no.  And speed was also different, because I started really not liking it (I hated not being able to sleep), but finding it hard to say no when everyone around me was getting high, so that seemed like the situation where I had the least control (though a lot of that had to do with being in a very fucked up living situation, and also the fact that I never stopped liking heroin, so doing it never seemed so paradoxical).  Also, not being able to say no to something that is right in front of you would probably be considered distinct from cravings.