If it weren't for drugs and alcohol, I might be out of a job.
I work as an emergency psychiatrist at San Francisco General Hospital.
Two out of three patients arriving in psych emergency suffer from a wicked drug or alcohol problem. In order of mayhem induced, the list reads like this: methamphetamines, PCP, cocaine, alcohol, hallucinogens, Ecstasy, heroin, cigarettes, and, last but not least, marijuana.
The most "in-your-face" are the speeders, of course. These aren't your run-of-the-mill giggly runny-nose tweakers, but the slammers, those who jam a needle packed with solubilized crystal methamphetamine into their veins. Lots of these folks go over the brink, becoming manic and psychotic. Meth is a brain destroyer.
PCP is called "angel dust." Nuff said, I hope.
Crack cocaine still makes people paranoid, twitchy, and restless and is a favorite of folks who take methadone-a little something to cut through the cerebral fog. While crack is particularly hard on your heart, it's not so great for your brain, either.
Alcohol. What can you say? Cheap, legal, eminently available. High-octane malt liquors. Fortified wines. Rotgut vodka. Gnarly depressants, one and all. A little crying in your beer (or cheap vodka) can turn into suicidal thoughts pretty quickly.
LSD, ‘shrooms, mescaline, peyote, and a veritable alphabet soup of designer drugs, these substances might transiently enlighten you, but ultimately they also rearrange your brain chemistry if you do them hard enough and long enough.
Ecstasy, in its effects, makes for a combination of speed and hallucinogen. Not surprisingly, it's also bad for your noodle. The only reason it's this low on the list is that most ravers can handle their drugs.
It's kickin' heroin that makes a person super-cranky and sick. The drug itself plows most people under and makes them snooze.
Cigarettes? Yeah, cigarettes can exacerbate psychiatric emergencies when someone who is bipolar and/or schizophrenic and/or high on one or more of the above substances is in the midst of a "niccie" fit and tries to AWOL out of the non-smoking zone.
Weed mostly chills people out. When it's dusted with something else that's problematic. But don't blame the cannabis.
So, in other words, if one removed drugs and alcohol from society, the incidence of behavioral emergencies would plummet.
Out of a job, really? Probably not since I've been working in psych emergency for nearly 20 years and seniority does count for something. At least for now.
For more information about club drugs and methamphetamine use in the gay community, respectively, check out www.dancesafe.org and www.tweaker.org.
Copyright Paul R. Linde, M.D.
