A Famous Case of Spontaneous Recovery
A Famous Case of Spontaneous Recovery
Hidden in Oliver Sacks’ fascinating recent book, Hallucinations, is a surprising tale of recovery. If you aren’t paying attention you may not notice it, since the language typically used to describe such experiences is scrupulously avoided. That’s why stories like his—which are actually far more common than recoveries that involve rehabs or 12-step groups—often go unrecognized. But they are critically important if we want to truly understand addiction.
For those unfamiliar with him, Sacks is America’s neurologist, best known as the brilliant doctor portrayed by Robin Williams in the film version of his book, Awakenings. That book told the story of patients with a now-rare form of Parkinson’s disease. They were “frozen” in their bodies following a bout of encephalitis, often unable to move or to stop involuntary motions, until a drug Sacks was testing briefly freed them. For many, the drug’s side effects, sadly, soon proved worse than the illness. Sacks’ meditations on his patients’ experiences and what can be learned from people with brain diseases that affect the self and the will paved the way for many of today’s most popular writers on neuroscience.
His empathy for people suffering perturbations of the brain and nervous system is hard won.
Some of Sacks experiences of drugs certainly sound like they could end up in an NA qualification. Since hallucination—not addiction or drugs—is the main focus of the book, however, these are treated as asides rather than the main event they would be in your typical addiction memoir.
Take a visit he had with a psychoanalyst friend of his parents, who went to see him while he was doing his medical residency in California. She apparently had learned a bit about his regular use of marijuana and psychedelic drugs and said, “You need help, Oliver. You’re in trouble.” But his dismissal of this concern as “nonsense” was not later reframed as denial, even though he subsequently had a hallucinatory incident in which he mistook her for an imposter who had for some inexplicable reason posed as his family friend.
Sacks goes on to describe the summer of 1965, when he had a break between the end of his residency and the start of a brain research fellowship in New York:
“It was during this idle, mischievous time that I descended deeper into drug taking, no longer confining it to weekends. I tried intravenous injection, which I had never done before."
After starting the fellowship, he found it a bad fit for his skills:
“Depressed and insomniac, I was taking ever increasing amounts of chloral hydrate [a sedative] to get to sleep and was up to 15 times the usual dose every night.”
When he ran out, he found his hand shaking as he tried to cut a brain slice for an experiment. Leaving the lab to get coffee, he began hallucinating. It was only when he called a doctor friend that he realized that he was suffering from withdrawal: as with alcohol, abrupt cessation of chloral hydrate can produce delirium tremens, or the DTs. He hallucinated for 96 hours, getting medical support from the friend. But undeterred from drug use after this experience, he then began taking high doses of amphetamine every weekend.
If you are used to 12-step qualifications, you probably expect what came next to be a “bottom,” followed by an admission of addiction. Except Sacks’ drug story ends quite differently. One day, he had an intense experience while high on amphetamine that inspired him to write a book:
“On every previous occasion, when I had come down after two days of amphetamine-induced mania, I had experienced a severe reaction in the other direction, feeling an almost narcoleptic sense of drowsiness and depression. I would also have an acute sense of folly, thinking that I’d endangered my life for nothing—amphetamines in the large doses I took would give me a sustained pulse rate close to 200 and a blood pressure of I know not what; several people I knew had died from overdoses of amphetamines.”
Fortunately, however, this time was different:
“I retained a sense of illumination and insight…. Bit by bit, I started to write my own book. The joy I got from doing this was real—infinitely more substantial than the vapid mania of amphetamines—and I never took amphetamines again.”
In Sacks’ case, most of us know the rest of his story: he goes on to become a leading neurologist, bestselling author and New Yorker writer, though his fame comes long after the publication inspired by that experience, which was a book called Migraine, dealing with the hallucinations and other strange phenomena associated with the dreaded headaches.
Was Sacks an addict? By his own account, he likely would have met enough DSM criteria to be diagnosed, displaying tolerance, withdrawal and compulsive use of drugs despite negative consequences. And yet the neurologist and author never defined himself this way. When I interviewed him for Time in 2010, I asked him directly, and he replied, regarding his amphetamine use, “Well, it certainly became a habit.”
Is his story unique? Hardly—although the successful book-writing aspect is definitely rare. At least 60% of people who would qualify for an addiction diagnosis at some point in time never seek treatment, and most resolve the problem without total abstinence.
For example, a major study of some 43,000 Americans examined whether people had had a lifetime diagnosis of substance dependence or were actively addicted in the past year. 7.7% had at one time in life qualified for a drug addiction diagnosis, but only 1.4% were currently addicted. And only 38% had ever been treated (the definition of treatment included attending NA or other self-help groups). For alcohol, 12.5% of this group had at one time met full criteria for alcoholism, but only 3.8% were currently dependent. 76% had never attended AA or received any type of treatment.