All Photographs + Text Copyright 2025 Christopher Keeley
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Addiction is a chronic but treatable brain disorder in which people lose the ability to control their need for alcohol or other drugs.
The American Psychiatric Association says that a person is dependent if their pattern of substance use leads to clinically significant impairment or distress shown by three or more of the following in a 12-month period:
1. Tolerance as defined by any of the following:
* a need for markedly increased amounts of the substance to achieve intoxication or desired effect
* markedly diminished effect with continued use of the same amount of the substance
2. Withdrawal, as manifested by either of the following:
* the characteristic withdrawal symptom of the substance
* the same or a closely related substance is taken to relieve or avoid withdrawal symptoms
3. The substance is often taken in larger amounts or over a longer period than was intended (loss of control)
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of control)
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance or recover from its effects (preoccupation)
6. Important social, occupational or recreational activities are given up or reduced because of substance use (continuation despite adverse consequences)
7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (adverse consequences)
* People who are addicted cannot control their need for alcohol or other drugs, even in the face of negative health, social or legal consequences.
* The illness becomes harder to treat and the related health problems, such as organ disease, become worse.
Addiction is a chronic, but treatable, brain disorder. People who are addicted cannot control their need for alcohol or other drugs, even in the face of negative health, social or legal consequences. This lack of control is the result of alcohol- or drug-induced changes in the brain. Those changes, in turn, cause behavior changes.
The brains of addicted people "have been modified by the drug in such a way that absence of the drug makes a signal to their brain that is equivalent to the signal of when you are starving," says National Institute on Drug Abuse Director Dr. Nora Volkow. It is "as if the individual was in a state of deprivation, where taking the drug is indispensable for survival. It's as powerful as that."
Addiction grows more serious over time. Substance use disorders travel along a continuum. This progression can be measured by the amount, frequency and context of a person's substance use. As their illness deepens, addicted people need more alcohol or other drugs; they may use more often, and use in situations they never imagined when they first began to drink or take drugs. The illness becomes harder to treat and the related health problems, such as organ disease, become worse.
"This is not something that develops overnight for any individual," says addiction expert Dr. Kathleen Brady. "Generally there's a series of steps that individuals go through from experimentation and occasional use [to] the actual loss of control of use. And it really is that process that defines addiction."
Symptoms of addiction include tolerance (development of resistance to the effects of alcohol or other drugs over time) and withdrawal, a painful or unpleasant physical response when the substance is withheld. Many people with this illness deny that they are addicted. They often emphasize that they enjoy drinking or taking other drugs.
People recovering from addiction can experience a lack of control and return to their substance use at some point in their recovery process. This faltering, common among people with most chronic disorders, is called relapse. To ordinary people, relapse is one of the most perplexing aspects of addiction. Millions of Americans who want to stop using addictive substances suffer tremendously, and relapses can be quite discouraging.
"It is devastating to me when I don't get [recovery] right," laments Brian, a Portland, Oregon, coffee shop owner who struggles with his cocaine addiction. "Man, I can't even describe it. It's just horrible. The guilt. The depression that comes with it because I screwed up again. It's an indescribable feeling that's just - man, it's low, low, low."
To appreciate the grips of addiction, imagine a person that "wants to stop doing something and they cannot, despite catastrophic consequences," says Dr. Nora Volkow, director of the National Institute on Drug Abuse. "We're not speaking of little consequences. These are catastrophic. And yet they cannot control their behavior."
* People who are addicted cannot control their need for alcohol or other drugs, even in the face of negative health, social or legal consequences.
* The illness becomes harder to treat and the related health problems, such as organ disease, become worse.
Addiction is a chronic, but treatable, brain disorder. People who are addicted cannot control their need for alcohol or other drugs, even in the face of negative health, social or legal consequences. This lack of control is the result of alcohol- or drug-induced changes in the brain. Those changes, in turn, cause behavior changes.
The brains of addicted people "have been modified by the drug in such a way that absence of the drug makes a signal to their brain that is equivalent to the signal of when you are starving," says National Institute on Drug Abuse Director Dr. Nora Volkow. It is "as if the individual was in a state of deprivation, where taking the drug is indispensable for survival. It's as powerful as that."
Addiction grows more serious over time. Substance use disorders travel along a continuum. This progression can be measured by the amount, frequency and context of a person's substance use. As their illness deepens, addicted people need more alcohol or other drugs; they may use more often, and use in situations they never imagined when they first began to drink or take drugs. The illness becomes harder to treat and the related health problems, such as organ disease, become worse.
"This is not something that develops overnight for any individual," says addiction expert Dr. Kathleen Brady. "Generally there's a series of steps that individuals go through from experimentation and occasional use [to] the actual loss of control of use. And it really is that process that defines addiction."
Symptoms of addiction include tolerance (development of resistance to the effects of alcohol or other drugs over time) and withdrawal, a painful or unpleasant physical response when the substance is withheld. Many people with this illness deny that they are addicted. They often emphasize that they enjoy drinking or taking other drugs.
People recovering from addiction can experience a lack of control and return to their substance use at some point in their recovery process. This faltering, common among people with most chronic disorders, is called relapse. To ordinary people, relapse is one of the most perplexing aspects of addiction. Millions of Americans who want to stop using addictive substances suffer tremendously, and relapses can be quite discouraging.
"It is devastating to me when I don't get [recovery] right," laments Brian, a Portland, Oregon, coffee shop owner who struggles with his cocaine addiction. "Man, I can't even describe it. It's just horrible. The guilt. The depression that comes with it because I screwed up again. It's an indescribable feeling that's just - man, it's low, low, low."
To appreciate the grips of addiction, imagine a person that "wants to stop doing something and they cannot, despite catastrophic consequences," says Dr. Nora Volkow, director of the National Institute on Drug Abuse. "We're not speaking of little consequences. These are catastrophic. And yet they cannot control their behavior."
Despite its ubiquity, addiction is often misunderstood. Parents are blamed for a child�s addiction; managed care companies restrict treatment; relapse is seen as a moral failure, rather than a normal stage on the road to recovery from a disease in which the addictive substances themselves distort the brain�s reactions.
1) Like hypertension or diabetes, addiction is a lifelong illness.
2) Biological and behavioral factors influence addiction, as they do other chronic conditions.
3) Addiction can be effectively treated and managed through lifestyle changes
* Medical professionals follow certain criteria to determine if a person abuses alcohol or drugs.
* These established criteria also can mark whether the substance abuse has progressed to dependence.
* Alcohol and drug dependence cause people to suffer from withdrawal symptoms when they stop using the substance. Dependence also causes major behavioral changes, such as overwhelming preoccupation with drug or alcohol use.
Some people who start as casual drinkers or drug users will stay that way. But others will become substance abusers or dependent, feeling that they need a drug to feel alive. The difference between abuse and dependence is not always clear to the general public, but medical professionals use a set of criteria to distinguish between these two categories of problem use.
The essential feature of abuse is a pattern of substance use that causes someone to experience harmful consequences. Clinicians diagnose substance abuse if, in a twelve-month period, a person is in one or more of the following situations related to drug use:
* Failure to meet obligations, such as missing work or school
* Engaging in reckless activities, such as driving while intoxicated
* Encountering legal troubles, such as getting arrested
* Continuing to use despite personal problems, such as a fight with a partner
Dependence is more severe. Medical professionals will look for three or more criteria from a set that includes two physiological factors and five behavioral patterns, again, over a twelve-month period. Tolerance and withdrawal alone are not enough to indicate dependence. And not all behavioral signs occur with every substance.
The physiological factors are:
* Tolerance, in which a person needs more of a drug to achieve intoxication
* Withdrawal, in which they experience mental or physical symptoms after stopping drug use
The behavioral patterns are:
* Being unable to stop once using starts
* Exceeding self-imposed limits
* Curtailing time spent on other activities
* Spending excessive time using or getting drugs
* Taking a drug despite deteriorating health
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Photographic Memories
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Collage DaDa
Art
In the treatment of alcohol abuse, which afflicts about 14 million Americans --
one in every 13 adults. Alcohol abusers are defined as men who have five or more drinks per day
and women who have four or more drinks each day.
Alcoholism is not a homogenous disease, so there is no magic bullet out there to treat it.
There is a biological component and a psychological component and a cultural component and a social component,
and they vary from individual to individual.
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Hillbrow with its corruption and violence, slum landlords, crooked police, strip-joints and night clubs, drug-lords, pimps, brothels and massage parlours, prostitution, sex buyers, and overall decadence have become the burial grounds for our children.
Some of our children died of Wellconal (pinks) OD, others from Heroin or more violently from crack cocaine rocks OD's.
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Many deaths were as the result of continued physical and drug abuse - the girls died of septicemia, thrombosis, heart failure, pneumonia, malnutrition, AIDS. As the victims of sexual perversions many girls were raped, mutilated and murdered. With their miserable lives becoming unbearable -
some of our heartbroken children chose the only way out left for them, they would cop out by committing suicide.
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There is always a need for intoxication:
China has opium, Islam has hashish, the West has woman.
Andre Malraux
(1901-1976)
MAN'S FATE
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White House Conference for a Drug free America - excluding Alcohol and Tobacco
According to federal government studies, 15 million Americans are addicted to alcohol, 12 million to other drugs.
The marketplace presents an ever-changing array of chemicals people can abuse.
Yet alcoholism is and always has been the No. 1 problem people seek treatment for.
In the early 80's, Valium was the second most abused drug, then cocaine surpassed it. Now opiates such as Vicodin, Percoset and OxyContin, usually legally prescribed, are in second place.
Recovery is also about the spirit, about dealing with that hole in the soul.
was born with what I like to call a hole in my soul.. . .A pain that came from the reality that I just wasn't good enough.
That I wasn't deserving enough. That you weren't paying attention to me all the time. That maybe you didn't like me enough.
is true for those who are genetically predisposed. We know from twin and family studies that about 50 percent of a person's vulnerability to addiction is genetic.
millions of addicts around the world have recovered without the help of medication.
the fact is that today 12-step treatment is still the best treatment there is
Ecstasy, popular among teenagers and young adults who attend rave parties, leads to the destruction of neurons in the brain.
Repeated users of the drug develop symptoms resembling those of Parkinson's and Alzheimer's diseases
- art that gets printed on LSD tabs.
This site showcases blotter art of everything from album covers to cartoon characters. Even Alice in Wonderland has her own tab.
Addiction is one of the nation's biggest public health problems, costing $524 billion (including lost wages and costs to the public health care and criminal justice systems) each year.
The majority of the estimated 20 million alcoholics and drug addicts in America (and millions more compulsive gamblers, overeaters and sex addicts,
if you accept an expanded understanding of addiction) never get help.
Those who do often relapse repeatedly, sometimes returning to treatment centers 5, 10 or 15 times (if they don't die first).
And many of those who"recover simply trade one addiction for another addicts call this dance switching seats on the Titanic.
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The brownish gum that bleeds out of a poppy plant is raw opium.
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Fire Barrel
About 60,000 District residents, or 12 percent of the population, have a substance abuse problem, according to the D.C. Addiction Prevention and Recovery Administration. Partly as a result, police say, liquor stores, food carryouts and gas stations stock items used in the illegal drug trade, including tiny rose vases that double as crack pipes, rolling papers used to smoke marijuana and small plastic bags used to package drugs.
And signs of progress are popping up. Next to the cooler of Wild Irish Rose and Thunderbird malt liquors at King's Mini Market in Anacostia, for instance, is a sign alerting patrons that the store no longer sells crack pipes and rolling papers.
dealers peddling heroin that they were calling "drop dead," "lethal injection," and "killer instinct" spread,
Like the regulars at Harry Hope's saloon in The Iceman Cometh, she'd reached the late stage of alcoholism where no matter how much she drank, she couldn't get drunk anymore.
addiction whether to alcohol, to drugs or even to behaviors like gambling appears to be a complicated disorder affecting brain processes
responsible for motivation, decision making, pleasure seeking,
inhibitory control and the way we learn and consolidate information and experiences.
the Fentanyl that has killed more than 60 heroin users in the Chicago area.
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Copyright Columbia Pictures, Easy Rider had an enromous influence on an
juvenile delinquent addict dreaming of growing up becoming an outlaw.
you're told that addiction is a disease that wants you dead, and it will go after you unless you use the tools you learn in the program
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Ed says - my mother's on Methadone, my father is incarcerated in prison, I graduated from highschool and I grew up in a barn without electric and water.
Ed's left index finger has Gangrene because he hit an artery while injecting Heroin into his arm.
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Dont Shoot Dope
OxyContin is a synthetic, time-released pill similar to morphine, and its benefits have been widely praised by terminal cancer patients and others with severe and intractable pain.
But the pills contain large amounts of the pure drug oxycodone, which abusers seek for its heroin-like high. They crush the pills and then snort or inject them.
Abuse of OxyContin has sparked what some authorities call an epidemic in several Appalachian states over the past few years, and the associated addictions and crime have migrated to suburban and urban areas.
OxyContin is a long-lasting version of oxycodone, a narcotic considered important therapy for many patients suffering chronic, moderate to severe pain from illnesses such as cancer. The tablet, when swallowed whole, provides 12 hours of relief.
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No Job Heroin Nod
But the drug can produce a quick and potentially lethal high if it is chewed, snorted or injected. It has been linked to more than 100 deaths and bears the government's strongest warning label, which says the drug may be as addictive as morphine.
PCP, the full name of which is phencyclidine, can produce hours of a frenzied high. The drug has unpredictable effects, and people under its influence have been known to behave erratically, from stripping off their clothing to killing with little or no provocation.
The drug PCP was popular in the District in the 1970s and '80s, when it was known as Love Boat or Buck Naked,
because many of its users shed their clothes while high. But the drug's popularity in Washington faded as crack cocaine took over.
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Signs and symptoms of drugging
Is something wrong?
Look out for the signs and symptoms of substance abuse:
Disinterest in previously important activities
Change in appetite and eating patterns
Withdrawal from family
Secretiveness about friends, lying
Lack of motivation
New friends
Needing abnormal amounts of money, stealing
Drug paraphernalia
Lack of energy, drop in attention span
Changes in values and beliefs
Period of unexplained absence from home
Deterioration in school marks
Short term memory loss
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Juvenile Delinquency
Jay, Robbie and Chris rolling a Joint of Ugandian Bhangi
1973 on the roof of the Narobi Hilton in Kenya.
Chris got clean ten years later. Robbie and Jay are most likely dead or rotting in a jail somewhere.
For their children, smoking marijuana is not a harmless rite of passage but rather a dangerous game of Russian roulette.
the number of children and teenagers in treatment for marijuana dependence and abuse has jumped 142 percent since 1992,
and the number of teen emergency room admissions in which marijuana is implicated is up almost 50 percent since 1999.
Though alcohol remains by far the teen substance of choice, teens are three times likelier to be in treatment for marijuana than for alcohol
(and six times likelier to be in treatment for marijuana than for all other illegal drugs combined).
As has been true of tobacco since the 1960s, we've learned a lot about the dangers of marijuana since the 1970s.
The drug adversely affects short-term memory, the ability to concentrate and motor skills.
Recent studies indicate that it increases the likelihood of depression, schizophrenia and other serious mental health problems.
Nora Volkow, director of the National Institute on Drug Abuse, has repeatedly expressed concern about the adverse impact of marijuana on the brain,
a matter of particular moment for youngsters whose brains are still in the development stage.
Volkow has stated: There is no question marijuana can be addictive; that argument is over.
The most important thing right now is to understand the vulnerability of young, developing brains to these increased concentrations of cannabis.
Psilocybin, the active ingredient of "magic mushrooms," expands the mind. After a thousand years of use, that's now scientifically official.
The chemical promoted a mystical experience in two-thirds of people who took it for the first time, according to a new study.
One-third rated a session with psilocybin as the "single most spiritually significant" experience of their lives. Another third put it in the top five.
It confirms what both shamans and hippies have long said -- taking psilocybin is a scary, reality-bending and occasionally life-changing experience.
Of the 36 people, 22 had a "complete" mystical experience as judged by several question-based scales used for rating such experiences.
Two-thirds judged it to be among their top five life experiences, equal to the birth of a first child or death of a parent.
Two months after a session, the people who had taken psilocybin reported small but significant positive changes in behavior and attitudes compared with those who had taken Ritalin.
There is no single known cause of alcoholism, but the researchers wrote that about two-thirds of alcohol dependence could be attributed to genetic factors and one-third to environmental causes like stress or emotional problems. Men and women are equally affected, and age does not appear to affect prognosis.
Crack users and heroin users are so disorganized and get in these frantic binges, they're not going to sit still and do anything in an organized way for very long,
Dr. Rawson said.
Meth users, on the other hand, that's all they have, is time.
The drug stimulates the part of the brain that perseverates on things. So you get people perseverating on things, and if you sit down at a computer terminal you can go for hours and hours.
For example, crack cocaine or heroin dealers usually set up in well-defined urban strips run by armed gangs,
which stimulates gun traffic and crimes that are suited to densely populated neighborhoods,
including mugging, prostitution, carjacking and robbery.
Because cocaine creates a rapid craving for more, addicts commit crimes that pay off instantly, even at high risk.
Methamphetamine, by contrast, can be manufactured in small laboratories that move about suburban or rural areas,
where addicts are more likely to steal mail from unlocked boxes.
Small manufacturers, in turn, use stolen identities to buy ingredients or pay rent without arousing suspicion.
And because the drug has a long high, addicts have patience and energy for crimes that take several steps to pay off.
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The overdoses took place in Minnesota, Texas and Florida and were blamed on 1,4-butanediol, which turns to GHB in the body.
Butanediol is used as an industrial solvent and is also included in supplements sold under names such as Thunder Nectar, InnerG and Zen.
Butanediol can cause dizziness, seizures and coma, and can slow breathing to dangerous levels. It can intensify alcohol's effects and is also said to be more dangerous when taken with other depressant drugs.
GHB, or gamma hydroxybutyrate, is sometimes used at all-night rave parties. It is known as a date rape drug for its ability to incapacitate people and leave them vulnerable to sexual assault.
is pleased to provide this on-line resource for locating drug and alcohol abuse treatment programs. The Substance Abuse Treatment Facility Locator lists:
1-800-662-HELP
1-800-662-9832 (Espanol)
1-800-228-0427 (TDD)
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How a Prisoner of the War on Drugs Painted His Way to Freedom
A powerful memoir of one man's struggle for freedom,
15 to Life tells in vivid prose the story of Anthony Papa, a painter and a casualty of the War on Drugs.
is a photojournalist specializing in
street photography, criminals, prisons, gangs, prostitutes & boxing.
including buzzing/ringing/whistling sounds at the
beginning, travel through a dark tunnel into light at
high speed, the conviction that one is dead,
'telepathic communion with God', intense visions, life
reviews, out-of-body experiences, mystical states and
transpersonal phenomena. Thus ketamine can release the
Bardo Body from its Earthly mooring, to transcend the
limits of time and space as described in The Tibetan
Book of the Dead.
In both a near-death experience and a ketamine
experience, there may be analgesia (inability to feel
pain), apparent clarity of thought, a perception of
separation from the body (an out-of -body experience),
visions of landscapes, beings such as 'angels',
'beings of light', people including partners, parents,
teachers and friends (who may be alive at the time),
and religous and mythical figures. There may be
interaction with these figures, who are sometimes
(although not always) perceived as helpful. Euphoria
is common.
Speedlore and Methology: Part II
The American Speedfreak is a lost soul. We know how to have fun between the first ether gasp and locking ourselves in the closet. A twisted wisdom creeps into those of us who manage to survive, a sort of collective unconsciousness, an unspoken Crankster ideology:
It's time to get some sleep when:
You're out of crank
Your face is bouncing off the table
Your veins have completely disappeared beneath pasty goose flesh
Your shoes don't fit anymore
24 simultaneous projects have stalled for lack of floor space suddenly
everyone is a cop
You've just set yourself on fire, again
You're nodding out...
into glassware
15 minutes after shooting a 1/4g
at stoplights
in mid-sentence
in mid-shot
in mid-fuck
(Speed Phreak)
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Methamphetamine -- a powerful stimulant that impairs the central nervous system -- is the latest drug scourge to capture the nation's attention.
Known as the poor man's cocaine because of its cheap price and lengthy high, meth has long been a drug of choice among low-income addicts. But what used be an isolated problem in pockets of the West and in rural areas has become a top priority for law enforcement officials across the Southwest and Midwest, where meth production and use has moved from biker gangs to mainstream.
According to a 2002 National Survey on Drug Use and Health report, 12.4 million Americans ages 12 and older had tried methamphetamine at least once, with most users between 18 and 34. Last year, more than 3,000 children were rescued during seizures of more than 15,000 meth labs nationwide, according to the federal Office of National Drug Control Policy.
Teenagers intentionally inhale the vapors of common household products such as hair spray, shoe polish and glue each year.
The health effects can include brain and neural damage, convulsions, deafness, impaired vision, depressed motor skills and death. The social effects, surveys show, include behavioral problems, other drug use and delinquent behavior.
Inhalants commonly sniffed, or "huffed," by children as young as 8 include gasoline and lighter fluid, spray paints, cleaning fluids, paint thinners and other solvents, degreasers, correction fluids, hair sprays and odorizers.
Slang term for a way of smoking heroin, which usually involves placing
powdered heroin on foil and heating it from below with a lighter.
The heroin turns to a sticky liquid and wriggles around like a Chinese dragon, hence the name. Fumes are given off and are inhaled, sometimes thorough a rolled up newspaper, magazine or tube.
Tonight when I chase the dragon / The water will change to cherry wine / And the silver will turn to gold - Time Out Of Mind
Addiction Treatment Forum
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There is no test for schizophrenia,
and doctors make a diagnosis based on symptoms.
Here is a list of some of the early warning signs of schizophrenia
- Hearing or seeing something that isn't there.
- Constant feeling of being watched.
- Peculiar or nonsensical way of speaking or writing.
- Feeling of indifference about important situations.
- Deterioration of academic or work performance.
- Changes in personal hygiene and appearance.
- Personality changes.
- Increasing withdrawal from social situations.
- Irrational, angry or fearful response to loved ones.
- Inability to sleep or concentrate.
- Inappropriate or bizarre behavior.
- Extreme preoccupation with religion or the occult.
The first step in preventing suicide is to identify and understand the risk factors. A risk factor is anything that increases the likelihood that persons will harm themselves.
However, risk factors are not necessarily causes. Research has identified the following risk factors for suicide (DHHS 1999):
* Previous suicide attempt(s)
* History of mental disorders, particularly depression
* History of alcohol and substance abuse
* Family history of suicide
* Family history of child maltreatment
* Feelings of hopelessness
* Impulsive or aggressive tendencies
* Barriers to accessing mental health treatment
* Loss (relational, social, work, or financial)
* Physical illness
* Easy access to lethal methods
* Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or suicidal thoughts
* Cultural and religious beliefs for instance, the belief that suicide is a noble resolution of a personal dilemma
* Local epidemics of suicide
* Isolation, a feeling of being cut off from other people
STREET SLANG
Hillbrow with its corruption and violence, slum landlords, crooked police, strip-joints and night clubs, drug-lords, pimps, brothels and massage parlours, prostitution, sex buyers,
and overall decadence have become the burial grounds for our children. Some of our children died of Welconal (pinks) OD,
others from heroine or more violently from crack cocaine (rocks) OD's.
Many deaths were as the result of continued physical and drug abuse - the girls died of septicaemia, thrombosis, heart failure, pneumonia, malnutrition, Aids, etc.
As the victims of sexual perversions many girls were raped, mutilated and murdered. With their miserable lives becoming unbearable - some of our heartbroken children chose the only way out left for them -
they would cop-out by committing suicide.Both Welconol and Mandrax have been widely abused in the sex work community.
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