Search This Blog

Tuesday, July 1, 2014

Intoxicants and Mental Clarity

The Fifth Buddhist Precept for lay people, though translated many ways, amounts to: "I refrain from
the use of intoxicants, which cause carelessness." Sometimes the word "heedless" is added, so that we refrain from the heedless use of intoxicants. This effectively changes the precept to mean that we might have a beer, but won't get buzzed. The reason is that substances bring with them a certain level of disinhibition. When a person has a few drinks, they tend to do or say things they otherwise wouldn't. Then there is the issue of the impact of intoxicants on our mind, and our awareness being clouded by the use of substances.

On the surface all of this seems like pretty common sense. In fact, as somebody who primarily experiences alcohol as a sedative I just don't drink much any more. I may have a beer at a wedding reception and I will certainly join in the toast of the bride and groom, but the truth is that for the most part the decision to have more than a drink or two is a decision to go to bed early and I am not very interested in that at my age. From what I gather, a lot of people experience alcohol differently and don't get especially fatigued from social drinking. They can just party all day and all night, and so for them this precept is probably a different issue entirely.

Where I run into conflict over this precept is pain medication. Some argue that pain medication clouds awareness and so should be avoided. That's great as far as it goes, but there are two problems. The first is that simply isn't my experience of pain medication. Of course, people can take too much pain medication and choose to zone out with everything that comes along with it - clouded sensorium, decreased awareness, altered mental states, and spending a lot of time sleeping. That really isn't taking appropriately prescribed pain medication - it's either being over prescribed or taking more than prescribed, or both. While there may be a period of adjustment when started on long acting pain medication, after a week or so the body adjusts and there aren't many, if any, side effects that impact awareness.

The second problem is that pain itself clouds awareness. It impacts concentration, mood, and mobility. Chronic pain often leads to depression, or in people with pre-existing depression it makes it worse. It isn't a matter of being uncomfortable with everything else in life moving along normally, rather it's about a constant struggle to find a position to sit or lay down in which one can be comfortable or get some rest, finding people to help doing the physical things that the patient can no longer do, and a host of other distractions that make awareness of the present moment problematic. Yes, there are meditative practices that help - but in my experience has been that may of them help only as long as one is
experience many of them help only as long as one actively engaged in them. It's great in principle to say that I can do body scan meditations and listen to guided meditations to reduce my pain, but there are still meals to prepare, work to be done, phone calls to make, and errands to run. Sooner or later you have to step away from intensive practice and then the pain returns. In my experience, pain that is out of control is much more disruptive of awareness than appropriately prescribed and taken pain medication. There are plenty of people who have heard some of the abundant horror stories around pain medicine and who have no actual experience with chronic pain and who become self-appointed experts full of rhetoric around pain and medication that simply isn't accurate - but that doesn't stop them from talking as if they were informed.

When it comes to spiritual practice, it's been my experience that poor pain control is one of the biggest barriers to effective practice. I'm aware that obstacles can actually increase the strength of our practice, but when the obstacle is trying to resist blowing your brains out because you just can't take the unrelenting pain any longer the obstacle is no longer an asset. The idea that someone shouldn't take any sort of medication because it is somehow better spiritually to suffer is nothing less than spiritual abuse - and I say that as someone who believes that dealing with unavoidable suffering is a path to great spiritual progress, but the key word is unavoidable. When I hear stories of people dumb enough to go have dental work and refuse Novocaine, which is a local anesthetic and so doesn't impact awareness at all, I have to shake my head in disbelief. Why not just hit yourself in the head with a hammer in the name of awareness and spiritual growth?

Our society tends to create stigma around illnesses and conditions that most people are afraid they might contract one day. They reassure themselves that they won't become pain patients because only weak people become pain patients and only addicts take narcotics, but the numbers of people affected by chronic pain are staggering. We do the same thing around mental illness, sexually transmitted infections, addiction, and even cancer. When it comes to the first four conditions in the last sentence we attribute them to weakness. When cancer is the issue we set out to blame the patient buy speculating about what lifestyle choices they made. The truth is, as the Buddha pointed out, we are of the nature to age, get sick, and die. All of us will eventually face something with which we will need help coping. When spiritual teaching actually gets in the way of quality of life, it's time to reform the teaching.

No comments:

Post a Comment