The World According to Vice. Vice Magazine

orange American cheese. I might actually vomit. Sam has a healthy appetite. In the past I have seen him eat a whole chicken down to the skeleton, but on rimonabant he picks at his omelette for a few minutes before loudly protesting, “If someone does not get this omelette away from me I’m going to vomit… I’m going to fucking vomit and then I’m going to die!”

      I am the least high person in the universe. Photo by Maggie Lee

      We leave the diner and anxiously walk down St Mark’s. I stop inside a bong store and touch my fingers to the glass like a peasant outside a department store on Christmas. I have never felt so un-high in my life. I must admit that my thinking is unusually clear and I could see a lower dose of rimonabant being helpful when studying for a test—well, it could if it didn’t make me feel like I was about to simultaneously cry, puke, and have a seizure. The fact that this is a widely prescribed drug is unbelievable. The idea of taking this daily is insane. It would be less than a week before I killed someone.

      In the late afternoon I try smoking some weed. I take a deep hit, feel a transient sensation of threshold stonededness, and then whatever it was passes in less than five minutes. Sam is not willing to let the rimonabant win, and throughout the day he continuously attempts to get high, taking hit after hit after hit from an aluminium cigarette. Around midnight, I hear him take a deep toke, sigh, and scream, “Damn it!”

      ANTI-LSD: RISPERIDONE DOSE: 4 MG

      Psychedelics like LSD were used in many early models of psychosis. Even today, the majority of scientific literature refers to psychedelic drugs as “psychotomimetics”, meaning drugs that mimic psychosis. Much psychedelic research has to be done under the guise of studying schizophrenia or related disorders. There is obviously a difference between schizophrenia and tripping on LSD, but the idea is that if drugs could be developed that did the opposite of LSD, they would be effective treatments for psychotic disorders. Antipsychotic drugs work by blocking the stimulation of dopamine and serotonin receptors, which are targeted by practically every enjoyable drug in the world from methamphetamine to cocaine to LSD. When the serotonin and dopamine receptors are blocked it effectively turns you into a zombie. Maybe you know a girl who takes Seroquel or you took it yourself once. It’s not fun. Just keeping your eyes open is an enormous struggle. Although, if you’re a paranoid schizophrenic, antipsychotics can chemically dull you enough to keep you from acting on violent impulses. They are also useful for aborting a “bad trip”, and unlike Xanax or Valium, which only calm you down but don’t actually stop you from tripping, antipsychotics stop the trip dead in its tracks.

       At the Chinatown needle exchange, where I am apparently a regular. Photo by Jess Williamson

      Before getting out of bed I take 4 mg of risperidone, a dose high enough to make a 300-pound homicidal maniac slumber peacefully. I get up and go out to get some vegetable juice. I walk down to the East River and look out across the water. After ten minutes I’m starting to feel sedated. I lie down in the grass. It starts to rain so I get up again; this time my entire body feels leaden. I have to think about picking up each leg as I walk. Pick up leg. I’m getting really wet and I don’t know if I will make it home. Pick up leg. A cop car drives by and slows down as it passes me. I feel painfully awkward because I know that I’m walking in slow motion through the rain without an umbrella, but I can’t move any faster. The cop car speeds off.

      Pick up leg. I’m a pharmaceutical masochist. Curiosity—the things you’ve made me do! I’m the least high person on the planet. In the history of humans no one has been less high than me. I take a Ritalin and it does nothing; I might as well have dropped it down the sewer. Pick up leg. A ten-year-old on Grand Street says that I’m “walking like a fag”, to which I respond, “What’s up.” I stumble into my apartment building and crawl up the stairs. I crawl to my door, crawl inside, and pass out on the floor into the deepest, blackest, most deathlike sleep I have ever experienced. I wake up eight hours later feeling like I just had a successful lobotomy.

      ANTI-HEROIN: NALTREXONE DOSE: 200 MG

      There are drugs called opioid antagonists, which do the opposite of recreational opioids like heroin. When paramedics treat heroin overdoses, they inject an opioid antagonist called naloxone into the body. On a molecular level, naloxone races into your brain, jumps ahead of the heroin molecules occupying your opioid receptors, and pushes them aside. Once the naloxone molecules are in place, the heroin can no longer suppress your breathing and the overdosee rapidly regains consciousness. Naloxone has saved countless lives.

      Researchers realised they could use a similar opioid antagonist called naltrexone to stop junkies from feeling the effects of heroin. A device was developed that is surgically implanted under the skin and releases a continuous supply of naltrexone into the body for several months at a time. Although some addicts have benefited from naltrexone implants, the results are usually disastrous. When you give a junkie naltrexone it not only prevents them from feeling heroin, it causes them to go into instantaneous accelerated withdrawal, exponentially worse than natural opiate withdrawal. Some people have killed themselves to escape the pain after getting naltrexone implants; others perform home surgery and cut the implants out of their body.

      In the same way that rimonabant blocks endocannabinoids, naltrexone blocks natural opioids called endorphins. Endorphins are pleasure chemicals commonly associated with sex and exercise, but more importantly they are regulatory factors in our daily mood and immune function. Even if you’re not a junkie, taking an opioid antagonist has a profound effect on your neurochemistry. For that reason, naltrexone has been shown to be an effective treatment for paedophilia and kleptomania. The natural opioid release from acting on these compulsions is blocked, so fondling a child or stealing an iPod loses its euphoric rush.

      I decide to take a dose of naltrexone four times higher than the daily dose used to treat opioid dependence. After taking the pills, I get on the train to Manhattan. I’m sort of giddy. I can’t quite describe the feeling but it’s not necessarily bad. The best anti-high thus far. I get off at Canal Street and I’m filled with tension amid all the shouting, sweaty, glistening tourists. At the same time I have this strange sensory enhancement that is not totally unpleasant. Vaguely erotic. I can feel each and every hair on my scrotum moving as I walk. Since I went to the bong store on rimonabant, I think it would only be appropriate for me to go to the needle exchange today. I walk inside and I’m immediately depressed and confused by my decision. As I’m filling out forms to get my needles, the woman looks at me and says my name is already in the computer—what? This twilight-zone moment makes me incredibly tense and paranoid. Why am I in the computer at the needle exchange? Why am I at the needle exchange? Why am I on naltrexone? I walk outside holding a paper bag full of needles and bleach and feel like I’m about to cry.

      I’m totally absorbed in frantic and confused thoughts. I wish I understood addiction. I have read so many books, known so many addicts, but nothing makes sense to me. I don’t want to say addiction is a disease, because diseases are excuses. Diseases are permission slips for being sick. If I’m addicted to Valium, that’s a conscious choice I make each time I swallow a Valium tablet. But how can I say that? I feel guilty. I’m so confused. Thomas Szasz said, “If the desire to read Ulysses cannot be cured with an anti-Ulysses pill, then neither can the desire to use alcohol, heroin, or any other drug or food be cured by counterdrugs.” But is he right? My trance is broken when someone offers me a flyer for “mad mojitos”.

      I get on the train to Union Square and find myself spontaneously breaking into song, then running full speed until I lose my breath. After running, my body is assaulted with sharp aches and pains. Is this what it feels like to be old? I almost step on a sparrow pecking at a muffin crumb and scream at the top of my lungs. Wow, am I on edge! When you meet new people, instead of shaking hands, both parties should scream at the top of their lungs. That would be the custom in a naltrexone alternate universe. As the day wears on, my muscles