DURHAM, N.C. -- You won't find a giraffe swaying to the
melody of Frank Sinatra, nor will a beautiful sunset inspire a
hamster to romance his cage mate. That's because scientists say
the ability to derive pleasure from the world and oneself is a
uniquely human characteristic -- one so ethereal that
describing the pleasure at hand fails to evoke the same delight
in the listener.

Just try going through life without being able to experience
beauty and pleasure first-hand and you'll get a glimpse of what
life can be like for many a drug addict, says Dr. Roy Mathew,
director of the Duke Alcoholism and Addictions Program. Many
former addicts describe themselves to Mathew as having been
incomplete, lacking in a fundamental quality they knew could
make them feel whole. Drugs, they say, replaced the pleasure
they failed to derive from life -- if only temporarily.

It is Mathew's goal to teach addicts how to experience real
pleasure in life, the kind that imparts sustained, long-term
fulfillment: the giddiness of new love, the warmth of cuddling
your baby, the satisfaction of a job well done.

Without that ability, he says, even the high of heroin or
cocaine cannot impart the sense of spiritual fulfillment one
derives from truly satisfying experiences.

"Addicts don't find long-term happiness in drugs," Mathew
says. "Addiction is often the only pleasure they've known. But
once you have experienced real pleasure, the lesser pleasures
derived from drugs lose their appeal."

It's an approach long embraced by recovery groups like
Alcoholics Anonymous, where spiritual pursuits are encouraged
as a way to replace the artificial and fleeting euphoria of
drugs. And while he applauds its merits, Mathew is not content
to dispense spirituality without understanding the mechanisms
that underlie its therapeutic effects.

Drug Research Provides Clues

Finding answers is more of a journey than a destination, he
admits. But along the way, he has gained some valuable insights
into how the brain works. By imaging the brain as it responds
to various experiences and chemicals, Mathew has found that
drugs like marijuana stimulate the very same pleasure centers
in the brain that are stimulated by spiritual experiences, such
as beautiful music or scenery.

Marijuana, for example, increases blood flow in a brain
region called the anterior cingulate, where emotions are turned
into conscious thought. It is in this region where feelings of
altered consciousness and dissociaton arise – experiences
common to both drug users and those who experience a spiritual
epiphany. In the cerebellum, marijuana acts to alter perception
of time and space. Such advances are admittedly incremental,
but Mathew is hoping they'll eventually shed light on a field
whose only hard data is that which the drug user describes.

"Knowing where the pleasure centers are, and how to invoke
them to respond, could give us the answers we need to
understand their craving for drugs," Mathew says.

It is far more complex than targeting a faulty gene or
neurotransmitter, he believes. Genes are only part of the human
equation, in which biochemical and behavioral elements converge
to create the unique perception of self. When the self is
incomplete -- as so many addicts describe -- you can't make it
whole by giving quick-fix remedies, Mathew says.

For example, giving methadone to a heroin addict inhibits
the user's craving for that particular drug but fails to
address his inherent need for pleasure and fulfillment. With
nothing to replace the addict's thirst for pleasure, the person
is likely to continue seeking socially inappropriate means of
pleasure, whether through drugs, gambling, sexual promiscuity
or other behaviors.

Drugs Without Addiction

But what about the individual who uses drugs to enhance an
already pleasurable state without succumbing to destructive
behaviors associated with addiction? Such is one of the many
questions that plague Mathew about the brain's response to
drugs and how the brain experiences the pleasure sensation.

"Fifty percent of drug users do so because they have a
mental disorder like anxiety or depression. The other 50
percent use them because they simply like to – because it feels
good," Mathew says. "Does that mean their baseline personality
is deficient in some way? Or does it mean that person is
unusually inquisitive about other mood states? In other words,
if an important part of life is feeling good, what's wrong with
using a drug that enhances that feeling?"

Mathew theorizes the difference may be in the user's ability
to evoke a spiritual response from within, independent of drug
use. Even though a starlit sky can bring about a spiritual
sense of awe and wonder, the brain should be able to experience
pleasure independent of external cues, independent of the five
senses and the information they bring.

Mathew points to the many cultures around the world that,
for centuries, have used drugs to enhance spiritual or
religious ceremonies, yet in that context, drug use is
considered a spiritual aid rather than a spiritual crutch.

The dichotomy that such varying perspectives on drug use
present are fueling Mathew's search to define pleasure and
impart its therapeutic effects in a holistic setting.