I’m still collecting thoughts and making memes for the Post-Vasectomy Thoughts post, so let’s switch topics for a minute until that’s finished. They’re somewhat related in the end.
Yes, I willingly started vaping nicotine, an addictive substance. Lots of people vape or smoke, so who cares that I started? I’ve made my peace with it, but I have so many thoughts circulating in my skull from addiction “education” in grade school, and the vasectomy kicked up lots of emotions around my childhood and overall health, so I wanted to offload them somewhere and clear up my head. I’m attempting to use responsibly. My family doc and allergist know about it, and I have an inhaler with a steroid and bronchodilator. Seems fine so far.
There’s certainly a foolishness in thinking I can wield this harmful and insidious substance. By subjecting my throat with highly energized matter in a gaseous state and coating my lungs with a waxy oil, the act of vaping decreases the lungs’ ability to fight off infection during a time when aerosol- and airborne-transmitted respiratory viruses abound. Using a high concentration sends me to the toilet. It’s too soon to tell what the long-term health effects of vaping are, even though it hit the scene in 2003. Rather than inhaling 7000 well-studied chemicals from cigarettes, I’m breathing in three less-studied ones. However, after about 10 years of imbibing, I’ve reached a point where I barely touch alcohol at all these days, even on nights out with friends. I’m not entirely sober, but whereas I used to have up to 15 drinks in a night and going out every weekend, I average maybe three drinks a month now.
What’s the upside? My anxiety is lower, I practice deep breathing, I take more breaks from various forms of work. Sounds great, right?!
The operative analogy in my head at the moment is a garden hose leaking. I have all this emotional pain stored inside me that wants to get out, but it’s coming out faster than I can manage. A person could spend their energies trying to plug up the outlet with fixtures and they could also turn off the valve upstream, but it’s easier said than done.
Miseducation About Addiction
What we grew up knowing about addiction was that it was simply a matter of choice. Campaigns like D.A.R.E and Nancy Reagan's “Just Say No” only reinforced that concept, which were good vanity projects but woefully inadequate for the audacious goal of understanding and stemming a public health crisis. If you engaged in your addictive behaviours, it was only because you wanted to. Anyone who didn’t want to stop chose not to, and as such, all energies were focused on changing their minds using facts and logic. Motivation took the form of appealing to their decision-making, using such effective techniques as guilt, shame, and brute force. Many would grow up confused when “just saying no” wasn’t enough to end their dependence on a substance. Free will is certainly one absolutely necessary tool in breaking the cycle of addiction, but what we know now about how trauma and Adverse Childhood Experiences™ affect health outcomes and substance use opens up treatment options that are more effective and efficient, without bashing people over the head with a social hammer.
Adverse Childhood Experiences
Trigger warning for those with severe anxiety or PTSD, there are mentions of various forms of abuse. For everyone else, it's just...depressing.
There’s a great TED Talk on Adverse Childhood Experiences as a primer on the concept. Here are some excerpts from the Wikipedia article:
Adverse childhood experiences (ACEs) encompass various forms of physical and emotional abuse, neglect, and household dysfunction experienced in childhood. The harms of ACEs can be long-lasting, affecting people even in their adulthood. ACEs have been linked to premature death as well as to various health conditions, including those of mental disorders. Toxic stress linked to child abuse is related to a number of neurological changes in the structure of the brain and its function.
The concept of adverse childhood experiences refers to various traumatic events or circumstances affecting children before the age of 18 and causing mental or physical harm. There are 10 types of ACEs:
physical abuse
sexual abuse
psychological abuse
physical neglect
psychological neglect
witnessing domestic abuse
having a close family member who misused drugs or alcohol
having a close family member with mental health problems
having a close family member who served time in prison
parental separation or divorce on account of relationship breakdown.
The different adverse childhood experiences are not isolated and in many cases multiple ACEs impact someone at the same time.
A study in the USA based on a large sample of people showed that more than half of the people have had at least one ACE and 20% experienced three or more ACEs. In England around half of the population have experienced one or more ACEs.
Adverse childhood experiences have a dose–response relationship with many health problems. As researchers followed participants over time, they discovered that a person's cumulative ACEs score has a strong, graded relationship to numerous health, social, and behavioral problems throughout their lifespan, including substance use disorders.
The World Health Organization administers one of the surveys. Mind you, I've never actually taken the ACEs questionnaire, which seems easy enough to do on your own and grade, but just reading through it is upsetting by itself, partly from recalling my own experiences but also from imagining what others had to endure. Thus I don't have my ACEs score, although I have a hunch it's not low. Let’s look at some of the questions:
1.4 At the time of your first marriage if you did not choose your husband/wife yourself, did you give your consent to the choice?
2.2 Did your parents/guardians really know what you were doing with your free time when you were not at school or work?
4.2 Did you live with a household member who was depressed, mentally ill or suicidal?
4.6 Did you see or hear a parent or household member in your home being yelled at, screamed at, sworn at, insulted or humiliated?
5.4 Did a parent, guardian or other household member hit or cut you with an object, such as a stick (or cane), bottle, club, knife, whip etc?
8.4 Was a family member or friend killed or beaten up by soldiers, police, militia, or gangs?
Depressing, right? It pains me to think of what other options have to live through as well as the various combinations.
My cute little garden hose analogy breaks down quickly when you realize that there are many fixtures that can easily screw something over the open end. I’m not a plumber like the Super Mario Bros 🍄, so bear with me. So let’s say that there is no threaded metal thing. There’s only a torn hose at the end and the water pressure is too high to easily cut the rubber, and maybe a stray dog is attacking the plumbers hired to fix it. How do you plug the leak when the soil is soaking and spilling into the neighbour’s yards? Emergency! Also, the faucet is jammed, so you can’t shut off the water at the source without a lot of effort. Maybe it’s corroded so badly that even a huge pipe wrench can’t turn the knob without causing further damage.
My approach so far has been to stop fixating on the spilled water and instead to refocus on closing the valve. I employed mostly talk therapy to address the sources of my emotional pain. And there’s been real progress! When I was still partying hard, I used to drink like a fish, though somehow I maintained enough discipline to very rarely indulge during the work week. I’ve treated my ACEs directly through prolonged exposure therapy, which has certainly prevented a lot of further suffering. But that heavy investment came at a cost, and now I’m tired. I’ve slowed the flow and clamped down on one leak, but now it’s relocated to another opening. It’s like when I switched away from Apple Music’s bugs and traded them for Spotify’s. And my arms are tired from prying the pipe wrench to close the valve from which my emotional pain flows.
Band-Aid Solution
I’m ready for Band-Aid solutions. I’ve traded my alcohol abuse for nicotine use. We now have the technology to reduce the amount of harm caused from smoking tobacco by getting to the nicotine directly. The toasted smell is replaced by delicious flavours, which create their own craving.
The average amount of nicotine absorbed from a cigarette is about 2 mg. My back-of-napkin calculation says that if a disposable vape has 9 mg of nicotine and a concentration of 20 mg/mL that lasts over 3000 puffs, which is probably an overestimate for marketing purposes, a person requires 33 puffs to inhale the equivalent of a cigarette. I’ve since switched to a refillable vape paired with an e-juice that has 5 mg/mL concentration with a menthol-like flavour called Extreme Ice. At one quarter of the concentration, it should take an average of 132 inhalations to equate to a cigarette, which also means that I use the vape and irritate my throat more. I’m probably more hooked than I would like to admit, but I also have more control than if I smoked tobacco.
Observing how nicotine boosts dopamine production, here’s a graph of my relative dopamine concentration throughout the day after taking Adderall XR. I have no idea what dopamine dispersion actually looks like, so this graphic is informed mostly by subjective experience and vibes.
I take a 10 mg capsule of Adderall with eXtended Release as soon as I wake up, around 6 or 7 AM, so I vape more before the Adderall fully kicks in and after it’s worn off to get out of the blue “Trapped in flesh prison” area. If I do it too much during the middle of the day, I get a headache, though the e-juice with lower nicotine concentration reduces that. Recall that the 15 mg capsule of Adderall was too much for me, sending me higher in the red “HEADACHE” zone for a few hours, and trying a 10 mg/mL nic salt e-juice, half the concentration of the disposables I started with, still made me go number two. Over time, drugs like nicotine shrink the green “Feels Good, Man” zone, so the goal is to eventually reduce both the vape time and budget using healthier alternatives, perhaps reversing the trend and growing the green section. Note how low the baseline is at the far left and right. It takes so much work just to climb into the green zone. It’s exhausting, and perhaps it merely requires more time to rest to naturally raise the baseline.
It feels like the fastest way out of this habit is through it. There’s no turning back now, and I need to approach ACE management from a different angle.
Trying an addictive substance once isn’t enough to get a person hooked. There are plenty who’ve tried out of curiosity or were surrounded by those that indulged liberally, but they walk away just fine. Weed doesn’t have a chemical pathway for addiction, but it surely can form a behavioural habit. I just finished reading “When the Body Says No,” which is an interesting examination of the physiological connection between chronic stress and disease via the hypothalamic, pituitary, and adrenal glands. Accordingly, not everyone develops a debilitating health condition when regularly consuming harmful substances, even with genetic predispositions. The book’s subjects all tended to compulsively take on especially elevated levels of stress from the people around them, whether by being forced by others or from their own desire to be loved. Predisposition suggests means that genetics alone don’t predict onset, and other factors are at play, namely psychosocial factors and chronic stress. How is someone like Snoop Dogg able to smoke so much weed? It’s consistent with his public persona to smoke a lot of fat blunts, but why doesn’t he prefer a less harmful option like a weed vape? Many drink and smoke well into old age, though I’m sure many more die prematurely. Hospital patients are given morphine, but not everyone leaves with an addiction to it. I’ve also never done nearly as much research on alcohol’s effects on the body as I am with nicotine, and I still put lots of it in my body anyway. Vaping is too new to investigate the long-term health effects, whereas researchers have very clear understanding of what happens when you’re rolling down the street, smoking indo, sipping on gin and juice. Using an addictive substance doesn’t seem to guarantee a full-blown addiction.
Recovering From ACEs
I don’t have it all that bad in recovering from my ACEs. Drawing insight from the Social Justice lens on topics like oppression and privilege, it’s less difficult for me to access resources to stop the leaks because I have many intersections close to the centre of the wheel of power/privilege. I’m an able-bodied, cisgender, Asian man with light skin, living in Canada in 2023, and I benefit from proximity to whiteness in its various forms. My Christian parents had full-time jobs and provided care and comfort. I’m a dual citizen of Canada and the USA, carrying passports for both. I can read and write in English, and I had access to enough capital to pursue a post-secondary education, with which I was able to obtain meaningful work at a decent income and purchase property. (The poorest 50% make fewer than 2,800 euros in purchasing power parity per year, about $4,100 CAD, and my household income puts me in the top 10%; I’d previously read somewhere that cited it was in the 1%, but this new World Inequality Report from 2022 corrects that. Maybe the massive upward transfer of wealth from COVID has changed the balance too.) I can afford mental health plumbers like a family doctor and psychologist. I never experienced violence from gangs, police, or military. As much as I whinge about my situation, it’s humbling to know that I’ll never have it as bad as many other children around the world and throughout history. In acknowledging my privilege, I can more clearly situate myself against a global context and leave my pity party, liberating me to use said privilege to liberate people who are far more oppressed than I am. Rather than giving to charity, consider sending money to Black people as mutual aid, like Taylor McNallie, Adora Nwofor, and D Fretter, especially for Black History Month. And after the month ends too.
The human brain is wired for negativity. A friend could give you 10 compliments and one criticism, and you might forget that you were ever complimented at all. Most people would rather prevent a small loss, even if it meant they could risk it for a much larger gain. This negativity bias is even more powerful for the traumatized person who has been shown that, in real terms, the world is a dangerous place. It takes a lot of reprogramming to open the mind’s eye to see the beauty in the world; if perhaps not within most interpersonal relationships, then at least in the natural world. Nevertheless, when you gradually meet the right people and keep out the harmful ones, a mindset of hope slowly replaces the negativity. The effect is positively asymmetrical too. Perhaps there really are a lot more dangerous individuals in your daily dealings, but it only takes a few good friends to counteract their darkness. Having a single true companion by your side is able to heal a lot more than the hurt caused by the bad eggs. It feels like a cliché of wedding speeches in popular media where one of them says to the other “I’ve made a lot of mistakes in my life, but I wouldn’t trade them for anything because they all led me to you.” The evolutionary helpfulness of the disproportionately negative focus of the brain has its limits, and it is far more beneficial to retrain it to see the positive, even for emotionally healthy individuals.
That’s all to say that I’m now reaching this plane of existence where I can remove the shackles of faith in the evil in people and lift my eyes to the wondrous beauty around me. I can safely trade my well-worn pessimism for an optimistic lens. And I also have to look back and weep at all of the signs of hope and the encouragement from others that I rejected. Far too many times, if someone tried to say they liked me as a person and enjoyed my company, that everything would be alright, I would pull back and wonder what kind of suspicious, ulterior motive they had, as if they were manipulating me into having positive feelings towards them. I still have trouble receiving harmless social niceties from new acquaintances like “it was nice to meet you,” but this new positive outlook is the antidote, even as I have to force it.
For my younger friends of the Generation Z, there are a lot of valid and convincing reasons to see that things are getting worse and to feel hopeless about the future. Your feelings are completely valid. The CDC says that 3 in 5 young women today are persistently sad and hopeless, the highest level in 10 years of surveys. If I lived in Ohio and a train full of dangerous chemicals exploded in a fiery blaze, I would pack my family in the car and move away as fast as possible. Leave all our belongings, maybe bring some cat food, but getting away from one of the worst ecological disasters in recent history seems okay. (Who knows what I would actually do? Watching “The Last of Us” has me thinking about post-apocalyptic scenarios.) US rail workers were recently denied paid leave along with the right to strike, and now we have this modern day Chernobyl. (Explain that, capitalists!) It seems like the fabric of society, cobbled together after the World Wars where it was agreed that civil rights should be extended to groups other than white men and that we should generally take care of each other, is unraveling. It’s sad to say, but there is a greater burden on individuals now to fend for themselves and their pods. But there are still reasons to hope.
It sounds crazy to feel hopeful. At the same time, there are still powerful structures still standing that altruistically support those that need a hand, enough that a strong counterargument could be made that we are still living in one of the most wonderful times in human history. AIDS is being cured in stem cell trials, mRNA vaccine research is being turned diseases like Multiple Sclerosis and cancer, workers’ rights and union sentiment are on the rise. There are food banks, activists risking their lives on the front lines, and the Internet to provide isolated individuals with a sense of community beyond their physical limits. I guess I’m saying I’d rather risk the heartbreak of hoping and being proven wrong than to be certain of disaster and be proven right. Hope feels like an act of resistance against the universe eventually averaging out to heat death and capitalists brazenly breaking the working class’ spirits for easier exploitation. My mind only knows to look for threats that aren’t there, so shouldn’t I at least give some equal say to the opposite, searching for reasons to hope even if there might not be any?
Killing Me Softly
There is the parable of the patient that goes to their family doctor and says “It hurts when I do this,” to which the doctor replies “Then stop doing that.” The way my personality developed was in response largely to trauma and unmanaged ADHD, and now it’s time to end a lot of those practices, like reassuring myself I have time to sort out my to-do list regardless of what my Temporal Neglect Syndrome (time blindness) tells me. The way that I exist and interact with my surroundings is part of what is killing me softly, so I’m putting an end to some of them. And vaping helps a little bit.
The vaping habit is a heavy-handed approach to managing my lower stress tolerance. It forces me to stop whatever upsetting thing I’m working on and go for a smoke break. I’ve historically accepted stress full blast, but now when I get that hot feeling in my head, I stand up and go for a walk with my vape. Stress prevention is the name of the game, and nicotine use can be more effective than my mindfulness practices. Snacking used to be my go-to, and nicotine is minimizing that. I sound like a fashion model trying to keep my weight down, I know. Do two wrongs make a right?
Hope In Action
A friend shared a tip from her therapist, which was to make an Anxiety Emergency Kit. When your brain starts to choke up and the walls start closing in, it can be hard to remember the tools you can use to get out of that situation. Since I have a weakness in down-regulating my stress and a terrible working memory, it's time I updated the list for when my vision starts to narrow.
I’ve talked recently about how I’m in the safest place of my life so far and about the process of throwing out stress from the deep freezer. The thawing effect of releasing old tensions is deeply uncomfortable. I think one of the typical outlets for this discomfort is physical activity. Since the three week ban on exercise post-vasectomy is ending soon, so I’d like to return to that soon. In the meantime, damn it’s fucking uncomfortable. Rest and relaxation are closely associated, but my experience of rest is not relaxing but has long been a painful sensation. Shaking it off is the way, and there’s a lot to shake off.
The plan is to reduce my vape dependence as the weather warms up and the de-stressing process tapers off, creating space to get my dopamine from natural and healthier sources. Using cigarettes and the disposable vape’s nicotine concentration as a starting point, smoking cessation usually follows a gradual reduction in concentration and slowing of release through nicotine patches, gums, and toothpicks.
This following list is more for my own reference, so feel free to skip the section below.
Featherweight: Up to 5% improvement in mood
Stepping out on the patio to listen to the birds chirping.
Healthy snacking. Veggies and hummus.
Playing vidya games. “Legend of Zelda: Tears of the Kingdom” comes out in May.
Smiling.
Meditating.
Splashing my face with water.
Drinking water.
Sipping fizzy sugar water. Simple sugars in liquid form help the ADHD brain with self-regulation.
Lightweight: <15%
Sitting in silence.
Phoning a friend.
Masturbating.
Showering or taking a bath.
Going for a walk. I should put my keys and earphones nearer to the door.
Blasting my favourite music. There’s an audiophile amount of speakers and headphones in my home, but I have to be in the right mood. My roommates don’t much like the noise though.
Wearing my night guard to bed.
Eating a warm pastry.
Stretching.
Taking a nap.
Self-massaging. Shepherd’s hook, massage gun, hockey ball, peanut roller, foot roller.
Laying down.
Crying. This one used to be impossible for me and not because I was such a toxically manly man. I repressed and suppressed all negative emotions and replaced them with humour. Can't run from the bad feelings forever.
Playing with the kitties.
Middleweight: <30%
Sexing.
Seeing friends.
Getting a massage.
Working out at home. Doing yoga with my long-distance girlfriend, Trainer Jessica on Apple Fitness+.
Seeing my therapist. It feels worse before it feels better.
Cycling.
Cooking.
Engaging in hobbies. I want to get back into audio and electronics.
Reading.
Writing.
Going out of town for a day or weekend.
Heavyweight: <50%
Dancing at a night club.
Working out at the gym. There's something special about the barbell.
Vacationing.
Why is the biggest category only up to 50%? I don’t exactly know, but I suspect it has something to do with my depression and anxiety. Maybe it should be higher, but that’s just how I feel, I guess. I don’t know what I need to get a higher score, but that has been my empirical observation. Is it even possible? Is it just a simple attitude problem? Further research is required.
Conclusion (finally)
Phew! Thanks for making it to the end!
I’m tired of healthy coping, so I started vaping. I’ve been through some big life changes in recent times that make me feel safer than ever, and the uncomfortable process of thawing from chronic stress has me turning to a simple fix to calm my nerves. I have some ACEs, and recovery has gone well. Hope is rising! I plan to reduce my nicotine dependence as winter ends and de-stressing wraps up so I can use healthy coping strategies from my new Anxiety Emergency Kit.
Nicotine has gotten me through a very odd, three-week period filled with several highs and lows. Combined with my prolonged exposure in treating my trauma, I’m finally able to take an optimist and positive outlook. And I can finally say it:
Life is beautiful.