A couple of weeks ago, d-Infinity Live! had an episode about intoxicants in games. A few very interesting questions were raised.

Awhile back the always-amusing podcast d-Infinity Live! had an episode about intoxicants in games. Encouraged by a modest amount of alcohol, the hosts held a spirited discussion about their experiences with drugs and alcohol in their own games and in different game settings. A few very interesting questions were raised which I thought would be interesting to comment on a little bit more here.

Perhaps the most interesting question asked was, why do people take a drug in the first place? Drugs can make for very effective story hooks but, as observed by the hosts, the reason(s) behind their use is often glossed over in games, in fiction, and in other related media. Instead, we take it as a given that people just use it, perhaps because we like to imagine that anyone who would harm themselves obviously hasn’t thought about it rationally. The conclusion reached on the show is that people use drugs because drugs make people feel good, and it’s important to remember that there’s more than one way that people can feel good. Pretty much by definition, anything with the potential to be addictive becomes so because, through one of various pathways, it triggers the brain’s reward system, but that doesn’t mean that the drug itself is pleasurable. Most drugs do indeed give one sort of pleasure or another, be it physical or mental. Many drugs, however, don’t make people feel good, but rather, numb or asleep. These drugs provide an escape from unpleasant realities, which is why they’re so popular in rural, under-privileged areas where boredom can be deadly. Similarly, many pain medications don’t actually give any sort of “high” feeling, and in fact cause terribly unpleasant side effects such as nausea and constipation, but the reward of pain relief can be powerfully addictive. Lastly, never underestimate the power of peer pressure; a certain percentage of people will get hooked on one drug or another, not because it makes them feel good, but because they can’t or don’t resist the social pressure, and they eventually fall victim to a physical addiction despite the drug not making them feel good. This same social pressure can be one of the hardest parts of treating addiction, because getting someone to stop drinking might require that give up their entire social network.

The second wonderful question that the hosts asked was, what about the one drug that no one would ever take? I may be biased – the fact is that I have a very low opinion of humanity in general, notwithstanding the fact that my work means I often see people at their worst – but I don’t believe that there is such a thing. As the science fiction author Bruce Sterling once observed, “it's genuinely useful to society to have some small, contained fraction of reckless fools who are willing to consume untested and unknown devices and substances.” It’s worth remembering that the vast majority of our knowledge about nutrition and danger in the natural world comes from the fact that as far back as there have been human beings, humans have been putting stuff in their mouths, painting stuff on their bodies, and rubbing stuff into their wounds to see what would happen. Large percentages of the human population have powerful impulsivity, irresistible curiosity, or an inability to learn from experience and a tendency not to think things through, such that if they have an inkling that something is pleasurable, even if they know it’s also harmful, some of them will expose themselves to it. Heroin, which they discussed during the show as a particularly terrible drug, isn’t an extreme enough example, because heroin isn’t actually  that physically dangerous if you can afford it and know how to use it safely. Instead, consider kids who take bath salts, which can not-so-rarely turn a person into a violently psychotic cannibal, or who sniff glue, which literally melts holes in your brain; people use these things. There may be drugs so horrible that MOST people wouldn’t use it, but I honestly believe that you would never find a substance whose effects were so horrific that not one person would ever use it, if it gave any sort of positive effect whatsoever.

Lastly, and perhaps most interesting for gamers, is the question of what might replace drugs in societies where everyone is immune to poisons. “Immune to poison” is actually a hard thing to imagine, because literally everything in the universe can be poisonous if you’re exposed to the wrong quantities and via the wrong mechanism of delivery, including both water and oxygen. Constructs might reasonably be immune to poison by virtue of not having any actual biological processes to disrupt, and we might accept that angels and devils are immune to poison because their bodies are composed of “energy,” whatever that means. According to the SRD, however, plants are immune to poison, which is patently false to anyone who’s ever bought weed-killer. Should drugs qualify as poisons? That’s a tough question when you really look at the details. Some drugs exert their effects because they’re really just low doses of poison, such as alcohol, which shuts off parts of the brain. Other drugs, like opiates or marijuana, exert their effect because they contain molecules able to mimic something the body already uses; they can hurt you in an overdose or over time, but they’re aren’t really “poisons” in and of themselves. Most storytellers and DMs don’t have the knowledge to know which drugs are poisonous, but it’s not unreasonable to rule that a creature is immune to some drugs and not others. It’s also important to remember that not all species are the same; several medications and foods that humans can consume safely might kill a dog or a cat, so who’s to say what’s poisonous to an elf or, for that matter, an otyugh? In any event, as they said on the show, things can be addictive, even if they aren’t chemicals, as long as they stimulate the right parts of the brain. Gambling can certainly be addictive. Sex, World of Warcraft, and other activities have all been implicated as addictive, although there’s evidence both for and against. A race which the main SRDs say is truly immune to the effects of all drugs, such as treants, nagas, or elementals, might certainly develop addictions to non-drugs. A treant becomes addicted to fresh rainwater and becomes irritable and aggressive after three days without it. An angel begins to experience goosebumps and headaches if it doesn’t pass judgment on a sinner each day. A lich knows that it has all the spells it can ever use, but can’t stop putting itself at risk trying to accumulate just one more book. In theory, anything that gives someone a sense of reward could become addictive, if the person with the right biopsychosocial vulnerability is exposed to it at the right time under the right circumstances. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on September 6, 2015. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system.