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This is a follow up from my earlier question, in which a virus has wiped out humanity's ability to get intoxicated or high.

During the peak of the pandemic, as more and more people lost their ability to get intoxicated, would there be a mass event of withdrawal from people that are drug or alcohol users?

I'm sorry if this question seem ridiculous, as I'm not that knowledgeable on the topic.

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  • $\begingroup$ A "mass" effect? Just how many people do you believe are there who are addicted to the kind drugs of drugs which can produce significant withdrawal effects? (The most widespread psychotropic drugs are coffee, tea, and tobacco. I have never heard of any significant withdrawal effects induced by lack of tea.) (And the vast majority of people who drink alcoholic bevereges do not ever drink enough to get intoxicated. Most people never get beyond the stage of a slight buzz. And very few people are addicted to alcohol; it is hard to get addicted to alcohol.) $\endgroup$
    – AlexP
    Commented Mar 15, 2022 at 9:56
  • $\begingroup$ well i ask for people that are those. would there be such event happening to them. like people who use hard drugs like fentanyl and heroin. $\endgroup$
    – faddllz
    Commented Mar 15, 2022 at 11:19
  • $\begingroup$ I changed my answer. $\endgroup$
    – imtaar
    Commented Mar 15, 2022 at 12:49
  • $\begingroup$ Lots of people will get into trouble. The high as well as the addiction depends on brain biology, people dependent on these brain effects will get into trouble, when the effects suddenly disappear. A very informative article on the subject is ncbi.nlm.nih.gov/pmc/articles/PMC2872279 $\endgroup$
    – Goodies
    Commented Mar 15, 2022 at 15:37
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    $\begingroup$ @AlexP I do know people who get headaches if they don't drink tea. It has plenty of caffeine to cause withdrawal effects if you drink it in significant volumes. Also it is just not true that the vast majority of people that drink alcohol never drink enough to get drunk. According to the NIAAA over a quarter of all people ages 18 and up report binge drinking in the last month, meaning 5 drinks or more for men and 4 drinks or more for women. Even if not all of those people were "drunk" according to whatever that means to you it is still a huge number of people drinking in significant volume $\endgroup$
    – Kevin
    Commented Mar 15, 2022 at 23:04

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It depends on both the specific drugs and how the virus works on a physiological level. Not all drugs cause withdrawal, and those that do, do so through different mechanisms.

If you want the effect to simply work like everyone quitting cold turkey, the virus might increase the ability for the liver to metabolize toxins quickly. This will cause the drugs to break down before they can impact the brain. In such a case, people would experience normal withdrawal symptoms.

Would this cause a mass withdrawal event? That depends on how many people are addicted to drugs, but I would say that yes, there would be enough people experiencing withdrawal to create a serious health crisis.

Let's ignore most drugs and only consider the most prominent one, alcohol.

This page shows percentage of the population with an alcohol dependency by country. Outside of northern Africa and the Middle East, most countries average around 5-10% of the population (some, like Russia, being as high as 20%) and this is plenty. Alcohol withdrawal is serious and can include anxiety, hyperactivity, hallucinations, and death. While I could not find the frequency of each symptom and how well it translates to the aforementioned numbers, even 1% of the country getting sick at once is a huge amount of people experiencing illness, which can threaten the integrity of the medical system if it happens in too short of a period.

You might be able to reduce the impact by slowing down the progress of the virus so they aren't all affected at once. The fact that the virus is only really dangerous to people addicted to alcohol, but people who enjoy drinking would obviously not want to get it, means that it's anyone's guess how effective this would be.

It is also worth noting that the virus' mechanism will probably render common psychiatric medications ineffective, as there is a great deal of overlap between these and recreational drugs (in fact, many prescription medications are used for recreation as well, and it's unreasonable that the virus would be able to differentiate). Even ignoring withdrawal, the direct impact of the virus will cause a lot of problems as people who keep their mental disorders in check with drugs will find them ineffective all at once.

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    $\begingroup$ Also, no painless surgeries, no most common painkillers... In short, you have just thrown the world into pre-anesthetic era. $\endgroup$
    – jo1storm
    Commented Mar 16, 2022 at 10:30
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    $\begingroup$ Part of this is that you need to distinguish chemical dependency from psychological dependency - this applies to alcohol as well but I doubt the numbers you list take this into account. Assuming that the people do not feel intoxicated, but still digest and process the ingested material as per usual, those with a chemical dependency will actually not be affected by this virus, at least not in regards to withdrawal, so long as they keep up their habit. Intoxication is only relevant for those with a psychological dependency, as they no longer get the mental haze they're after. $\endgroup$
    – Flater
    Commented Mar 16, 2022 at 13:14
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    $\begingroup$ ...And if the assumption that the ingested materials are still digested and processed is incorrect; then you're messing with biochemistry in a way that withdrawal is not the biggest fish to fry by a very long shot. $\endgroup$
    – Flater
    Commented Mar 16, 2022 at 13:18
  • $\begingroup$ @Flater I'm only taking chemical dependency into account. I don't see how even a gene-manipulating virus could undo a psychological dependency, as this would require it to analyze the neural structure and alter specific nerve connections, and if it could do this you could pretty much reprogram the entire brain however you wanted. $\endgroup$ Commented Mar 17, 2022 at 14:12
  • $\begingroup$ @IndigoFenix My point is precisely that it wouldn't be able to undo a psychological dependency, therefore leaving these people jonesing with no more access to their fix. Comparatively, the (solely) chemically dependent would have less issues as they can still get their chemical fix. $\endgroup$
    – Flater
    Commented Mar 17, 2022 at 14:27
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Small but significant

Just looking at alcohol, in 2015 it was estimated that 2.6% of people over the age of 15 suffer from alcohol dependence, the vast majority of them male. That's roughly 170 million people, if I have my population demographics calculated correctly.

WHO estimates that about 35 million users of psychoactive drugs are affected by drug use disorders, meaning harmful use pattern or dependence.

Just because it makes for a nice round number, if we assume that there is an overlap of 5 million people who are dependent on both psychoactives and alcohol then there are around 200 million people worldwide who will be significantly affected to some degree when their drug/s of choice no longer affect them.

This does not include groups such as tobacco users - from my observations of people who have quit smoking there will be a lot of very cranky people out there who did not plan on quitting, albeit less than there would have been a few decades ago.

Reactions

While some people with drug dependency may find their new condition to be a blessing, those who have been using drugs or alcohol to deal with pain they cannot cope with any other way may react very badly. Even with rapidly deployed therapeutic support, it is practically inevitable that there will be millions of additional suicides, accidental deaths due to overdoses of substances that no longer provide a high but are still fatal in large doses and accidental deaths from other practices that create an altered state of mind through oxygen deprivation. (Desperate people will try anything, no matter how dangerous.)

Out of all the hundreds of millions of people on the planet who miss their drug use (and the suppliers who consider them to be a commodity), someone is unfortunately bound to revive "recreational" research into direct stimulation of the pleasure centres of the brain. It will take some time, but eventually the "wireheads" envisioned by Larry Niven and other SF authors will come into being, unless someone comes up with a cure for the virus that has affected humanity.

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Let's talk a little about intoxicants and why it's a Really Bad Idea™ to mess with them like this.

The most common legal intoxicant on the planet at the moment is alcohol. Alcohol is a poison that interacts with your brain chemistry, monkeying with the production of various neurotransmitters. It suppresses the release of glutamate, a neurotransmitter responsible for increased brain activity and energy levels, leading to a general slowdown in your reactions and thought processes. Next it increases the production of GABA, further reducing energy levels. These are the reason alcohol is classed as a depressant. On the other hand it also increases the release of dopamine, the pleasure chemical, in the reward center of your brain. So your reactions are slowed down, your get clumsy and tend to fall over things other people can't see, but you feel really happy about it.

And that's just one of many.

Your virus has to do one of two things: rewire the entire chemical system in the brain to make it immune to these effects or change the blood/brain barrier to prevent all intoxicants from entering. From a biochemical perspective no virus is ever going to be able to achieve either of these. But just for the hell of it, let's assume that they could.

The first option is a big ask, and almost certainly fatal. We're not just talking about blocking a few receptors here, you're looking at recreating the brain pretty much from scratch to use an entirely different set of chemical processes. Every part of each of 86 billion or so neurons in the brain needs to be altered to use entirely novel chemical processes. All of the glands in the body will need to be changed to produce the new standard chemicals, etc. I couldn't even begin to list the hundreds of thousands of new reactions that you'd need at the end of the process, but I can tell you flat out that there's no way you're going to rebuild a human body over a few days and have it functional the whole time. Either your body manages to fight off the infection - making it ineffective - or you die, no middle ground.

The second case could possibly be done, and wouldn't necessarily be fatal, but it's going to cause serious issues. Firstly, chemical withdrawal just as bad as going cold turkey on everything they take. For most of us that's not a problem, but anyone with severe chemical dependence is going to have a really bad day. Or month. Some of them will die because the medication to help them with their withdrawal is also blocked, since it's generally an analog of the drug that screwed them over in the first place. No synthetic analogs to help trick the brain's chemistry into thinking it's being gently eased off the addiction, just a hard stop on the chemical you're dependent on. Not a fun thing, by all accounts.

Of course you're not going to get all intoxicants this way. While most common intoxicants are poisons that mess with your brain chemistry, a few are things that your body produces and needs for healthy operation, just at levels well below the point at which hallucinations and so on occur (looking at you N,N-Dimethyltripamine). You can't close off the brain to everything, it'll shut down in seconds. Any channel you leave open will be identified and a whole new batch of intoxicants will be on the shelves in time for <insert holiday of choice>.

Another down-side of the whole thing is that there are a lot of drugs that fall into the 'intoxicant' category when used to excess that in other situations are actually quite important. Opioids for pain, Benzodiazepam for a variety of issues, Dazepam (or Valium if you prefer the branded pills) for a bunch of things... and so on. Millions of people around the world are living healthy, happy lives because their doctors prescribed the right dosage of happy pills, and your virus is going to take that all away. (And that's not counting the millions more who are just prescribed the pills because their doctor gets kick-backs.) How many people are going to handle life when they're suddenly dumped back into their worst mental states with no warning and no way to deal with it?

And since we're tangentially approaching the topic, let's have a quick glance over at psychological dependence. The habitual drinkers might be OK once the dry terrors are over - they can still drink after all - but the ones that have a deep conviction that they need to get drunk/high/wasted/whatever to get anything good out of life, to enjoy themselves or just to unwind... they're going to be damned hard to deal with. Don't underestimate the power of mental convictions and conditioning. I know people who can go months without touching a drop but hit the bar to blow off steam when the stress levels get high enough, and some of them are going to go off the rails in terrible ways if they can't relieve their stress that way.

So yeah, I don't want to live in that world. I don't drink much, I don't take drugs recreationally and I'm not dependent on medication for (what I will laughingly refer to as) my sanity. But although I don't have a real dog in the fight, I really don't want to watch the world go even more insane than it already is.

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No withdrawal symptoms

As told here

People feel intoxicated after using drugs. Over time, the brain is changed by drugs. The brain becomes desensitized to the drug so that more of the drug must be used to produce the same effect.

You told that "virus has wiped out humanity's ability to get intoxicated or high" which means that changes made by the drug in brain are reversed and will not occur again.

The result is that alcoholics will not suffer any withdrawal symptoms because the brain is not demanding drugs anymore.

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  • $\begingroup$ The question, as I understand it, is whether alcoholics will suffer withdrawal symptoms when they can no longer be affected by alcohol. Discussing the total lack of impact on people who didn't drink alcohol previously does not answer the question. $\endgroup$ Commented Mar 15, 2022 at 11:35
  • $\begingroup$ i belive you are mistaken. yes goody kerravon has sight the right meaning of my frain. $\endgroup$
    – faddllz
    Commented Mar 15, 2022 at 12:09
  • $\begingroup$ @KerrAvon2055 Thank you for explanation. I changed my answer. $\endgroup$
    – imtaar
    Commented Mar 15, 2022 at 12:47
  • $\begingroup$ This answer ignores secondary chemical reactions that happen when people drink alcohol to excess, and the secondary behaviors connected with alcohol addiction. I've heard that it takes only 24-48 hours to clear the body of alcohol, but several weeks to clear out the rest of the chemicals and years to clear out the secondary behaviors. $\endgroup$
    – David R
    Commented Mar 15, 2022 at 14:01
  • $\begingroup$ @David R The question is about withdrawal symptoms. The health benefits of alcohol are very limited , for small amounts of alcohol (no intoxication), for age <60. So if a person keeps drinking after this virus, he will not get intoxicated but his health will keep deteriorating like normal heavy drinkers. $\endgroup$
    – imtaar
    Commented Mar 15, 2022 at 14:50
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(Refer to my other answer for why you shouldn't do this.)

Now that we've got a bunch of reasons not to, here's how you can do this without breaking the world and killing a ton of people.

Instead of a virus, infect the planet with a smart nanoplague. I know, nanotech isn't actually magic, but it's a heck of a lot more believable than a virus that stops people getting drunk without doing anything bad to them.

The initial 'infection' period is due to the nanites scavenging various things from your blood, lymph fluids and fat stores to build manufacturing and storage devices into the lymphatic system, slightly increasing the size of your lymph nodes in the short term and causing inflammation in various places in the body.

In the second phase the nanofactories in your lymph nodes start to produce and stockpile toxin binders that will capture and neutralize various chemicals in the blood stream. These are stored in capsules throughout the body, attached to the circulatory and lymphatic system. When the levels of target chemicals reach certain levels the appropriate stores open and flood the blood stream with toxin binders specific to that chemical. Each binder vacuums up a few molecules of alcohol or PCP or whatever and then makes like an expired blood cell and is collected by the body's waste disposal processes, ending up in the bowel for convenient disposal later.

There are a few upsides to this system:

  • You can tune the activation levels to allow a small amount of various chemicals through - you can get a slight buzz from a bottle of beer but several bottles isn't going to do much for you.
  • The initial build-up of toxin binders can be slow enough to wean addicts off slowly - a couple of weeks for alcohol, maybe a slow few months for crystal meth.
  • The system could adapt to produce more binders for toxins it detects and less for ones it doesn't, so you're not wasting storage or production on binders that aren't ever used.
  • Properly tuned the system allows for medication, and we could include some sort of trigger to shut it down temporarily in situations like surgery where the anesthetic and pain relief would normally be blocked.
  • Can also bind to non-intoxicating chemicals like cyanide, arsenic, dioxin and so on.

Downside? You can only store a certain amount of each type of binder, so if you drink a few bottles of high-proof spirits you'll reach the limit of what it can do. Getting smashed is still a possibility, it just gets a hell of a lot harder to achieve. And more dangerous, since you can't be absolutely certain of how many bottles of Old Neuron Embalmer #7 it'll take to get past the cleaners. Expensive habits will get a hell of a lot more expensive, and probably kill a lot more people.

And of course there 100% will be a black market trade in whatever it is that lets you switch the system off during surgery. You'll get a modern equivalent of opium dens where you can pay to have the system disabled long enough for you to get high on your drug of choice, but this is going to be way out of the price range that the huddled masses can afford. Intoxication will be the domain of the rich... until someone finds a way to bypass the system cheaply.

Eventually we'll find all new drugs to replace the ones we used to have. Be prepared for all sorts of nasty street drugs, and some quite interesting designer drugs, to start popping up in a couple of years time.

Now that would be an interesting world. Let's go with that version :P

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The virus would kill everyone it infects

Intoxication happens when a foreign substance causes a dopamine response. In order to make a person chemically unable to feel intoxicated, the virus would need to destroy, block, or otherwise disable all the dopamine receptors in your brain... but your brain needs these receptors to function.

As the the virus kills off your dopamine receptors, the virus would basically act like getting very rapid onset Parkinson's Disease. The patient would experience symptoms like depression, schizophrenia, psychosis, tremors, muscle rigidity, loss of unconscious movements, and finally heart or respiratory failure.

Furthermore, intoxication happens across the whole brain; so, you can not just isolate the virus to disabling some specific part of your brain. Excitation happens in your frontal cortex, pleasure and abnormal memory patterns happen in your limbic system, disorientation happens in your motor, sensory, and visual cortexes and cerebellum. So, there are too many vital areas of your brain that are effected by intoxication for them to be selectively altered.

You also can not change the way your body absorbs dopamine stimulating substances by just preventing it all from reaching your brain because most of what we eat is designed to activate dopamine receptors. Basic stuff like carbohydrates, fats, and proteins make you mildly intoxicated by triggering a dopamine response. If you block all intoxication, you also block the positive feelings you get from eating food; so... not only will addicts feel withdrawals from drugs, but normal people will feel withdrawals from food. At first people will feel like they are starving all the time because thier body is not receiving any confirmation of getting food; so, they will over eat then after a period of acclimation they will stop ever feeling hungry which will cause people to starve themselves to death.

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For the nanoplague, there is a way to make drinking more booze than the binders can catch nearly impossible. Attach an enzyme to the binders, which destroys the drug. So they get free to be re-used and kill the next molecule. The enzyme should alter the structure of the binder. When it grabs a drug molecule, it gets in alarm shape, and will stay this for a while after the drug is destroyed. Binders in alarm shape will not be filtered out of the bloodstream.

This should make flooding the system with drugs extremely difficult. Even if you manage to get drunk or high, the effect will last only for a very short time.

The "new street drugs" problem is more difficult. Junkies usually do not want to be high in specific way, anything that causes a dizzy head will do. And they do not care about health damage. Therefore any household or industry chemical which disturbs the brain function is a possible replacement for alcohol, but with much worse side effects.

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