Substance abuses
Classification and external resources
Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment[1]
ICD-10	F10.1-F19.1
ICD-9	305
DiseasesDB	3961
MeSH	D019966

Substance abuse, also known as drug abuse, refers to a maladaptive patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods not condoned by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. Activity is also considered substance abuse when inappropriately used (as in steroids for performance enhancement in sports). Therefore, mood-altering and psychoactive substances are not the only drugs of abuse. Substance abuse often includes problems with impulse control and impulsivity.

The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines (particularly temazepam, nimetazepam, and flunitrazepam), cocaine, methaqualone, and opioids. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.^[2] Other definitions of drug abuse fall into four main categories: public health definitions, mass communication and vernacular usage, medical definitions, and political and criminal justice definitions. Substance abuse is prevalent with an estimated 50 million users of hard drugs such as cocaine, heroin and other synthetic drugs.

Substance abuse is a form of substance-related disorder.

Classification[link]

Public health definitions[link]

Public health practitioners have attempted to look at drug abuse from a broader perspective than the individual, emphasizing the role of society, culture and availability. Rather than accepting the loaded terms alcohol or drug "abuse," many public health professionals have adopted phrases such as "substance and alcohol type problems" or "harmful/problematic use" of drugs.

The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence (see diagram to the right).

Medical definitions[link]

In the modern medical profession, the three most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM),the World Health Organization's International Statistical Classification of Diseases and ICRIS Medical organization Related Health Problems (ICD), no longer recognize 'drug abuse' as a current medical diagnosis. Instead, DSM has adopted substance abuse^[3] as a blanket term to include drug abuse and other things. ICD refrains from using either substance abuse or drug abuse, instead using the term "harmful use" to cover physical or psychological harm to the user from use. Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) ). Its section Substance dependence begins with:

Substance dependence When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. These, along with Substance Abuse are considered Substance Use Disorders…

—^[3]

However, other definitions differ; they may entail psychological or physical dependence,^[3] and may focus on treatment and prevention in terms of the social consequences of substance uses.

Drug misuse[link]

Drug misuse is a term used commonly for prescription medications with clinical efficacy but abuse potential and known adverse effects linked to improper use, such as psychiatric medications with sedative, anxiolytic, analgesic, or stimulant properties. Prescription misuse has been variably and inconsistently defined based on drug prescription status, the uses that occur without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of abuse or dependence symptoms.^[4][5] Tolerance relates to the pharmacological property of substances in which chronic use leads to a change in the central nervous system, meaning that more of the substance is needed in order to produce desired effects. Stopping or reducing the use of this substance would cause withdrawal symptoms to occur.^[6]

As a value judgment[link]

Legal drugs are not necessarily safer. A study in 2010 asked drug-harm experts to rank various illegal and legal drugs. Alcohol was found to be the most dangerous by far.

Philip Jenkins points out that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries. Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as an abuse. Strict temperance advocates, which may or may not be religiously motivated, would see drinking even one glass as an abuse, and some groups even condemn caffeine use in any quantity. Similarly, adopting the view that any (recreational) use of marijuana or amphetamines constitutes drug abuse implies that we have already decided that the substance is harmful, even in minute quantities.^[7]

Signs and symptoms[link]

Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.^[8]

There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse.^[9] In the USA approximately 30 percent of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.^[10]

Drug abuse, including alcohol and prescription drugs can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during the withdrawal state. In some cases these substance induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation of use and cannabis may trigger panic attacks during intoxication and with use it may cause a state similar to dysthymia^{[citation needed]}. Severe anxiety and depression are commonly induced by sustained alcohol abuse which in most cases abates with prolonged abstinence. Even moderate alcohol sustained use may increase anxiety and depression levels in some individuals. In most cases these drug induced psychiatric disorders fade away with prolonged abstinence.^[11]

Drug abuse makes central nervous system (CNS) effects, which produce changes in mood, levels of awareness or perceptions and sensations. Most of these drugs also alter systems other than the CNS. Some of these are often thought of as being abused. Some drugs appear to be more likely to lead to uncontrolled use than others.^[12]

Traditionally, new pharmacotherapies are quickly adopted in primary care settings, however; drugs for substance abuse treatment have faced many barriers. Naltrexone, a drug originally marketed under the name "ReVia," and now marketed in intramuscular formulation as "Vivitrol" or in oral formulation as a generic, is a medication approved for the treatment of alcohol dependence. This drug has reached very few patients. This may be due to a number of factors, including resistance by Addiction Medicine specialists and lack of resources.^[13]

The ability to recognize the signs of drug use or the symptoms of drug use in family members by parents and spouses has been affected significantly by the emergence of home drug test technology which helps identify recent use of common street and prescription drugs with near lab quality accuracy.

Epidemiology[link]

Disability-adjusted life year for drug use disorders per 100,000 inhabitants in 2002.

  no data

  less than 40

  40-80

  80-120

  120-160

  160-200

  200-240

  240-280

  280-320

  320-360

  360-400

  400-440

  more than 440

The initiation of drug and alcohol use is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.^[14] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.^[14] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.^[15] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million suffered alcohol-related problems.^[16]

Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%).^{[citation needed]} According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."^[17]

Total recorded alcohol per capita consumption (15+), in litres of pure alcohol^[18]

History[link]

APA, AMA, and NCDA[link]

In 1932, the American Psychiatric Association created a definition that used legality, social acceptability, and cultural familiarity as qualifying factors:

…as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien."

^[19]

In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision':

…'use' refers to the proper place of stimulants in medical practice; 'misuse' applies to the physician's role in initiating a potentially dangerous course of therapy; and 'abuse' refers to self-administration of these drugs without medical supervision and particularly in large doses that may lead to psychological dependency, tolerance and abnormal behavior.

In 1973, the National Commission on Marijuana and Drug Abuse stated:

...drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions. It is an eclectic concept having only one uniform connotation: societal disapproval. ... The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong.^[20]

DSM[link]

The first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.

The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987, the DSM-IIIR category "psychoactive substance abuse," which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous." It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis.

By 1988, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal." Substance abuse can be harmful to your health and may even be deadly in certain scenarios

By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, the DSM-IV-TR, defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." followed by criteria for the diagnose^[3]

DSM-IV-TR defines substance abuse as:^[21]

• A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

• B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

The fifth edition of the DSM (DSM-5), planned for release in 2013, is likely to have this terminology revisited yet again. Under consideration is a transition from the abuse/dependence terminology. At the moment, abuse is seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's 'dependence' term, as noted above, does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requests input as to how the terminology of this illness should be altered as it moves forward with DSM-5 discussion.

Society and culture[link]

Legal approaches[link]

Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition

Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what is illegal is their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.^[22][23] In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.^{[citation needed]}

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity.

Cost[link]

It is important to obtain estimates of the costs of problems stemming from substance abuse. In order to make informed decisions when allocating scarce resources, policymakers must have a sound understanding of the relative costs of drug-related interventions. Other things being equal, the lower the cost, the more cost-effective a program or intervention will be, or the higher the net economic benefits it will generate. An appropriate drug policy relies on the assessment of drug related public expenditure on efficiency grounds. This is not feasible without giving a preliminary clear and well-defined classification system where costs are properly identified.

Labelled drug-related expenditures are defined as the direct ex-ante planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. Direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. Unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. Starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (Unlabelled Drug-related Expenditure = Overall Expenditure × Attributable Proportion). For example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given fiscal year, and the attributable proportion of inmates due to drug-related issues. The product of the two will give a rough estimate that can be compared across different countries.^[24]

Europe[link]

As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction's network of national focal points set up in the 27 European Union (EU) Member States, Norway, and the candidates countries to the EU, were requested to identify labeled drug-related public expenditure, at the country level.^[24]

This was reported by 10 countries categorized according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of Health (66%) (e.g. medical services), and Public Order and Safety (POS) (20%) (e.g. police services, law courts, prisons). By country, the average share of GDP was 0.023% for Health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of Health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for Health, and a 6-fold difference for POS. Why do Ireland and the UK spend so much in Health and POS, or Slovakia and Portugal so little, in GDP terms?

To respond to this question and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared Health and POS spending and GDP in the 10 reporting countries. Results found suggest GDP to be a major determinant of the Health and POS drug-related public expenditures of a country. Labelled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of Health, and r = 0.91 for POS. The percentage change in Health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively.

Being highly income elastic, Health and POS expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions.^[24]

UK[link]

The UK Home Office estimated that the social and economic cost of drug abuse^[25] to the UK economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year.^[26] However, it^{[clarification needed]} does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. Those aspects are necessary for a full analysis of the economics of prohibition.^[27]

The Home Office has a recent history of taking a hard line on controlled drugs, including those with no known fatalities and even medical benefits,^[28] in direct opposition to the scientific community.^[29]

US[link]

In the year 1995, drug abuse cost the American economy $109.8 billion.^[13]

Treatment[link]

Treatment for substance abuse is critical for many around the world. Often a formal intervention is necessary to convince the substance abuser to submit to any form of treatment. Behavioral interventions and medications exist that have helped many people reduce, or discontinue, their substance abuse. From the applied behavior analysis literature, behavioral psychology, and from randomized clinical trials, several evidenced based interventions have emerged:

• Behavioral marital therapy
• Motivational Interviewing
• Community reinforcement approach
• Exposure therapy
• Contingency management^[30][31]
• Pharmacological therapy - A number of medications have been approved for the treatment of substance abuse.^{[citation needed]} These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form (under the brand name Vivitrol). Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion (Zyban or Wellbutrin), Modafinil (Provigil) and more.

According to some nurse practitioners, stopping substance abuse can reduce the risk of dying early and also reduce some health risks like heart disease, lung disease, and strokes.^[32]

In children and adolescents, cognitive behavioral therapy (CBT) ^[33] and family therapy ^[34] currently have the most research evidence for the treatment of substance abuse problems. These treatments can be administered in a variety of different formats, each of which has varying levels of research support ^[35]

It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious,^[36] including managing the social environment.^[37]

See also[link]

• Addictive personality
• Combined drug intoxication
• Drug addiction
• Drug overdose
• Harm reduction
• Low-threshold treatment programs
• Needle-exchange programme
• Poly drug use
• Polysubstance abuse
• Risk factors in pregnancy
• List of controlled drugs in the United Kingdom
• List of drug-related deaths
• Self-medication
• Substances controlled for their drug effects by the US federal government

Notes[link]

Further reading[link]

• Lowinson, Joyce H; Ruiz, Pedro; Millman, Robert B; Langrod, John G (eds) (2005). Substance Abuse: A Comprehensive Textbook (4th ed.). Philadelphia: Lippincott Williams & Wilkins. ISBN 0-7817-3474-6. http://books.google.com/books?id=HtGb2wNsgn4C&printsec=frontcover&dq=substance+comprehensive+textbook#v=onepage&q&f=false. Retrieved 2 December 2010 

External links[link]

• Substance abuse at the Open Directory Project

v t e Recreational drug use Major recreational drugs Opioids Buprenorphine (Subutex · Suboxone) Codeine Dextropropoxyphene (Darvon · Darvocet) Diamorphine (heroin) \ Morphine (Opium) Hydrocodone Hydromorphone (Dilaudid) Methadone Mitragyna speciosa (Kratom) Oxycodone Depressants Barbiturates Benzodiazepines Ethanol (Alcoholic beverages) GHB Kava Nonbenzodiazepines Stimulants Amphetamine Arecoline (Areca) Betel Caffeine (Coffee Tea) Cathinone (Khat) Cocaine (Coca) Ephedrine (Ephedra) Mephedrone Methamphetamine Methylphenidate Nicotine (Tobacco) Theobromine (Cocoa) Entactogens MDA MDMA (Ecstasy) Hallucinogens Psychedelics Bufotenin Psychoactive toads Vilca Yopo DMT (Ayahuasca) LSA LSD-25 Mescaline Peruvian Torch Peyote San Pedro Psilocybin \ Psilocin (Psilocybin mushrooms) Dissociatives DXM Inhalants Nitrous oxide alkyl nitrites – poppers, such as amyl nitrite Ketamine MXE Muscimol (Amanita muscaria) PCP Salvinorin A (Salvia divinorum) Deliriants Atropine and Scopolamine Datura Deadly Nightshade Henbane Mandrake Dimenhydrinate Diphenhydramine Cannabinoids JWH-018 THC (Cannabis Hashish Hash oil) Oneirogens Calea zacatechichi Silene capensis Drug culture Cannabis 420 Cannabis cultivation Cannabis smoking Legal history of cannabis in the United States Legality of cannabis Marijuana Policy Project Medical cannabis NORML Religious and spiritual use of cannabis Stoner film Psychedelic Art Drug Experience Literature Music Other Club drug Counterculture of the 1960s Dance party Drug paraphernalia Drug tourism Entheogen Hippie Party and play Poly drug use Rave Self-medication Sex and drugs Problems with drug use Abuse Dependence Prevention Opioid replacement therapy Rehabilitation Responsible use Drug-related crime Fetal alcohol spectrum disorder Illegal drug trade Long-term effects of cannabis Neurotoxicity Overdose Date-rape drug Passive smoking (of tobacco or other substances) Legality of drug use International 1961 Narcotic Drugs 1971 Psychotropic Substances 1988 Drug Trafficking Cannabis reform at the international level State level Drug policy Decriminalization Prohibition Supply reduction Policy reform Demand reduction Drug Policy Alliance Harm reduction Law Enforcement Against Prohibition Liberalization Students for Sensible Drug Policy Transform Drug Policy Foundation Drug policy by country Australia Canada Germany India Netherlands Portugal Sweden Switzerland Soviet Union United States Just Say No Office of National Drug Control Policy School district drug policies California Colorado Maryland Virginia Other Arguments for and against drug prohibition Capital punishment for drug trafficking Designer drug Drug court Drug possession Drug test Hard and soft drugs Illegal drug trade in Colombia Mexican Drug War Narc Opium production in Afghanistan Politics of drug abuse War on Drugs Zero tolerance Lists of countries by... Alcohol consumption Cannabis legality Annual use Lifetime use Cigarette consumption Cocaine use Opiates use

Alan Wilson Watts

Born	(1915-01-06)6 January 1915 Chislehurst, Kent, England
Died	16 November 1973(1973-11-16) (aged 58) Mt. Tamalpais, California, USA
Era	Contemporary philosophy
Region	Eastern Philosophy
School	Zen Buddhism · Hinduism · Pantheism · Religious naturalism · Taoism
Main interests	Personal identity · Higher consciousness · Aesthetics  · Public Ethics

Alan Wilson Watts (6 January 1915 – 16 November 1973) was a British philosopher, writer, and speaker, best known as an interpreter and populariser of Eastern philosophy for a Western audience. Born in Chislehurst, he moved to the United States in 1938 and began Zen training in New York. Pursuing a career, he attended Seabury-Western Theological Seminary, where he received a master's degree in theology. Watts became an Episcopal priest but left the ministry in 1950 and moved to California, where he joined the faculty of the American Academy of Asian Studies.

Living on the West Coast, Watts gained a large following in the San Francisco Bay Area while working as a volunteer programmer at KPFA, a Pacifica Radio station in Berkeley. Watts wrote more than 25 books and articles on subjects important to Eastern and Western religion, introducing the then-burgeoning youth culture to The Way of Zen (1957), one of the first bestselling books on Buddhism. In Psychotherapy East and West (1961), Watts proposed that Buddhism could be thought of as a form of psychotherapy and not just a religion. Like Aldous Huxley before him, he explored human consciousness in the essay, "The New Alchemy" (1958), and in the book, The Joyous Cosmology (1962).

Towards the end of his life, he divided his time between a houseboat in Sausalito and a cabin on Mount Tamalpais. His legacy has been kept alive by his son, Mark Watts, and by many of his recorded talks and lectures that have found new life on the Internet. According to the critic Erik Davis, his "writings and recorded talks still shimmer with a profound and galvanizing lucidity."^[1]

Early years[link]

Watts was born to middle class parents in the village of Chislehurst, Kent, in 1915, living at 3 (now 5) Holbrook Lane. His father was a representative for the London office of the Michelin Tyre Company, his mother a housewife whose father had been a missionary. With modest financial means, they chose to live in pastoral surroundings and Alan, an only child, grew up playing at brookside, learning the names of wildflowers and butterflies.^[2] Probably because of the influence of his mother’s religious family^[3] the Buchans, an interest in "ultimate things" seeped in. But it mixed with Alan’s own interests in storybook fables and romantic tales of the mysterious Far East.^[4]

Watts also later wrote of a mystical vision he experienced while ill with a fever as a child. During this time he was influenced by Far Eastern landscape paintings and embroideries that had been given to his mother by missionaries returning from China. The few Chinese paintings Watts was able to see in England riveted him, and he wrote "I was aesthetically fascinated with a certain clarity, transparency, and spaciousness in Chinese and Japanese art. It seemed to float...".^[5] These works of art emphasized the participative relationship of man in nature, a theme that stood fast throughout his life.

Buddhism[link]

Seated Great Buddha (Daibutsu), Kamakura, Japan

By his own assessment, Watts was imaginative, headstrong, and talkative. He was sent to boarding schools (which included both academic and religious training of the Muscular Christianity sort) from early years. Of this religious training, he remarked “Throughout my schooling my religious indoctrination was grim and maudlin…”^[6] During holidays in his teen years, Francis Croshaw, a wealthy Epicurean with strong interests in both Buddhism and the exotic little-known aspects of European culture, took Watts on a trip through France. It was not long afterward that Watts felt forced to decide between the Anglican Christianity he had been exposed to and the Buddhism he had read about in various libraries, including Croshaw’s. He chose Buddhism, and sought membership in the London Buddhist Lodge, which had been established by Theosophists, and was now run by the barrister Christmas Humphreys. Watts became the organization’s secretary at 16 (1931). The young Watts explored several styles of meditation during these years.

Education[link]

Watts attended The King's School next door to Canterbury Cathedral. Though he was frequently at the top of his classes scholastically, and was given responsibilities at school, he botched an opportunity for a scholarship to Oxford by styling a crucial examination essay in a way that was read as presumptuous and capricious.^[7]

Hence, when he graduated from secondary school, Watts was thrust into the world of employment, working in a printing house and later a bank. He spent his spare time involved with the Buddhist Lodge and also under the tutelage of a "rascal guru" named Dimitrije Mitrinović. (Mitrinović was himself influenced by Peter Demianovich Ouspensky, G. I. Gurdjieff, and the varied psychoanalytical schools of Freud, Jung and Adler.) Watts also read widely in philosophy, history, psychology, psychiatry and Eastern wisdom. By his own reckoning, and also by that of his biographer Monica Furlong, Watts was primarily an autodidact. His involvement with the Buddhist Lodge in London afforded Watts a considerable number of opportunities for personal growth. Through Humphreys, he contacted eminent spiritual authors (e.g., Nicholas Roerich, Dr. Sarvapalli Radhakrishnan) and prominent theosophists like Alice Bailey. In 1936, aged 21, he attended the World Congress of Faiths at the University of London, heard D. T. Suzuki read a paper, and afterwards was able to meet this esteemed scholar of Zen Buddhism. Beyond these discussions and personal encounters, Watts absorbed, by studying the available scholarly literature, the fundamental concepts and terminology of the main philosophies of India and East Asia.

Influences and first publication[link]

In 1936, Watts' first book was published, The Spirit of Zen, which he later acknowledged to be mainly digested from the writings of Suzuki.

In 1938 he and his bride left England to live in America. He had married Eleanor Everett, whose mother Ruth Fuller Everett was involved with a traditional Zen Buddhist circle in New York. A few years later, Ruth Fuller married the Zen master (or "roshi"), Sokei-an Sasaki, and this Japanese gentleman served as a sort of model and mentor to Watts, though he chose not to enter into a formal Zen training relationship with Sasaki. During these years, according to his later writings, Watts had another mystical experience while on a walk with his wife.

Watts' fascination with the Zen (or Chan) tradition—beginning during the 1930s—developed because that tradition embodied the spiritual, interwoven with the practical, as exemplified in the subtitle of his Spirit of Zen: A Way of Life, Work, and Art in the Far East. "Work," "life," and "art" were not demoted due to a spiritual focus.

Priesthood and after[link]

Watts left formal Zen training in New York because the method of the teacher didn't suit him. He was not ordained as a Zen monk, but he felt a need to find a professional outlet for his philosophical inclinations. He entered Seabury-Western Theological Seminary, an Anglican (Episcopalian) school in Evanston, Illinois, where he studied Christian scriptures, theology, and Church history. He attempted to work out a blend of contemporary Christian worship, mystical Christianity, and Asian philosophy. Watts was awarded a master's degree in theology in response to his thesis, which he published as a popular edition under the title Behold the Spirit. The pattern was set, in that Watts did not hide his dislike for religious outlooks that he decided were dour, guilt-ridden, or militantly proselytizing—no matter if they were found within Judaism, Christianity, Hinduism, or Buddhism.

All seemed to go reasonably well in his next role, as Episcopalian priest (beginning in 1945, aged 30), until an extramarital affair resulted in his young wife having their marriage annulled. It also resulted in Watts leaving the ministry by 1950. He spent the New Year getting to know Joseph Campbell; his wife, Jean Erdman; and John Cage.

In early 1951, Watts moved to California, where he joined the faculty of the American Academy of Asian Studies in San Francisco. Here he taught alongside Saburō Hasegawa, Frederic Spiegelberg, Haridas Chaudhuri, lama Tokwan Tada, and various visiting experts and professors. Hasegawa, in particular, served as a teacher to Watts in the areas of Japanese customs, arts, primitivism, and perceptions of nature. Besides teaching, Watts served for several years as the Academy's administrator. One notable student of his was Eugene Rose, who later went on to become a famous Hieromonk and theologian in the Eastern Orthodox Church of America.

Watts also studied written Chinese and practiced Chinese brush calligraphy with Hasegawa as well as with some of the Chinese students who enrolled at the Academy. While Watts was noted for an interest in Zen Buddhism, his reading and discussions delved into Vedanta, "the new physics", cybernetics, semantics, process philosophy, natural history, and the anthropology of sexuality.

Middle years[link]

After heading up the Academy for a few years, Watts left the faculty for a freelance career in the mid 1950s. In 1953, he began what became a long-running weekly radio program at Pacifica Radio station KPFA in Berkeley, which continued until his death in 1973. Like other volunteer programmers at the listener-sponsored station, Watts was not paid for his broadcasts; they did, however, gain him a large following in the San Francisco Bay Area. These programs were later carried by additional Pacifica stations, and were re-broadcast many times over in the decades following his death. The original tapes are currently held by the Pacifica Radio Archives, based at KPFK in Los Angeles, and at the Electronic University archive founded by his son, Mark Watts (alanwatts.org).

In 1957 when 42, Watts published one of his best known books, The Way of Zen, which focused on philosophical explication and history. Besides drawing on the lifestyle and philosophical background of Zen, in India and China, Watts introduced ideas drawn from general semantics (directly from the writings of Alfred Korzybski and also from Norbert Wiener's early work on cybernetics, which had recently been published). Watts offered analogies from cybernetic principles possibly applicable to the Zen life. The book sold well, eventually becoming a modern classic, and helped widen his lecture circuit.

Around this time, Watts toured parts of Europe with his father, meeting the renowned psychiatrist Carl Jung. In relation to modern psychology, Watts's instincts were closer to Jung's or Abraham Maslow's than to those of Freud.

Experimentation[link]

When he returned to the United States, he began to dabble in psychedelic drug experiences, initially with mescaline given to him by Dr. Oscar Janiger. He tried LSD several times with various research teams led by Drs. Keith Ditman, Sterling Bunnell, and Michael Agron. He also tried marijuana and concluded that it was a useful and interesting psychoactive drug that gave the impression of time slowing down. Watts’ books of the ’60s reveal the influence of these chemical adventures on his outlook. He would later comment about psychedelic drug use, "When you get the message, hang up the phone."^[8]

For a time, Watts came to prefer writing in the language of modern science and psychology (Psychotherapy East and West is a good example), finding a parallel between mystical experiences and the theories of the material universe proposed by 20th-century physicists. He later equated mystical experience with ecological awareness, and typically emphasized whichever approach seemed best suited to the audience he was addressing.

Supporters and critics[link]

Watts's explorations and teaching brought him into contact with many noted intellectuals, artists, and American teachers in the human potential movement. His friendship with poet Gary Snyder nurtured his sympathies with the budding environmental movement, to which Watts gave philosophical support. He also encountered Robert Anton Wilson, who credited Watts with being one of his "Light[s] along the Way" in the opening appreciation of Cosmic Trigger.

Though never affiliated for long with any one academic institution, he did have a fellowship for several years at Harvard University. He also lectured to many college and university students. His lectures and books gave him far-reaching influence on the American intelligentsia of the 1950s–1970s, but he was often seen as an outsider in academia. When questioned sharply by students during his talk at University of California Santa Cruz in 1970, Watts responded that he was not an academic philosopher but rather "a philosophical entertainer."

Watts has been criticized by Buddhists such as Roshi Philip Kapleau, John Daido Loori, and D. T. Suzuki for allegedly misinterpreting several key concepts of Zen Buddhism. Examples of the criticisms by those who believe that zazen can only be achieved by a strict and specific means of sitting as opposed to a cultivated state of mind available at any moment in any situation would be when Kapleau claimed that Watts dismissed zazen on the basis of only half a koan.^[9] In regard to the aforementioned koan, Robert Baker Aitken reports that Suzuki told him "I regret to say that Mr. Watts did not understand that story."^[10] In Loori's translation of Dogen's The True Dharma Eye, the author also mentions this and expands further to suggest that Zen in its essence is zazen, and cannot be grasped without the practice. This had been the predominant interpretation of Zen in the West before Alan Watts began to write. One major point raised today, however, is that the state of Zen is like that of a dog, always in the moment, regretting nothing. Although in one Koan Zhaozhou is said to have answered that a Dog does not have Buddha nature, in a different Koan from the same period Zhaozhou answered the same question in the positive, demonstrating the disagreements between the sects of 'walking monks' and 'sitting monks' that go back thousands of years. In his talks, Watts addressed the issue of defining zazen practice when he said, "A cat sits until it is tired of sitting, then gets up, stretches, and walks away."

He did, however, have his supporters in the Zen community, including Shunryu Suzuki, the founder of the San Francisco Zen Center. As David Chadwick recounted in his biography of Suzuki, when a student of Suzuki's disparaged Watts by saying “we used to think he was profound until we found the real thing," Suzuki "fumed with a sudden intensity," saying, "You completely miss the point about Alan Watts! You should notice what he has done. He is a great bodhisattva."^[11]

Applied aesthetics[link]

Watts often wrote about, or sometimes alluded to, a group of neighbors in Druid Heights (near Mill Valley, California), who had endeavored to combine architecture, gardening, and carpentry skills to make a beautiful and comfortable life for themselves. These neighbors accomplished this by relying on their own talents and using their own hands, as they lived in what has been called "shared bohemian poverty."^[12] Druid Heights was founded by the writer Elsa Gidlow,^[13] and Watts dedicated his book The Joyous Cosmology to the people of this neighborhood.^[14]

Regarding his intentions, Watts attempted to lessen the alienation that accompanies the experience of being human that he felt plagued the modern Westerner, and (like his fellow British expatriate and friend, Aldous Huxley) to lessen the ill will that was an unintentional by-product of alienation from the natural world. He felt such teaching could improve the world, at least to a degree. He also articulated the possibilities for greater incorporation of aesthetics (for example: better architecture, more art, more fine cuisine) in American life. In his autobiography he wrote, "… cultural renewal comes about when highly differentiated cultures mix".^[15]

In his last novel Island (1962), Aldous Huxley mentions the religious practice of maithuna as being something like what Roman Catholics call "coitus reservatus". A few years before, Alan Watts had discussed the theme in his own book Nature, Man and Woman. There, he discusses the possibility of the practice being known to early Christians and of it being kept secretly by the Church.

Later years[link]

In his writings of the 1950s, he conveyed his admiration for the practicality in the historical achievements of Chán (Zen) in the Far East, for it had fostered farmers, architects, builders, folk physicians, artists, and administrators among the monks who had lived in the monasteries of its lineages.

In his mature work, he presents himself as "Zennist" in spirit as he wrote in his last book, Tao: The Watercourse Way. Child rearing, the arts, cuisine, education, law and freedom, architecture, sexuality, and the uses and abuses of technology were all of great interest to him.

Though known for his Zen teachings, he was equally if not more influenced by ancient Hindu scriptures, especially Vedanta, and spoke extensively about the nature of the divine Reality Man that Man misses, how the contradiction of opposites is the method of life and the means of cosmic and human evolution, how our fundamental Ignorance is rooted in the exclusive nature of mind and ego, how to come in touch with the Field of Consciousness and Light, and other cosmic principles. These are discussed in great detail in dozens of hours of audio that are in part captured in the ‘Out of Your Mind’ series.

On the personal level, Watts sought to resolve his feelings of alienation from the institutions of marriage and the values of American society, as revealed in his classic comments on love relationships in "Divine Madness" and on perception of the organism-environment in "The Philosophy of Nature".

In looking at social issues he was quite concerned with the necessity for international peace, for tolerance and understanding among disparate cultures. He also came to feel acutely conscious of a growing ecological predicament; as one instance, in the early 1960s he wrote: “Can any melting or burning imaginable get rid of these ever-rising mountains of ruin—especially when the things we make and build are beginning to look more and more like rubbish even before they are thrown away?"^[16] These concerns were later expressed in a television pilot made for NET filmed at his mountain retreat in 1971 in which he noted that the single track of conscious attention was wholly inadequate for interactions with a multi-tracked world.

Political stance[link]

Distrusting both the established political left and right, Watts found political inspiration in the Chinese sage Chuang-Tzu, an ancient Taoist thinker^{[citation needed]}. He disliked much in the conventional idea of "progress." He hoped for change, but personally he preferred amiable, semi-isolated rural social enclaves, and also believed in tolerance for urban tenderloins, social misfits, and eccentric artists. Watts decried the suburbanization of the countryside and the way of life that went with it.

In one campus lecture tour, which Watts titled "The End to the Put-Down of Man", Watts presented positive images for both nature and humanity, spoke in favor of the various stages of human growth (including the teenage years), reproached excessive cynicism and rivalry, and extolled intelligent creativity, good architecture and food^{[citation needed]}.

On spiritual and social identity[link]

Watts felt that absolute morality had nothing to do with the fundamental realization of one’s deep spiritual identity. He advocated social rather than personal ethics. In his writings, Watts was increasingly concerned with ethics applied to relations between humanity and the natural environment and between governments and citizens. He wrote out of an appreciation of a racially and culturally diverse social landscape.

He often said that he wished to act as a bridge between the ancient and the modern, between East and West, and between culture and nature.

Watts led some tours for Westerners to the Buddhist temples of Japan. He also studied some movements from the traditional Chinese martial art T'ai chi ch'uan, with an Asian colleague, Al Chung-liang Huang.

Worldview[link]

In several of his later publications, especially Beyond Theology and The Book on the Taboo Against Knowing Who You Are, Watts put forward a worldview, drawing on Hinduism, Chinese philosophy, pantheism, and modern science, in which he maintains that the whole universe consists of a cosmic self playing hide-and-seek (Lila), hiding from itself (Maya) by becoming all the living and non-living things in the universe, forgetting what it really is; the upshot being that we are all IT in disguise. In this worldview, Watts asserts that our conception of ourselves as an "ego in a bag of skin" is a myth; the entities we call the separate "things" are merely processes of the whole.

Internet phenomenon[link]

As part of his growing popularity, Matt Stone and Trey Parker—creators of the animated series South Park—have also contributed a video tribute by animating some of his lectures. This has spawned a culture of user-animated videos all around the net.^[17]

Personal life[link]

Watts married three times and had seven children, five daughters and two sons. His oldest son, Mark Watts, currently serves as curator of his father's work.

Watts met Eleanor Everett in 1936, when her mother, Ruth Fuller Everett, brought her to London to study piano. They met at the Buddhist Lodge, were engaged the following year and married in April 1938. A daughter, Joan, was born November 1938 and another, Anne, was born in 1943. Their marriage ended eleven years later, but Watts continued to correspond with his former mother-in-law.^[18]

After leaving Eleanor in 1950, Watts married Dorothy DeWitt and moved to San Francisco in early 1951 to teach. They began a family that grew to include five children: Tia, Mark, Richard, Lila, and Diane. However the couple separated in the early sixties after Watts met Mary Jane Yates King while lecturing in New York. After a difficult divorce he married Mary Jane in 1964.

Watts lived with Mary Jane in Sausalito, California, in the mid-60s.^[19] He lived his later years at times on a houseboat in Sausalito called the Vallejo,^[20] and at times in a secluded cabin on Mount Tamalpais.

In October 1973, Watts returned from an exhausting European lecture tour to his cabin in Mount Tamalpais. On November 16, 1973, he died in his sleep of heart failure.

Publications[link]

• 1936 The Spirit of Zen, Paperback. 1969 ISBN 0-8021-3056-9 A preview from Google Books
• 1937 The Legacy of Asia and Western Man
• 1940 The Meaning of Happiness, Paperback. 1970, ISBN 0-06-080178-6
• 1944 Theologica Mystica of St. Dionysius, (translation from Greek of pseudo-Dionysius, available online)
• 1948 Behold the Spirit:A Study in the Necessity of Mystical Religion, Vintage ed. 1972, ISBN 0-394-71761-9
• 1950 Easter – Its Story and Meaning
• 1950 The Supreme Identity, Vintage ed. 1972, ISBN 0-394-71835-6
• 1951 The Wisdom of Insecurity, Vintage ed. 1968, ISBN 0-394-70468-1
• 1953 Myth and Ritual in Christianity, Beacon Press 1971, ISBN 0-8070-1375-7
• 1957 The Way of Zen, Vintage Spiritual Classics 1999, ISBN 0-375-70510-4
• 1958 Nature, Man, and Woman, Vintage reissue 1991, ISBN 0-679-73233-0
• 1959 Beat Zen Square Zen and Zen, Paperback, ASIN B000F2RQL4
• 1960 "This Is It" and Other Essays on Zen and Spiritual Experience, Vintage reprint 1973, ISBN 0-394-71904-2
• 1961 Psychotherapy East and West, Vintage ed. 1975, ISBN 0-394-71609-4 An excerpt
• 1962 The Joyous Cosmology – Adventures in the Chemistry of Consciousness
• 1963 The Two Hands of God – The Myths of Polarity
• 1964 Beyond Theology – The Art of Godmanship, Vintage 1973, ISBN 0-394-71923-9
• 1966 The Book – On the Taboo Against Knowing Who You Are, Vintage reissue 1989, ISBN 0-679-72300-5 An excerpt
• 1967 Nonsense, ISBN 0-525-47463-3. (This book is a spiritual application of literary nonsense).
• 1970 Does It Matter?: Essays on Man's Relation to Materiality, Vintage ed. 1971, ISBN 0-394-71665-5
• 1971 Erotic Spirituality – The Vision of Konarak
• 1972 The Art of Contemplation
• 1972 In My Own Way – An Autobiography 1915–1965, Vintage 1973, ISBN 0-394-71951-4 A preview from Google Books
• 1973 Cloud-hidden, Whereabouts Unknown: A Mountain Journal, Vintage 1974, ISBN 0-394-71999-9