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There’s No Biological Free Lunch (From Drugs)

Everyone wants to take drugs, eat foods, and supplements for short-term gain, but most are not prepared to face the long-term consequences.  Most people are okay with binging on carbohydrates (e.g. chips, pretzels, pastas), sugary treats (e.g. ice cream), and alcohol – but are totally unaware that there’s a biological consequence for each of their decisions.  Ingesting certain substances will have a biological strengthening effect, while ingesting others will decrease our mental and physical strength.

This is why people get a stomach ache after eating a whole pizza, or why they feel sick after eating too much cake.  It’s because for every short-term hedonistic euphoria, there’s an inevitable oppositional effect – even if it cannot be pinpointed.  Some people become so caught up in short-term pleasures from drugs, foods, etc. – that they end up facing long-term health consequences that seem to befuddle them.

In reality, there’s a complex biological reaction associated with each of the choices they make: foods that are consumed, drugs that are ingested, environment they live in, etc.  This article is focused mostly on the drug aspect of the “biological free lunch” that everyone is out to get.  Everyone wants the Utopian long-term sustained efficacy of a drug with no side effects and no withdrawals (e.g. a “biological free lunch”).

Unfortunately, this is not biologically feasible – we didn’t evolve to take drugs.  If you want gratification from a drug whether it be short-term, moderate-term, or long-term, you’re going to need to pay the biological costs.  You can’t expect to use up all your dopamine for momentary pleasure only to feel like equally oppositional crap upon discontinuation.

What is a “biological free lunch?”

We’ve all heard the expression “there’s no such thing as a free lunch.”  This implies that in order to get our midday meal, we have to earn it.  We can earn it by working to earn money, which can then be exchanged for a lunch.  Our hard work indirectly gave us the money to attain a lunch that was not free – it had a price.  To get a better quality lunch (e.g. wild salmon), we will likely have to work harder than we would for a frozen pizza.

Theoretically, you could also steal a lunch and it would not be free.  However, stealing a lunch would come at a cost and produce a backlash.  You may become paranoid or feel guilty if you don’t get caught, you may get caught and end up with jail time and a ruined reputation, and you may be banned from shopping at the place you stole from in the future.  No drug allows you to attain a biological free lunch.

Whatever substance you take to give you a desirable effect – that effect is likely coming at a cost – even if you don’t know it.  If you’re taking an antidepressant that’s been working well for 10 years and you’re happy, you may have also gained weight, experienced heart problems, or high blood pressure.  Regardless of the substance that you take to get an effect, even if you’re high on your own adrenaline, there will be an inevitable crash.

Evidence that there’s no biological free lunch…

While not all drugs elicit the same effects, an easy way to understand that there’s no biological free lunch is by drinking a large quantity of alcohol to the point that you’re drunk.  If you keep drinking, you’ll likely experience side effects (e.g. dizziness, poor coordination, reduced cognitive function) and you’ll wake up the next day with an uncomfortable hangover (characterized by vomiting, nausea, and lethargy).  As much fun as you had getting drunk, you may experience the equivalent opposite the very next day.

Alcohol is not the only substance that we could pick on, plenty of other drugs do the same thing.  Take the popular psychostimulant Adderall for example and you’ll probably feel more focused, motivated, and in a better mood.  However as the effect wears off, you’ll likely experience an “Adderall crash” – characterized by lethargy, sleepiness, and poor concentration.

Factors to consider in the case of a biological free lunch

Some people may argue that there is in fact a “biological free lunch” that should be associated with certain substances (e.g. nootropics).  However, many of these same individuals are currently still getting the effect and haven’t stopped using these substances to face the backlash of consequences.  In theory, it is possible that certain substances may be physiologically protective and/or restorative, but most pharmaceuticals (and even foods) are not.

1. The Drug

Certain drugs are going to pack more of a biological punch than others.  Some will get you “high” upon ingestion – these are usually controlled substances or illicit drugs.  Other drugs may take a longer time to achieve an effect (e.g. antidepressants), but the effect will still be strong.  Those with less potent effects like caffeine will likely have minimally noticeable biological consequences.

2. Dosage

Both the particular drug and the dosage dictate its potency.  Those taking a high dose of a particular drug are more likely to experience more noticeable biological consequences than those taking lower doses.  A good rule of thumb when taking any drug is to take only the “minimal effective dose.”  In other words, it means starting at a subtherapeutic dose, and working your way up to whatever works – particularly with psychiatric medications.

3. Duration & Frequency

The duration and frequency of drug ingestion will also determine the biological consequences.  Those that have used a substance infrequently over a short-term will likely not have as severe of consequences to pay as someone who’s used the same drug over a long-term.  Most long-term frequent users of any drug (alcohol, caffeine, marijuana, etc.) notice that the effect diminishes.

In other words, the “effect” or “high” that they attained from their initial drug usage wasn’t matched by subsequent uses.  Even people notice that over time, their antidepressant stops working and their doctor recommends increasing the dose – this is a result of tolerance.  Should a person want to stop after long-term usage, they’ll notice antidepressant dependence, and withdrawals may be perceived as insurmountable.

Due to biological consequences, in most cases it is recommended to take the drug as long as you need, but no longer.  Piggybacking on the antidepressant example, this is why it needs to be emphasized that people need to learn how to use antidepressants properly (as a tool) rather than relying on them in order to function.  Same goes for all therapeutic substances – use them as a temporary tool, rather than a long-term crutch.

4. Individual factors

Some people will argue that they’ve never experienced biological consequences from a certain drug.  This may be chalked up to impeccable genetics, but it may also be due to the fact that the person lacks awareness of the consequences.  Some people are in such a “haze” that they wouldn’t even be able to recognize the biological consequences if the consequences extended a limb and smacked them in the face.

  • Age: Any drug that affects the brain may have more potent effects based on a person’s age.  Those with developing brains (e.g. people under 25) may end up permanently altering their neurochemistry and neural development by using certain drugs.  Therefore it is recommended to minimize drug and unnecessary supplement usage until a person is at least 25 years of age.
  • Awareness: Some people are very externally focused and aren’t in touch with their bodies to the point that they cannot distinguish that they are experiencing a withdrawal, side effects, or consequences as a result of using a particular drug.  While it is possible to not have noticeable withdrawals if a person uses a low amount of a substance infrequently, many people simply lack the awareness to pick up on subtle changes that may have resulted from their drug consumption.
  • Environment: Certain individuals live in a calm, happy, safe environment, while others are faced with dodging potential violence and finding their next meal.  If you live in a difficult environment, it may be tougher to cope with biological consequences of using a particular drug.
  • Genetics: It has been speculated that genetics dictate how quickly a person will recover from using a drug and/or the severity of biological consequences.  Someone who is at a naturally “happy” genetic set point” may experience “mild depression” when discontinuing a medication, whereas a person who has a preexisting mental illness may experience “severe, suicidal depression” when discontinuing the same drug and dosage.
  • Lifestyle: Some of the biological consequences of drugs can be mitigated with healthy lifestyle habits such as proper diet, exercise, sleep, stress reduction, and social interaction.  Even with the perfect lifestyle, not all biological consequences can be reduced.  Lifestyle generally helps those dealing with biological consequences of drug usage to better cope with them.
  • Other drugs: Many people are on poly-drug combinations and end up noticing that they feel “OK” when they discontinue one medication.  In these cases, the other substances are generally masking the consequences of the drug that was discontinued.  It isn’t until the individual discontinues all of the substances that they get hit with a double, triple, or quadruple whammy of biological consequences.
  • Supplements: In addition to pharmaceutical drugs, various supplements may also mask withdrawal symptoms of certain medications or biological consequences.  While some supplements may not carry any major biological consequences, many do.  Even people taking certain nootropics for extended periods of time tend to find that most wear off, followed by an oppositional mental crash upon discontinuation.

Drug-Based Biological Consequences

There are several different types of biological consequences associated with using various drugs.

  • Anecdotal consequences:  These are the consequences that maybe haven’t been sufficiently reported, but are circulating online in forums, anecdotal reports, etc.  They may not have been reported in scientific journals, and your doctor may be unaware of them, but word of mouth from other first-hand users has confirmed your experience.
  • Documented consequences: These are the consequences that have been scientifically documented and are present in literature.  These are the consequences that your doctor knows about and that you could read about in a medical journal.  The documented consequences are constantly being updated as science gets better.
  • Logical consequences: These are the consequences that theoretically should happen when you discontinue a medication or continue to use it.  For example, using a DRI (dopamine reuptake inhibitor) should burn up a lot of dopamine over the long-term.  Logically, you’d think that after awhile, you’ll end up with low dopamine levels that will need to be replenished.  The same concept applies to SSRIs.
  • Unrelated consequences: These are consequences that nobody really knows about but could be from the drug that you’re taking.  In other words, you may end up with joint pain after taking an antidepressant for 5-years.  The unrelated consequences will leave you befuddled, thinking that something else had to be the direct cause, when in fact the drug you were taking, altered biological function “A” which had a cascade effect on biological functions “B,” “C,” and “D” which resulted in chronic joint pain.  Some people are able to connect the dots between unrelated consequences such as: When I started or stopped taking “drug X” I noticed that I developed eye twitching.
  • Unknown consequences: There are many consequences that we likely don’t know about nor know how to measure as a result of taking certain drugs.  Therefore it is important to never assume that all side effects, withdrawal symptoms, and long-term effects are set in stone and have already been covered.  Drugs get approved all the time, then you see a lawsuit commercial on TV in 10 years explaining that they’re associated with a severe health hazard or condition.

Cost-Benefit Analysis: Some “Lunches” are (Likely) a Better Deal than Others

There are likely people out there reading this article thinking, well marijuana doesn’t have any consequences – it gives me a biological free lunch.  I’d like to direct those individuals over to the marijuana withdrawal symptoms page to read some accounts of people that are experiencing gut-wrenching discontinuation effects (biological consequences).  That said, some lunches are a better deal than others.

It is important to always conduct a cost-benefit analysis prior to taking a drug as well as while you are taking it.  It is also important to keep in mind the fact that for some individuals, the cost associated with not taking a medication may be greater than taking one.  This applies to those who may not be able to function physically or mentally without a specific drug.  In these cases, it is important to choose the optimal drug and the minimal effective dosing.

Consider the following…

  • Dosing: Taking a high dose of a drug may give you a more desirable short-term effect, but the long-term consequences may be unfavorable. Therefore it should be recommended in all cases to take the minimal effective amount or least amount that successfully treats the condition.
  • Efficacy: Some drugs are clearly more effective for treating certain conditions than others. The goal should be to choose the most effective drug with the least biological consequences, both short-term (e.g. side effects) and long-term (e.g. discontinuation effects / potentially permanent effect).
  • Individual genetics: If there are genetic tests that can determine individual reactions to certain drugs, get them done. For example, now people can test for MTHFR gene polymorphisms to dictate over or undermethylation and there are other companies that offer genetic testing to determine antidepressant efficacy.
  • Mechanism of action: Certain drugs may have safer and more targeted mechanisms of action than others. Instead of dropping a neurochemical equivalent of an “atomic bomb” they are designed to act as “smart bombs” – targeting a specific neurotransmitter or receptor rather than the entire brain.
  • Necessity: If you are medicating a certain condition, make sure that the medication you’re taking is a necessity. Talk to an experienced professional and make sure you absolutely 100% need the drug without a second thought in order to function.  If you plan on taking an antidepressant, but could’ve overcome depression using logic and lifestyle changes, you may pay for it over the long-term.
  • Scientific literature: Although newer drugs may seem safer, they probably don’t have as much scientific literature surrounding their usage. Long-term scientific evidence suggesting that a drug is safe is what people should want.  The more long-term and favorable the literature, the greater the likelihood of safety.
  • Side effects: Take a look at the side effect profile of any drug that you plan on taking and realize the potential consequences. Many people believe that the drug they take will be void of side effects – which is generally never true.
  • Withdrawal symptoms: Most people hop on a drug without even considering the implications of a future withdrawal. Then when they attempt to discontinue, they realize that they’ve really dug themselves into a deep hole.  In most cases, the greater the effect of the drug, the more pronounced and contrasting the withdrawal symptoms.

Are biological consequences of all drugs equally oppositional to the desired effect?

No.  Many people think that for every action, there’s an equal and opposite reaction.  While that is true for physics, it’s not necessarily true for drug usage.  Some people end up getting a pretty “good deal” on their biological lunch, while others end up getting ripped off – overpaying for a sandwich out of the dumpster.  In most cases though, the biological consequences are close to being equally oppositional, but this isn’t always accurate.

Example of a “good deal” (Greater benefit than debt)

Some people have reported good deals from certain drugs, taking them for years and experiencing no major withdrawal symptoms or unfavorable side effects.  These good deals are few and far between and unlikely to apply to everyone.  A combination of aforementioned factors are usually favorable for the individual and they have found a way to mitigate some of the unpleasant effects that they’re experiencing.

An example of a drug that some have considered a biological “good deal” is that of Provigil – it helps them focus, without a noticeable withdrawal or side effects.  This isn’t to say that Provigil is a utopian drug though, not everyone has the same experience.

Example of a “rip off” (Greater debt than benefit)

An example of getting ripped off would be taking an antidepressant that’s supposed to make you feel good, but it ends up making you feel worse. (Read: Antidepressants can increase depression and suicidality).  You take it for awhile, and end up experiencing a deeper, more severe depression than you have in your entire life.  When you quit taking the drug, you somehow managed to feel even worse than you did while taking it; you hit the lowest of the lows.

In this case, not only are you now paying the consequences with an antidepressant-induced chemical imbalance, you never even got a good lunch in the first place.  You took a drug that made you feel worse, and you feel worse as a result of the biological consequences that occurred as a result of taking it.  It is important to realize that the drug’s effect doesn’t always need to be “desirable” for the concept to apply.

Another example would be taking a certain substance and then experiencing a permanent drug-induced psychosis.  While this is a rare consequence, it can happen to some people.  In other words, the drug permanently alters a person’s neurochemistry, making them prone to future psychotic episodes or involve an extensive (long-term) recovery period.

Example of “you get what you pay for” (Equal benefit to debt ratio)

An example of getting what you pay for at lunch would be taking a drug that does what it’s intended to do, then experiencing biological consequences equally oppositional to the benefit.  In other words, you may end up taking an antidepressant and notice that you feel significantly better while taking it.  However, you may notice that you end up gaining a little bit of weight and cannot focus as well (due to side effects).

You may also notice that although you feel happier, you notice that depressive feelings come back two-fold when you discontinue the medication.  In this case, you know that you’ll have to put up with some side effects and withdrawals (biological sacrifices) in order to attain the favorable effect from the drug (lunch).

Note: You may not fit one of these descriptions perfectly, but chances are you can identify with one more than the others.

General rules to consider when taking a drug

There are some general rules that you may want to consider when taking any drug.  A smart way to think about this is that the duration of the “high” or desired effect, usually dictates the duration of the “low” or counter-effect upon withdrawal.

  • Short-term benefits may result in short-term detriment: This means that a drug that provides short-term benefit (e.g. treating a cold) may come with short-term side effects such as lethargy, grogginess, dry mouth, etc.  It is important to also consider that short-term benefits may also result in long-term detriment.  The positive effect may be short-lived, but the consequences may be long-term.  An example would be antidepressants causing tinnitus permanently after taking them for just a week or two.
  • Long-term benefits may result in long-term or short-term detriment: This can be evidenced by those that take psychiatric or illicit drugs for an extended duration. When they attempt to discontinue, not only is their neurochemistry reliant upon the drug they’d been taking, but it will take awhile to restore normative functioning without it.  In some cases people recover more quickly than expected, making the short-term detriment worth the long-term benefit that was attained.
  • Drugs alter physiology: Taking any drug will alter your physiology to the extent that you’ll likely notice some side effects. If you haven’t noticed any side effects, you may lack the awareness and/or they may be occurring at seemingly microscopic or undetectable level.
  • Greater the effect, greater the side effects: If you aren’t experiencing side effects, but are experiencing a large effect, chances are you just haven’t pinpointed the side effects and/or consider them to be favorable. Someone losing weight on a stimulant may not report it as a side effect because it is what they wanted, but it’s still a side effect.  Additionally it can take time for the body to express damage or toxicity as a result of long-term drug usage.
  • Biology always adapts: If you feed your body a stimuli for an extended period (e.g. a drug), it will adapt to whatever you’re giving it. The adaptation may result in dependence, but may also result in altered physiological functioning.  The drug, dosing, and individual can play a role in influencing adaptation, but eventually you’ll adapt to anything.

Taking Prescription Drugs without Biological Costs?

Most people placed on drugs believe that the medication they are taking will come without any costs.  In fact, taking a drug to improve something as simple as blood pressure, could have numerous effects on your biology that you nor your doctor, nor the drug company even knows about.  Science continues to advance at a rapid rate, and 20 years from now, medical professionals will look back at today like we were in the Stone Age of medicine.

  • Brainwashing: Most pharmaceutical companies do a brilliant job at marketing their drugs.  New medical “conditions” are being created and medications are being manufactured for semi-pseudo conditions or conditions that don’t really warrant a prescription.  Billions of dollars are poured into marketing to people that they need medication, rather than into creating better drugs or finding some actual cures.  Even medical experts are being brainwashed by big pharmaceutical companies via selective publishing of studies and sales reps.
  • Common sense: Your common sense should say that if a drug is giving you a massively desirable effect, it’s probably not sustainable and will have long-term consequences.  In other words, if it sounds too good to be true – it probably is.  Most people assume that whatever their doctor prescribes is perfectly safe and that it shouldn’t have any consequences.  If you’re getting a big “effect” from the drug, it may be enjoyable, but a time will come in the future where you’ll have to face the consequences (which can be uncomfortable).
  • Skewed literature: Back in the 1990s, a doctor would’ve laughed at you if you said you were withdrawing from antidepressants.  Antidepressant withdrawal? You’re probably just crazy, here take some more of this drug and we’ll add this one too.  Matter of fact, let’s just play antidepressant roulette – this guy keeps getting crazier.  The literature at the time suggested no such thing as withdrawals.  These days people know better, but much of the literature is still skewed and selectively published.  Therefore a drug that currently appears to have a benign profile, may end up with a messy track record a decade from now.
  • Taking the easy way out: An example of someone relying on medication to take the “easy way out” would be someone taking Adderall for weight loss.  They may end up losing a lot of weight, but they’ll eventually build up a tolerance, deplete their dopamine stores, and potentially face other long-term detrimental effects (e.g. heart problems).  Additionally they never learned how to put forth hard work of proper diet and exercise to lose their weight.  Their rebound weight gain and lethargy will hit upon withdrawal.  There are plenty of other examples as well of people using drugs to take the easy way out, rather than dealing with tough problems.

Does this article suggest to avoid all prescription drugs?

No, not at all.  However, it does suggest only taking prescription drugs when you absolutely need them.  In other words, your condition or issue shouldn’t be solvable via lifestyle modifications – it should be something that absolutely requires medication; there should be no doubts.  It also means that you should proceed with absolute caution whenever taking a pharmaceutical medication as to minimize side effects and over-the-top favorable/gratifying effects.

Prior to using any drug, you’ll want to: A) Ensure that you need it, B) Conduct a cost-benefit analysis associated with taking it, and C) Take the minimal effective dose.  You’ll also want to limit the total number of medications and other supplements that you ingest as taking multiple medications can result in physiological chaos.  You also need to listen to your body if it isn’t reacting well to a particular drug or you end up feeling worse.

Many people assume that their doctors are omnipotent superhumans, when in fact they are just doing their best to get you the help you need.  They don’t know how you’re going to react, and they’ve also been duped by much of the existing literature and lack of information regarding certain drugs.  It is equally important for you to play your role and be your own advocate when it comes to ingesting any drug, knowing that there will never be a biological free lunch.

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{ 3 comments… add one }
  • Bren May 23, 2016, 8:05 am

    Well said, Lisa. I agree with you 100%.

  • lisa June 2, 2015, 2:54 am

    This is a great website. Our culture creates a divide between our physical and mental health, but there really is no divide. The article also made me think about how sometimes among the choices you face, none are ideal. I started taking Celexa 2 years ago for anxiety. I didn’t really want to be medicated. I was concerned about weight gain, eventually getting off of the drug, and the unknown.

    But my anxiety was so bad that I had to do something. It was affecting my relationships with my husband and kids. It had gotten increasingly worse. I had had YEARS of talk therapy that did nothing. There is no free lunch-but my choices were, continue on which was untenable, and taking a biological and physical risk. I have gained weight. But I don’t have that nonstop negative tape-loop about my inadequacy playing anymore.

    I am down on myself for gaining 20 pounds-but am currently working on that with JumpstartMD. I honestly believe my anxiety was destroying my feeling of self worth. Can an SSRI permanently change the pathways of the brain? If a person stops taking it, will the same symptoms return or not? Other reasons I started meds were my younger daughter was starting high school and I was returning to work full time. Life has stress all the time but not the same amount all the time.

    I’m 50 and realizing how finite it all is. I do hope to someday get off Celexa, but I do feel grateful that it has helped me. I still have social anxiety but I also have more self acceptance. I really enjoy CERTAIN people. Others trigger my anxiety. I don’t have to be the perfect wife, mother, woman in the community-that sounds so 1950s-but separating out social pressures and internal pressures is important in our own happiness, whether we choose to medicate or not.

  • Rip Price May 6, 2015, 9:14 pm

    Thanks very much for this article. Gave me a lot to think about. I discontinued an antidepressant in March 2013 because I didn’t like the side effects and I felt it was no longer helping me. Even though my doctor helped me wean myself off the drug, I still went through a bad withdrawal, sinking into an even worse depression than before and having lots of suicidal thoughts and thoughts of hopelessness. But now I’m going to read more of your articles and try to find some kind of hope and keep telling myself that I’m not just crazy and that maybe there is still help and hope for me. Thanks again.

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