Comment by munificent | Hacker News Reader

Comment by munificent | Hacker News Reader

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I've had various forms of anaesthesia, uh, five times in the year or so.

> What always amazes me is how there’s absolutely no sense of time having passed once I wake up.

My experience is that this depends on the med. With propofol, indeed it's like an editor took a razor, cut a few inches of memory tape out, and spliced the remains back together. I'm signing a consent form, and then a second later I have teleported to the recovery room where I'm having apple juice.

What's wild about propofol is that lost time does not mean you were unconscious the whole time. With twilight anaesthesia, you are often semi-lucid and able to respond to commands from the doctors. You are aware and having an experience. It just gets erased afterwards.

With midazolam, it was a much stranger experience. After the procedure, I can remember telling my wife that I remembered everything. She said I seemed totally lucid. But I no longer remember what I did remember then. Throughout the day after the procedure, memories faded out. Now it's almost all gone, including much of the time after the procedure was done.

> I've never felt as much peace as I do right before going under anesthesia. It’s probably just the drugs, but honestly it felt like coming home, even though no such home exists, and no one is there to return to it.

It's the drugs. Specifically, it's fentanyl.

For my second surgery, the anaesthesiologist pushed the fentanyl before the propofol, and told me he was doing so. When he said we was going to, I remember telling him. "OK. Oh! OK." It feels like every worry in the world has disappeared. Everything is cozy. Everything is fine. It's like being in the womb again.

I understand how people can get addicted to it.

> I understand how people can get addicted to it.

That was my exact thought the moment it was injected as a painkiller after a surgery. World went from pain to bliss with frightening speed and ease.

The crazy thing is that fentanyl doesn’t even have that much euphoria, heroin and oxycodone have a much, much stronger feeling of euphoria than fentanyl does. Fentanyl is very sedating in comparison.

> It feels like every worry in the world has disappeared. Everything is cozy. Everything is fine. It's like being in the womb again.

> I understand how people can get addicted to it.

If you really care that much about making "every worry in the world disappear" from your mind by entirely artificial means (even to the point of remarking that you understand the POV of those who get addicted!), you might benefit from learning about how to live your life with more equanimity. It's a vastly healthier approach to coping with the challenges of a stressful life than any kind of strong narcotic. The topic is explored in great depth in both Stoicism and Buddhism - and via the latter, in more generic "mindfulness" approaches. (It can of course be useful to cross-reference all of these philosophies; they tend to have complementary perspectives.)

Needless to say, therapy can also have very similar benefits, and many people will derive even more benefit from that kind of highly structured approach.

No amount of therapy or Buddhism will make you feel how fentanyl makes you feel and to claim otherwise is disingenuous at best.

That's right, no amount of therapy or Buddhism will make you an addict who might overdose at any moment with deadly consequences. I think it's quite sensible to care about that.

I find your lack of faith, curious. I’ve experienced stronger and more intense joy from meditation than from 200mg of MDMA

The beauty of meditation is that no faith is necessary. No belief. Just a willingness to explore one’s own mind in new ways.

All of the claims made by practitioners can be individually/personally verified.

With all respect, I would encourage you to investigate this more deeply, and the swipe is unnecessary.

I realize it sounds preposterous. I spent the majority of my life holding a similar view. I mentally categorized meditation as another religious affect not much different than prayer or the bliss people report about their personal relationship with some deity.

My view changed when a confluence of life circumstances led to an experience that opened my mind to the possibilities and I ended up going down a meditation rabbit hole where I found that I could access those states at will. What I found was entirely unlike my preconceptions, and made me realize that I’d been summarily dismissing (and judging) people for something I did not understand.

There’s a reason that many people find meditation through prior drug experiences. More commonly psychedelics, but dissociative anesthetics as well.

Certain drugs basically guarantee you’ll experience these states, while learning to meditate “properly” is something that most people find difficult or confusing. I think this confusion comes from the baggage people associate with it and from the frankly terrible meditation and mindfulness apps, books and gurus that have flooded the market, and the “do thing, get result” framing that is common in western contexts. I don’t think most people’s pop understanding of meditation even scratches the surface.

I’ve experienced the bliss of anesthesia drugs. Achieving similar states through meditation is a real thing. This doesn’t have to be “Buddhism” per se. It just happens to be one of the most well known and structured paths for exploring this.

For the record, I’m a materialist and agnostic atheist. My views were formed based on experience, not belief. I think Buddhism is useful in a utilitarian sense, but there are paths of practice that don’t require all of the religiosity.

I try to respond to comments like yours because I see an earlier version of myself in them. I take some issue with how the original comment was framed, but meditation is the real deal and worth exploring.

I think you're interpreting

> I understand how people can get addicted to it

as

> I understand how people can get addicted to it and I endorse it as a route to making all your worries go away.

I'm going to put words in the ops mouth here and assume what they were communicating is more akin to: "It's absolutely terrifying how quickly, easily, and thoroughly fentanyl can erase your sufferings and worries, replacing them with a feeling of total peace."

I'm assuming they didn't immediately become a fentanyl addict, precisely because they understand how destructive a path to equanimity it is.

Meditation and therapy are great, but addiction disorders often come with comorbidities like (or are comorbid to) PTSD, ADHD, MDD, and bipolar disorder. These are all things that can make establishing a habit like meditation difficult to impossible. Combine that with a lack of life skills and limited access to healthcare (or a complete unfamiliarity with navigating that system re:life skills) and therapy feels impossible as well.

In the last two years I've lost two very close family members to fentanyl. We scheduled therapy sessions and drove them there ourselves, we helped try to find rehab centers, we worked with them to find jobs, walked them through buying cheap transport on craigslist, helped work through medicaid paperwork with them, connected them with people we know who've gone through similar things, and in the end, they didn't make it.

I'm going to guess you're getting down-voted because your response interprets the OP as being against or unaware of meditation and therapy as tools for healthy living; it reads as lacking empathy and a recognition of the realities of addiction.

I'd encourage you to look into the literature in that area and read through the stories of people who have gone through it and survived. I find that for me it was especially helpful to find the stories of people who had life circumstances similar to mine, and still fell into addiction.

I also have strong opinions on the likelihood that meditation and therapy could mimic or match the physiological response a brain has to fentanyl, but the whole topic is draining for me. I hope you'll forgive me for passing on it. I think it might be worth your time to specifically research the physiological mechanisms as well, though.

It's less a reading of "GP endorses it as a route to making all your worries go away" and more one of "GP thinks it should be especially salient to us as a route to making all your worries go away". This is where I disagree. If the thought of erasing all your worries from the mind is tempting to you to the point that you "understand" the addictive potential of a narcotic drug through that one lens, your first-line approach should be learning about equanimity and structured therapy, not strong narcotics.

Also, clearly we don't need to "match the physiological response a brain has to fentanyl" (though there are newer substances like suboxone, now approved for medical use in the US and the EU, that seem to have some limited potential wrt. this), we only have to offer genuinely viable and sustainable approaches (which of course fentanyl isn't) to the narrower issue of dealing with the stressful worries in one's life.

You misinterpret me. I have never taken fentanyl outside of a surgical setting and have no intention of ever doing so.

But because I have experienced it (in a surgical setting), I have a better understanding of the motivations behind people who are addicted to it.

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