Vermis Odium

The structural formula of metal consists of a classic rock ring in its most basic 1-5 manifestation and an extreme state of dynamic compression, and is generally distinguished by the presence of one or more tritones (TT). A progressive rock (PR) chain of varying lengths may also be present (Figure 1.1). Like those molecules to whose structure it is closely related, metal and its derivatives mimic and potentiate the synaptic action of norepinephrine (NE) in the central nervous system, particularly in the cerebellum’s vermis, while inhibiting frontal lobe activity. A second, sedative-hypnotic “rebound,” thought to be associated with increased serotonin levels, has also been identified, and has become the subject of some clinical attention.

Metal was first synthesized at the end of the 1960s by O. Osbourne and his legendary team of occult doctors. Working secretly in laboratories around Birmingham, England, it is said that Dr. Osbourne did not immediately recognize the combination of dissonance, distortion, blues riffs and pounding rhythms as a distinctly new molecule, and that it was only upon mistakenly ingesting a small quantity that he cried out, “What is this that stands before me? / Figure in black which points at me!”

Usage of metal increased steadily during the 1970s, although abuse did not become widespread until the early ‘80s, when derivatives like glam and speed began to be synthesized for use in a wide variety of recreational settings. The latter represents the beginning of a disturbing trend in the history of metal abuse, as the speed derivative greatly increased the potency of the original molecule by adding one or more hardcore (HC) groups, and by turning up the volume of ingestion. Indeed, perhaps no other aurally-ingested drug has been so widely abused as metal, leading to concerns about its impact on public health. Over the last two decades, despite brief dips in popularity, metal has remained a drug of choice among the young, with new, even more potent derivatives appearing every few years, such as death, doom, goth, and black, as well as “designer” compounds, like nu and groove. Chemically, these derivatives can be distinguished by the addition of a rap group (HH) or EMO ion, and by the multiplication and permutation of PR, HC and HH molecules.

The increasingly potent strains of metal that continue to be synthesized are a logical response to tolerance, which develops quickly (5-10 albums) in many users, as is the increasing use of metal in combination with other drugs, either to intensify its euphoric effect or mitigate its toxicity. Research into clinical varieties that exploit the sedative-hypnotic “rebound” effect in the treatment of Obnoxiously Violent Disorder (OVD), ADD, and other anxiety and mood disorders continues despite concerns about the drug’s highly addictive qualities.

Characteristically, metal produces a state of euphoria. Psychomotor performance may be improved, although this is quite erratic and improbable. Users also experience augmented alertness and the fight/fright/flight response, increased wakefulness, and feelings of power, invincibility, and the urge to dominate. In its post-stimulant, sedative-hypnotic phase, metal acts like a low dose of barbiturates, inducing a mild euphoria almost indistinguishable from that experienced at low-dose ingestion, as well as an increased sense of well-being, relaxation, and relief from anxiety. In its everyday use, metal is often combined with amphetamines, marijuana, alcohol, and, less frequently, with hallucinogens.

Despite the number of derivatives available, the effects are quite similar to that of its generic parent, mostly varying in the quantity that needs to be consumed; therefore, so-called “classic” metal will be discussed at length, and its derivatives compared as differences present themselves.

Pharmacological Effects

Effects vary markedly with the dose of the drug. In general, though, they may be categorized as those observed at low-to-moderate doses (5 to 50 minutes at medium to high volume) and those observed at high doses (above 100 minutes, often administered via headphones or at concerts). Again, these dose ranges are calculated for classic metal. Low-to-moderate doses of speed metal range from 2 to 20 minutes, while the effects associated with high doses can occur at 30 minutes or even less. Death metal and grindcore derivatives such as Napalm Death, which contain several HC groups and few or no PR chains, are even more potent, and doses have to be lowered even further. According to one recent study (Benton, 2006), a single minute of Deicide was enough to kill white bunny rabbits and other animals associated with childlike innocence and goodness (hence the unfortunate moniker “Bunnycide” which the band has carried ever since). “Designer” compounds are qualitatively less predictable, as the synergies between HH, HC and PR groups on the compressed rock ring are still poorly understood, and the mildly inhibitory effect of PR on HC groups requires further investigation. Generally speaking, however, “softer” designer derivatives mitigate the more deleterious effects of “meth metal” by inhibiting the function of the HC group, whether by frontal-lobe reactivitation or by promoting reuptake of NE from the synaptic cleft (DeGarmo, 1989; Keenan, 1996).

At normal aural doses, metal induces an increase in blood pressure, and a variety of other responses that are predictable from drugs that mobilize NE and thus induce the fight/fright/flight response (increased blood sugar, increased blood flow to musculature, decreased blood flow to internal organs, dilation of pupils, increased rate of respiration, and so on). In the CNS, metal is a potent stimulant, producing both EEG and behavioral signs of increased alertness and excitement. Characteristically, wakefulness, a reduced sense of fatigue, mood elevation, increased motor and speech activity, euphoria, and feelings of power and task-worthiness occur. Task performance may improve, although dexterity may not, as evidenced by increased errors that can result from the irritability and nervousness that occur. When short-duration, high-intensity energy output is desired, such as in athletic competition, performance may be enhanced despite the fact that fine motor skills may be reduced.

These responses continue for up to 30 minutes after ingestion has ceased, with predictably cumulative effects for longer ingestion durations. At this point, most users will experience a rebound feeling of lethargy, satiety, and well-being, as after successful copulation, sometimes lasting up to 12 hours. Prolonged use of low doses of metal or single use of a high dose is characteristically followed by this relaxed, soporific, careless state, customarily referred to as metal-induced satiety (MIS).

At moderate doses (5 to 50 minutes), effects include stimulation of respiration, production of a slight tremor, restlessness, increased motor activity, insomnia, and agitation. Blurred vision and cardiac palpitations may also occur. In addition, metal prevents fatigue, suppresses appetite, and promotes wakefulness.

During chronic uses of metal at high doses (100 minutes or more), a different pattern of physiological effects is observed, in part because such high doses are usually administered through headphones or at outdoor rock festivals, at volumes intended to saturate the auditory system and maximize the rates of neuronal activity—all of which abet the suppression of impulse control and activate the subject’s “lizard brain,” with particular, unrelenting excitation of the vermis, the locus of feelings of hatred and aggression in the brain (hence the epithet vermis odium, or “hate worm,” for metal among the drug’s more literate addicts). Doses in the range of a few hundred minutes to several days have been reported. During prolonged, high-dose “sprees,” an individual experiences a manic megalomania—the so-called “berserker state”—induced by radical changes in brain chemistry, chronic lack of sleep, and high levels of distortion. Users are put at risk of injury and even death from the irrational, violent behavior that follows the ingestion of high doses. High-level earphone delivery provides a “rush,” described by users as being extremely pleasurable and very similar to a violent sexual orgasm. In addition, MIS is at once more intense and more extended than at lower doses. These pleasurable effects, however, are offset by the more toxic ones. After the sedative-hypnotic period wears off, the subject will still appear lethargic, but also anxious and intensely hungry. Food, counseling, and Neil Diamond may be helpful in this withdrawal period. Otherwise the user may turn to more injections of metal, thus initiating a new spree. In the words of Araya et al. (1994), the “chemical rush” of metal may “leave [behind] a suicidal hole.”

Psychological Effects

The psychological effects of metal differ widely, depending upon the dose administered. At low-to-moderate doses, an individual typically experiences increased alertness, wakefulness, elevation of mood, mild euphoria, possible freedom from boredom, and increased energy. Occasionally, aggression, hallucinations, and psychosis may occur, but usually only at higher doses.

High-dose “berserker” use induces a pattern of psychosis characterized by confused, disorganized behavior, compulsive repetition of meaningless acts (maniacal laughter, headbanging, violent bodily contact with others, making the “evil eye”), violent thoughts and urges (to dismember, eviscerate, defenestrate, etc.), sadistic megalomania, impatience with the weak and helpless, delusions of imperviousness to pain and bodily immortality, gross paranoia, apocalyptic hallucinations, a Manichean worldview, and mild irritability. Individuals who inject high-potency death, black, and grindcore derivatives on a regular basis often attempt to antagonize high-dose toxic symptoms by adding an analgesic or other CNS depressant (e.g., Pink Floyd; Led Zeppelin III, side 2). Such a concoction is called a “speedball.” Chronic metal users also usually consume large amounts of these CNS depressants.

Interestingly, MIS may be accentuated by the use of these depressants, and the euphoria produced by sedative-hypnotic rebound may be more intense, with users falling toward the hypnotic-anaesthetic range of the sedative continuum. Post-berserker “deep MIS” is characterized by a marked decrease in anxiety and aggression, feelings of peace on earth and goodwill toward men, renewed ability to deal with annoying people, and repetition of stock phrases like “it’s all good” and “no worries.” An increased ability to concentrate on minor tasks is only hampered by lethargy and overall feeling of a need to sleep. This is sometimes accompanied by a giddy feeling of having survived mortal danger, similar to that survivors of natural catastrophes or terrorist attacks feel, but without concominant feelings of guilt.

Reinitiation of metal use generally follows the end of deep MIS, initiating a new cycle.

Side Effects and Toxicity

The side effects induced by low doses of metal are usually extensions of the drug’s behavioral actions. These side effects are usually tolerable and decrease within a few days as tolerance develops. Metal can cause heart palpitations. Sweating, dry mouth, nausea and vomiting may also occur.

The side effects of prolonged use of high doses are more serious. Psychosis and abnormal mental conditions, general mental dimness, muscular fatigue, a negative outlook on life, infections resulting from neglected hygiene and a variety of other consequences occur because of the drug itself and because of poor eating habits, lack of sleep, and the use of unsterile listening equipment.

Most high-dose users show progressive social, personal, and occupational deterioration, and their course is often characterized by intermittent periods of hospitalization for episodes of toxic psychosis, often directly after attending a “show” or similar event where high-potency, prolonged use is collectively reinforced.

Fatalities directly attributable to metal are rare, but humorous. Individuals with no tolerance have survived three-day black metal festivals—in Norway, of all places—and even larger doses are tolerated by chronic users. The slogan “metal kills” does not refer to a direct result of a single dose but, rather, to the deteriorating mental and physical condition and the destructive behavior induced by prolonged high-dose metal sprees. Only rarely does a high-dose use of metal result in the lethal rupture of blood vessels or twiglike snapping of the brain stem as a result of prolonged, excessively forceful headbanging, or a “breaking wheel” or self-eviscerating accident in the mosh pit.


Metal dependence is twofold: psychological and physiological. Psychological dependence is described as a compulsion to listen to the music repeatedly for its enjoyable effects. The “berserker” state that sometimes follows even moderate doses of metal, and the “rush” that may be induced by high-volume use, can lead to a compulsion for misuse. MIS may be itself habit-forming, although it cannot be regarded in isolation from the drug’s other effects.

Withdrawal from metal produces a period of rebound passivity and exhaustion, prolonged inactivity, and EEG changes characteristic of sleep. This may be followed by severe emotional depression, often brought on by feelings of abandonment, sometimes expressed verbally by the addict as having been forsaken by metal. Once MIS has worn off, the patient generally returns to his previous level of anxiety, leading to an ever-deepening cycle of anxiety, metal aggression, and rebound satiety.


Tolerance to the many effects of metal develops at different rates and to different degrees. The habitual user is able to increase the dose considerably and/or resort to more potent derivatives in order to attain a desired effect as his or her tolerance to the central effect builds.

Medical uses

Since the discovery in the late 1980s that MIS can moderate mood and anxiety disorders, particularly OVD, research has been directed toward developing a safe, non-toxic treatment derivative. Challenges are myriad, and include: the extremely addictive nature of metal; the drug’s widespread availability outside a clinical setting; the relatively short duration of MIS; and the rapid development of tolerance, necessitating new ingestions of metal at ever-higher doses and more frequent intervals.

Artificial forms of metal, such as mixing amphetamine derivatives like Benzedrine or Dexedrine with grunge, or combining Bad Company with selective norepinephrine reuptake inhibitors (SNRIs), as well as low-potency dilutions of true metal, such as injecting grindcore with L-tryptophan, or adding a POP group or boy band (BB) subgroup to the metal molecule (e.g., My Chemical Romance), have thus far failed to produce either a weakened berserker state followed by extended MIS, or—grail of grails—to isolate the MIS period itself for subjects suffering from OVD. It is thus widely believed that the intensity and duration of the MIS period is directly proportional to the intensity of the CNS effects of metal and the duration of the ingestion period (Figure 1.2). Except in rare instances, low-volume exposure has proven ineffective (Halford, 1993).

Some evidence exists that, when low-potency, low-toxicity derivatives were administered to children with a genetic propensity for developing OVD, they acted as a gateway to true metal addiction, and that said addiction developed earlier than in untreated subjects (Portnoy et al., 2011). This seems likely given the rapid development of tolerance, especially among younger listeners. Regrettably, these compounds have become wildly popular among pre-adolescents, and are so cheaply and easily produced (and hence so profitable) that they are now available over the counter in most shopping malls and suburban convenience stores.

Results from short-term, high-dose “metal blasts” have shown more promise. Occulta and Apollyon (2002) showed that periods of MIS double the normal duration could be induced in patients suffering from OVD after a series of 30-second exposures to Amon Amarth.

If POP and BB  have failed utterly to treat anxiety and mood disorders like OVD in adults, this is likely due to the fact that children have as-yet underdeveloped senses of hatred, vengeance, betrayal, anger, and bitterness needed to appreciate true metal. In sum, while it may be true that music therapy has helped people to overcome a broad range of psychological problems, we are a long way from understanding how to use metal for this purpose. One must continue to strive for non-chemical alternatives to curb the propensity for violent behavior.

Metal and Public Safety

Given the pharmacological profile of metal that has been presented, what conclusions can be drawn about its social impact and continuing legal status?

While metal clearly has public health consequences, whether its production and consumption needs to be regulated, curtailed, or even criminalized, as some have argued, remains an open question. Certainly, metal culture has been demonized to the point that all recreational users are stereotyped as devil-worshipping baby-killers, and the music itself as a weapon of mass destruction against America’s youth. Consider, for example, the story of one young man, who, after 67 straight hours of listening to Pig Destroyer, was reported to have spontaneously combusted. In another, a Cannibal Corpse fan on a two-day grindcore binge began (according to his similarly inebriated girlfriend) bleeding from his eyes before collapsing; a brain autopsy later showed the cerebrum had been cooked into a hard paste which had to be chiseled off the inside of the skull. Stories of spontaneously aborted fetuses, massive cerebral hemorrhages, and literally exploding cardiac tissue have also made their way into the tabloid press. While they might be intended to warn users away from the drug, these sensationalized portraits of hardcore abuse at once attract new users (by the aura of glamorized danger) and serve as fodder for those groups lobbying for all metal’s criminalization.

On the other side is the phenomenal rise of metal rights groups in most major cities around the world, which advocate for the use of metal in its unadulterated, natural, “homegrown” form. These groups tend to paint a utopian picture, with metal in a role similar to that played by LSD for the “flower children.” Unlike acid, however, metal is understood as a conduit for channeling and dissipating “negative energy.” (“The releasing of anger,” remarks Phil Anselmo, a sort of tattooed Timothy Leary, “can better any medicine under the sun.”) The original sin, according to these groups, was the turning over of metal to vast record conglomerates, who make false metal for profit. The metal lobby has worked to have metal protected under the same laws that allow some Native American tribes to use drugs such as peyote in religious rituals, and “medical metal” has become something of a buzzword in the Bible Belt states, where religious fanatics are pursuing an aggressive ballot-initiative strategy to criminalize metal.

Of course, metal is neither a panacea nor a doomsday device. It is, rather, a faithful reflection of our aggressive, anxious times, where young people and adults alike consume drugs like metal to escape day-to-day problems, deal with assholes, and generally get by.

Correlations between metal and violent crime have generally been overstated. Even in a concert context, the controlled environment and relatively short duration of berserker effects post-ingestion, combined with the rapid onset of MIS, prevent violence from going beyond overturning and burning a few automobiles in the parking lot, a couple of fistfights, and a beer bottle broken over somebody’s head. Users are generally too stupified by the high-dose effects of the drug to plan antisocial behavior—as is to be expected, given the total inhibition of frontal lobe activity (the so-called “metal lobotomy,” the lack of EEG activity suggesting a cerebral “dead zone”). Rather, aggression is largely expended in the aforementioned behaviors, and the most dangerous effects seem to be confined to crowds in the grip of metal frenzy, and to the contusions, lacerations, head trauma, and acute spine and joint pain the high-dose user experiences as MIS begins to wear off, colloquially referred to as a bangover.

It is moreover unclear to what extent the other drugs often consumed simultaneously with metal are responsible for other violent acts for which metal bears the brunt of the blame. In short, neither informed current professional opinion nor empirical research has produced systematic evidence to support the thesis that metal, by itself, either invariably or generally leads to or causes violent crime. Instead, the evidence suggests that social and cultural variables account for the apparent statistical correlation between metal use and crime or delinquency.

The greatest danger to public safety today probably involves driving a car while in a state of acute metal intoxication. Feelings of invincibility, together with impacts on motor coordination and the visual impairment that results from headbanging, even with both hands on the wheel, can lead to excessive speed, erratic driving, extra miles, and poor choices.

While the public continues to debate the criminalization or regulation of metal, various harm-reduction approaches could be tried and evaluated. Safer modes of dispensing metal would go a long way toward curbing the more deleterious effects of the drug, as would federally-enforced volume limits. Albums could be made shorter, and listening equipment programmed with dissonance and dynamic compression sensors to filter total metal output. Perhaps the most conservative course of action would be for society to oppose widespread listening to metal, while at the same time refraining from punishing or demonizing those who choose this genre of music to listen to. Youth should be counseled, to borrow the words of Headlock, to “Tak[e their] hate and spend it wisely.”


Many passages in this post are embellished plagiarisms of passages from A Primer of Drug Action, by Robert M. Julien, M.D. (New York: W.H. Freeman and Company, 1988). Thanks to Dr. Julien for writing such an engaging textbook, filled with so many fabulous words.

Leave a Reply

Your email address will not be published. Required fields are marked *