Does drug dependency create isolation, or the other way around?

June 26, 2017 The Noffs Team Comments

Drug use and illicit drugs generally are associated with antisocial behaviour[1], however, in my experience of dealing with young people I have found that drug use always starts out as an intensely social experience.

I've always felt as though the personal connections, rituals and shared experiences that go along with drug use are a more powerful source of habit formation and dependency than the “chemical hooks” theory that has been promoted in anti-drug campaigns over the years.

The evidence seems to back me up and that's what I would like to discuss in this article.

I would like to open your eyes to the evidence that suggests drug dependency is more about psychology than physiology.

In fact there is one psychological component that features more than any other in the academic literature on drug dependency and that is isolation.

I don't mean isolation purely in the sense that someone is alone with no human contact, but more the sense of isolation that comes with a lack of connection or feeling of belonging.

Teenagers go through a very difficult time when they are half in and half out of a household - half child and half adult - and I think it is no coincidence that this is a time during which our young people are vulnerable to the formation of problematic drug use.

This isn't me “blaming the parents” or saying it's only wayward teens that will come across these problems.

It can happen to literally any young person at any time.

If we develop a more compassionate framework for dealing with substance abuse and dependency then we can help them come out the other side of this turbulent time unscathed.

THE HISTORY OF THE CHEMICAL THEORY OF DEPENDENCY

Our culture is fixated on the idea that a drug’s chemical potency is the sole source of dependency. The theory of chemical dependency has long been consumed by the public through a means of moralising the capacity in which one “chooses” to use a substance. This serves a scapegoat function as the social ills like violence, crime, poverty, unemployment and widespread inequality are blamed solely on the individual.

In my understanding, official warnings surrounding the dangers of certain drugs and their bewitching qualities serve a specific isolating purpose. By initiating fear in the public, government agencies aim to dissuade the general populace away from first contact with the demonised drug.

The problem herein lies with the population who are already reliant on the substance, for whatever intents and purposes, usually within a pain-relieving context.

They are criminalised, shamed and stigmatised into segregation.

A chemical’s “captivating” narrative is rooted, in part, within 19th century Victorian temperance society. Whether or not the dialogue surrounding drugs was used intentionally as a social segregating mechanism cannot be confirmed.

However, the consequence of placing social blames like poverty on the appearance and character of a drug had this inevitable ostracising side-effect.

Alcohol, for example, was used as a scapegoat for a variety of social ills, conveyed to the public in form of pulpits and tract prints, and later in magazines and newspapers. A 1947 temperance tract reads:

A father took a little child by his legs and dashed his head against the house, and then, with a bootjack, beat out his brains. Once that man was a respectable merchant, in good standing, but he drank alcohol. J. Edwards (1947, p. 37, as cited in Aaron and Musto, 1981, p. 144)

Before heroin and methamphetamine became societies’ routine scapegoat, Victorian rhetoric concerned itself with the demonisation of tea. A narrative developed between the classes that specifically imprinted a malign character upon tea consumption by the bottom class, furthering a sense of shame and isolation.

Safe-drinking tea practices belonged to the ‘refined context of the middle-class home and the indulgent.’ In contrast, morally corrupt drinking habits were reserved for the lower classes. Ingrained class impoverishment and substandard health requirements were placed on the burden of a tea-drinking custom to paint a social picture of tea as causing gradual insanity and tendencies for “revolution.” The same narrative that would 70 years later be placed on cannabis and the counterculture movement.

An example from Wales reveals how temperance society laid the moral groundwork for the 20th century prohibition monster that we know today. By homogenizing an immoral footprint on drugs, specifically by exaggerating the ill effects of tea, we begin to see how society began to associate an evil dimension to psychoactive substances, the poor and their overstated, disordered relationship.

Dean of Bangor, Henry Thomas Edwards, in 1883 interjected at a public meeting on domestic education to declare that “excessive tea-drinking creates a generation of nervous, hysterical, discontented people” insisting that “the torrents of bad tea seem to me to be swelling into a flood of Radicalism. This bad housewifery is not only productive of possible revolution, but of lamentable immorality”. (“A Dangerous Revolutionary Force Amongst Us”: Conceptualising Working-Class Tea Drinking in the British Isles, c.1860-1900, Cultural and Social History, 10:3 (2013))

Unfortunately not much has changed now from the dramatic framing of demonic drug possession from the early 20th century drug militants. During the “crack” hysteria of the 1980’s it was common for media outlets to refer to the free base form of cocaine as “the most addictive drug on earth” causing “instant addiction” (Trebach, 1987; Reinarman and Levine, 1997, chap. 1).

The problem is normally threefold. Having a government conceive detailed “intelligence” about the drug. Having an obedient media translate these messages in hyperbolic form through breaking news reports and having a medical field anchor these messages with scientific evidence.

Unfortunately, when it comes to methamphetamine currently in Australia, the media and academic circles need not involve themselves too heavily. The Australian Government’s Department of Health takes the responsibility for scaring the population into oblivion though widespread demonisation of the drug.

The National Drugs Campaign’s main website leads with the title “Ice Destroys Lives”, framed in front of a picture showing a young man in an act of rage launching a chair into a glass window in what appears to be a hospital (I’m sure you’ve seen the advertisements).

The next picture, even more demonic in nature, shows a young woman picking at her skin, behind the words “Some ice users feel like bugs are crawling under their skin”.

These images that are directly contributing to the hysteria surrounding ice. More critically, however, these pictures make discriminative counteractions from the police permissible in the public’s eye.

Unbeknownst to many, public backlash manifests as internalised shame within a substance user, and in fact entrenches dependency rather than disengaging it.

THE PSYCHOLOGY OF DEMONISATION

As a society we are brought up fixed to a rehabilitative paradigm in which places abstinence as the foregone conclusion to recovery. In his book, Chasing the Scream, Johann Hari challenges this model claiming instead that “the opposite of addiction isn’t sobriety, it’s connection”.

It is dis-connection, however, that runs punitively through our prohibition policies. Our police are constantly required to round up street-users into prisons or intimidate them into cordoned off spaces away from public view.

Through the intimidating face of law enforcement our most vulnerable citizens develop motions that aim to self-protect but in the process segregate themselves from any possible help if problems persist.

Stigma is the reason there is so much social and legal discrimination against people with drug dependencies (2). The fears that are nationally broadcast are internalised into shame from a user’s perspective, driving further use and further isolation.

Ultimately, it can be discerned that marginalising drug dependent populations drives a separating mechanism that contributes heavily to a poorer standard of physical and mental health.

Social shame brought about by stigma and discrimination has been used for centuries to rid societies of unwanted behaviours.

However, when we are dealing with populations that require such behaviours, like drug use, to relieve emotional pain and feel “normal” then we must rethink the stigmatic strain our voices are having on our most vulnerable. [3]

SNAP OUT OF IT!

As a society we have a pretty rigid view of how recovery is supposed to work.

You lock yourself in a room like Renton from Train Spotting.

You check into rehab and live on coffee and cigarettes instead of heroin (a popular trope I have always found amusing given how much more destructive smoking is for your health than just about any other substance … but I'll leave that for another day).

It's all about white knuckles and willpower.

Kick the habit.

Turn over a new leaf, stay optimistic, you can achieve anything.

The saddest thing about this model of recovery is that it places all the blame on the individual who struggles achieve this ideal, without acknowledging the fact that almost no-one recovers in this way; at least not first go.

In fact, willpower is a fragile and scarce resource. Ever wondered why you slip into old habits when stressed? You are literally “using up” all your willpower dealing with the stress in your life and have little left over for staying committed to change (Dickinson, Wolf, & Schwabe, 2011)

It has been noted by numerous academics that stress and its effect are constantly cited by drug users as a major reason for relapse (Brandon, 1994; Kosten, Rounsaville, & Kleber, 1986; McKay, Rutherford, Alterman, Cacciola, & Kaplan, 1995). Goal-directed behaviour during the rehabilitative phase of recovery can be overshadowed by how acute stresses cause the reactivation of drug-related habits (Dickinson, Wolf, & Schwabe, 2011). These stressors promote the chances of relapse by reactivating the motivational value of drug-related cues (Goddard & Leri, 2006).

In other words, the threat of criminalisation brought about by police or the shame sparked from someone howling verbal abuse at an “addict” can accumulate into relapse by stimulating the subconscious senses one has for drug use.

In overcoming drug dependency, one’s willpower and control over cognitive processes is instrumental for change (Bechara, 2005). One way of understanding this ability to believe in yourself and withstand temptation is picturing the will as a muscle, for the “willpower” required to override compulsive tendencies needs more than just attention, it needs focused and repeated attention; it needs practice.

Charles Duhigg adds volume to research suggesting the need to flex habits that help combat compulsive behaviours. He speaks of the gravitational pull environmental “triggers” can have in reinforcing negative habits.

This is significant because when we isolate people into socially shamed exile they are surrounded by all the environmental cues and routines that feed someone’s dependency. [4]

How unfair is it, then when we expect people to change their drug habit FIRST before they have dealt with all the issues in their life that were causing undue stress in the first place!

In almost all cases people will “mature out” of a drug addiction [Peele, Brodsky, & Arnold, 1992] and we just need to help them stay safe while they work through it. This maturation process almost always is accompanied with a “cutting down” phase.

We need to remain humble with those going through the recovery process. Whether it be total abstinence or controlled drug use, remaining patient and offering encouragement during one’s maturation can go along way. As ultimately learning to take care of oneself is more than just a skill, but it is something experienced as a value and an attitude (Peele, 2002).

This notion, hopefully, will lead to the understanding that we can accept all human beings as imperfect without endorsing such imperfections.

CONCLUSION

Recovery is not a binary result. You get benefits from using less harmful substances, or using less frequently.

Ideally we would have the ability to prescribe illicit substances to people to help them during the transition but even then this is not a purely chemical problem.

We have to work on the social and psychological stressors that are leading to the propensity for substance abuse and dependency in the first place.

That means we can't just treat drug problems in isolation (excuse the pun). It's not a solution that policy makers want to hear, but we have to look at the whole support framework that we have for vulnerable people.

We have to look at why our society is increasingly creating the sense of isolation and lack of belonging in young people that leads to drug dependency.

[1] http://www.aic.gov.au/publications/current%20series/rip/1-10/05.html

[2] https://www.hbo.com/addiction/stigma/52_coping_with_stigma.html

[3] https://www.researchgate.net/publication/6678630_Stigma_discrimination_and_the_health_of_illicit_drug_users_Drug_and_Alcohol_Dependence_882_188-196

[4] https://www.thefix.com/content/the-power-of-habit-on-addiction-10082?page=all

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