Tuesday, 8 April 2008

Trauma, drug misuse ... and bigotry

I'm reading a very interesting and important book at the moment, 'Trauma, Drug Misuse and Transforming Identities: A Life Story Approach' by Professor Kim Etherington. Kim's book looks at the lives of ex-drug users told in their words. It illustrates the links between early childhood experiences and drug misuse, and also shows pathways to recovery and transformation.

The book illustrates how some people use drugs, in particular heroin, as a coping mechanism to help them deal with traumatic experiences in their childhood. Such trauma may have involved chronic parental neglect, physical and emotional abuse by parents, sexual abuse by a family member, rape by a stranger, or racial abuse and harassment. 
Heroin and other opiates are used medically as analgesics to reduce physical pain, but they also alleviate psychological pain. It is not surprising that a traumatised person may use heroin as a coping mechanism and take up the heroin-using lifestyle. Becoming part of the heroin-using culture can also be of 'therapeutic value' because the person associates with other heroin users who may identify with their problems and past experiences. Some of these people will have had similar experiences.
Most non-drug users do not see beyond the heroin user stereotype - the 'dirty, devious, criminal junkie'. They do not stop to think that the heroin user may have experienced a traumatic childhood and have started along a path to addiction as a natural response to trying to deal with their resulting anguish and psychological pain. They did not set out to become an addict, and they very likely did not know the addictive potential of heroin and the heroin-using lifestyle.
These same non-drug users may have no problems at all with other people going to their doctor because they felt anxious or 'down' and being readily prescribed with anti-anxiety drugs (that are highly addictive) or anti-depressants. The distress these people are experiencing may be minimal compared to the heroin user described above and the necessity for prescribed drug use unjustified. However, the person wants to feel they are being 'treated', the doctor wants to keep the patient happy, and the drug company (which some people might argue is a legal drug dealer in certain circumstances) makes its profits.
We are in a hypocritical society which on the one hand demonises use of illegal drugs - without thinking about why these drugs might be used - whilst at the same  time encouraging people to take legal prescribed drugs, which are in many cases more dangerous than legal drugs.  
And we get bigoted comments like that reported to have been made by Tory MP (Monmouth) David Davies last week - 'Taxpayers will be outraged that so much of their money is going to junkies and winos who will use the money simply to fund their disgusting habits.' Such people need to move past the end of their noses and get a dose of reality - assuming that they understand or care about problems experienced by other people. They must stop making naive and nasty generalisations.  


steve said...

Lets hope a relative of these bigots dosn't get a dose of our reality that we endure every day
give US the care & drugs we need

Anonymous said...

Great article professor!

David Davis comments were appalling!


Anonymous said...

Agreed completely with this blog!! Great work!

Kev said...

I was also horrified by David Davies comments. What an idiot.

Anonymous said...

Great blog David.

I have yet to meet anyone who set out to become addicted. The problem is that whatever the initial sensitising cause/experience, leading to use, no one, least of all the user, can know, whether, or not they are going to become addicted. It may be purely coincidental, that those who do are those who have experienced the type of trauma David describes.

Science has shown us that through some accident of genetic make up, there are others who are also vulnerable, together with those, who for unexplained reasons are lonely and tend to isolate. Perhaps the saddest thing of all is that some of those who become addicted are what might be classed as ‘recreational users’, but again for reasons that are post, rather than pre, event identified, their tolerance for drugs is lower than others.

There are possibly more theories about what causes addiction, than there are drugs, and whilst the reasons people become addicted, may be of scientific, or social learning interest, or the personal interest of the addict, we need to be aware they can serve as a ‘reason’ for the person remaining addicted, which only adds to their problem, or increases the severity of it.

It is, in my experience , more conducive to recovery, if and it is a very big if, the user can first come to understand how their drug(s) of choice serve to aggravate their problem, far more than the transient relief their use provides, and then help them to find ways to accept that reality. We should not assume that everyone knows the difference between understanding and acceptance.

Whilst it is true that society finds it easier to condemn than to understand, we in the business, need to acknowledge that addiction is not only a condition that attracts misunderstanding, it not infrequently defies understanding. We rush to treat the addiction with ‘less harmful’ substitutes, whilst failing to recognise or accept, that addiction itself is irreversible. We do all that we can to ensure that the users are fed clothed and sheltered, whilst again failing or unable to understand, that damage caused by what I refer to as Drugs of Destruction, is irreversible; that the harm, mental, physical and spiritual harms, they have inflicted on the users and those close to them, cannot be ‘reduced’, but that further harm can be prevented. Not, as we have been led to believe by substitute drugs to treat the addiction, which because of its nature, is not treatable, and then have the arrogance, to label those who do not comply, as ‘treatment resistant’, thus adding to their feelings of rejection, isolation and hopelessness.

The most effective way of preventing further harm so that the healing and recovery process, can begin, is to treat the addict, in a way that helps him to understand that he is ill, that the ‘self medication’ he has been using to ease his mental physical and spiritual pains, is perfectly understandable, whilst helping the addict to understand how continued use of them is causing him further harm. We need to help the addict come to terms with the fact that there is no cure for his condition, but it can be put into remission.

We need to provide appropriate, addiction specific, qualified help to help the addict come to terms with whatever trauma(s) trapped him into addiction in the first place.

Then, if we recognise and respect, the need for the addict to regain, their dignity, we have to help him come to terms with the guilt and self revulsion that addiction has inflicted on him, whilst recognising that they too are traumas, which the addict may be unable to acknowledge, or understand, is causing him as much, if not more distress than the trauma(s) which initiated use. Realistically, we need to accept that some will be more difficult to treat than others, but that does no mean they are ‘treatment resistant’.

Above all we need to accept that treating the addict cannot be accomplished by 20 minutes a week of ‘counselling’ and a script. As members of the human family, addicts have the same ‘human rights’ to dignity and personal security as the rest of the human race, and that lasting recovery, can only be achieved by treating the addict, not the addiction. Treatment of that quality is more likely than not, require a warm, caring nurturing, and other than that which is prescribed fore each individual, drug free, environment, where the addict can learn that it is possible to feel safe and secure, without causing himself further harm by the ongoing use of addictive substances. How long is it likely to take? As long as is needed, and even then, depending on the extent of the damage that both the trauma(s) and Drugs of Destruction have caused, we need to understand and accept, that ongoing care and support is needed.

Finally if we stop sending out ‘educational messages’ such as the vast majority of people can use addictive substances, without harming themselves or others’, because that is a lie as we have no way of being absolutely sure how anyone is going to react, to addictive ‘Drugs of Destruction, and stop ‘educating’ children and adults with messages about how some drugs can be ‘beneficial’, a task which is the prerogative of the medical and psychiatric professions on a one to one basis with their patients, rather than garbled information dispensed b a social learning graduate, to ‘enable’ our children and others, to make an ‘informed’ or so called ‘free choice’, we may, just may, prevent more people unnecessarily experiencing the suffering and hell of addiction.

Science has yet to come up with an addictive drug that does not cause some form of harm, so let’s stop dispensing on an indiscriminate basis, highly questionable disinformation, about how they can be used ‘safely’ When we’re willing to do that we can then start educating others to understand that addiction is a cancer that eats away at those who are unfortunate enough to succumb to it. As such, they are more deserving of our compassion than our condemnation.

As for those with similar attitudes to David Davies, we need to accept, that one cannot teach pigs to sing, it doesn’t work and it only irritates the pig. It is far more productive to spend our time helping others to recover, because they by their example will make far more of an impression that any distaste we feel, or express.

Anonymous said...

Too right. David Davis is a simpleton.

Unknown said...

"addiction itself is irreversible"

I stopped reading after that absurd comment.

I'm a drug user - this will be my 31st year of using. I'm no longer using anywhere near as much or as often but still regularly inject heroin, meth, and use other drugs like E.

While I agree Davies comments are awful I think we (those that work in the industry) need to realise that the tripe about all user suffering emotional pain is... tripe.

I have met many users over the years - the vast majority people like myself - people how use as part of their life, not their whole life.

I have met people raped at 8, runaways at 12, heavily addicted at 15.

They tend to be the minority.

There is a huge chunk in the middle who are, well, scum. They feed off the garbage handed out by people working in the drug field giving them excuses for being scum.

About time we stopped dicking around and start to recognise that there are drug users who simply are a waste of skin. Drug use did not make them that way, they were like it beforehand.

Giving them an excuse only helps people like Davies.

David Clark said...

Ja, I agree with you - all users do not suffer emotional pain. And some of them were 'bastards' before they started using.
What I am trying to do is to break people out of generalisations - and I may have become a victim myself!
There are good and bad people in all aspects of life. Not all heroin users are bad people. And even bad people can change - and merit the opportunity to be able to change.
Thanks for provoking discussion, which is an essential element of the blog experience. David