Just say no

In 1986, Nancy Raegan gave her famous televised speech, “just say no” to drugs. This signalled a continuation of efforts by the United States of America to continue its war on drugs. Like all wars, this one has, and continues to have, significant casualties. The illicit market of drugs has no moral code at their higher levels, with Dutch gangs constructing torture chambers, Columbian cartels still murdering their neighbours and London gangs stabbing each other to death. Examples are numerous and well documented in the media so I won’t delve into that. On the other hand, many people suffer from the ill-effects of illicit drugs, finding that their heroin contains fentanyl, being given extremely powerful ecstasy tablets or having ground up glass put in their cocaine to increase the rate at which it enters their bloodstream. However, these are the problems of a criminal market, one without regulations or reasons to prevent violence. It is a true free market, and that is why the least ethical become the most successful. But it didn’t have to be like this.

Numerous people use prescription drugs for the management of their health. It may be that, as is the case for me, someone benefits from Lorazepam in order to quell flashbacks or other extreme emotional states that can lead to self-harm, suicide or other socially unacceptable coping strategies. Likewise, significant numbers of people find a reprieve from their pain by taking opiate-based medications such as co-codamol, oxycontin and morphine. There are others who benefit from stimulants, myself included, such as methylphenidate, which increases extracellular dopamine to improve symptoms of ADHD.

I am someone who will speak to anyone who will speak to me, and have spent quite some time talking to people who use illicit drugs. The theme I very quickly picked up on is that they all had trauma in common and were using the drugs as a means to cope on a psychological level. These people had been failed by a medical system that viewed their social class as a reason to not prescribe them ‘top-shelf’ medications that I have been given access to. I think this is because of two main reasons. Firstly, they generally started using drugs before the age of 15, so as a consequence missed out on the ‘normal’ childhood that society demands us to have. Secondly, they had not been treated well by health professionals so struggled to engage with a system that is geared up to block them ‘seeking drugs’, further compounded by their history of wholly inadequate interactions with health professionals.

So, what is the difference between those who treat their mental health with street Lorazepam and someone like me who treats my mental health with prescription Lorazepam?

We each take the drug for the same reason and continue to do so because it enables us to cope with life and find function and meaning. But, we have totally different routes to acquiring this medication, the main difference being that they (in using illicit drugs) have to go meet with violent and predatory people who use profits to perpetuate their cruelty while selling poor quality drugs cut with adulterants; whereas I discuss psychiatry, pharmacology and how to manage risks with my doctor who then prescribes me my tablets, often made in Germany to the highest of standards, which I know for a fact are pure. By no means am I saying that I do this better – it’s just a consequence of my life experience, just as theirs is a consequence of their life experience – I am saying that they live in the social class of the ‘junkie’ whereas I live in the social class of the ‘patient’.

This is not talked about nearly enough and countless lives are being lost or irreparably damaged as a result. I recall speaking to one man, one of the kindest, deepest but most troubled I have met, who had owed £10 to a heroin dealer. The response to this debt? They took him to an abandoned building and then beat his legs with a baseball bat – beyond their breaking point – for four whole hours. For a £10 debt. Had this man been listened to by his Doctors, then they could have prescribed him morphine. This would then enable him to reach a point of stabilisation. Then, he could have been well enough to apply for social housing, to engage with therapy, to engage more with society, to not be in constant pain and/or terror, and found the peace he so desperately needed in order to survive.

Sadly, this can’t happen, because here in the UK, it’s only ‘good patients’ that can access ‘top shelf’ drugs like morphine. So, all those people who are needing an opiate drug because it’s the only way they have to cope are being denied access to high quality, clean, ethical and controlled medication. Why? Because Nixon-era drug policy has persisted through until today. The war against communism is still raging, even though it has been won. The Americans continue to offer Oxycontin in their left hand and an M16 in their right hand.

There is a way forwards, though. It requires Doctors to listen to why they are using these drugs and to give them advice on how to do so as safely as possible. It requires Doctors to be open-minded, and to consider offering other drugs that achieve the same desired effect through a safer pharmacological mechanism. But, above all, it requires all of us to trust that if someone is using drugs, illicit or prescription, they have a damn good reason.

I mentioned Nancy Reagan at the start, partly because I want to twist her words here at the end. I believe that if drug users are trusted with drugs (and supported as they take them!) that they will find their balance. Once they find this, having had everyone say yes to drugs, they will know that we accept them for who they are. If they need to take morphine then we still love them. If they take Lorazepam, we still love them. Whatever drug they need, we still love them. This is where I invoke Nancy, because once someone gets that acceptance and stability, they start to heal. Over time they will start to have moments where they don’t need the drug so much, and they will start to “say no” to drugs. For some it takes weeks, others it takes months, and for many it takes years. But that’s ok. We have enough drugs to go round and we have a criminal network that needs dismantling. The best way we can help each other help ourselves is to give people the drugs they need to do so.

So, when it comes to the question of whether we should be prejudiced towards drug users? Well, Nancy has a little something to say to you:

https://youtu.be/aB4rVJsy8z8?t=5