This article is the follow-up to the first part of The Culture of Addiction.
Society makes judgements about different types of psychoactive drug. As Bill White points out in his book Pathways from the Culture of Addiction to the Culture of Recovery, the social status and value attached to a particular drug by society influence several things:
- The risks associated with use of the drug
- The organisation of ‘tribes’ within the culture of addiction
- The characteristics of each tribe and the impairments that members experience from both the drug and the culture itself.
Clearly, there are likely to be differences in a variety of factors for drugs that are legal (e.g. alcohol) and those that are prohibited by law (e.g. heroin). Simply by using a prohibited drug, a person increases the risks associated with this drug, relative to what it would be if the drug could be legally obtained. Whilst society applies technology to reduce the risks of using legal substances, it often withdraws technology to increase risks from use of prohibited drugs.
‘We prohibit a ‘bad’ drug on the rationale that it is dangerous, and then construct social policies that assure high risks related to the drug’s use.’ William L White
White compares the technology applied to legal and prohibited substances. With legal substances, we reduce risks by ensuring that substances are not contaminated, adulterated or misrepresented. This is rarely done for prohibited substances, greatly increasing the risks associated with their use.
With legal substances, we reduce risks by packaging the substance in ‘dosages’ that provide predictable and desirable effects.
The person using a prohibited substance such as heroin rarely knows the purity of the substance purchased—this being determined by actions of illicit suppliers, when they cut the product—and therefore the dose they are taking. This increases risks when using, with potential overdose being a reality on a day-to-day basis.
With legal substances, we screen out and discourage use by those people who might be susceptible to the detrimental effects of a particular substance. The packaged drug contains a message saying that it should not be used if a person has such-and-such a problem, or if the person is using another particular substance.
The person using a prohibited drug will generally not get this form of information, thereby increasing the risks they are likely to face.
Legal substances are administered into the body in a way that is designed to reduce untoward consequences, such as the spread of disease. Injecting drug users can contribute to the spread of blood-borne viruses such as HIV and hepatitis C by sharing needles, syringes and other injecting paraphernalia.
Therefore, users in the UK (and many other parts of the world) are given access to clean injecting equipment—e.g. via treatment agencies, some pharmacies—to reduce the likelihood of blood-borne viruses being spread. However, this harm reduction practice does not occur in some parts of the world, including a number of states in America. It is argued by some people that provision of clean needles and syringes encourages drug use.
In essence, technology is being withheld in order to keep the risk of prohibited drug use high, in the hope it will deter use. This is morally wrong. The price of this approach is that people contract disease and die not because of the drug, but because of the social policy that prevents society from reducing risks associated with its use.
Harm reduction and harm minimisation techniques can be applied to the other points raised above, and in this country are applied to at least some extent. For example, warnings are put out if a particularly high purity sample of heroin is identified to be available on the street.
At the same time, however, it is argued that if prohibited drugs were made legal, then issues of purity, adulterants, etc would become a thing of the past, because people would purchase heroin from a government-controlled source.
There is another major way that legal status affects the substance-using culture and the way that people behave and think. When a drug is classified as illegal or prohibited, a powerful social stigma develops that impacts on the emotions and behaviour of people who use the substance. This arises because of the attitudes of society towards users of prohibited drugs – drug users become stigmatised, stereotyped and prejudiced against.
Negative attitudes have developed towards drug users over the past 150 years or more, particularly driven by prohibition movements and fuelled by the popular media.
One would like to think that regulation of drugs (legal vs. illegal) has actually been developed on the basis of their dangers to health, but this is not in fact the case. A variety of political, social and economic factors have played a greater role.
Bill White describes a number of themes that develop from public movements towards criminalising drugs and their users. The drug is associated with a hated sub-group of people, who become caricatured in a certain way.
The drug and its users are held responsible for a number of problems in society, and the survival of society can be portrayed as being dependent on prohibition of the drug. The drug, dealers and even users are viewed as ‘evil’, corrupting our young people.
Anyone questioning these statements is attacked and sometimes characterised as part of the problem that needs to be eliminated.
The arising prejudice to drug users, and ex-users, makes it even more difficult for them to overcome their addiction, as an essential element helping this recovery is an acceptance of the person as ‘normal’ by so-called ‘normal’ members of society.
