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Apr 16 2023
My new book on autism and addiction is now available!

I am really excited to tell you all that I ha e published a new book!

Unusual Medicine: Essays on Autistic identity and drug addiction

This book explores my personal experiences with being Autistic and addicted to drugs and alcohol. It considers my recovery and what was unique about my experiences.

Alongside this, I also bring my professional insights as a person who works with Autistic addicts. I make suggestions on basic changes to services that would make them more accessible, and how we can change societies framing of addiction.

It is currently available on Amazon in most territories, and will also soon be available from some other online retailers.

If you would like purchase a copy, see the buttons below!

UK Amazon Link
US Amazon Link

Also, don’t forget that you can subscribe to my Substack for bonus content!

David Gray-Hammond 1 Comments
Jan 15 2023
Drug-use and harm reduction: what does it look like?

When we consider harm reduction strategies for drug-users, we often think about education on the safer use of drugs. Things such as safer injection practices and “tasting the hit” to reduce accidental overdoses. While things such as safe consumption rooms and needle exchanges can reduce a lot of the surface level harms, there is a wider conversation about the factors leading to drug-use and the fall out from drug-use once it has initiated.

Here are some of the things that, in my opinion, are important factors to consider when trying to reduce the harms from drug-use.

1. Trauma-informed practice

First, we need to stop viewing trauma through a normative lens and realise that trauma can be experienced from just about any source. As I discussed with Tanya Adkin in the Creating Autistic Suffering Series, trauma is a subjective experience.

Once we have shed our misconceptions of what constitutes trauma, we need to recognise the role that traumatic experiences play in the harms associated with drug-use. Anyone supporting people around harm reduction needs to remember that they are more than likely working with traumatised people.

2. Responsible prescribing practices

The pathologisation and subsequent medicalisation of distress has done many people a great deal of harm. For many people, myself included, it has meant trading addiction to illicit drugs for addiction to prescription drugs. In my case, prescription drugs were more dangerous than the illicit ones due to ease of access.

People don’t like to admit it, but doctors often end up being a person’s main supplier of drugs.

3. Move away from current diagnostic models in psychiatry

Distress doesn’t have to be centred as a problem in the person. In fact, I would argue that it’s necessary to externalise it by looking to the environment, and subsequent experiences of people in distress. We need to consider that if we want people to be safer in the use of drugs, we need to think about what in their life has brought them to using them.

For a good example of this, check out the power threat meaning framework.

It is also important to embrace neurodiversity models. It’s not just Autistic people that are Neurodivergent. Neurodivergence can be acquired in a number of ways, or you van be born with it. It is important, though, to recognise that “mental illness” as a concept has not improved outcomes in psychiatry in over 50 years. Recognising Neurodivergent people in distress will take you much further.

4. End prohibition

The war on drugs is a lie. It has not stopped drug use, and neither has abstinence-based education. Making drugs illegal does not stop their use, it empowers clandestine markets to exploit the distress of vulnerable people, for profit, and increases harms through the lack of regulations around purity and age restriction.

This is a non-exhaustive list. We need to have a wider conversation about racism and other bigotry, socioeconomic status, housing, access to healthcare, and myriad other factors. I do not believe I could do this justice in a short blog.

I hope that we can move into a world where we support people rather than criminalise and institutionalise them. I hope that medical professionals can take a moment to acknowledge the harm their profession has done. I hope that we can all assess our own internalised ableism towards drug-use and addiction.

We may not be able to solve this issue over night, but little by little, we can make the waves that will sweep away the old models and make space to replace them with something that works better for every one. The greatest thing we can do is have a little compassion for others who are suffering.

David Gray-Hammond 0 Comments
Jan 13 2023
Autistic drug-users and the lack of solid guidance in support services

In the UK the majority of mental health support and treatment is guided by an organisation called The National Institute for Health and Care Excellence (NICE). Their guidance sets out how each and every person treated in a clinical setting should be managed, and what treatment modalities are appropriate and inappropriate. Except there is a glaring gap in this guidance, this gap is with regards to the treatment of Neurodivergent drug-users. They have guidance on the dual-diagnosis intersection where drug-use and “severe mental illness” meet, but nothing regarding neurodivergence.

This presents a unique challenge to practitioners working in the field of substance-use; it certainly contributes to the misconception that drug-use is a non-issue for Autistic people. Of course, if it was an issue, why wouldn’t it be in the guidance?

Neurodivergent people exist at multiple intersections of race, gender, sexuality, socioeconomic status, why is it so hard to understand that we often turn to drugs in order to self-medicate the trauma of our improper society? Weir et al (2021) showed definitively that while we are less likely to report using drugs, we are more likely to report self-medicating with what can be considered “recreational substances”. This pulls the plight of Neurodivergent people into the spotlight. Where self-medication exists, the potential for escalation to addiction exists.

Without concrete guidance in place, support for those existing at this intersection of experiences is likely to continue down a path of inadequacy. Some might ask what guidance should look like, while I have some specific ideas, I believe there is a wider need for understanding of Neurodivergent experiences in service providers. Guidance can’t just be drawn up in a “one-size-fits-all” manner, clinical commissioners and others involved in treatment policy need a nuanced understanding of our experiences.

This understanding can only come from co-production of material guidance. Autistic and otherwise Neurodivergent people need to be involved in the generation of guidance and policy. Having worked in service user involvement models, I have seen first hand the vital impact that the voice of those affected has on steering policy.

The truth is that many people writing guidance and policy have little to no experience of the real world effects of drug-use, let alone the real world impacts that drug-use has on Neurodivergent people in particular. Most of them are still rooted deeply in medicalised ideas of neurodivergence. Their are broad issues to consider.

Drug-use is intrinsically linked to socioeconomic status and further marginalisation. When you consider that only 22% of Autistic people are currently in any form of employment in the UK (Office for National statistics, 2020), not to mention the number of us existing in the court and judicial system; Neurodivergent young people represent a particularly large portion of youth offending populations (Day, 2022). We are 7 times more likely to be permanently excluded from mainstream education (Gill et al, 2017), representing 44% of all permanent exclusions (Vibert, 2021).

It seems as though Neurodivergent young people exist on a school to self-medication to prison pipeline, and that is assuming the drugs don’t end their lives before they have begun. The guidance is not only needed, it needs to consider all aspects of life that are contributing to it. We cannot claim that we are engaging in harm reduction while such things are happening. Let us not forget the horrifically traumatic experiences that Autistic people face (Gray-Hammond & Adkin, 2021). It’s a perfect storm for drug-use and addiction. We need guidance from official governing bodies.

It’s vital to mention that neurodivergence doesn’t end at 18. Neurodivergent young people turn into Neurodivergent adults. We need support and guidance across all age groups.

Until NICE and other clinical governing bodies work with Neurodivergent populations to produce guidance that is fit-for-purpose, we will continue to see the premature death and imprisonment of Neurodivergent people who are doing nothing but trying to survive in a system that sets them up to fail. We need guidance across all settings, but especially clinical ones.

Please sign this petition regarding the lack of NICE guidelines

References

Day, A. M. (2022). Disabling and Criminalising systems? Understanding the experiences and challenges facing incarcerated, neurodivergent children in the education and youth justice systems in England. Forensic Science International: Mind and Law, 3, 100102.

Gill, K., Quilter-Pinner, H., & Swift, D. (2017). Making the difference: Breaking the link between school exclusion and social exclusion. Institute for Public Policy Research.

Gray-Hammond, D & Adkin T (2021) Creating Autistic Suffering: In the Beginning there was trauma. Emergent Divergence

Office for National Statistics (2020) Outcomes for disabled people in the UK: 2020

Vibert, S. (2021). Briefing: Five things you need to know about SEN in schools: February 2021.

Weir, E., Allison, C., & Baron-Cohen, S. (2021). Understanding the substance use of autistic adolescents and adults: a mixed-methods approach. The Lancet Psychiatry, 8(8), 673-685.

David Gray-Hammond 0 Comments
Dec 20 2022
Rat Park: Addiction misunderstood

Johann Hari did a lot for the popularisation of the rat park experiment. This person’s now infamous Ted Talk flung open the conversation that perhaps, just maybe, addiction was not biological in origin. While this attempt to depathologise human experience was admirable, both sides of this argument miss a vital cornerstone that bridges so many gaps in our understanding of addiction.

Rat park suggested that the reason the rats preferred drug-laden water was because of the lack of a meaningful social environment. While I will argue that this certainly plays a role on the perpetuation of addictive behaviours, there is more to be considered.

There have been various retorts, but in my opinion, we need to discuss one thing in particular. We need to talk about trauma.

It doesn’t matter what kind of privilege you have in this world, trauma can set off a domino effect, leading you down a path towards addiction. I am yet to meet any addict who was not trying to hide from pain. Some might argue that not all addicts are traumatised, but I would respond by saying that we need to ditch the normative ideas of what trauma is.

Anything can be traumatic, trauma is relative to the Self, not the external observer.

So, yes, a lack of a meaningful social environment can play a big role in addiction, but I do not believe that is what pulls people into the grasp of active drug addiction. It is what keeps them feeling as though they have no way out. That in itself is a traumatic experience which leads to increased drug use.

This is why we need to constantly be aware of the structures and people that comprise our environments. These components are what scaffold us into active addiction. We respond to our environment, yes, but the factor from that environment that plays the largest role is trauma, not sociality.

David Gray-Hammond 1 Comments
Oct 15 2022
I’ve launched my own business! DGH Neurodivergent Consultancy!

For a while now, it has been a dream of mine to make Autistic knowledge sharing my career. I love the Autistic community, and want to help improve the environments thar we exist in. That is why I am happy to announce DGH Neurodivergent Consultancy.

Launching this business will help me keep my writing and online activism free and accessible on the Emergent Divergence platform, while allowing me to work towards a better world for Autistic people, and have enough money to turn the radiators on at home this winter!

If you think you could benefit from my experience, please visit my new website for more information.

A final note, emergentdivergence.com isn’t going anywhere, this is a home for my writing that I intend to keep going for many more years.

David Gray-Hammond 3 Comments
Jul 20 2022
Addiction doesn’t strip us of our humanity

Trigger Warning: This article contains discussion of addiction, death, metaphors around death, dehumanisation, and mistreatment.

What defines us as a human?

Is it rhetorical ability? Emotional experiences? Perhaps the tools we use?

I would argue that one of the defining characteristics of our humanity is our ability to to recognise humanity in others, or perhaps more specifically, our ability to deny the humanity of others. Thanks to years of colonialism, warfare, and eurocentric beliefs, we have developed a strange sort of morality. This morality is what we use to ordain or deny a person or object as human/human-adjacent.

Unfortunately, when you are an addict, human-adjacent would be a big step up in how the world sees you. For as long as we have existed, we have been ignored, spoken over, driven out of our homes, and killed. This because contemporary spins on normative morality posit that to be an addict, is to be a monster. We are beyond help and reason.

We are what you fear your children will become.

The truth is that all judgements on addiction come from a place of moral relativism. Addiction is only seen as a moral failing because of cultural attitudes towards the behaviour associated with addiction. Fundamentally, it is seen as a moral failing, rather than a response to trauma and unmet support needs. If we could move society to a more “trauma-informed” culture, it is likely that attitudes towards addiction would alter quite significantly.

This isn’t to say that addiction doesn’t represent a risk to others. As addicts, we find ourselves doing things we never imagined or wanted ourselves doing. The lengths that one might go to in that desperation can lead to some truly awful consequences. To put it another way; we still have to take ownership of our shitty behaviour, whatever the reason. However, we also require some level of compassion. Compassion can go a long way one the journey to recovery.

Sadly, compassion doesn’t go all the way. We still need professional input from those who know how to deconstruct the circumstances of addiction, and help the person to rebuild their life. We need to build a life where it is easier not to engage with our addiction. This is made ever more difficult by the defunding of services that work to do such things. Besides that, we need to recognise that heroin, crack, and alcohol, are not the only substances that need attention from services. The world of addiction grows more complicated by the day, especially since the dawn of novel psychoactives.

Considering the future, we need to build a world where it is not necessary to become addicted to survive. A world where if we do become addicted, we are not shunned to the outer edges of our community. We need people to stop acting like addicts choose to be addicts. Addiction knows no boundaries, it can come for anyone.

Deconstructing societal and cultural attitudes will take a long time. Things like decriminalisation are important, but if done badly could actually reinforce moral judgements of substance users. For this reason, we need further longitudinal data looking at other countries that have done such things, seeing where the positives and the pitfalls lie.

It’s vital that we do this work, because moral judgement and “not in my neighbourhood” attitudes are literally killing addicts. The world has blood on its hands, and it doesn’t even realise it.

Addicts deserve their humanity.

David Gray-Hammond 2 Comments
Jul 10 2022
Back to the corner: Psychoactive drug use, my Autistic experience

Some 4(ish) years ago, my debut blog post on this website was Standing on the corner: Where autism and addiction meet shortly covered by Recovery services as an Autistic adult. Back then My writing was merely an attempt to scream into the void, offloading my frustrations. Little did i know that in 4 years, my articles would have garnered over 25,000 views, and that people would ask me to go places and do things. I was also pretty surprised to discover that for the most part I don’t mind going places and doing things.

With that in mind, I decided it’s time to take another crack at this one, seeing if 4 years of experience makes for an improved experience for you, my wonderful readers and followers.

So here we are.

I’m David. Born Autistic at the dawn of the 1990’s. My life was pretty standard for what you’d expect of a truamatised, psychotic, recovering addict. So let’s consider where this particular part of my journey started.

October 2008.

My long term relationship came to an end (mutually, but still painful none-the-less). On that very same day, I had a peculiar experience. I heard a number of voices calling my name, but it seemed that it wasn’t the people around me that were doing so. Interestingly, this was the day of my first ever cigarette as well. Hindsight tells me that the fact that my first cigarette led to me smoking an entire pack in a number of hours should have been a huge warning for what was coming. Sadly, hindsight isn’t good for much, and I have a traumatised AuDHD brain that at the time was going through what some might term a “prodromal phase” for the psychotic condition I would later be diagnosed with.

Over the next week I discovered that smoking cannabis really helped my growing paranoia and auditory disturbances chill the f*ck out, and that when drank a litre of vodka, I just didn’t give a sh*t. Just a note here for anyone who can’t see what’s coming; drug-use and trauma is a volatile mix. Some people use psychoactives safely and medicinally their whole lives, with no real negative outcomes. I on the other hand came to resemble one of those warning videos your school would have shown you about the dangers of peer pressure and drug-use.

So, naturally I did what any normal AuDHD’er would do when they discovered something that makes them feel good. I did it again. And again, and again, ad infinitum. Each time I used, my consumption grew. Each new environment I entered I would break down another boundary in my life. First it was cannabis, then alcohol, and I figured that since these two weren’t the dangerous and hellish things my school had made them out to be, perhaps other psychoactives would be okay as well. Side note: this is why using scare tactics and abstinence based approached to stop young people from getting high is f*cking irresponsible, because when they find out they’ve been lied to, they don’t truat you on ANYTHING.

My time at university can be summed up by quoting myself “I don’t think you’ve ever seen me this high, have you?” and the phrase said to me most often “How the f*ck are you still alive?”. You see, I hadn’t noticed it, but I was taking drugs by the shed load. I was out of my mind on pretty much anything I could get. It’s easier to list the drugs I haven’t used than the drugs I have used; To date, I’ve never used “street” heroin, or crack cocaine. More on this in a moment.

What this meant was that when I ran away from my environment, making the 300 mile journey back to my mother’s house, I swore I would never use again. After all, I had nearly died on a couple of occasions, and found myself on the radar of what one might describe as “less than savoury people”.

More on my drug use…

Yes, I have never used Heroin or Crack, but what did happen was that I got addicted to Oxycodone, Diazepam (Valium to my american followers), and Spice (you know, that zombie drug that everyone was talking about for a matter of months until it became illegal and everyone decided to pretend like the problem was solved). Of course, I was drinking a litre of whiskey most nights, and I also had excellent taste in red wine and ales.

Unsurprisingly, I found myself under the treatment of what would describe itself as a “Substance Misuse Service” (SMS), interestingly, there seems to be an unwritten rule that when you spend more time in hospital from drug overdoses than you do at home, they get a little angsty with you. Here’s where I start getting pissed off.

By the time I was under the SMS, I actually wanted to stop using, but had completely forgotten what normal life was like. I hadn’t been sober a number of years, and was quite frankly spending most of the day looking like I had just left the set of Fear and Loathing in Las Vegas. My keyworker was a wonderful person, and conveniently specialised in Novel Psychoactives like Spice. Sadly, that’s about as far as my good experiences go.

You see, I had also been referred to the local secondary care mental health service, referred to as the “Assessment and Treatment Service” (ATS). Again, they took umbridge with my repeated unaliving attempts, and decided they should probably do something about this obvious wild card called David.

Here’s the problem though.

The SMS needed my mental health to be treated. How can a person stop using drugs to hide from trauma, when that trauma is still ongoing and not being processed? Luckily, the ATS had a stellar response; “We can’t treat your mental health until you are sober”. Thank goodness that we could all agree on absolutely nothing.

I was quite privileged eventually, because my lead practitioner at the ATS actually spoke to my keyworker at the SMS, and we eventually got somewhere. It was a psych ward, but it was still somewhere, and that’s what matters.

I detoxed off the psychoactive stuff, and then detoxed some more in the community. April 7th 2016 I had my first day of sobriety in close on a decade. This warranted a celebration, naturally, so naturally I threw myself into a monotropic spiral, had a major psychotic episode as a result, and earnt myself a free trip back to the psych ward. Oh, and by the way, being Autistic on a psych ward is a huge steaming pile of bullsh*t that has been placed in an already burning dumpster.

So what other issues did I face? Services were woefully ill equipped to take on a neurodivergent client on just about every front.

The entire system for appointments was clearly designed by and for neurotypical people who assumed that everyone had a good grasp of time-keeping, sensory regulation, emotional regulation, and their short term memory. It was an absolute nightmare.

So what was different about my drug use compared to a neurotypical?

I think the largest difference was my approach. Drugs were my special interest, still are to an extent (just without the use of said drugs). I used myself as a science experiment. I kept detailed journals of what I’d taken, what dose, what I had combined it with, and how it affected me over a number of hours. My ultimate goal was to find the sweet spot where I was no longer aware of my existence, but still alive.

Another interesting aspect of my drug use was my blatant identity crisis. Growing up Autistic meant being constantly told that who I was, was incorrect. Everything about me was a target for the neurologically provincial bigots. So when I discovered that drugs allowed me to build a new identity, one that I felt was better accepted (says something when your addict identity feels better accepted than your Autistic one, doesn’t it?), I leaned into it and allowed psychoactives to become my ENTIRE identity.

Of course, I was still Autistic and ADHD as hell, so drugs often served to extend my spoons reserves far beyond their limit.

The biggest pull of drugs though? I could switch off my feelings, or change them in a matter of minutes to hours. I had the control, I felt what i wanted to feel. Take that, brain!

Of course I tried things like the 12-step program to get sober. It really wasn’t my sort of thing, but apparently voicing that in meetings is a huge faux pas that means none of the 12-steppers continue to talk to you when you leave the program. I ended up taking things I had learnt from multiple sources and building a life where it was easier to not use anymore. When I was struggling, I would reach out and help someone who needed help. It became a philosophy that I lived by. These days I have to be a bit more careful with my spoons, but still essentially try to live life by helping others out of the dark spaces that litter the world.

The fundamental problem with my experience in “the system” was that no one had any appropriate training around neurodivergent people. To be fair, I didn’t even know of things like monotropism, double empathy, meltdowns, burnout, or really anything to do with actual neurodivergent experience, so I couldn’t really act surprised when services didn’t either.

Life hasn’t been perfect since I got sober, but I’m glad I got to experience it. Sobriety has been a gift that I gave to myself, I don’t intend to ever return it, but one thing I have learnt more recently is that if you spend your entire life trying to predict the future, you’re not going to have a fantastic experience of the present.

A set of final words? If you are struggling right now, with any of the stuff in this article, I want you to know that it CAN get better. I don’t say that to bullsh*t you. The ugly truth is that not everyone survives this stuff. I do, however, urge you to give yourself the best chance you can. 7 years ago, as I embarked on my recovery, I could not have imagined being where I am today. The suffering I was experiencing seemed unending and inescapable. I got out, though.

I truly believe that everyone deserves a chance to be a happy and content member of the society they live in. Of course mental health and addiction are only a small part of peoples experiences, which no doubt I have already, or will, elaborate on in some capacity.

I just need one thing from you, dear reader, don’t give up. Keep trying.

David Gray-Hammond 1 Comments
May 18 2022
Autistic Substance Use Survey 2022

Below is a survey on Autistic people and substance use. The aim is to collate data anonymously on the use of drugs and alcohol in the Autistic community, and use that data to write a report that will be published on this website.

The hope is that these insights may help Autistic people better advocate for themselves with regard to this topic.

None of the questions are mandatory, but the more that you can answer, the more data we will have to look at.

David Gray-Hammond 1 Comments
May 2 2022
How the shame cycle barricades us from recovery

They say in life that nothing is certain, but if anything is, then it’s the fact that shame will deny us entry into recovery.

I’m going to consider this from the perspective of addiction recovery, although it applies to recovery from any psychological trauma. I merely choose addiction recovery for this article because it makes the illustration of my point much more simple.

Consider the nature of addiction. A person’s needs are unmet. Due to the trauma that arises from this they seek to escape their pain, and in doing so turn to a path of addiction.

Addiction is seen by society as a moral failing, and so is the behaviour exhibited by those under the influence of their addictions. People are chastised for their addiction which creates shame.

This is a fatal mistake.

Shame is like poison to an addict. Shame in itself creates more trauma from which their is even more need to escape. Which in turn results in further, or even increased engagement with their addiction.

This in turn leads to further chastisement, and thus the cycle perpetuates.

This cycle can, and often does, continue until fatal consequences occur.

In order to help an addict break away from active addiction and enter recovery, we need to remove the shame that comes with addiction.

This takes many forms such as trauma-informed treatment, adequate socioeconomic support with things like housing and finances, and an adequate support network.

It’s not just about being nice to addicts, it’s about putting them in a safe place to rediscover their love and pride for themselves. This applies to more than just addiction.

Shaming addiction and other forms of psychological trauma is an act of violence that can both directly and indirectly kill people by barricading recovery. Until society drops the moral judgements, shame will continue to kill indiscriminately.

David Gray-Hammond 0 Comments
Apr 12 2021
How can substance use services be more accessible to Autistic clients?

I have written before about the barriers to accessing substance use services when you are both autistic, and an addict; today I’m going to approach from a different angle.

In this post, I will be talking about a few things that such services can do to increase accessibility, improving the quality of treatment that autistic and neurodivergent substance users recieve.

Let’s begin.

One of the first things I always point out, is how difficult it can be to keep track of appointment schedules when you are autistic. Services can improve this by using automated messages several times leading up to an appointment in order to remind the client of the details.

Services can also offer an array of reminders through different mediums so that the client can pick the reminder that will work best for them. It would also be helpful if key workers a medical staff could let clients know what will be discussed in the appointment so that they can prepare themselves for it.

The next one is a personal favourite of mine, and I’m yet to see it implemented.

The waiting room environment in treatment facilities can be overwhelming. Sensory friendly waiting rooms, designed by autistic people, for autistic people, could make a real difference here.

It’s impossible to recieve effective treatment if you are going into an appointment already overwhelmed. Thought should also be given to the appointment environment.

The last two are connected, and vital.

First, staff need to be trained on the difference between a panic attack, and a meltdown, and how to calmly and compassionately de-escalate both. Both of these situations have the potential to completely derail treatment if they are handled inappropriately.

Finally, staff need to recieve regular training on autism and neurodiversity, from Autistic and neurodivergent trainers (bonus points if they are also in recovery from addiction). Many staff in these places only know what medical schools and brief awareness courses teach. Often, they view things through the deficit-based medical model of neurodiversity.

Anyone of these changed could vastly improve accessibility, but all of them together would make a vast difference to the treatment environment. It’s important to note that it would not just benefit autistic clients.

When we improve the environment for autsitic and neurodivergent individuals, it generally improves it for everyone.

David Gray-Hammond 0 Comments
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