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AuDHD addicts don’t respond to shame the way you want them to: Here is why

I have written before about how How the shame cycle barricades us from recovery in terms of addiction. In particular, here, I think about people who are AuDHD. If you exist at that particular intersection of experience, there is an increased likelihood that you use substances to improve your own wellbeing. Where there is self-medication, there is an increased risk of addiction. Where their is addiction, there are people trying to shame them into quitting.

Autism, ADHD, and shame

Being neurodivergent usually comes with a level of shame. This is due to the fact that society uses neuronormativity to police how we think, feel, act, and emote. It is estimated that ADHD children receive around 20,000 negative or corrective comments by age 10. Let us not forget that if a child is AuDHD, then there is a risk that they have been exposed to harmful interventions such as ABA or perhaps even MMS to try and make them “indistinguishable from their peers”.

When we consider this with respect to AuDHD adults, we are literally creating a factory line that takes children and turns them into adults who believe that who they are is wrong, invalid, a failure, or subhuman. To be AuDHD is to be constantly told why you are not enough. I believe from this you can already see why we may turn to drugs and alcohol to feel better.

Why does shame not stop addiction?

Clockwise arrows move between the words “shamed by people” and “use to cope” around the word “addiction”.

Addiction is insidious. It creeps into your life and slowly dismantles it. Stripping away your sense of identity, your relationships, your economic stability. It slowly takes everything from you until it is ready to take you away from the world. Addiction is not a moral failing, and it certainly is not a choice. No one wakes up one morning and decides to give away their liberty in the pursuit of oblivion.

One of the reasons we seek that oblivion is because the pain we experience is so intense that we would rather feel nothing at all. Shame adds to this pain. It eats away at us, tells us we should hide and obfuscate those parts of us that need to be in the light. If open communication is the key to recovery, then shame is the barricade keeping us from it. For this reason, shame will only ever keep us heading back towards oblivion.

What helps AuDHD people recover from addiction?

As we have discussed. AuDHD people are already driven to conceal themselves from childhood. Driving that further by shaming their drug use only serves to entrench that more deeply. In order to recover, we need to be able to communicate our inner experience openly and honestly. We have to create environments where a more natural embodiment of our internal experience is not something that will be penalised. To consider it another way; we have to let people be themselves.

Before we can be ourselves, we have to know ourselves. This is why community connectedness is so very important. Aside from an overall reduction in minority stress, it allows us to learn about ourselves through shared experience with others. By engaging in natural communication and AuSociality, we learn what it is to be us, and how to improve our wellbeing. When we begin to feel good about ourselves, it becomes easier to tackle addiction.

There is no one-size-fits-all approach to addiction recovery, but I am certain that shaming AuDHD addicts will never achieve what you hope it will. If we want to save lives, we have to begin creating safe and nurturing spaces, not driving people back to the oblivion they already feel they deserve.

AuDHD and cigarettes: What is the relationship?

Autism and ADHD are often reported to have vastly different relationships with regard to the smoking of cigarettes. Research suggests that among Autistic people, we see a reduced rate of smoking, while ADHDers generally report smoking more frequently (nearly half reported daily smoking by age 17). I believe, however, that a serious oversight has occurred in research regarding the co-existence of both Autistic and ADHD identities in individuals (also known as AuDHD).

I had previously highlighted that around 37% of Autistic respondents to a Twitter survey reported current or historical smoking. I discussed that this may be because Autistic people use smoking as a stim and for sensory breaks, but when we consider the overlap between autism and ADHD (estimated to be 50-70%) we start to see more reasons for why there may be increased smoking of tobacco between neurodivergent people.

ADHDers often smoke as a way to self-medicate (nicotine is a stimulant) or due to impulsivity (see this study). When we combine ADHD and Autism, we combine the risk factors for smoking cigarettes. Not only do AuDHDers need a reason to escape environments or use smoking as a stim, the nicotine helps to regulate attention.

So, when we consider research that finds Autistic people to have a lower than average prevalence of tobacco smoking, I have to question whether or not the sample was biased. At least half, if not more Autistic people are also ADHD, and therefore should be subject to the sake prevalence and risk factors for smoking as those assumed to only be ADHD.

Smoking rates are an important thing to consider in neurodivergent communities, given their link to early mortality. Autistic people face a mortality risk suggested to be 51% higher than the general population with Autistic people living an average of 16 years less than non-Autistic people. Increased rates of smoking in AuDHD demographics almost inevitably contribute to our shorter than average life span.

This raises important questions for cessation and maintenance of abstinence from tobacco in nicotine dependent AuDHDers. Substance use services are notoriously ill equipped to work with neurodivergent people; the same could be said of smoking cessation services. Most of which are run out of pharmacies in the UK with no reference to neurodivergence in NICE guidance.

As with most cases of chemical dependency and addiction, neurodivergent people are forced to find their own route to abstinence or harm reduction. This matter only becomes more complicated with the co-occurrence of multiple neurodivergent identities.

AuDHD people are often ignored in research, probably due to the complicated nature of identifying exact co-occurrence rates in a world where diagnostic criteria miss the identification of many. When we consider research into AuDHD substance use, we can appreciate that it is not a simple affair and that it would be a significant undertaking to obtain truly accurate figures.

Regardless, Autistic and ADHD people deserve a shift in research priorities, away from causative factors and genetics, towards meaningful insights into our quality of life and longevity.

Nothing will shorten our lives more than ignoring the issues that shorten our lives.

Autism and alexithymia: The fallout for our mental health

Autism and alexithymia are two things you might see discussed in tandem quite regularly. In fact, Vaiouli and Panayiotou (2021) found a strong postive correlation beween Autistic experience and alexithymia with Kinnaird et al (2019) finding a prevalence rate of nearly 50% among Autistic people. Considering the very high rates of alexithymia among Autistic people, it is necessary to think about how this might contribute to issues in healthcare settings where professionals are largely trained in non-autistic expressions of emotion.

Alexithymia (according to the Merriam-Webster dictionary) is the inability to identify and express or describe one’s emotions. In other words, an alexithymic person experiences emotions in a way that means they struggle to attribute the internal sensations to descriptive language. It is subset of interoceptive differences which is discussed by Adkin (2023) in relation to their concept of “Meerkat Mode”.

This obviously presents issues with accessing support for our mental health. How can we explain our struggle if we can’t put it into words? Professionals often take us less seriously because if it was “that bad” we would be able to voice our suffering. Unfortunately it is not as simple as this. Even in my own experience, I often struggle to feel the difference between emotions like anxiety and excitement. Happiness and sadness also feel similar to me, and exhaustion is something I often can’t recognise until I am at the point of crisis.

This is a significant enough issue to face as an Autistic adult, but it happens to Autistic children as well. We regularly see Autistic people turned away from services such as CAMHS because they are in no way equipped to help us. Children are naturally less adept at describing emotions, especially the big emotions, and when you throw alexithymia in on top of that it leads to a breakdown in communication that can have life threatening consequences.

I have found myself at multiple points in my life being administered medication that I did not need because the ways I have learned to articulate my very abstract feeling emotions have been misunderstood (accidentally and willfully) by psychiatrists. We live in a world that pathologises our suffering, meaning that we can face horrific side effects to treatments that we might not have needed had professionals been culturally competent with regards to mental health in Autistic people. Tanya Adkin and I have written about the importance of competence previously (Gray-Hammond & Adkin, 2023).

I often ponder on the relationship between my early experiences of not being able to communicate my emotions effectively to professionals and my subsequent years of a drug and alcohol addiction. Honkalampi et al (2022) found a positive correlation between alexithymia and substance use, which in my opinion may indicate a mechanism behind the findings of Weir et al (2021) showing significantly higher rates of self-medicating with recreational drugs among Autistic adolescents and adults. In fact, one of the primary drivers behind my drug use was having control over my emotional experience. I would hazard a guess that drug use is so common in the Autistic community because it allows us to feel a familiar and more easily described feeling.

It is clear that alexithymia is a significant issue for not just Autistic people, but also for professionals working in healthcare and wellbeing practices. The links between alexithymia, poor access to mental health support, and risk taking behaviour are clear. It’s necessary for professionals working with Autistic people to find ways to help Autistic people articulate their emotions rather than to just ignore us or belittle our struggles.

Our lives depend on it.

References

Adkin, T. (2023). What is meerkat mode and how does it relate to AuDHD? https://emergentdivergence.com/2023/06/06/what-is-meerkat-mode-and-how-does-it-relate-to-audhd/

Gray-Hammond, D., & Adkin, T. (2023). Creating Autistic Suffering: Autistic safety and neurodivergence competency. https://emergentdivergence.com/2023/04/11/creating-autistic-suffering-autistic-safety-and-neurodivergence-competency/

Honkalampi, K., Jokela, M., Lehto, S. M., Kivimäki, M., & Virtanen, M. (2022). Association between alexithymia and substance use: A systematic review and meta‐analysis. Scandinavian Journal of Psychology63(5), 427-438.

Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry55, 80-89.

Vaiouli, P., & Panayiotou, G. (2021). Alexithymia and autistic traits: associations with social and emotional challenges among college students. Frontiers in Neuroscience15, 733775.

Weir, E., Allison, C., & Baron-Cohen, S. (2021). Understanding the substance use of autistic adolescents and adults: a mixed-methods approach. The Lancet Psychiatry8(8), 673-685.

Autism and drug-use: drowning in the void

It’s no secret that I’m a recovering drug addict. It’s certainly even less of a secret that I am also Autistic/multiply neurodivergent. When one considers the reality of meeting diagnostic criteria for autism, ADHD, and schizophrenia; It’s easy to see how drug use was an inevitability. I often joke that AuDHD isn’t descriptive enough for me, and that I should describe myself as AuDphrenic.

It’s important to note that I don’t like to differentiate between “drugs” and “alcohol” given that alcohol itself is a drug. The separation of the two has been instrumental in the dehumanisation of those struggling with their use of things outside of the world of alcohol.

Autistic people can and do use drugs. Many professionals believe that we don’t, but we do. We often have access, means, and reason to use drugs. Allow me to present some statistics on drug use, found in this study:

  • Despite over all being less likely to report recreational drug use, there were some significant findings:
    • We are nine times more likely to report using recreational drugs to manage our behaviour.
    • We are more likely to report using recreational drugs to manage our mental health.
    • We are more likely to report vulnerabilities associated with drug use such as;
      • Childhood drug-use
      • Being tricked or forced into drug-use

This highlights some significant points of consideration for Autistic people. Those of us on the AuDHD intersection may be experiencing atypical burnout. This presents a high likelihood of Tanya Adkin’s concept of meerkatting coming into play. For an Autistic person in meerkat mode, drug use may offer a great deal of reprieve and give the feeling of an extended number of spoons/cognitive resources (see spoon theory).

When I was using drugs, I treated myself as a science experiment. For an AuDHD Schizophrenic, drugs allowed me to find a flow-state. They made the management of my Self and identity more manageable. I would keep journals of my drug use in order to see how far I could push it. Just how high could I get?

Some Autistic people use drugs safely. Cannabis and psychedelics are very popular options for self-medication, and I know of many who use them as such. It’s important that we recognise the risks without invalidating those who use them safely as medicine. In a world where a trip to the doctors can bankrupt you, we should not judge those who self-medicate. We should create a space where it is okay to explore all the pros and cons.

It’s also important to note the aforementioned risk of forced drug use. Many of us wish desperately to be part of friendship groups, which places us in a vulnerable position. Mate crime and criminal exploitation can often start with forced drug use. We need to protect Autistic people against the inevitable black market that has arisen from prohibition.

Addiction is a real risk, I know because I am an addict. For many of us, things can spiral out of control. Societies framing of addicts as something inhuman has created a world where it is unsafe to discuss this fact of life. We need to build communities where people can access meaningful peer-based support and advice for drug-use that has spiralled out of control.

In a world where up to 66% of Autistic people have considered suicide, and 35% have attempted suicide (see this study), we need to take a really good look at how we support Autistic people with things such as drug-use.

Being sober isn’t a competition

Today, I received my first 1 star review for one of my books on Amazon. Within the review, they stated that my 6 years of sobriety (it’s actually 7 now) was merely a blip, and that I would not be sober until it was at least 60 years. Attitudes like this are incredibly dangerous.

Early sobriety is complicated and messy. At times you are clinging on for hours or even minutes at a time. Setting yourself goals and hoping that you can stumble painfully across the finish line. For me, those early days were spent in a psychiatric ward. One might think that’s a safe place for someone getting sober, but trust me, there isn’t a lot that doesn’t make it’s way past security checks in those places.

Drugs and alcohol were readily available.

I remember celebrating one year of sobriety. A friend and I went to London and saw Lindsay Stirling perform live. It was a huge moment in my life, I had managed to go 365 days without getting drunk or high. Had someone like the aforementioned amazon reviewer spoken to me then, they way they have today, it wouldn’t have gone well.

When someone is getting sober, they need support. It’s likely they have done things they are not proud of, they probably wish that life could be as simple as switching of their emotions with a drink or a pill. Invalidate a person at the wrong time and they might just throw it away.

When you’re a sober addict, you live with the knowledge that your brain will find any excuse to go running back to its addiction. It doesn’t just go away. Anyone claiming it does is lying to you. Telling someone they’re not sober enough is gambling their life. This doesn’t just apply to length of time as a sober person, I have seen people be told they can’t be sober because of medicine they take or the way they have separated themselves from the harms of addiction.

Quite frankly, if you are sober, I don’t care how you do it, I don’t care how long you’ve been doing it; I’m proud of you. Even if sobriety has been an on and off affair; I’m proud of you. Perhaps you’re just thinking about it but haven’t quite started; doesn’t matter, I’m proud of you.

Every time a person makes the decision to heal themselves, the world becomes brighter. We are the cycle breakers. We are the one’s who stand proud and say “this suffering ends here, I choose to live”.

So, people like my Amazon reviewer can take their crappy opinions and keep them to themselves. I am proud of everyone fighting this battle.

Autism and addiction: co-existing with a mind that seeks oblivion

The narratives around autism and addiction are both peculiar. Things are the same while appearing different. On the one hand, autism is viewed by wider society as something that happens to a child, as if an unseen force has stolen their humanity. On the other hand, addiction is seen as a moral failing. We are often told that we chose that life.

The one thing they both have in common? People see you as less human than they are.

There are a multitude of reasons for this, but at the core of this experience are the power dynamics within a person’s life. You could be forgiven for believing that the power horizon within and Autistic or addicted person’s life can only be felt in the immediate vicinity, but it stretches much further. Both autism and addiction narratives are controlled and perptuated by governments and media.

The public views us through the information disseminated by those in power.

This makes for an upsetting experience when we are both Autistic and in the throws of addiction. Autistic people are infantilised and mourned as tragedies, but addicts are positioned as hedonistic and selfish. They contradict each other. Most people don’t understand how an Autistic person could become the monstrous embodiment of addiction (and there have been times when I was in active addiction that I was monstrous).

In a study from the University of Cambridge, Autistic people were less likely to report recreational drug use, but nine times more likely to report self-medicating with recreational drugs. Specifically, we were more likely to report using drugs for behaviour management and alleviation of psychologically distressing experiences.

There is a significant link between trauma, addiction, psychological distress, and perceived challenging behaviour. Trauma underlies all of these things. At this point I feel it necessary to highlight that Autistic people are More likely to experience PTSD. I have also explored our relationship with trauma with Tanya Adkin in a wider context here.

The real issue is that addiction professionals tend to lack cultural competency with Autistic people, meaning that they lack the nuanced understanding of the reasons why we use drugs and what that use may look like. This results in an environment where Autistic service users are seen to not engage well or even resist treatment. Rather than consider how to adapt the environment to suit the Autistic person’s needs, we find ourselves left out in the cold.

For me, this meant that once I was a few months sober, I was left with nowhere to turn but twelve-step programmes that really didn’t meet my needs well. I eventually realised that if I was going to stay sober, I had to learn how to do it on my own. Yes, I had supportive friends and family, but no peers to support me from addiction communities.

This is ultimately how I ended up doing g the work I do. I had to learn to co-exist with myself, and part of that process was to use my suffering for something positive. I can’t take back the pain and the wrong turns, but I can hone them into something that can make a clear path for others to walk. I can’t undo the past, but I can make sure that others don’t have to struggle the way I did.

I had to become altruistic. It was a difficult process because the addicted mind is focused on one thing, instant gratification, instant relief from the pain of existence. Existence can be so very painful. Through altruism, I had to teach myself that not everything pays off immediately and that the time I spend working towards something good will often be far more gratifying than popping a pill or smoking a pipe.

I still battle with myself from time to time. Addiction doesn’t just disappear. I have moments where my brain tells me to throw it all away, but co-existence has taught me that I don’t have to listen to the self-destructive thoughts. I have learned it’s okay to pause and wait.

Addiction is one hell of a fight, but coming out of the other side of it is a beautiful thing. It doesn’t make us less valuable to the world. It gifts us a determination to achieve our goals that nothing else can. Recovery is not a straight path, and there are times when we feel like turning back. The journey is worth it. The grass is, in fact, greener on the other side; I know, I’m here.

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!

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

The nature of sobriety

Today marked seven years of total sobriety for me. For seven years, I have been drug and alcohol free. While abstinence is not suitable for everyone, I decided, on April 7th, 2016, that the consumption of mind-altering substances was not safe for me.

I will say I have never approached it through the guise of eternity. “Never say never”, as the saying goes. Instead, I have woken up each day with a commitment to remain sober for that one day. During the challenging times, I have committed to hours and minutes. Whichever way I approached it, I have accumulated almost ¾ of a decade.

Addiction is peculiar. So many think that the focus of the addiction is the issue. We are easily fooled into believing that stopping behaviours such as drug use solves the issue. I lament the fact that it is not so simple. The addicted bodymind is more complex than compulsive behaviours.

I am an addict. I hate drugs and what they do to me, but I adore the feeling of being high. The ability to enter oblivion through a pill or a line is an all too attractive concept to me. Even now, closer to ten years sober than to zero, I find my mind craving it. It’s insidious. Little thoughts of the ways I could get away with it. The ways I could covertly enjoy the feeling of not existing.

I am happy with my sober life. I would not trade the life I have now for something so meagre as drug induced euphoria. That doesn’t mean that living in my Autistic, ADHD, and Schizophrenic mind without switching off for years has been easy. At times, I have been exhausted. An exhaustion I can’t put into words.

I am committed each day to just one more day of sobriety. Because each subsequent day of sober existence brings with it the truth of existence;

Life is a gift. It is meant to be used and spent. The bitter and painful lows only make the highs even more beautiful. Every time I survive a new challenge while maintaining my sobriety, I am able to enjoy the good in life in a vividly high definition.

Sobriety to me is a matter of life or death, and I, for one, choose life.

Drug use, addiction, and neuroqueering

I have extensively explored my Autistic relationship with addiction thus far. I have considered and lamented the inappropriate treatment services, the suffering, and rejoiced in the moment that I came out the other side. I have listed numerous reasons that contributed to my active addiction, but what I have not done is really drive home the core point of why I kept coming back to drugs. I need you to know what gave me that drive to persevere with something that could have very well cost me my life.

I was undiagnosed Autistic for the first 26 years and 7 months of my life. I know that many, if not most of you, will understand the isolation and alienation that comes with such an existence. It seemed as though everywhere I turned, I was met with condemnation and assertions of my inadequacy. It extended far beyond bullying. It was more than abuse. The world taught me that who I was, the very essence of me, was only as valuable as my ability to assimilate into the culture of my local environments.

I had never wished to enter into the culture of normality. I felt that my lack of desire to fit in reduced me to a non-person. In a world where I could be anything, I would give anything to not be me. My fluid identity was more akin to vapour at this point than it was to any tangible form. Society constructs our sense of Self through our interactions with the environment. My environment rejected me like a gangrenous limb.

Perhaps then you can start to see where the twisted beauty of drugs seeped into my life. Not only could I alter my perception of the environment, but I could also alter the way those in my environment perceived me. Different drugs allowed me to put on and take off identities like clothes. They allowed me to explore the inner workings of my mind. I could manifest the Self in whatever way I saw fit.

Much like the sculptor trying to free the art from its marble prison, I was able to shed the constraints of human thought. Drugs allowed me to rewire my bodymind. I was no longer the necrotic manifestation of the universe, but instead the explorer. I was attempting to neuroqueer without even knowing it.

Sadly, this lifestyle was not sustainable. In order to explore the fluidity of one’s identity, it is necessary to be at some level of peace with your Self. At least in my experience. My attempt to neuroqueer my way to peace was fundamentally flawed. I wanted to subvert myself, not normative attitudes. I was trying to diverge into neurotypical performance.

Perhaps that is why I kept returning despite the dangers. Neurotypicality was a performance that I could never manage. What is it they say about try8ng the same thing over and over and the definition of insanity?

The irony in this story is that at almost seven years of tee total sobriety, I can now see that my journey through that time has actually made assimilation not just less possible; The thought is abhorrent to me. For my safety now, I steer clear of “recreational drug use”. My days as a self-confessed psychonaut are over, and quite honestly? I’m okay with that.

Some people falsely believe that addiction is an illness. Personally, I believe that given the right environmental ingredients, it becomes an inevitability. For me, addiction has been a necessary evil. It was necessary for me to deconstruct the Self that had been built on the rotten foundation of subjugation and childhood trauma. That deconstruction allowed me to make space for the infinite possibilities that lay within my neurology.

The world needs us to regularly deconstruct that which society has built. It’s often a violent and painful process, but necessary as we explore what it means to be neurodivergent. Perhaps more so, what it means to be human.

If I could ask one thing of you, dear reader, it is this; when you see a person suffering, do not offer them vague pity and generic platitudes. Offer them your hand to place a new foundation, upon which all can stand to explore the fluid nature of human identity.

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.

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