Search for:
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.

Neuronormativity, the pathologisation of Mental health, and the normalising of suffering

In recent years mental health has become more widely talked about, thanks to the popularisation of the “it’s okay not to be okay” trope. On the surface this is a wonderful approach to the normalisation of Mental health issues, but does it have a darker side?

There are currently over 300 “disorders” listed in the DSM 5, the diagnostic manual used by psychiatrists around the world. One could imagine that between them they account for the vast majority of human experience; a concerning thought to say the least.

What benefit does this serve us as a society?

Realistically, it only benefits those who adhere to normative standards.

We’ve been taught that mental health concerns are an illness, that we have a pathology that requires treatment. Despite this, there is no biomedical test that can definitively diagnose any of the numerous entries in the DSM. So perhaps there is something more to the pathologisation of human experience.

Our society is broken, it has fixed rules that apply to fewer and fewer people, while trying harder and harder to assimilate people into it’s normative standards of behaviour. Szasz would argue that this approach serves to provide a sort of social control over us.

So now we live in a society where anyone who doesn’t fit cultural standards of normal is considered “sick” or “ill”.

Thus, we reach a point of starting to understand why “it’s okay not to be okay” might have a darker side to it. Mental health issues (in my opinion) arise from living in an environment that can not fulfill the individuals needs. An environment that consistently traumatises those living in it.

However, we are now normalising human suffering. It’s okay to say “I’m not okay” but we must never normalise human suffering. When we do or say things that uphold the pathology paradigm, we are allowing our oppressive society to continue on its harmful path.

We need to do the work to rebuild society into a brighter place, thar meets the needs of the many, and not just a selected few. We do this by recognising that neurodiversity is about more than Autistic and ADHD experiences.

The change starts with us, and it ends with a brighter future.

It’s never okay to suffer.

Verified by MonsterInsights