Archives for posts with tag: addiction

Part I

Vancouver is Dying starts with a threat to its viewers. You are not safe; every day there is a statistically improbable risk that you will be assaulted by a stranger. The cops have been castrated by woke mandates to avoid overt brutality, and so the city has run amok. There are no consequences to the choices people make, so we mourn the passing of a once great city. The reason for all of this… is drugs. Not poverty; not the civil disenfranchisement of a particular neighbourhood; not the modern cumulation of centuries of colonialism. It’s drugs. Possibly woke-ism too, since the defecator of this trash, Aaron Gunn, literally says that the Left believes opiates are a good thing, but he focuses on drugs as the root of Vancouver’s degeneration. Drugs, we are told, are bad.

Lest we forget!

Despite being the alleged cause of everything evil that’s happening in Vancouver, Gunn doesn’t actually spend all that much time talking about them. What is a drug? Alcohol has been shown to be the most destructive addictive substance, but I guess alcohol is irrelevant to the Downtown Eastside (it’s not). Both sugar and caffeine hit the same dopamine receptors in your brain as crystal meth, but those also don’t count (how many people reading this rely on caffeine to enable their daily functioning?). We can also safely ignore process addictions too, like gambling and video games. When Gunn talks about drugs, he only means the highly unregulated ones, the ones they don’t advertise on TV. Seeing the harms of addiction in a wider context of mass consumerism might lead to… a criticism of capitalism! And we can’t have that.

So of course Gunn avoids that context to the best of his ability. In the few brief interactions he has with active drug users, he asks one what she thinks about addiction. She brushes off the harms that everyone already knows about with street drugs to talk about global addictions, like the equally suicidal addiction humanity has with oil and gas, or the addiction to money in the financial markets, or the addiction to consumer goods we might indulge in after losing our life’s purpose during a midlife crisis. Rather than discuss the threads linking micro and macro addiction, Gunn says, behind her back, that she must be in denial. She didn’t deny that her drug use was harmful; she just wanted to talk about the context as to why all of these problems exist, and Gunn absolutely does not. So he calls her delusional without giving her an opportunity to respond – but who cares; she’s just a supid junkie, right?

Only one of these counts as a person.

According to Gunn, addiction is a silo that only impacts a ‘certain type’ of person, and isn’t connected at all to the culture or global habits surrounding it. So where does it come from? Why do people use drugs? Drugs seem kind of bad, so how come so many Vancouverites… sorry, people specifically in the DTES and nowhere else… how come they do the drugs? Par for the course, Gunn doesn’t really explain. He makes one inference, and expects the viewer to figure it out for themselves.

The closest Gunn comes to explaining where drug use comes from is by talking about the choices that some homeless people make to stay in the street. Our old friend Colonel Quaritch has the unmitigated gall to suggest that it’s easy to get housing in Vancouver (as a social worker, I found this to be particularly offensive), and Gunn doubles down on this by showing that there has been 1,400 new supportive housing built over the past four years, with 350 new ones being built. Of course, those 1,400 are already full (the waitlist for supportive housing is a couple of years), and there are an additional 2,000 homeless people that need help, so his optimism is… misplaced. We can also combine his bullshit with another ignored statistic that about 7,000 housing units are in need of replacement, and we can see that the rumours about the challenge of housing in Vancouver are in fact true. Turns out it is expensive and difficult to find housing in Vancouver! Who could have guessed!?

I will put this in every single one of my blogs from now on if I have to.

Okay that rant was mostly for my own benefit, but let’s return to Gunn. He wants to show that the chaos is a choice – that the option for stability is there for those who want it, but that people live in squalor and disease because… they’re crazy, I guess? A DTES resident tells him that people sometimes choose to live in the streets because of the restrictions in a lot of the supportive housing units, and then that’s enough for him. No point in exploring what those restrictions might be, or what the benefits of the streets might be otherwise, just enough that we have captured a DTES “resident” confirming what we already know. People who use drugs are just completely irrational.

It turns out though, that even people who use drugs are rational in their choices – they are just too often limited in the choices they can make. If a drug user has a choice between using drugs in such a way that it is likely to kill them, or to use drugs in a way that is likely to not, they’re going to choose the way that allows them to avoid death. Rational! Same thing with homelessness. If we talk to people who do choose that lifestyle, they are often fleeing violence that is pervasive in shelters and some SROs, or they want to live in a community of mutual aid amongst their peers without officious oversight. The restrictions that Gunn avoids talking about are typically restrictions on visitors, meaning that your loved ones aren’t allowed to visit. This means you essentially can’t have a partner or children or friends. If I foreshadow a bit that the opposite of addiction is connection, then we can see that these restrictions would actually encourage drug use rather than help eliminate it. It would be rational for someone to choose their loved ones over rat/lice/bedbug/cockroach infested housing, wouldn’t it? Gunn even acknowledges that a lot of the housing is awful, that it’s filled with drug dealers and drug users, but then seems vindicated in degrading homeless people when he’s able to confirm that people don’t want to live there because of that very awfulness. He doesn’t offer a clarion call for better housing in more suburban neighbourhoods where people might escape violence, addiction, and poverty because presumably that would entail the spread of their disease into the ‘purer’ neighbourhoods.

Good miniseries on this very topic!

If people don’t use drugs because they’re just cuckoo-bananapants, then why? It’s a question that should have been at the forefront of anything trying to be a documentary about drugs.

The secret they don’t tell you about drugs is that they’re not actually bad. Drugs are amazing. You’ve likely at least had sugar, caffeine, and alcohol, and most people have a lot of fun with those things! The trouble with drugs isn’t that they’re so amazing that they become addictive, it’s that they’re a problem for those people whose lives are so awful, so that when they do take drugs, their amazing-ness brings them to about normal. Heroin feels like a warm, loving hug; imagine what that must be like for someone who has never felt a secure connection. The first experience of drugs that people who often become addicted is usually, “this must be what everyone else feels like all of the time!”

Addiction typically begins around adolescence when teenagers are supposed to be learning how to cope with complex emotions, and if someone with a lot of complex emotions learns that drugs are an incredibly effective way at dealing with them, that’s how they learn. Just like it’s hard to learn a new language once our first becomes so ingrained into our way of navigating the world, so too is it a challenge to learn a new way to process our emotions once we’ve already established something that works. The physical dependence of drugs can be overcome in a few days, and for drugs like crystal meth, you literally just sleep it off and then you’re done. The psychological dependence, the need to numb yourself from all those accumulated feelings, that’s what causes relapse. You may have heard that an addiction is a behaviour that continues despite negative consequences; well, the negative consequences of not using are often worse. Feeling decades of trauma all at once when the drugs wear off is more often than not still worse than any infected absess. Drugs are not the problem of addiction. It’s just that people with addiction have drugs as their only workable solution to help them cope with what they’re going through, and it’s hard to learn other ways – particularly when drugs work so well and so quickly. Some call addiction a learning disorder rather than a disease for this very reason.

When I was a child, I had a fever. My hands felt just like two balloons. Now I’ve got that feeling once again. I can’t explain, you would not understand; this is not how I am!

Rat Park is an experiment that sought to question the original idea of addiction. We once understood addiction as absolute – a rat was put in a cage, and had two options: a regular water, and water laced with cocaine. Those rats consistently chose the cocaine water until they died. Rat park was an alternative: rats were put in a cage with tubes and balls and other fun rat activities and, most importantly, with other rats. The two water options were the same, but these rats only had the cocaine water every once in a while. The rats lived full and healthy lives, and occasionally got to have wild parties when they opted to go for the cocaine water. Remarkably, rats from the first cage could be put into Rat Park, and they would lose their addiction relatively quickly. To sum up, it’s never been about the drugs, but about the lives of the people who use them.

What if we understand addiction as a response to something rather than the problem itself? Looking at process addictions and less stereotyped substances might become relevant to our thesis. Global patterns that impact culture might contribute to the so-called disease. If we are told to always be consuming more and more to avoid loneliness, grief, to find meaning, then perhaps a comparison to a midlife crisis sports car is actually quite apt, and it is Gunn that is actually the one in denial. What is addiction a response to? If it is getting worse, what is going on in the world that is exacerbating it? I guess if we never ask what addiction or drugs are, then we avoid that pesky subject entirely.

Enough trauma can manifest itself anywhere to produce an addiction, but the most visible problems from it sure do seem to crop up in one particular demographic. I’m sure it’s nothing!

Drugs start out as the rational choice to cope with childhood trauma, to the point where drugs can even save someone from suicide. That becomes their only method of coping, and then they become stuck in that lifestyle even past the point when its consequences start to outweigh its benefits. Ending drug use is only ever really an option if the person has meaningful activities and connection waiting for them on the other side, in an environment stable enough to maintain it. Do police and jail sound like the optimal environment to provide that? Is Gunn right that we should be bullying people into quitting drugs? Or should we recognize that a sober lifestyle just isn’t a reasonable option for a lot of people given their circumstances within capitalism, and do our best to support them in the world they’re stuck with, recognizing and respecting their rational choice in opting to live this way? Perhaps we could make sure that the drugs they take don’t kill them, since they’re human beings still worthy of dignity, perhaps more worthy given the wars they’ve lived through.

Fuck them, says Gunn. They will live and die as he decrees. Join us next time, when Aaron Gunn will try to suggest that having more harm for people who have endured so much already is a good thing actually.

Part III

The communist that everyone loves to hate, Joseph Stalin, is credited with having said that, “The death of one is a tragedy, but the death of millions is just a statistic.” This obviously refers to the intimate heartbreak of having some one person in our lives pass away versus the math class-styled boredom humanity possesses toward the deaths of millions of “other” people. Now I can very easily link this to the anti-vaxxers who either shrug off or outright deny the literal millions of people who have died from Covid-19, but I’m not going to because the vast majority of Canadians have recognized the severe nature of the disease and acted accordingly. The point I’m actually going to make is that the response to this pandemic refutes the quotation: millions died, but there was action taken to mitigate those deaths on a global scale. Despite the impossibility of connecting on a personal level to all of those who were dying, we all got together to do something about this catastrophe. Covid is more than just a statistic; it’s human enough to elicit a response.

On the other hand, we have the communist that everyone hates to love, Karl Marx, being credited with having stolen this line from Friedrich Engels, “First as tragedy, then as farce.” This is referring to the notion that when tragic history repeats itself, the second instance is often a cruel parody of the first. If the deaths from Covid are the tragedy, then drug overdose deaths are the on-going farce.

And we all know Marx liked to party.

In British Columbia, we’ve had 3,547 deaths from Covid so far; in contrast, since the start of the pandemic until March of this year, there have been 4,552 deaths from drug overdoses, with 2022 set to outpace the previous record from the year before. Certainly the measures taken to limit the impact of Covid have significantly reduced the number of deaths that we would have faced otherwise, but we have harm reduction measures to mitigate drug deaths too with remarkable success (no one dies from overdose at safe injection sites, for instance). My point is that one set of deadly statistics was collectively agreed upon to be a tragedy, and the other was not.

Some might argue that a drug overdose death isn’t the same because they cynically believe addiction to be a choice, and therefore, a death arising from that choice is the addict’s own fault. I don’t think that this belief is as prevalent as it used to be. BC just decriminalized small amounts of all drugs, and even the conservative news outlet, the National Post, is framing this decision as being in response to a health crisis. Obviously it’s a health condition, right? Everyone is saying so.

This looks like candy, and I want to eat it.

In response to this fading belief of personal choice resulting in death, alleged advocates will point out that many of the overdose deaths are not regular substance users, but result from those who casually use drugs receiving a sketchy concoction that they were not physiologically prepared for. This is trying to paint a picture where real humans are dying from drug overdoses, so please care about them! Don’t think this is just sub-human junkies! This could just be someone who likes to party! You like to party, right? Even Marx liked to party!

This mad dash to declare addiction a health crisis to eliminate stigma is inevitably destined to fail. During the AIDS epidemic, people were stigmatized not because of the disease ravaging their bodies, but because they were gay. Everyone knew it was a health crisis, but nobody cared because it was ideologically chained to the homos. Similarly with opioid deaths: you can scream all you want that it’s a health crisis, but no one is going to detach drug use from drug users. Destigmatizing drug use will never work so long as we’re ignoring the stigma attached to the users themselves.

I expect that a drug user Pride event would be less colourful, but probably more fun… cuz, ya know, the drugs

If we see stigma as being attached to the addict in the same way that AIDS stigma was attached to the gay community, then what is it about filthy junkies that we just hate so much!? What biblical sin have drug users committed that earned them this stigma? Well, drug users are racialized, for one. They’re poor. They’re abused. They’re hobbled. They’re men (not in a femi-nazi way, but in a “failed men deserve to be discarded” way). Drug users are imbued with the sin of being socially despicable across all fronts. When society starts to embrace its homeless, when Indigenous people stop being followed around in stores, when we stop pitying the disabled, and when we allow diversity within masculinity, then maybe, the stigma against drug users will wane. Unfortunately, we’re nowhere near that.

The ads I see around town regarding substance use these days are linked to the Drug Free Kids organization which, hence the name, advocates an abstinence-based approach to drugs. We’re still teaching our kids abstinence-only programs like we were sex educators in 1950s America. It’s like we haven’t progressed at all since Nancy Reagan told us to just say no. We seem to have evolved passed the puritanism that demonized sex before marriage, accepting that kids are gonna bone and that’s okay, but we have not yet exorcized the demons from the devil’s weed.

I haven’t seen the show, but I wouldn’t believe you if you told me that none of these kids bone

Remember when sex would immediately result in pregnancy and syphilis? From my old textbook on addiction, “Estimates are that only around one-third of people who have injected heroin become addicted, compared to 22% for cocaine and 8% for marijuana. Only one drug causes addiction among a majority of its users—nicotine.” This little tidbit is completely irrelevant because we don’t want our babies to grow up to be crippled natives living on the street, and complete abstinence is the only way to be sure. Our reaction to drug users is an emotional response curated by centuries of racist, ableist, and classist attitudes, and patriarchal definitions of men. Any kind of drug education or strategy that isn’t addressing that is actively harming our chances at overcoming the opioid crisis.

The millions of deaths from Covid-19 are a tragedy because in theory, if not in practice, it can impact anyone regardless of status. There’s no stigma to it. I got Covid. You probably got Covid. Overdose deaths are for “them.” No matter how much the term “health crisis” gets bandied about to proselytize a benign neutrality, it won’t stop drugs from being a social issue. When we stop the farce and address those social issues, then maybe it will be just as okay for people to use drugs as it is for kids to bone.

There is an episode on the podcast Crackdown that posits that, despite less effective results, doctors will still push Suboxone over Methadone when prescribing opiate replacement therapy. In theory, Suboxone is supposed to be safer because it has Naloxone chemically baked into the compound which prevents additional opiates from connecting to their neurological receptors. In short, it prevents you from getting high. Methadone, just being another opiate, allows additional opiates to be used on top of it if the prescription isn’t strong enough to prevent withdrawal. The podcast describes the social rewards of appeasing the medical professionals and being one of the “good” recovering addicts, despite the additional challenges that recovering on Suboxone has over Methadone, and the bitter disappointment of the failure that can come along with that. Ultimately, the podcast concludes that Suboxone is preferred by healthcare workers because it discourages the euphoria that is associated with opiate use on a molecular level.

This was literally the first image on my Google search for, “Doctor Knows Best.” I thought, why not, let’s sex-up this blog a bit.

To be upfront, I struggled with this on a personal level. I have worked with drug users for years, and I always went along with what the doctors and nurses suggested when it comes to opiate replacement therapy because they allegedly know “what’s best” when it comes to prescribing medication. I was told Suboxone is better because it prevents overdose, and who cares what the drug users themselves think, because if they want recovery and no longer want to get high, then why do they want to get high? I didn’t know better, and I didn’t have anyone offering any counterpoints, so it just became an assumed truth: Suboxone is better than Methadone.

Of course, when Mary Poppins says that a spoonful of sugar helps the medicine go down, we just blindly accept that firing the dopamine receptors in the brain is an easy way to make adhering to a pharmaceutical regimen more palatable. Heaven forbid you need a pharmaceutical regimen to overcome addiction, however. Then it’s no sugar for you!

The deepfake you didn’t know you needed

Why do we care if those seeking a less life-threatening way of living their lives happen to have a bit of pleasure within it? While I certainly can’t speak for everyone, I bet that it likely has something to do with the emotional reaction to drug use as a fundamentally hedonic lifestyle. We see the panhandler begging for change, decrepit and not having showered in months, and we think, that’s just the consequences of a lifetime of seeking pleasure right there, and so sad that they still haven’t learned that this is where euphoria leads you. Its cure must therefore involve the complete annihilation of any synthetic joy because only real, pure happiness is socially acceptable.

It doesn’t matter that addiction is the learned coping mechanism developed in response to trauma. No one cares about that. As much as people talk about the opioid crisis being a health crisis, no one seems to do anything about it which would be strange if, as a culture, we accepted addiction as what it actually is. Opiates have killed well over a thousand more people in British Columbia than have died from Covid-19 since Covid-19 became a thing, and the response to Covid-19 has been to shut down the world. We don’t care: drug deaths are the tragic but earned result of insatiably seeking an impure pleasure.

Even if we did offer solutions, drug users would still choose to slowly kill themselves, so what’s the point? I understand addiction.

Moral foundations theory is the belief that our morals are determined by the core emotional responses we have to certain situations. We respond with compassion to instances of harm, with indignation to cheating, with disgust to degradation, and so on, and thus are born the moral guidelines of care, fairness, sanctity, etc. Looking at the lives of a drug user, we might be moved to compassion, sure, but the judgier among us are likely to react with disgust. This creates the blueprint for moral blame toward those who indulge in profane pleasure, and thus it becomes that much easier to avoid caring about how many people who use drugs are dying.

If there is a profane pleasure, then surely there must be sacred pleasure, right? What would that be? It certainly isn’t sex, and the social categorization of sex workers would likely fall well within the scope of my thesis here. In Christianity, heaven is described as hanging out with God – being close to God is the sacred pleasure. Within Islam, heaven is a nice garden. Epicurus, the philosopher of socially appropriate hedonism, recommends just having some nice cheese as a sacred pleasure one might indulge in. The thing is though, these all seem kind of… incredibly lame and boring. Don’t get me wrong: cheese is fine, spiritual contemplation can be relaxing, and gardens are quite pretty, but is this really what we want for our sacred pleasure? It seems like the sacred euphoria is to not really have all that much pleasure in your life at all. And that’s the point: all pleasure is inherently profane. The sacred life is about restraining yourself from pleasure because pleasure is dirty.

I wonder what the perfect symbol for the maxim, “The less pleasure you have in your life, the more sacred you become,” would be? It’s on the tip of my tongue…

We’re all susceptible to this. The thing about moral foundation theory is that we all have emotions, and while some emotions may hit us individually harder than others, we can’t escape them. I myself am guilty of this, as I was describing my own thought process above. But remember, addiction is miserable. It’s an endless cycle of desperately trying to escape overwhelming pain. It is patently false to describe addiction as hedonic excess because the euphoria from any drug, let alone the banality of methadone, pales in comparison to the suffering of addiction itself. If the maxim about suffering being the road to sanctity were true, there would be none more sacred than the drug addict.

As bizarre as the moral condemnation of all pleasure is, it is completely irrelevant to the discussion at hand. It’s a trap constructed by the likes of Nancy Reagan, anti-drug campaigns, and ultimately, the racist origins of the drug laws themselves. They used to give opiates to children to calm them down, and even gave it the kind of kitschy name you’d expect for such a product, Mrs. Winslow’s Soothing Syrup. Not that this was particularly healthy for the kids, but it gives you an idea as to the benign perception of narcotics prior to their criminality. Unfortunately, racism needed a way to control immigrant communities, drug use was thus linked to those communities, and drug laws were born to prevent Asian men from boning white women. The disgust associated with drugs was created and perpetuated outside their capacity to induce pleasure (excluding the ecstasy of interracial sexy-times), and so it makes sense that the lived experiences of drug users are irrelevant to our moral condemnation today.

Oh yeah, this is definitely a lifestyle that has far too many happy outcomes in it

I am writing this piece as a means of organizing my thoughts. I did not have a conclusion in mind when I started, and so it’s actually been a longer process than it normally would be for me to write one of these things. I have to come to grips with my own biases and take the time to reflect on what they are and where they come from. The debate about the comparable benefits between Methadone versus Suboxone is pretty niche, but I knew going into this that the exploration of this topic was going to touch on more than just that. The social attitude toward drugs and the moral condemnation toward their users is ubiquitous, and no one is exempt. Even drug users will hold themselves to a higher moral standard than other drug users citing the arbitrary standard of, “Well, I would never do such and such!” as a means of separating themselves from the impure. Sometimes they end up getting to the point where they do that thing, and this is often brought up in 12-step meetings as the time they knew they had lost control. Sometimes, a new bar will be set, “I may have done such and such, but I would never do such and such!”, and the desire to maintain moral purity remains.

In all honesty, Suboxone does work for some people. It’s good to have as an option for those who might genuinely want it. The point is that we shouldn’t use moral condemnation borne out of historical racism to coerce people into a recovery that doesn’t work for them. Addiction is hard enough as it is.