I am a drug and alcohol counselor. I am at least okay at my job; clients will occasionally tell me they feel better after having spoken to me, which is as good a metric as any, and the odd client might even stop using drugs and/or alcohol if the stars are aligned just so. It’s a complicated career in which the measures of success are vague, yet regardless of whether or not I’m successful (whatever that means), a new client will always come in. This new client with their new idiosyncrasies are, more often than not, fundamentally similar to the old one. The tide comes in, the tide comes out, then, as per the pull of the moon, the tide comes back in again.

There will always be drug addicts, right? One must imagine Sisyphus happy in order to avoid the soul-crushing burnout of facing off against the boulder of the opioid crisis. And yet, even in the name, its immutability is questioned. It is called the opioid ‘crisis’, not the opioid ‘way of life’. A crisis is temporary. Solutions are possible. Causes can be identified.

Of course, a crisis can simply be an act of God or a natural disaster. There might be those who argue that nothing can be done about this crisis since its causes are out of our hands. Fentanyl is a thing now, so people will just die more because of it. There is some merit to this argument: Fentanyl is certainly deadly and more prevalent which is going to inevitably lead to more deaths. As any consumer advocate would tell you, the solution to a deadly product is of course a well-regulated market, but this ignores why people might seek out Fentanyl in the first place. Even if people take healthy doses of untainted heroin (or meth, or crack, or all the other drugs now laced with Fentanyl), this still doesn’t change the tide.

There are several theories about the causes of addiction. Trauma is a big one, and yet trauma is not preordained. The trauma of neglect is often predicated on poverty which can be alleviated through wealth redistribution (consider that there is more than enough housing for everyone, despite large numbers of homelessness. Similarly, we have enough food to feed the planet. Supply is not the issue, distribution is), livable minimum work standards (since many of those in poverty do indeed work), and so on. Trauma based on domestic abuse can also be curtailed if we shift masculine culture away from domination and violence.

There is also the lack of connection that drives addictive behaviour. This connection has been driven out of society by the cultural forces of individualism and competitiveness, and can just as easily be reduced by the imposition of their opposites. Solidarity with coworkers and neighbours, an emphasis on community values, respect for nature, and a reignition of hope; these too will reduce the need for the synthetic connections induced by narcotics.

Of course, there is also simple education. Not the education that tells us that drugs are bad. Drugs are actually amazing. Drugs offer solutions to problems when nothing else seems to have worked before. An individual, often having gone through trauma or who is suffering from mental illness, does not know how to cope with that trauma or illness. Along comes drugs, and all of a sudden the baggage associated with those things don’t seem so awful now! What needs to be taught are healthy coping skills as well as information on mental health that will help identify and then deal with these developmental dangers before addictive alternatives become the norm.

You may note that none of these things involve cognitive behavioural therapy, nor harm reduction, not even admitting you are powerless over your addiction and that your life has become unmanageable! The methods of dealing with those in addiction (with their varying degrees of effect) are only ever reactive, and ignore the systemic issues that produce drug addiction in the first place. Social fixes ought to attack the root of the problem rather than focus on managing its aftermath.

One of the stories I tell myself to endure the Sisyphean drudgery of endless addiction is the story of the curmudgeonly old man and the beach full of starfish:

Once upon a time, there was an old man who used to go to the ocean to do his writing. He had a habit of walking on the beach every morning before he began his work. Early one morning, he was walking along the shore after a big storm had passed and found the vast beach littered with starfish as far as the eye could see, stretching in both directions.

Off in the distance, the old man noticed a small boy approaching.  As the boy walked, he paused every so often and as he grew closer, the man could see that he was occasionally bending down to pick up an object and throw it into the sea.  The boy came closer still and the man called out, “Good morning!  May I ask what it is that you are doing?”

The young boy paused, looked up, and replied “Throwing starfish into the ocean. The tide has washed them up onto the beach and they can’t return to the sea by themselves,” the youth replied. “When the sun gets high, they will die, unless I throw them back into the water.”

The old man replied, “But there must be tens of thousands of starfish on this beach. I’m afraid you won’t really be able to make much of a difference.”

The boy bent down, picked up yet another starfish and threw it as far as he could into the ocean. Then he turned, smiled and said, “It made a difference to that one!”

This metaphor does help me feel better about the work I do, because ultimately helping one person live a better life is a worthwhile goal. It matters. However, the metaphor fails because a tide is by definition unstoppable, and drug addiction is not. The starfish have not been washed up onto the beach by some immutable fact of nature, they have been pushed by cultural ideologies, economic oppression, and brutish stigma.

Why bother with drug counselling? It does help, but it will never stop the tide.