nursingforsocialjustice

Narratives are powerful. The stories that we tell about people shape how we think about the world and the groups of people who live in it. The stories that we tell about people who use drugs are still cautionary tales of how not to live our lives lest we fall into deep pits of deceit and painful despair.

When I refer to drug use I mean drugs aside from legal drugs like alcohol, cannabis, and prescription drugs that are taken as prescribed. Don’t even get me started on how illogical the line we draw between alcohol and the so-called “hard drugs” is. But, I digress. Despite anti-stigma campaigns, and efforts of public health clinicians, educators and advocacy groups we continue to tell stories about illicit drug use as warning stories, the stories of what not to do, and how our lives will go horribly wrong if we don’t make the right choices. This is the reason why stories like those of women being sexually assaulted in drug use recovery centres are relevant not only as evidence that men in positions of power prey on women in places of vulnerability, but also as evidence that the voice of drug users are dishonest, unreliable, and at worst manipulative for personal gain.

The narratives are powerful. In reading and hearing the news stories about the multiple women who were sexually assaulted by a staff members of the drug use recovery program located in New Westminster, BC, some thoughts might pop into your head. It’s worth it to examine them and think about how they were formed and what they mean about your own values and beliefs. I read the comments attached to some of the news stories and people contributed a range of responses, from support for the women to criticism of the recovery house. I couldn’t help but think about the responses that framed this as the fault of the women, that these women would not have been sexually assaulted if they didn’t put themselves in this position to begin with.

How do we move past the stigma of drug use when we (the Royal we, the societal we) cannot seem to get past the underlying assumption that drug use is all negative and whatever negative experience someone who uses drugs has is part of their poor judgement and thus deserved.

We (meaning the healthcare community) have been trying to change this narrative for decades, unsuccessfully.

I deliberately use the term drug use because substance use is a medicalized term. Such medicalized terms, while perhaps have been helpful in moving explanations of drug use away from understand as moral failures, these are terms that are contested, and do not come from communities and people who use drugs. The accepted terminology of the medical world.

However, is drug use in itself a medical issue? Is it an inevitable disorder waiting to happen? Research evidence tells us no. The scientific evidence tells us that drug use is something exists on a spectrum from no use, to social use, to dependence and habitual use. We can conceptualizer drug use the same way we conceptualize eating candy and other types of junk food, meaning there are benefits and risks. We can also conceptualize drug use as a behaviour like engaging in sports like sky diving. We know that the brain changes when we do things and we know that chemical changes happen maybe fast and furious with drug use. But we also know that these changes are permanent and we know this because there’s lots of research on it now. In 2023 we have much more knowledge, much more scientific evidence about this but it’s tough to change the strategies that we approach this from.

If we continue to frame the best case scenario as no drug use at all then how can anything change?

Love,

Michelle D.