Drug addicts have a lot in common with other marginalised groups, such as sex workers, people with disabilities and asylum seekers in that many people have never met them and know very little about the realities of their lives. Where there is a void of factual information, stigma and prejudice often rush in to fill the space. This week's report from the UK drugs policy commission, Sinning and Sinned Against: the Stigmatisation of Problem Drug Users, confirms this. The report finds that many people don't like drug users and that this dislike hinders the prospects of social integration and future employment for this group.
This stigma is based on a fundamental misunderstanding of drug users and the nature of drug use. Problematic drug use often develops as a result of many and complex issues such as childhood abuse, dysfunctional family life, social exclusion and various emotional traumas. Class A drugs such as heroin and cocaine can provide a convenient form of chemical oblivion for those who want to blot out pain. Many who become addicted to these drugs are self-medicating to deal with this emotional and sometimes physical pain.
It is easy for those who have never experienced these problems to apportion the "undeserving" tag to drug users, but a failure to understand the starting point for addiction means that policies that spoon-feed attractive soundbites to Middle England about getting all addicts off drugs are unlikely to translate into successful outcomes for users.
Some people who use drugs problematically may stop using them by engaging with a variety of different treatments, such as methadone maintenance or residential rehab, while others stop without any conventional treatment because circumstances in their lives, such as the promise of getting back children previously removed by social services or a relationship with a new partner who encourages them to become drug-free, motivates them to change.
There is a huge emphasis on treatment but those who stop using drugs without treatment are not recorded in the official statistics. The statistics also don't comprehensively record those who relapse months or years after treatment – a common problem because addiction is a chronic, relapsing condition.
It's important to recognise that addiction, once it takes hold, is not logical. I used to edit a magazine for an HIV charity that did outreach work with drug users, providing clean needles and other paraphernalia. I'll never forget the woman who limped into the outreach van with a horrific abcess on her leg from repeatedly injecting into it. Drugs workers warned her that she needed to get down to A&E immediately otherwise she was in danger of losing her leg. She declined the offer of a staff member to drive her to the nearest hospital, said that her priority was not her leg but her next fix and limped away.
Many drug users are able human beings who, with the right support, can make a contribution to society. This means emotional, as well as practical, support, including housing and employment opportunities, rather than a three-line whip to "get clean or else". Treatment can help problematic drug users but without kindness, support, empathy and an absence of judgmentalism it will fail many.
People often stop using class A drugs because something or someone better comes into their lives. But for those who are leading truly wretched lives they may feel that there isn't anything better than crack and smack. The government needs to address this uncomfortable reality for which there is no quick, cheap fix and beware of coercing people into a vacuum. If they really want to help drug users, they need to look beyond drug use.
Diane Taylor @'The Guardian'
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