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28 February 2023

TESTIMONIES OF DRUG ADDICTION: Emerging from the labyrinth

Writing by Aicha Laha @ullsdeaa

In these lines we approach drug addiction from different points of view, from professionals in the field and from rehabilitated and non-rehabilitated people. It is well known that drugs are substances which, introduced into the organism by a variety of routes, intoxicate it and affect the central nervous system, reducing the individual's capacities, making it very difficult to stop taking them even with help; even so, a large number of users are unaware of their devastating effects, precisely because the dividing line between consumption and abuse is very fine. 

Thus, the effects of drugs extend to many facets of the addict's life. It is noted that cocaine use, like many other substances, has an impact on mental health: "at the weekend I went overboard with cocaine; the following week I was terrified to go out in the street, I had repeated panic and anxiety attacks, (...) To this day, I still use drugs" (anonymous testimony, user). Moreover, early use of some substances such as cannabis has special repercussions: "When you start using very early you stop maturing emotionally, because all the answers to the things that happen to you and that hurt you, (...) when you are addicted all this is solved with the only answer you know, which is drugs" (anonymous testimony, rehabilitated). Therefore, the step from becoming aware of drug abuse to seeking help is complex and slow: "addiction is the disease of self-deception (...) an addict is always looking for ways to justify their consumption (...) all the time they are making excuses" (anonymous testimony, rehabilitated).

Moreover, social discrimination against drug addicts makes them avoid seeking help, both personally and professionally. Even shame and isolation can intensify drug use (National Institute on Drug Abuse), feelings generated by publicly assuming one's addiction status. Thus, stigmas and limiting ideas also hinder the involvement of the socio-familial environment, whose support is very important, especially with regard to treatment: "remove all alcohol from the house, do not drink alcohol during family gatherings..." (doctor-psychiatrist). When there is no such accompaniment from the treatment centres, community entities and programmes are used: "We look for other sources of support (...) links with social and mental health entities in the territory that can provide support. So that the patient can do activities and not feel alone" (doctor-psychiatrist). This, in turn, helps the community to be more aware of the complexity of the situations and consequences they are going through, as well as to prevent them from falling into these situations.

However, the truth is that drugs, from an old conception, have been considered a moral problem rather than a disease: "It is thought that a person who has an addiction has it a little because they want to and... if they are not cured it is due to a lack of will (...) they continue using because they want to" (doctor-psychiatrist), which is why it often generates a lot of social echo, e.g. in relation to assisted venipuncture rooms, spaces for consumption with a harm reduction approach. Moreover, stigma is more prevalent among women, who encounter barriers to accessing treatment: "Around 80% are men, only 20% are women (...) being a woman (...) it is much harder to ask for help and to show it (...) it is also harder to adapt to treatment, e.g. when dispensing methadone, women with children have to make their schedules more flexible due to the responsibilities they have" (doctor-psychiatrist).  

In addition, drug use is socially normalised (present in the mass media, in the streets, in bars...) and its access is increasingly easy: "with a bad concept that it is something natural, (...) in reality there is no such thing as soft drugs... (...) it has much more serious effects than people think" (anonymous testimony, rehabilitated). In fact, many addicts have a duality of trying to keep up with life while at the same time being immersed in drug abuse: "Deep down you know you have a problem, but you fool yourself by saying that you have a more or less functional life (...) in work and family environments, (...) you always have that worry of hiding, of lying, of pretending something that is not really there" (anonymous testimony, rehabilitated). Although the limitations of abusive consumption are clear: "you leave many things behind to be able to consume, (...) this happens with all drugs, your world is reduced to the drug" (anonymous testimony, rehabilitated). 

In this way, accessing treatment means reinforcing the awareness of illness, "When you arrive at a drug dependence centre you feel liberated, you feel that you have taken a weight off your shoulders, that you have an explanation for what is happening to you (...) it is a very long process where you need a lot of awareness and (...) use the tools of treatment a lot so that you don't fall behind" (anonymous testimony, rehabilitated).

It should be noted that not all substances have specific treatments, so the effectiveness of rehabilitation varies depending on the substance (among other factors). In the case of alcohol and heroin, there are more specific treatments based on scientific evidence, so that between 70% and 90% of patients have a good evolution in the treatment process, significantly reducing consumption or even being abstinent. In contrast, in the case of other substances such as cocaine, cannabis and amphetamines, for which there are no specific treatments, other medications considered useful are used, with an efficacy of around 30%. However, it is important to remember that this is a chronic substance use disorder, with a tendency to relapse. This is how a rehabilitated person experiences this fact: "even if you are discharged and you can consider yourself recovered (...) you will have to take care of yourself all your life (...) I now live it normally and naturally, I know where my limits are (...), I know which situations can harm me (...) and (...) periodically I check myself". 

In conclusion, we highlight that drugs and social inequalities feed back on each other, since unfavourable social, family and economic conditions imply a greater risk of the disorder and probably a lower chance of access to private treatment; in some very vulnerable communities, a large part of family income is spent on alcohol (Generalitat de Catalunya, 2022). It is also necessary to involve the community, which can detect situations of drug abuse, exchange experiences, guide addicts to health services, denormalise and teach other healthier leisure models to children and young people, among other tasks; especially bearing in mind that drugs leave many aspects to be compensated at different levels.

Editor: Aicha Laha

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The KörperMagazine team would like to thank the interviewees for the information they provided, which made this research article possible.

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