User's story: Competing Oppressions
Sometimes I feel as though I am stuck between competing oppressions. By this I mean that the rules of society (both straight and drug using) and the medical establishment have me trapped, pushing me around with all their conflicting rules and stereotypes.
It frustrates me that certain types of users or consumers are valued above others. Why are people with mental health problems seen as more deserving of health care than people with drug problems? Meanwhile, in drug using society, my history of lying to doctors in order to get prescriptions is seen as somehow not a ‘real’ user’s story as I have never injected or abused street drugs. But my need and desperation are still the same and in many ways I have probably had to tell more lies than the average heroin addict. This is the stigma of stereotyping and has no part in a humane society.
Another issue for me is the way people with a history of abuse are forced to revisit their trauma by the medical establishment. The number of individuals with drug dependency issues who have a history of child or sexual abuse is staggering, yet health services rarely screen for these background issues. I was sexually abused by a teacher at my Catholic high school. He raped and assaulted me on many occasions and would regularly humiliate and demean me. Having to give supervised urines during my six years on methadone (used as a substitute for prescription opiates) transported me back to feeling abused, vilified and out of control. Feeling that shame and having to submit to the clinic’s rules is a subtle way of being forced to recall the abuse.
I’m now on bupe, but putting that tablet under my tongue transports me back to my teacher coming in my mouth.
It’s ironic that the process of getting the only drug which helps with my addiction causes me the same feelings which initiated it. Standing in front of a clinic full of people leads me back to the shame and ridicule I experienced as a second form student walking into a classroom after being abused, but my clinic refuses to hear me on these issues. Even though I am on Suboxone, my mental health status means that I cannot get takeaways. I have made so many complaints about my care that I have had to sign a contract stating I will not complain any further. Putting that tablet under my tongue drives me to distraction. It is only when I get takeaways that I can take the tablet in a way I can tolerate, which is standing under the shower and letting the water run over my mouth.
Another dilemma for me is the medicalisation of my behaviour. I believe that an approach to drug use that privileges a disease model feeds into the trauma, for if we understand the compulsion to use drugs in terms of a disease, then the political dimensions of the underlying trauma are lost. For me, the urge to cut myself is a shame-based behaviour which is a response to my abuse, not the symptom of a disease, and the only way I know to stop myself is by taking a powerful sedative. This is how the disease model silences people like me: it is an overly mechanistic view of human behaviour. Unfortunately, this approach seems to permeate addiction medicine and the health system generally.
Having said that, there might be some benefits to applying the disease model. For example, it may alleviate some of the stigma associated with the ‘addict’ label. Also, it might allow drug users to access health services more easily. These are important things to remember.
For me drug use is also a type of narcissism. Narcissus is a character in Greek mythology who rejected the beautiful nymph Echo and, as a punishment, was doomed to fall in love with his own reflection. Narcissism (in the psychological sense) is defined as a constant longing for perfection in self. By using drugs we seek to perfect the way we feel about ourselves and our lives: many of us feel more ‘real’ or more ourselves on drugs than without them.
We drug users are important custodians of a collective reality. We must always insist on telling the truth of our stories and never be silenced. That is why I look forward to reading this magazine as I find a clear and coherent truth in many of the stories and articles. No one is left out. I think this is a striking example of a humanist ethic often lacking in the health system.
We all need to be open to debating these issues. What is addiction? And why are so many of us traumatised by the very services designed to care for us? A huge number of drug users have abuse in their past, and we need to insist on telling our stories with dignity and pride. Otherwise men like my maths teacher have won.
Illustration by Renata Pari
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