Poor, depressed, lonely? Join meth users!

1) You will have a lot of friends!

Using meth will become a door key to the company of young, funny guys who never get tired and are really enjoying their lives; they are not stuck in stereotypes and prejudices as, for example, your parents; their life is full of adventure and unusual experience, you will never feel alone; and they will be anxious to teach you everything about your new life…

2) Your mood will improve rapidly!

You will be achieving states of high euphoria you have never experienced; you will feel self-conscious and self-confidence you have always dreamt about; your communication skills will improve, there will be no nervosity in your voice any more; of course, there will be hard times when you will be out of meth, but you will already know exactly what will make you feel better…

3) You will become „somebody“!

If you have had doubts about your role in your life, forget it. You will never be a „loser“ anymore. You will become a cool guy, you will feel brave and strong, you will get slim, you won´t need to do any difficult decisions; people will be noticing you more: even those who currently seem to lose interest in you, your parents, friends, they will be concerned and worried of you; moreover, there will be an army of outreach workers who will be offering you clean needles and vitamins; there will be case workers who will be offering you treatment; but you will be just refusing it and your value will go up in the eyes of your new friends…

4) You will learn how to get money very fast!

People who will be around you already know how to gain money quickly and they are ready to teach you that. Everybody can do it, it is just about practice. You will learn how to steal expensive brand clothes, good cars, jewelry and other stuff. Or, you can learn how to prepare meth! It is pretty easy and there is a lot of money for that! You will learn quickly from your friends how to rationalize your behaviour so that you wouldn´t feel any blame. Lately, you even won´t feel any blame to steal something in your parents´s house. It is just about practice, you will get used to…

5) People will care about you!

If you will be really down, you won´t need to explain anything. You may just say that you are „addict“ and there will be people who will give you place to stay and food for free. You can have a rest for three or more month in a clinic (at worst,in a prison – but the treatment units are quite comfortable there) and then you can come back to your friends! Maybe, your life won´t be so long as that of your parents, but who cares… short but amazing life is better than long, depressing, lonely dying, don´t you think?

Attractive advertisement, isn´t it? The people I was talking to, heard such a calling before they started to use meth. What I want to emphasise is that it is not calling of the drug itself but rather of the idea of drug user, of the life-style, the identity that is connected to use of methamphetamines in specific geographical and historical situation. It was not only the effect of the drug that they appreciated but also the relationships, status, activities, all the important aspects of particular identity that was starting to develop. More importantly, even the „effect of the drug“ was gained through the relationship with others. People was taught how they should take, enjoy and feel about the drug.

This identity I am talking about is not a product of neurotransmitters, genes, pathological family or evil soul. It is an ever changing social product and many social groups were and are taking part in creating the contemporary image of „meth user“, including politics, medical scientists, psychologists, policemen, social workers, judges, journalists, policy makers, and of course, the meth users themselves. To put it more clearly, the person who start to use meth inevitably enters the identity of meth user that is already there. He or she can distance themselves from the identity, they can even change it, but not avoid it.

In this blog I would like to describe the process of creating the „idea of meth user“ in more deatil, both from the perspective of society and the individual. Since the most important thing I believe is that the identity is a dialectical process: the person enters some already established identity and at the same time he or she is actively creating and re-creating it. Most of my theoretical thinking is inspired by the classical work of P. Berger and T. Luckmann Social construction of reality, also by I. Hacking: Social Construction of What? and finally by I. Burkitt and his 2nd edition of Social Selves. The application of their thoughts for the use of methaphetamine comes out from my interviews with ex-users.

Do we need a higher power?

As a regular subscriber and reader of Daily Dose and blogs of prof. David Clark, I have recently found myself being more familiar with the current situation and discussion around drug policy in UK than in my home country! So, after I realized this, I checked some of the Czech websites aimed at drug and alcohol issues. At the homepage of Centre for Addictology I found a draft document of a conceptual plan for ambulatory/out-patient care in Czech Republic. Authors of this document stated that they appreciate comments to this draft so I decided to think about it.

After reading it, my immediate idea was to write something from the point of view of potential service user since one of the important points of the document is not to make distinctions between different types of drugs as methamphetamine, tobacco, marijuana, heroin, kaffein, or alcohol. Their suggestion is to develop a network of out-patient centers with secured funding where users of the substances mentioned above and others could seek help. So I was wondering what kind of help could I seek as a kaffein, nicotine and alcohol user and I found that it is first of all treatment that is being offered. Still, I was not able to find out what precisely is behind this word: „treatment“. In another words, what would happen to me if I come?

By chance, during the last weekend when I was thinking about this document, I had very interesting experience. I decided, while in U.S., to attend a meeting of Narotics Anonymous. In fact, it was not my idea but of one of the clients of treatment center I attended two weeks ago in Galveston. He thought that it could help me to get rid of some of my pressumptions about AA movement. So I went. I checked on the internet where the nearest meeting is and I found it was right behind the corner. I came there, asked if I can join them and they agreed. Personally, I am not comfortable with things like: „we must admitt our powerlessness…“, „Hi, I am Mark and I am addict…“, „we gave up…“ simply because it implies that there is some higher power that knows what is best for some group of people defined by a regular use of some substance such as heroin or cocaine. But I was surprised that these things was really not so much important. It was written in the book they were reading from but then they could freely comment on these thoughts, comparing it to their experience. They could be critical (and they were), there was no one to tell them what they are supposed to do. There were just them, people who are trying to maintain drug free life. Voluntarily. There was no priest, no psychiatrist, no counsellor, no social worker (except for me…). And it was precisely this what the people evaluated as the most beneficial. That they can come to a group of people who are experiencing similar situation and that they can freely talk about it. Nothing less, nothing more.

Now, back to the draft document of a conceptual plan for ambulatory care in Czech Republic. Personally, I am not comfortable with things like: „patients were treated…“, „syndrome of addiction which is determined by…“, „…psychological and biological predispositions“, „…care must be provided concordantly with recommendation of proffesional associations“, „treatment of addictive illnesses…“ simply because it implies that there is some higher power that knows what is best for some group of people defined by a regular use of some substance such as tobacco, heroin, kaffein, alcohol, methamphetamine or marihuana. Since I suppose that this document will be used to raise funding from the health insurance system, I understand the use of language of people who will be actually doing the decisions about the money. But I wonder how will this affect the people that are going to receive the care?

I do not have many years of experience in the field of substance abuse (I have just started my sixth year) but I have already been to more countries where I had a possibility to talk with people who are receiving some kind of care (Czech Rep., England, Mexico, USA). And what I am still hearing is that they benefit most from the possibility to talk to someone who treat them as people, as humans, who give them space to express themselves in the way they like. And they appreciate when they have possibility to talk to someone with the same experience as they have or who is going through a similar situation. Even people that were not using any services (whom I talked to in my research) needed something like that! In fact, we all need something like that…

This is what I miss so much in the draft document. What will the „treatment“ be like? When someone seeks help: where will he go, what will be written at the door, who will sit inside, what will he be telling him or asking him about. In my worst imagination, it will be somewhere in a medical center, there will be a sign „Addiction treatment“ at the door and inside there will be a man in a white coat sitting in a comfrotable armchair, there will be his diplomas on the wall and he will be asking a lot of personal things not saying anything about himself, typing it at one time. Does this document prevent things like this? I am not sure. I would be very happy, if Czech Republic would join or at least find some inspiration in the discussion about recovery in UK that is well captured for example by the Consensus statement of UK Drug Policy Commission. And maybe we could also get some inspiration from the people that we are trying to offer the care to. I have already cited here that guy who was using meth for two years and never went to any service, but here it is again:

"It should have more trustworthy and consultation face, that they would more likely provide them with consultation than with treatment. Or that they would help them. To offer help, not treatment. Because everyone would be afraid of that."

"…mělo by se to tvářit důvěryhodně a poradensky, že by jim tam spíš poradili, než je nějak léčili. Nebo že jim pomůžou. Nabízet pomoc a ne léčení. Protože toho se každej bude určitě bát.“

How to start when you´ve stopped?

„You may start taking drugs with others, but to stop taking drugs, you must do it just on your own,“ one girl from my research project said. I think this is an interesting idea not only for the people that are quitting regular methamphetamine use without any formal treatment (which was my concern in the project) but for all the people who want to quit illicit drug use and maybe any kind of harmful behaviour. However, we have to consider the phrase „on your own“ in more detail.

The point is, that the actual exit from the regular use of meth (if we take it as an example) can be facilitated by various circumstances: you can be arrested, your parents may give you your „last chance“ before kicking you out, you may appear at the detox unit, your dealer is out of town or in prison, your friends left,… there are many options. That certainly does not mean that you will stop using forever. Even if you are not using, you may be attached to the image of the drug in your mind and wait as long as the restriction will last. On the other side, there may be much space now for the other things to attach to.

One of the „things“ you may be attached to, is actually „yourself“. You may start an inner dialogue not only with „you as a junkie“ but also with your other possible selves. Your past selves, your future selves. Since these selves themselves were created with other people, these are actually their voices that resonate in your head. This period is really not very pleasant. There is a lot of blame, a lot of fear, a lot of guilt. As one of my informants puts it:

„…(as the bunch of friends broke up) …I started to spend more and more time just with myself and the feel of blame started to penetrate through me. That I really… hurt a lot of people… especially my mother, during the time she had to care about my little sister and had a lot of troubles, she had to have trouble because of me. There was gold, money, disappearing from the house. So as I was just with myself, I started to hate myself. And I knew that I have to do something. That I will either leave the house or I will kick the habit.“

Still, in the inner dialogue, a nucleus of a new self may start to be created. This is how I interpret the common statements of my informants who said that it had to be first of all „their own decision“: as a decision coming from the inner dialogue. Not from the dialogue with the parent, treatment provider, prison officer, friend or anyone else, even if their presence may be very important in this decision. The „I“ which comes from this inner dialogue is not more real or more true than those that come from the other dialogues but it is definitely most close to the person and spends with her/him most of the time. This is the start of the process of the new self development which necessarily requires the other people who confirm and support this self.

So, what I read in the interviews is that there is always this „new self-birth“ needed if the actual quit from regular drug use is to be maintained for longer time. It may take several months or even years until this moment. During the time, the person may be preserved in some reality that is imposed to her but that she does not accept as her own. Then, the „relapse“ can be as immediate as the new chance to take the drug. Of course, the new self is not a guaranty of success but it seems that it is the necessary condition for stepping forth.