I work with drugs! Talking about addiction research without shaming

I joke that being a PhD student is the best bar-conversation-starter ever:

“So what do you do?”
“Ah, actually,” I smile; pause. My job is definitely one of my favorite topics. “Drug research.”
“Drugs? Like, medicine?”
“No, drugs-drugs. You know,” (f there’s a pint nearby, I gesture towards it and raise my eyebrows) “alcohol, hash. Mainly heroin, though.”

Sometimes talk of work ends there. If I’m in a group, a few jokes are usually made by those listening, and the conversation moves on. But when speaking one-to-one, I’m often asked for more details, and it is here I begin to take the conversation more seriously.

I explain my interest in exercise and quality of life. Exercise, because it’s such a promising therapy among other chronic disease groups but less often implemented in drug treatment; because it works for me, and I’m not all that different from the people in the study I work with. Quality of life, because it’s an outcome that allows people to say how life in general is going for them; because reducing drug use is important, yes, but so is simply feeling like your life is ok.      

In these introductory conversations – which I have also had on the subway, while getting a haircut, after a spinning class, at house-warming parties – I distance myself from what I identify as a more standard attitude towards people with drug issues, saying that I think people with drug issues are people like anyone else, and that they need to be listened to. This seems to do something.

People I have met minutes ago tell me about their mothers’ drinking. They tell me their sister lost her job in finance because her boss found out about her Ritalin habit. They tell me there was a period in their early twenties when they smoked weed daily, and it eventually cost them their partner. They tell me about their own previous methamphetamine use. They tell me how many months since they have been sober. Sometimes they just say, “drugs are fun, right? But it’s hard,” and I understand they are struggling. Seldom do I hear a justification of drug use; it is simply presented for me to react to.  

I gather that many have rarely had the opportunity to talk about the proximity of such an issue to their own life, and I think that has to do with shame. Voicing the drug issues of someone you love, not to mention your own, makes you vulnerable to judgement and disrespect. This hides problems, reduces the complexity of drug issues to misleading stereotypes, stigmatizes treatment, and makes it harder for people in need of help and support to access them. Shame is an internalized sense of fault: it tells us that we deserve to feel badly about the shortcoming or impropriety at hand.  When I present my PhD work without propagating this shame, some dare to risk vulnerability, which in turn allows me to meet them with compassion and respect.

Society in its entirety must be more of a safe space. We need to be able to talk about drugs and about people who struggle with them in respectful, non-stigmatizing ways, and all of us need to be able to talk without being shamed. Drug issues don’t affect only the people who use. Their family members, their friends, treatment providers, researchers, and PhD students such as myself witness or are confronted with shame constantly, which also means we have daily opportunities to contribute to reducing shame. Simply nodding when someone tells you that they used to use heroin – without judgement; allowing them to talk further or not – is one such way.

(Details of what people have told me and where are fictitious. I cut my own hair.)  

Note: User-led groups like proLAR and groups that advocate for those affected by their loved ones’ drug use such as Ivareta (previously Landsforbundet mot stoffmisbruk) are important resources for building solidarity and dismantling stigma.