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Barriers to Recovery: Stigma & Discrimination

Julian Buchanan Associate Professor Victoria University of Wellington
by Julian Buchanan on 10 September 2013

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Transcript of Barriers to Recovery: Stigma & Discrimination

This presentation will explore our understanding of, and reactions to problematic drug use. Populist punitive discourse perceives physiological and psychological dependence upon drugs as key drivers that perpetuate ongoing ‘addiction’ that threatens society.
However, drawing upon 25 years experience of working in the drugs field (as a practitioner, researcher and academic), I want to explore the links between the war on drugs, the social construction of 'drugs' and the difficulties faced by problem drug users.
I will illustrate how the by-products of this ‘drug war’ - stigma, discrimination and exclusion- are for most people, more powerful in keeping them trapped in a drug centred lifestyle than the drug dependence.
Vast majority of drug interventions are geared towards helping people below the Wall of Exclusion. Assisting them to reduce harm or become drug free.

The Recovery movement is trying to break through the barrier by robust proclamations of 'recovered'. But once outed as a drug 'addict' requalification and reintegration becomes overwhelmingly difficult.
No legitimate constructive lifestyle to return to or recall

Limited social capital, support or resources

Ascribed identity of PDU they become morally and culturally bankrupt – and shunned by society

A drug centred lifestyle becomes a (perverse) solution not the problem
Drug misuse is a social construct

Preferred drugs come ‘in and out’ of favour

Some drugs are culturally promoted

Some drugs are demonised
Recovering drug users ....

hampered by the consequences of events in their early history at home and at school that have led to their use of drugs and their subsequent dependence on them.

The decline into social exclusion brings with it further disadvantage...

a criminal record adds another barrier...

Unemployment ...brings with it financial deprivation, poor living conditions and a further lowering of self-esteem.

Lack of school qualifications, training and work experience

Support at this time is critical to their ability to overcome the multiple disadvantages and gain success.

Associate Professor Julian Buchanan
julian.buchanan@vuw.ac.nz

Programme Director
Institute of Criminology
School of Social and Cultural Studies
Victoria University of Wellington
Te Whare Wananga o te Upoko o te Ika a Maui
Tough drug policy does not result in decreased drug use

Tolerant drug policy does not result in increased drug use

Tough drug policy does make it harder for dependent drug user to seek help and more dangerous all round.

Tolerant drug policy does result in more people seeking help, greater recovery and less drug related harms; such as crime and HIV rates
p vi Klee, H., McLean, I. and Yavorsky, C. (2002) Employing drug users Individual and systemic barriers to rehabilitation Joseph Rowntree Foundation 2002
1. Has no idea of the strength of the drug - it could be so strong it could result in risk of overdose or death.

2. Has no guarantee about the purity or indeed content of the drug - it could be contaminated or even mixed with toxic ingredients that could cause serious harm even death.

3. Has to buy the drug ‘underground’ - exposing the person to the vagaries of a potentially dangerous criminal underworld.
4.Buying, using and sharing illegal drugs puts the person at risk of serious criminal sanctions such as a community sentence with a drug rehabilitation requirement or even imprisonment.

5.A person using an illegal drug risks acquiring a criminal record for a drugs offence - which could have lifelong consequences upon employment prospects, opportunities for world travel and housing.
6.Has to use the drug in secret. For some people this may mean using in an isolated location that could be potentially dangerous especially when intoxicated - such as a condemned building, under a railway bridge, a canal etc.

7.Has to hide the use of illegal drugs making it more
difficult to manage and harder to seek help, support or advice if a problem arises.
Wilkinson RG, Pickett KE. The problems of relative deprivation: why some societies do better than others. Social Science and Medicine, 2007

UN Office on Drugs & Crime, World Drug Report 2007.

Wilkinson RG, Pickett KE. The Spirit Level. Penguin. 2009
Definition of Problem Drug Use










UNODC World Drugs Report, 2011 p.23
citing EMCDDA definition
http://www.unodc.org/documents/data-and-analysis/WDR2011/World_Drug_Report_2011_ebook.pdf
'injecting drug use or long duration/regular use of opioids, cocaine and/or amphetamines'
EMCDDA Drug Policy Profiles: Portugal (2011)

'has developed a policy that appears internally consistent and that tries to respond to drug problems in a pragmatic and innovative way. This is not always the case in modern drug policy .... best described as being a public health policy founded on values such as humanism, pragmatism and participation.'
Hughes, C. and Stevens, A. (2010) ‘What can we learn from the Portuguese decriminalization of illicit drugs?’, British Journal of Criminology 50, pp. 999–1022

- small increases in reported illicit drug use amongst adults
- reduced problematic drug use
- reduced adolescent illicit drug use (since 2003)
- reduced burden of drug offenders on the criminal justice system
- increased uptake of drug treatment
- reduction in opiate-related deaths
- reduction in infectious diseases
Portugal
Global Commission on Drug Policy 2011
http://www.globalcommissionondrugs.org/


'End the criminalization, marginalization and stigmatization of people who use drugs but who do no harm to others. Challenge rather than reinforce common misconceptions about drug markets, drug use and drug dependence.

Encourage experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of their citizens.'
Switzerland
The Platzspitz or Needle Park, Zurich
Here is an excerpt from an article which appeared in the “New York Times” September 27th, 1990.

“The strange scene has been a fixture in Zurich for several years, tolerated by city officials who are convinced that drug use should be regarded as a sickness rather than a crime. Social and medical workers estimate that about 300 to 400 heavy drug users live in the park without shelter, toilets or showers, and that as many as 3,000 others pass through daily to buy and use drugs………..the midway of the grotesque carnival is a concrete path along the edge of the Limmat River, lined with makeshift counters covered with neatly arranged spoons, bottles of water and paper cups bristling with slender, disposable syringes. The crowd thickens as night falls and drug hustlers work their way through the sea of bodies clogging the path, calling out ''Sugar, sugar, fine sugar!'' when they mean heroin, and ''Cokay, cokay!'' for cocaine……..the other night, three men crouched under a park lamppost, dividing a white powdery pancake of heroin with a Swiss Army knife. Next to them, a woman lay in the dirt in a stupor. Four or five men were intensely working needles into their arms. A woman in a striped sweater probed for veins in one hand, blood streaming down her fingers, as a woman in leather pants and stained blouse wobbled past, a bloody syringe dangling from her neck.”
Drug use and inequalities
http://www.moh.govt.nz/moh.nsf/pagesmh/9841/$File/drug-use-in-nz-v2-jan2010.pdf
Barriers to Recovery:
Stigma & Discrimination
Listen to the presentation (audio):http://www.drugfoundation.org.nz/through-the-maze/podcasts/

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