Archive for July, 2013

Drug policy fails – again

Wednesday, July 24th, 2013

Another kick in the teeth this week for Theresa May and her determined squeal that drugs policy is working. After ignoring the research-based recommendations from a group of cross-party peers concerning decriminalisation, then developing selective deafness towards her drugs advisory board by banning khat, Theresa seems fixated on perpetuating the War On Drugs, whether anyone agrees with her or not.

It will be interesting, then, to see how she reacts to the news that cannabis psychosis admissions have actually increased since the drug was reclassified as a Class B substance. Yep, you’ve got us there, Theresa, you font of knowledge for all things street – clearly drugs policy is reducing use and minimising harm just as it should. Well done for sticking to your guns, and thank god those running the country know what they’re talking about. Phew.

Tottering Tory Totty aside, I have to admit this is a pretty bizarre finding. At no point did I think that reclassifying the drug would decrease the harm caused – why would it, it’s still illegal and that didn’t put people off before – but the inverted correlation between cannabis-related psychosis hospital admissions and reclassification of the drug is difficult to explain.

I have been pondering on this. Without subscribing to the Journal of Drug Policy (which is, I have to admit, surprisingly tempting, but takes money, of which I have little), I can’t see whether participants who suffered psychotic admissions had taken solely cannabis. My hunch is that something different may be afoot here. Rates of psychosis amongst my client-group have gone through the roof since MCat has surfaced, and I have heard similar reports from prisons regarding synthetic cannabanoids. I know that, until very recently, and certainly not within the confined dates of this longitudinal study, testing facilities for these drugs had not been developed – and even if they had, the average mental health ward would not have had access to them. So, my sneaky conclusion is that the increased rates of psychosis admission may have been due to the use of other substances – which were not only impossible to detect, but were also legal at the time and so potentially not reported or classified.

That is my suspicion. Just don’t tell Theresa. I can’t wait to see what shit she spins to explain away this one. Although, to be fair, I think she’s more likely to get a bad case of tinnitus than indulge in any scientific analysis. You keep on trucking girl, we’re all behind you (with a metaphorical spade).

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Baby wants a double vodka

Saturday, July 20th, 2013

Pregnant women who use methadone are likely to under-report their alcohol and drug use, a piece of research published this month has found. The admittedly small sample of fifty-six opioid-dependent women, prescribed methadone as a substitute for heroin, were found to continue taking illicit drugs and alcohol during their pregnancy, as discovered by testing mothers’ and babies’ urine, and meconium (first stools). The study showed that 91% of women taking part in the study had used illicit drugs – 73% had continued taking opiates, and 70% had used benzodiazepines (which are thought to be linked to birth defects). 47% of the babies had also been exposed to alcohol use at levels of at least 2 units a day or 5 units at once, despite only 5% of the women disclosing this level of alcohol use. The most common combination (drug workers won’t be surprised to hear) was heroin, cannabis and alcohol.

Now this is clearly a highly-contentious area to discuss. On one side of the debate, there are people who acknowledge that women become pregnant for a variety of reasons, not necessarily through choice, and that the lifestyle that comes with heroin addiction may not be the most happy or meaningful existence, or borne from the most stable of upbringings. Once pregnant, drug users typically face extreme feelings of guilt – feelings which they have historically used drugs and alcohol to manage. And then the judgements and processes they are subjected to during pregnancy – safeguarding procedures and meetings, constant monitoring, reports written weekly about them and their parenting capacity, every bad decision they have ever made dragged up and pored over – make pregnancy not a joyful but a very stressful experience.

And then, on the other side of the debate, there are the tabloid readers – and there is so much meat on this bone for them to chew. First of all, of course, all drug users should die. They sacrificed their right to be on this planet the first time they smoked a spliff. Then – it gets worse – they are mothers. Should a woman not cease to exist in her own right the instant she conceives? She is, after all, a vessel. She should be pure and demure and fit all the glowing, maternal images we associate with motherhood. So the lifetime of misery, abuse, ill-treatment and self-deprecation should end the second that sperm hits that egg.

Now, don’t get me wrong, I find it very hard not to judge drug-using mothers-to-be. The unborn child is helpless and dependent on her to meet its every need, and it is heart-wrenching to think that it is disadvantaged before it has even left her womb. I do read the riot-act to these women, making it very clear that they are putting their baby’s welfare at risk, and increasing the chance that, once born, their baby will suffer painful and distressing withdrawal symptoms. What a sad and sorry start to life.

However, one thing is for sure – guilt does not perpetuate healthy behaviour. The fact these women are under-reporting their substance use is a sure sign that they already know all of this. You can bet your bottom dollar that they are beating themselves up more than anyone else ever could. And it is the discrepancy between what is expected of them and what they believe themselves to be capable of that makes burying one’s head in the sand the most realistic option.

I would imagine that most women who have had children would find this research both sickening and saddening. Whilst the idea of doing anything that may put their babies at risk may repulse them, I bet most of them have also felt judged, squeezed by other people’s expectations, desperate not to stand outside the prescriptive maternal mould that is dictated to them. Surely there is no worse judgement than being a bad mother. And not breast-feeding…?!

In the late stages of her pregnancy, I took a good friend of mine out for a drink. She was a single mum with two other kids at home, and she was desperate, for one last time before her baby was born, to just be herself for a night. She hadn’t drunk at all throughout her pregnancy, but on this occasion, I bought her a bottle of Corona, and she savoured it as we sat talking for an hour. We were in Wetherspoon’s – not an establishment known for its distinguished clientele with high moral values – but you should have seen the looks she got that evening. People gathered to bitch and point; judgements were formed, comments were made. At the time, she was drinking within the acceptable limits in pregnancy (guidance has since changed to ‘no alcohol during pregnancy’, although I believe this was mainly due to the fact that people struggle to quantify a unit), and she certainly wasn’t putting her late-stage pregnancy at any risk by her action. But as she sat there, gorgeous and bulbous, trying to enjoy her one night of being a person before months of being a multi-tasking milk machine, she was deemed by the other drinkers gathered that evening as the scourge of the earth.

So I suppose, in conclusion, I just want to say – this piece of research is sad. It is sad for the babies, it is sad for the mothers, it is sad for society. But maybe, maybe, if we saw pregnant women as people first and mothers second, the gap between expectation and reality might not be so great, and the image of the happy, stable, glowing mum-to-be might change into something more achievable for all pregnant women.

Theresa May – khat(ban)woman

Wednesday, July 10th, 2013

Well, Theresa May has pulled another shit idea out of her seemingly bottomless bag. Proving that she not only has no idea about the young people in this country, she has now managed to alienate the Somali, Yemeni and Ethiopian communities too. Ignoring her advisors and their indepth research, which indicates that khat use is neither significantly dangerous to meet illicit criteria, nor on the increase, the daft old bat has decided that, yes, it should definitely be illegal.

Khat (a phonetic spelling of a word that basically sounds like ‘cat’) is a plant that, when chewed over a long period of time, produces a mild stimulant effect. An integral part of the community in Somalia, Yemen and Ethiopia, it helps people working long hours stay up, and is primarily used socially.

In the communities I have worked in, there has been a small amount of problematic use, and the head of the London Somali Youth Forum claims that young people are also starting to use the drug. However, when we consider that many of the Somali, Yemeni and Ethiopian people living in this country arrived here seeking asylum after fleeing their war-torn motherlands, having witnessed some fairly grim atrocities and then landing here at possibly not the best time to be a Muslim, I don’t think we can be too hard on them for using the drug in a slightly different manner than they would have done in their homelands, where use is unproblematic.

In terms of the social context, to me it stinks of oppression and racism. It’s worse than the Americans labelling Mexicans as mentally-deranged marajuana users, worse even than them labelling black Americans as crack users – because the plot there was to over-associate a widely-used drug to criminalise a specific population. Khat, in comparison, is pretty much only used by these communities – so from where I’m standing, this is out-and-out racial oppression.

Let’s draw a comparison. Imagine that the South of England invades the North. (It can only be a matter time, really – the BBC have already started.) A civil war ensues, killing thousands and displacing many thousands more. Some pretty nasty things take place, everyone is affected – both the Northerners who see their homes and families destroyed, and the Southerners who lose their fathers and sons in the fighting. Eventually many people have no choice but to evacuate to Ireland.

Now the Irish aren’t too keen on the English, for some reason. They begrudgingly offer them asylum, but they don’t want the English to feel too at home, or too equal. So they take from them the one thing that helps them cope, the one familiarity that brings people together and unites their communities, the thing that they sit down to with family, friends and neighbours when times are hard – the good old cup of tea. The Irish make caffeine illegal. And the English cry. (I know the Irish love it too – but just humour me for the span of this brief analogy.)

Now caffeine is addictive. It can be misused. In fact, in the 80s the World Health Organisation recommended that caffeine should be banned, because of the huge number of people presenting to GPs with headaches, migraines and anxiety problems resulting from excessive use. When we are upset or tired, we tend to drink more of it. Something bad happens – sit down, I’ll put the kettle on. Something needs discussing – come on, let’s go for a coffee. Imagine the social impact we English would experience if caffeine was removed from our culture.

And, likely as not, instead of having a cuppa or meeting for a coffee, we would go to the pub. In times of trauma and displacement, we English would need each other, to remember our old lives, and to help heal the wounds of war. And without a cuppa, what would we go for..? A run? A bath? I think not – we would go for a pint.

So I am suggesting, Theresa, you silly sausage / evil Aryan witch (delete as you see fit), that this policy might not be one of your best. I can’t imagine that the Somali youth are going to take up badminton instead. And at least this is a habit they can share with their parents and get useful advice on, instead of taking up something that alienates them from their heritage and no-one has any useful information about – like MCat.

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