For years, Mark* woke up each morning, made breakfast for his two young children, and dropped them off at school before continuing to his own job as a pre-school teacher in Baltimore, Maryland. His life was ordinary—except that each day before breakfast, he went into the bathroom and injected black tar heroin into his veins. He took another shot at lunchtime, one after work, and a final hit before bed. Now 33 years old, he has been injecting heroin for six years.

    Alice* is a health educator from Denver, Colorado, who works primarily with people living with HIV and hepatitis C. She and her partner will soon celebrate 20 years together. Alice, who is 40 years old, has lived on the same tree-lined street for 15 years. She attends neighborhood association meetings, stays involved in local politics and spoils her cats. She also injects heroin 5-7 times each day.

    Mark and Alice might seem like anomalies, rare superhumans who can conquer heroin’s primal pull towards chaos. Popular wisdom tells us that all illicit drug users teeter on the brink of collapse. The media depicts them as scavengers in a desperate, perpetual search for the next fix—liars and thieves who are incapable of maintaining steady work and families.

    Drugs are just too addictive, people say. No matter how strong you think you are, they will get you in the end.

    But the evidence tells a very different story.

     

    Double Standards

    Myriad studies have investigated the prevalence of addictive behaviors in everything from work to drugs to sex. One comprehensive evaluation of dozens of them published the following information on addiction rates among the overall population of U.S. adults:

    Eating—2%

    Gambling—2%

    Internet—2%

    Love—3%

    Sex—3%

    Exercise—3%

    Illicit drugs—5%

    Shopping—6%

    Work—10%

    Alcohol—10%

    Cigarettes—15%

    Note that only one item on this list is preceded by the word “illicit.” Despite approximately half of us being affected by addiction of one kind or another in any 12-month period, the other substances and activities on this list are not only legal, but often actively encouraged.

    Every day we endure a blitz of commercials, billboards, sale signs, click-bait, coupons and ads. The siren call of the Internet keeps our noses glued to our phones. The porn industry has swollen larger than Hollywood. And alcohol, though it’s experienced addictively by twice as many Americans as experience illicit drugs in this way, is heavily embedded in aspects of our culture. Yet we reserve our guns, handcuffs and cinder-block cells for a war against one thing only: drugs. Or rather, the people who use them.

    Imagine if such a war were waged against exercise. Picture the nightly news splaying pictures of hollow-cheeked gym rats with spidery limbs forged from hours on the elliptical. The TV shows following interventions to save a marriage doomed because a husband neglected his wife for the gym. Imagine police arresting fitness instructors for hooking customers onto $150/hour “training sessions;” The Slammer hawking morbid photos of balding exercise freaks, their hair falling out in brittle clumps from mineral depletion; public hysteria over injury and premature death via workout overdose; the demands that justice be served to anyone caught peddling illicit free weights and packets of powdered Gatorade.

    Silly, right? And yet this is what we do with drugs, despite the fact that the prevalence of illicit drug addiction—5 percent—is on par with addictions to other substances and behaviors.

    Of course, it is true that there are far more drug-related deaths than exercise-related ones. But it is equally true that the very stigma against drugs prevents people from accessing safer forms of substances or safer modes of ingestion—and is therefore directly responsible for many of those deaths.

    It wasn’t the heroin that took everything from him. It was the discovery that he was using heroin.

    It is not easy keeping a stigmatized secret. Many functional illicit drug users are forced to live a double life, under constant threat of losing everything because society has decided to scapegoat their particular activity.

    During the first year he started injecting drugs, Mark was ashamed to tell even his wife about his heroin use. “I wore long sleeves all the time. I made sure we only had sex in the dark,” he tells me.

    When he couldn’t bear to hide anymore and finally blurted out his secret, his wife reacted with shock and disbelief. She was no longer willing to live with him, and Mark became homeless. Divorce papers soon followed.

    But it wasn’t the heroin that took everything from him. It was the discovery that he was using heroinand the fear and stigma that discovery unleashed.

    Alice has a partner who also uses heroin, so they hold their secret together, choosing to share it with some loved ones and to hide it from others. Alice says that most of her co-workers are aware of her drug use, but her mother does not know.

    “It’s not that she wouldn’t love me, I just don’t want her to worry,” says Alice, who acknowledges that it is unusual to be open about drug use with co-workers. “Even being in a supportive environment, I still deal with the same shame and fear that everyone else does.”

    Alice has also previously suffered periods of homelessness and chaotic use. But, just as Mark found, this occurred only when a family member—in Alice’s case, her mother—found out that she was using drugs and decided she could no longer live under the same roof.

    Often, the first reaction from a loved one upon discovery of drug use is to resort to “tough love” in the hopes that it will teach the user a lesson. In reality, that kind of reaction often fuels chaotic use. “When you have already had everything taken from you, it is hard to fight the voice that says ‘let’s get high’ in your mind,” says Alice.

    Certainly for people who use drugs regularly, even those who do not develop problems, the specter looms large. For many, a job loss due to a random drug test unrelated to performance, an unsupportive family member, or a stint in jail could precipitate a decline in overall health and coping skills, which could fuel chaotic drug use. Chaos triggers consequence, which breeds more chaos. Some people never break the cycle. For lifelong drug users who oscillate between periods of stability and instability, the volatility is often sparked by policy, legal or stigma-related eventsnot the chemical effects of the actual drugs.

    Dr. Carl Hart, a neuroscientist at Columbia University, has studied and published books on drugs and addiction. He notes that illicit drugs are physiologically no different from equivalent licit drugs on the marketand that both can be used responsibly to benefit people.

    It makes no sense to criminalize methamphetamine while marketing its sister drug, Adderall—chemically almost identical—to people with ADHD. Hart’s study, among others, showed that regular meth users were unable to distinguish between the two when ingesting equivalent forms and doses. Similarly, fentanyl is legal or illegal depending on where it is manufactured—or who profits off its sale.

    So how is the myth—that drug use inevitably causes chaos, rather than the other way around—allowed to continue? Why do we focus so heavily on the 7.4 million Americans addicted to illicit drugs and ignore the 32 million-plus addicted to work—people who are also at risk of losing their families, their health and therefore even their lives?

     

    An Entrenched and Harmful Myth

    The answer is complicated, with roots deep in history, economics, race and power. But one simple answer is that drugs are easy to demonize because they can readily be classified as “other.” Most Americans don’t use illicit drugs, whereas most of us do engage in work, exercise, shopping, sex and drinking. We may be aware that a small percentage of the population becomes addicted to these activities, but we also know that most people do not. We tell ourselves that although any activity is potentially addictive, drugs are particularly addictive, hence they should be prohibited.

    But here, too, statistics beg to differ.

    “Blaming drugs for our problems detracts the public from other factors such as job loss or a broken mental health system,” Dr. Hart tells Filter.

    According to data from the most recent National Survey on Drug Use and Health (2016), 48.5 million U.S. residents ages 12 and older report using illicit drugs in the past year (about 15 percent of the population). Of these, 7.4 million (15 percent of illicit drug users) exhibit possible signs of dependence (more than half of these—4 million—to marijuana). And of these, 2.1 million (4 percent of the total) meet criteria for “abuse.”

    Put another way, 85-96 percent of people who use illicit substances do not develop problematic behavior.

    This figure roughly matches those reported internationally. According to the anti-drug United Nations Office on Drugs and Crime, a little over 10 percent of worldwide drug users are “problem” drug users—which leaves almost 90 percent who are not.

    This reality does not tally with our portrayal of drug users as slaves to a poison that hijacked their brain. To be sure, some people do become problematic users, and the consequences can be tragic and even deadly. But pop culture enormously exaggerates the percentage of people who develop chaotic behavior through drug use, while ignoring the same symptoms when they develop through legal activities. We obsess over the 2.1 million people who “abuse” illicit drugs, while forgetting the other 46.4 million users who quietly blend in with the rest of us.

    “Blaming drugs for our problems detracts the public from other factors such as job loss or a broken mental health system,” Dr. Hart tells Filter. He notes that this allows politicians to vilify people who use drugs rather than focus on solving larger problems. Demonizing drugs also directs resources towards law enforcement, the prison-industrial complex, and more recently, “treatment” centers that often lack any basis in evidence.

    Dr. Hart is currently working on a book about the other side of drug use: the medicinal, social, recreational side. “[Drugs] can enhance the human experience, improve performance, facilitate better social interactions and intimacy,” he says. He hopes that science can help explode myths about drugs and lead us to a place where drugs are legally available to responsible adults.

    For Mark, that day can’t come soon enough. He recently decided to be open about his heroin use in his Baltimore community. Today he lives once again with his former wife, so they can co-parent their children. He works for a nonprofit in Baltimore that provides health services to people who use drugs.

    The decision to be open about his drug use has cost him some job prospects and friendships. He has neighbors who won’t let their kids play with his children if he is the only adult present. But Mark does not regret his choice. “We have to acknowledge that non-chaotic use is possible and to help people through the harm reduction way of thinking,” he says. “I’m not hurting anyone by choosing to imbibe poppies instead of beer.”

    Mark emphasizes that there are many paths to recovery, which include getting healthier, building positive relationships and being honest with yourself and others. He dreams of one day taking a bike trip from New York to Atlanta to show people that you can be healthy and active on large daily doses of opioids. “I want to post pictures of myself eating kale and drinking methadone,” he laughs.

    “As soon as we find out a person is an IV drug user, we strip away all the reasons for them to be anything different,” says Alice.

    Perhaps reasonable drug policy will someday arrive, but in the meantime, it is difficult to reverse decades of fear, hype and false information. With exhaustive media coverage of opioids, a death toll that continues to climb, and many people witnessing addiction in their families and neighborhoods—coupled with the obvious disincentives for people who use illicit drugs non-problematically to “come out”—it can be easy to disbelieve that the overwhelming majority of people who use illicit drugs do not develop problematic behaviors. But the numbers don’t lie.

    “As soon as we find out a person is an IV drug user, we strip away all the reasons for them to be anything different,” says Alice.

    For the people who do become chaotic users, we should increase our resources for mental health, education, training, coping skills and economic development to help build positive relationships and fulfilling lives that may or may not include drugs.

    For the rest—the Marks and Alices of the world—we should ensure their right to pursue life, liberty and happiness without hindrance. It is one thing to criminalize harmful behaviors such as theft or intoxicated driving that are carried out under the influence of a substance. It is quite another to criminalize the substance itself when no crime or harm has taken place.

    Why punish anyone for merely ingesting something? Why encourage fear and stigma to rule personal relationships instead of honesty and love? Why give people reasons to use chaotically?

    The invisible majority, the tens of millions of Americans who use illicit substances each year without significant negative consequences, deserve peace—and the right to respond to their own needs without fear of being caught, criminalized and caged.

    *Names have been changed.


    Photo via 13on on Unsplash

    • Show Comments

    • 0796616

      I believe in harm reduction. However, if you’re my kid’s preschool teacher and you’re shooting up on your lunch break, then yes, I absolutely believe that is problematic. If Alice is shooting up 5-7 times a day, then I think it’s probably affecting her life somehow too- whether financially, legally whatever. To pretend that these aren’t problematic examples seems a bit… problematic. Megan Johnson

      • The New Impostor

        Why? If they get their heroin/morphine off a doctor it’s OK, but if they get it off a dealer because they have to self-medicate it’s not OK? The main effects of heroin last around 30-40 minutes, then most users are in a similar mental state to others. And most users take maintenance doses when they are working or busy, just enough to stop withdrawals without being ‘on the nod’. Many heroin users learn how to manage their habits safely and sensibly – especially if they are lucky enough get a prescription (as in Switzerland and the Netherlands).

        • ripp846

          Are you F-ing kidding me? This junkie is a train wreck. It just hasn’t happened yet. It’s not noticeable to others yet. But it will be. Heroin? Really? Yuk.

          • MonicaSpudsMcLewinsky

            You know, obviously there’s more than one side to this issue. But so far your comment is the only one I’ve gotten to objecting to the article….and your comment is completely stupid. “Are you fucking kidding me” and “yuk” are not well-made, smart points. The rest of your comment was a juvenile insult and a prediction about the future. Nobody thinks you know how to predict the future.

            Pretty sad. I don’t do heroin, but I’d rather hang with the people in this article than you.

            I’d love to read a well-written and reasoned comment from somebody who feels just as strongly negative about this article. EDITED TO ADD: somebody did.

    • Dag Nasty

      “I just can’t deal with anyone until I’ve had my coffee…”
      “Mummy needs her wine…”
      Hell, we not only accept some addictions, we accessorise and fetishise them.

    • Mat Southwell

      Thanks for this campassionate and balanced discussion of our lives.

      • Scott Scale

        “Our lives”?
        You do the heroin before breakfast ?
        The NHS did right .
        Seems your “balanced” story claims :
        ‘It is one thing to criminalize harmful behaviors such as theft or intoxicated driving”
        Yet the story tells :
        before breakfast he shot dope then
        ” two young children, and dropped them off at school before continuing to his own job”
        That would be intoxicated driving as well shooting up on lunch break
        The story goes on :
        “I’m not hurting anyone by choosing to imbibe poppies instead of beer.”
        For sure you cannot drink beer before driving kids to school . Or drinking before breakfast is a problem and as well teaching kindergarten and drinking on your lunch break.
        To think this story and the other injection drug user are non problematic is completely ridiculous.
        The wife kicks him out so he becomes homeless ? That is high function?
        Like why can’t he spend the kids college fund on dope?? LOL
        Yeah, you getting really popular, real fast.
        Does approving this nonsense come natural or do you have to practice ?

        • DeathIndustrial

          That’s not true.

          Heroin’s effects wear off in a couple hours, some times even within an hour.
          Not to mention heroin doesn’t affect coordination and balance the same way alcohol does.

          So no, you DON’T know if he “drove intoxicated”. Heroin doesn’t affect your judgement like alcohol either, as in if you’re too high to drive on heroin, you’ll know not to drive. But if you’re too drunk to drive, driving might sound like a good idea and you’ll do it anyway.

          You obviously have zero experience with drugs.

          • Scott Scale

            Yes he drove intoxicated . Look at the news . People are having car crashes on opioids all the time. They are also OD and crashing.
            Where do you get such nonsense.
            What is really funny is you point out the person drunk doesn’t know the difference because they are drunk . Same for Heroin, you think you are alright and probably think you function better. LOL .

    • Samantha Brown

      I’m sorry but I lived with a person who injected heroin until he had to stop to save his life. There are too many externalities with drug use to promote it in the general population. Injecting and smoking to get high are not safe methods–infections are common. Finding veins, overdoses, etc. I never smoked a cigarette and when someone smokes around me it makes me sick. It is not a victimless activity because when you get addicted (and no one knows who will get addicted) you may not be able to support yourself making yourself dependent on your family or the state. All social problems are exacerbated by drug and alcohol use. Adding a bunch of lethal drugs to alcohol just compounds the problems. The rights of non smokers and non injectors and non glue sniffers to breathe clean air, not be saddled with homeless addicted people or hospital er visits from addiction surpasses your desire to get high. The morgue is littered with bodies of those who said their drug or alcohol use was safe. Just when we are in the midst of a huge epidemic and our children are dying on a daily basis you double down on promoting drug use you have learned NOTHING.

      • ripp846

        Absolutely right. About 75,000 Americans will overdose to death in 2020. This is the worst time in American history for this preventable death. Don’t applaud these people for being junkies. You have no idea what heroin use does to the human mind.

      • MonicaSpudsMcLewinsky

        I respect and appreciate all of your comment, except only for the last sentence. Is the article really promoting drug use, or is reporting the experiences of some drug users and also citing statistics? I see the latter, and not much of the former.

        There has never been a day in human history when children didn’t die. Adults too.
        And, actually, I learned quite a bit reading this, and have learned plenty about other things in my time, too. I know you meant that last part as a rhetorical flourish, but it’s silly. The rest of your comment makes good points.

    • MsNooneinparticular

      15 year recreational opioid user myself. Never overdosed, never injected anything, never bought shady pills with fentanyl in them, never spent money I didn’t have on drugs, never stolen/doctor shopped, etc. I use opioids like I use my Prozac–as an antidepressant, except they actually WORK.

      And because I fear vomiting so much (always have), I haven’t ever pushed the dose up too high for fear of getting sick. I also can’t afford to have them stop working for my depression/social anxiety since they’re so effective. I have Asperger’s & can only comfortably make eye contact with an opiate in my system. Never tried anything stronger than OxyContin 20 but even 30mg of codeine gets me where I want to be, 15 years in.

      I’ve quit for 6 months, 8 months & a little over a year in this time period but it always felt like something was missing… like I wasn’t operating on all cylinders. Could I have gone on like that indefinitely? Absolutely. But it feels like a total waste to go through life like that. For what? Or who? Maybe it’s not socially acceptable to admit that certain drugs can be used responsibly for long periods, but it’s the truth for some of us. Science & medicine shouldn’t grind to a halt because it’s not politically correct.

      • DeathIndustrial

        Same here!

        I’m going on about 12+ years of opiate/heroin use and about 20 years altogether for poly drug use.

        I never once overdosed on any opiate or heroin. I was smart enough not to mix them with tons of other benzos or alcohol. My heroin dealer was respectful enough not to give me fentanyl and to give me my heroin raw, so I didn’t have to worry about all that. I always made sure to do a tester bump to see how potent it was before digging in. Never injected it.

        Currently on buprenorphine now but I still miss heroin. It’s one of the only drugs that helps calm my mental health. I am so tired of people crying out their misinformation that it will “kill you”. It’s not true if you know what you are doing. it’s fentanyl that is killing people, along with ignorant younger people not knowing better than to not mix opioids with tons of other downers.

    • The New Impostor

      You forgot to put caffeine on the list – over 90% have a caffeine habit

    • Hidden Chamber Studio

      No. I don’t agree with this article. Our bodies were designed (through millions of years of evolution) to properly operate on healthy food, water, clean air, exercise, and social interaction. If you feel the need to injure yourself on a regular basis (such as causing injury to your nervous system) then I believe you have a problem.

      The “good feeling” is supposed to be when you feel normal. Haven’t you experienced a stint where you were sick (flu or some virus) and when you came through the other side of it… you felt amazing. That’s what feeling “normal” is supposed to feel like. Amazing.

      If you still need to feel like you’re floating, then I recommend you get in a pool of water. Give it a try.

    • Marc Burrows

      Such a good piece. We live with these laws and act like it’s normal. Meanwhile, alcohol and tobacco kill more people every year than all other drugs combined. It’s systemic racism at its best.

    • Scott Scale

      “Mark and Alice might seem like anomalies, rare superhumans”
      I doubt very much anyone is confusing junkies as superhumans.
      ” heroin’s primal pull towards chaos” is exactly what happened when their families would no longer support their drug use.
      As well the linked study absolutely does not say anywhere in that study that the vast majority use non problematically.
      ML Lanzilotta wrote and linked to this article claiming she was non problematic .
      She was recently admitted to hospital for injection related blood infection.
      All injection drug use is problematic.

    • DeathIndustrial

      Heroin overdose is a myth.

      I’ve used heroin & various other opiates for 12+ years. My dealer was always respectful enough to give me my heroin in raw rock form and never cut it. Had me try fentanyl once and I hated it, it was nothing like heroin and I told him I never wanted that shit again, so he never gave it to me again.

      I never once overdosed. And I started to wonder why after all these years. And I found this information which seems to make sense. A lot of “opiate overdoses” are actually people who combined a bunch of drugs with an opiate (like alcohol, benzo’s, etc..) So when they end up dying from poly-drug intoxication, just because there is an opiate in their system, it will get labeled an “opiate overdose” or “heroin overdose” to keep this fear & misinformation surrounding heroin going.

      Anyone with an opiate tolerance is not going to die from doing a little extra heroin one day. It just doesn’t work that way.

      And while many people may go through rebellious stages in their youth and get hooked and then decide they want off of it, they think everyones experience with it is universal when it’s not. Just because YOU didn’t like heroin and couldn’t be responsible with it, doesn’t mean WE ALL can’t be. Heroin is the only thing that works for my mental health. I literally cannot function without an opioid daily. I’m so tired of these drugs being stigmatized.

      Opiates are some of the only drugs that will NOT cause brain & organ damage when taken in the long term, compared to MANY MANY LEGAL DRUGS!

      LEGALIZE HEROIN!!!! The longer we put this off, the more people will die from fentanyl and uneducated poly-drug overdoses!!

      This website is from Australia, but I’m speaking from a US stance.
      http://www.drugtruthaustralia.org/heroin.html

      • Scott Scale

        Just because “YOU” didn’t like fentanyl doesn’t mean others don’t . There are plenty of articles from Vancouver that clearly show that it is the drug of choice.
        As well Estonia ,which was number 1 for OD mortality until Scotland took over, the addicts don’t want heroin at all. It is too weak.
        Interestingly since Estonia has the usually misrepresented “decriminalization” since 2005 .
        Like people who want fentanyl the are the vast majority that are poly drug users. Even the beginners and is clearly documented in WDR. So people combine drugs and alcohol is because that is what they want .
        The longer we pretend drug addicts don’t want fentanyl then the harder it will be to deal with this situation.

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