Interview with Dr Aidan Kelly on Drug Abuse and National Drug Strategy

Bill Lonergan

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If you address the social drivers towards addiction, you will see far less drug abuse”

courtesy of drugabuse.com

Drug addiction and abuse should be accepted as a society- wide problem, where individuals are not neglected.

We live in a time of change. In truth, this statement could be cast off as a lazy rewording of a Bob Dylan classic. But, Ireland is truly experiencing a considerable shift in cultural outlooks, particularly as the once vice like grip of the Catholic church loosens. Generations of unavoidably conservative thinking have given way to the widespread acceptance of a more liberal, sensitive approach to societal issues.

It has been reported that decriminalisation of all drugs, including heroin, cocaine and cannabis, for personal use is one of the policy options outlined in the forthcoming National Drugs Strategy which is expected to be published before the summer.

In addition to the provision of rooms for injecting heroin, it appears that serious consideration is being given toward the decriminalisation for possession of small quantities of illicit drugs.

Senator Aodhán Ó’ Ríordáin, the driving force behind the more holistic approach, has said that he is “ in favour of a decriminalisation model, but it must be one that suits the Irish context and be evidence based”.

Without getting into the specifics, it seems that decriminalisation will apply across the board to all illicit substances.

Can we follow the lead of Portugal, of whose 2001 policy Mr Ó’ Ríordáin is a vocal advocate, in decriminalising possession of illicit substances? Or, is it possible to expect a separate culture and society to react in the same way when it comes to a blanket policy on harmful substances?

When it comes to drug abuse there are in effect two schools of thought. The first, hardline attitude is that the user has become an addict by their own volition. The ‘you made the bed, now go sleep in it’ line of thinking.

The second, more human approach is that countless people from varied backgrounds get addicted to drugs and they need help. The former attitude is, for the most part, reductive and callous and fails to take into account the person as an individual. Mr Ó Ríordáin’s policy, accepting that drug abuse can never be eradicated, seeks to assist those who have developed a serious addiction to one or more drugs.

I spoke to Aidan Kelly, Doctor of Clinical Psychology, to discuss the implications that the proposed drug policy might have on Irish society in general. At the forefront of my concerns was whether the Portuguese model was readily applicable to Ireland, particularly it can’t be presumed that societal behaviour is homogenous in separate countries. And whether we, as a society, have a proper understanding of addiction.

B.L.: Dr Kelly, do you think it is right to follow the strategy used by Portugal?

A.K.: There do appear to be some encouraging statistics coming from Portugal under their drug policing model. However, I would caution against blindly adopting a model that is used in a different environment and context. Portugal has their own unique set of circumstances that, from my limited knowledge, contributed to their decision. For example, they considered the high levels of aids/HIV in their drug using population when introducing their policy, whereas in Ireland we have a relatively low level of HIV/aids in comparison. I believe the rationale for this was that intravenous drug users who had contracted HIV were reluctant to access services due to their fear that they may be criminally charged because of their drug use.

So, Ireland’s problem is different?

Ireland does have a problem with drug use and we do have pressure placed upon our policing resources, particularly since the recession. It makes sense to concentrate these (resources), and, a considered approach where a model such as Portugal is used as a guide but not a protocol seems to me to be a good place to start.

Could Ireland’s ambiguous relationship with alcohol mean that decriminalisation could see a pique in the use of other drugs?

I don’t think there is any evidence for this. Studies have shown that alcohol is not a ‘gateway’ drug. Cannabis is sometimes shown to be that, which could make the basis for an argument to ban it totally. I think the real issue is that addiction is a social issue first before it becomes a physiological addiction. If you address the social drivers towards addiction, you will see far less abuse of drugs and alcohol. Addiction is not a simple mistake you make once, it takes a repeated and consistent abuse of the drug before you become physiologically addicted (with the exception of some of the harder ones like heroine perhaps). This tells you that somebody repeatedly chooses to opt out of reality to the point that they are damaging their body. This makes me more interested in what their reality is, ie what is so bad about it that they feel that excessive drug taking is their best option.

The bigger picture here is to offer superior services to those with a serious addiction. Do you think the benefit of this would eventually be lost on people who have the misguided view that drugs will, in effect, be legal?

For the chronic user, this is only good news. Not simply because they will not criminalise addiction anymore but more so it can be seen as an ‘illness’ or social problem which will attract resources and support accordingly. It’s actually quite interesting when you view a problem, such as this through a different lens, from the criminal to the social/health. The resources and funding saved from this initiative need to be then be diverted to social and health interventions that target the underlying causes of addiction. These causes are currently unrecognised and not spoken about in our society today, as they are damning and embarrassing for everybody in that society.

So, society does not recognise or deal with the existence of addiction appropriately?

We live in a harsh world where those at the bottom of the social ladder are far more likely to live a life of addiction than those in the middle or top, although they are not immune either. Our society, a capitalist one that promotes individualism and competition does not take responsibility for the problems it creates, rather it makes the people who suffer the consequences take responsibility for them. This, as you can imagine can feel overwhelming and doubly traumatising for the individual as not only have they suffered this fate they are then made to take responsibility for their own rehabilitation. Obviously, this could be perceived as unfair and not right by the individual and may lead them to avoid, block out or rebel against a society which has treated it this way. As a result, it might seem like an attractive option to block out or numb yourself to the harsh world around you and the emotional pain within.

 

Are we individually and collectively responsible enough to view decriminalisation as a method of improving the lives of thousands of addicts and not just another great indication that Ireland has stepped out of the shadow of the repression of the Catholic church?

I am guessing that what you are asking me here is, are we doing this as a way of genuinely helping a vulnerable segment of our population or as a way of rebelling against a former repressive master in the church?

Yes, exactly.

Well, I guess we may be doing this as a bit of both really. You cannot separate the act from the context within which it takes place. The facts of Irish history remain true with regards to the church and that it has influenced all of our society and culture to the point that this wave of new liberal opinion (i.e. gay marriage and increasing support for the pro-choice movement) are able to operate in this post-church Irish society. However, I do not think this is the primary motivator for the argument to decriminalise drug possession. The age of enlightenment in Europe was characterised by a freedom of thought and intellectual pursuit that may also have been driven by a desire to rebel and push back against the oppressive power or mode of thinking of the church, but whatever the reason the progress during this period is undeniable.

Do you believe there will there be any negative implications for society with the introduction of the new drug strategy? For example, widespread increased consumption of drugs.

  1. 6 I don’t know if this move would increase the amount of people who are drug users. It will still be illegal to buy and sell, the production and import will still be illegal so the supply chain will still be under the same pressures if not more pressure due to the reallocation of resources to target these areas. Drugs are available at present, if a teen or twenty-something wants to get drugs anywhere in Ireland, then they can. Society accepts drug use as a normal recreational pastime, just look at the movies and popular culture. Throughout history, laws and the state have responded to societal changes, not the other way round. Just look at the suffragette movement and the women’s vote or the gay marriage referendum in Ireland. Popular opinion demanded that the state change and in the case of the woman’s vote, they did so through acts of public disobedience. I don’t think this will happen with drug use but I see the shift of perception of drug addiction from a criminal one to a health/social one as a progressive one that I wholeheartedly welcome.

 

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Bill Lonergan