Can compassion words change the addiction discourse?

As a PhD student, I joked that my work was the best bar-conversation-starter ever:

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

Sometimes talk of work would end there. If I was in a group, a few jokes were usually made by those listening, and the conversation moved on. But when speaking one-to-one, I was often asked for more details, and it was there I began to take the conversation more seriously.

I would 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 distanced myself from what I identify as a more standard attitude towards people with drug issues, saying that I thought people with drug issues are people like anyone else, and that they need to be listened to. This seemed to do something.

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

I gathered 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 presented my PhD work without propagating this shame, some dared to risk vulnerability, which in turn allowed 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.)