Issue #29  November 2023

[This issue includes a modified and updated excerpt from “Buzz Kill: The Corporatization of Cannabis”.  NOW AVAILABLE at or at your local independent bookstore. They could really use the support.

In the previous issue, I discussed ways in which people use drugs that increase the risk of experiencing some harm from that use. The harm is not a certainty, but its likelihood is increased. In subsequent issues I will discuss the prevalence and types of actual drug harm that people experience. In this issue, I will lay down some foundational concepts of drug-related harm so we can better appreciate the data in the ensuing issues. 

A drug problem is a very generic term that can involve not only various kinds of drugs, but also apply to many different scenarios related to a single drug type. A drug problem can be obvious. It can also be subjective and elusive to define.  

One of the longest-lived and still unresolved controversies in the drug field is why some people use drugs to the point that it seriously disrupts their lives and continue to do so until it takes their lives. There are many theories covering biological, psychological, sociological, commercial, political, economic, and environmental factors. Many clinicians point to trauma or elevated levels of chronic stress as major contributing factors among the people who come to their clinics. 

There is no single theory that has emerged to stand above all other theories in explaining harmful drug using behaviour. It is possible that all these explanations have some legitimacy and make some amount of contribution. Just as there can be several roads leading to the same city, there is no reason to believe that there would be only a single path to a drug problem. Individuals may get there via different predisposing and enabling factors and via different paths.  

I want to start by dispelling a popular notion that there are safe and unsafe types of drugs and that drug problems occur when people use the unsafe ones. The reality is that any drug type can be used in ways that are safe and any drug type can be used in a manner that is dangerous. It is more about safe and dangerous decisions that lead to safe and dangerous behaviour and result in safe and dangerous consequences. 

As discussed in the previous issue, consuming copious amounts of a drug, using drugs often, and in perilous circumstances, are all high-risk factors for experiencing problems. Drug problems become conspicuous when there are specific tangible adverse harms arising from the person’s use. An important consideration is whether a person’s drug use is interfering with their responsibilities or aspirations in life. Is the drug use interfering with the person’s health or daily functioning, their family life, the welfare of their children, and other relationships? Is it harming financial and housing stability, or performance in school or at work? This perspective places an emphasis on being able to maintain control of one’s use of the drug when it might interfere with safety, obligations, or aspirations. In other words, who is in control—the drug user or the drug? Tangible evidence of the latter, coupled with specific identified harms, almost always indicates a problem. The problem may not be the person’s fault, but it is theirs to solve. And help is available.

Drug problems, like drug use, also occur on a spectrum. At one end the consequences of misuse can be rare incidents that are embarrassing but otherwise benign. There is no shortage of such incidents (“fails”) that have been immortalized in video on the internet. (I occasionally ponder my good fortune and gratitude for there being no internet during my early adult years.) At the other end of the spectrum, dire consequences can occur daily and disrupt and literally destroy lives. Many people with drug problems will experience consequences between these two extremes.

The critical point to be made is that the world is not so simple that we have only two distinct groups of people, one who’s drug use is “normal” and the other made up of people who are often referred to as “alcoholics” or “addicts.” The people bearing these labels can be regarded in a very stigmatized manner with the labels being used derisively to add discrimination to their difficult lives. We have all heard descriptors that are equally or even more judgmental and harmful. We should all stop using stigmatizing language directed at people with drug problems and we should encourage others to do likewise.

If we could count them all we would find that there are many people who develop problems from their drug use. However, we should not lose sight of the fact that they are a small portion of people who use drugs. Most drug users lead lives that are as happy, productive, and fulfilling as people who do not. But there is also a segment of drug users that is more vulnerable. We will explore this group in subsequent issues.

Mike DeVillaer
Hamilton Ontario Canada
November 27 2023