EPISODE 1: Just a sign

This is the story of Jude, some of her fellow drug users and some health professionals who work with drug users on a regular basis. She was one of the earliest drug user activists and has been a member of the injecting drug using community for 40 years. A former President of AIVL the Australian peer based drug user group, she is currently employed by AIVL as a project worker.

It’s clear through our interactions with Jude that she is not just here to represent herself, rather she’s sharing her story on behalf of her community, in the hope that a better relationship between drug users and healthcare professionals is achievable.

Jude : It's part of my life and it always will be. Human justice will always be part of my life, no matter what aspect it takes on, and drug users aren't the only group of people that I work with. Women and children, I'm interested in. It's discrimination. I'm a hunter for discrimination, a non-discriminatory non-discriminator.

We first met Jude in May. She came into our office in a flourish.. A notable limp didn’t seem to slow her down in her excitement to explore our tiny office in an old converted flour mill – our normal day was about to get a lot more interesting. Here Jude tells us about what a normal day might look like for her.

Jude : I get up in the ... probably about 6 o'clock. I wake up at 5:00. The older I get, the earlier I seem to wake up. Then I lie in bed and think, "Will I get up and do exercises for my leg," because I'm having a bit of mobility problems, and decide not to. Go back to sleep for a little while. Then I go to work. I usually have to go to the chemist and pick up my methadone…

Jude is a mother, a wife, an early riser, an employee – someone who hits snooze rather than doing some stretches that she knows will make her life easier on a cold morning. It became increasingly clear that Jude’s story of heading to the GP to get her script was not a simple tale – due to the fact that Jude likes to use drugs, It was this that made the trip to the GP the perfect vehicle for this series.

In the making of this series, we’ve also talked to some other drug users and heard a lot of stories about why people begin taking drugs in the first place, you’ll hear more from these guys in later podcasts. For now, we asked Jude to share her story – you’ll hear Kim our roving reporter, it won’t be the last time!)

Kim : How did you start taking drugs?

Jude : I read a book when I was about 15 called Panic in Needle Park, and I just ... I wrote an email to you last night. I think it was the intensity of the way those people lived that I thought, "God, I want to try that." I spent 18 months trying to find a shot of heroin, and as a 16 year-old in Canberra that was hard.

Kim : Did you know, I got to say this respectfully. I'll just say it, did you know that it could be a bad thing, or it could be ...

Jude : I knew it was proscribed, but I didn't know why, and I didn't ... Even at that age I didn't trust what I was being told. There was no reason that people would take that, and the sort of people that took it were the sort of people that I was really interested in like poets, and singers, and songwriters, and there was this real intellectual curiosity about it as well as I just wanted to do it. I wanted to do it, and I knew I was going to do it.

Jude went on to get married and have children. Listening to Jude talk about her family life was like listening to stories from any other mother about juggling commitments in their lives – only with slightly less ‘F’ bombs.

Jude : God, but it was so fucking hard, like before methadone, like trying to manage children, a full-time job, and a heroin habit, like fuck me. It's just so exhausting because you never know if the dope's going to be there. You never know if the dealer's going to be there. You don't know if you're going to have money that day to get it. One of the kids might come home and need shoes, and they got their shoes obviously, but far out. It was tiring. I was just tired. Then when methadone comes along and it's something that, although it's a substitute, it just does whatever it is that heroin does that ... The first time I tried it, I just said, "Oh, this is what other people feel like. This is what normal is." Then once you feel that, you're not going to give it up.

This concept of ‘normal’ is supported by a conversation we had with Associate Professor Linda Gowing, Faculty of Medical Sciences at the University of Adelaide. She has worked closely with drug users, specifically heroin users over many years, and has been instrumental in developing a number of important strategies in this area. Professor Gowing believes that if you can get closer to a more normal day, you can do activities that are enjoyable, you can increase leisure activities, all sorts of things.

Linda Gowing : What we're trying to do with methadone is you're extending that cycle of intoxication and withdrawal. So, someone who's on heroin they feel withdrawal symptoms, they use heroin and that alleviates that and they have a period of intoxication and then they get withdrawal symptoms again. With methadone, we're trying to stretch that timeframe out so that instead of using two, three, four times a day, they're only taking a single dose a day, and that means that their day is not so dominated by that repeated cycle of obtaining and using the drug so that you can normalise your day a little bit more.

Unfortunately, we uncover that methadone alone is not the key to normalising the day for a drug user, the way that they are perceived and treated by society is a constant weight that swings the pendulum between feeling normal and feeling – well not entirely human.

Kim : Why is there a stigma in society?

Jude : I don't know. There's always been someone who hasn't been liked.

Ok hold up here. You will meet Finn properly in a later episode, but this line triggered something that we’d heard from him in one of our interviews; a bloke who suffered severe injuries from a motor accident, that ended in a permanent physical disability. . .

Finn : Look I have things that happen and I know that there's some form of discrimination, but I don't know which one it is, you know? I don't know whether it's because I'm trans or because I'm disabled. Some things I know it's not because of the drug use because they don't know about it.

Jude explains her theory.

Jude : Once you start separating human beings and passing them off into different sections, you start dehumanising them, and once you've dehumanised them, you can let the ... You'll allow other people to treat them any way they see fit, because you know they're not a person of any value.

Jude doesn’t look like a ‘stereotypical’ drug user, and I’m using air quotes. She’s an attractive woman in her late 50’s, articulate - and to be honest it wasn’t until about half way through our initial meeting that I actually remembered oh yeah Jude uses drugs. She explains to us the concept of passing and some of the tried and tested methods in the community used to ensure their drug use isn’t the first thing people notice.

Jude : We call it pass, passing.

Kim : Tell me about passing.

Jude : Ajax and a Brillo pad girls. You get yourself sparkling from head to toe.

Kim : What do you mean by getting sparkling?

Jude : You make sure that you're looking well, because if you don't look well there's assumptions that it's around your drug use.

Christian has a successful job, he’s part of a loving relationship with his long-term partner – and he is a drug-user. Christian explains to us that ‘passing’ for him goes beyond just the GP and the pharmacist.

Christian : ... People who use drugs are under a lot of pressure to manage their lives. Part of that is not letting their drug use in any way at all negatively affect any other part of their lives. That's what we put a lot of work into doing.

Following the concept of ‘passing’ and what a ‘typical’ drug user looks like – the conversation fell into labelling drug use. Whether we’re talking about scientific terms or personal preferences, we found there was an interesting point of difference and a question begging an answer – well what do you call someone who uses drugs? We hear from Finn again on how these labels can actually effect how he is treated;

Christian : I feel like I'm being treated as a junkie and I'm doing the quotation marks, I hate that ... I like that word and I hate that word, you know? In the States junkie originally from people who used heroin, we call it junk, so someone who uses junk is a junkie. It gets used really derogatorily here, so ... But I don't like being treated like I'm a less than person just because I'm on Suboxone first of all.

Meanwhile, Professor Gowing explains to us that the word ‘addiction’ or ‘addict’ is often used interchangeably with ‘dependence’ in the research community – while ‘substance abuse’ has been swapped out for ‘substance misuse’. We asked Professor Gowing if she had a preferred term – and her reasoning behind this.

Kim : This is fantastic and I really appreciate this. The one thing Jude said is that she's really uncomfortable with the term "drug addict." She would prefer drug user or even junkie.

Linda Gowing : Yep. I think, at least in the research literature, there is a little bit more of a shift towards it's not as neat and tidy but using a phrase like people who use drugs or people who inject drugs, and I tend to prefer that sort of wording because it puts the emphasis back on the fact that what you're dealing with is a person.

Kim : Jude – your thoughts?

Jude : Yeah. I like a user. I'm a user. Who wants to be a person who uses drugs. I mean fuck, if they have to tell people that I'm a person in the sentence, like that's just so appalling I don't even want to go there. I'm a user. I'm a drug user. I'm not an addict. I'd be a junky before I'll be an addict.

Brian our resident pharmacist who you will meet properly a little later in the series, when questioned regarding his use of the word ‘addict’ responded;

Brian : “Well, it's terminology that I've grown up with. What I've started to learn is that anybody who gets a prescription is a drug user. It's just that we have a delineation of what's legal and what's illegal and what's addictive or habituating.”

Now while we are being quite metaphorical regarding signs in this episode, the inspiration was a physical sign that started a whole conversation, and what that little plastic sign meant for drug users who encountered it before they even entered the GP’s office. It’s the sign that reads, in some form, ‘NO DRUGS OR CASH KEPT ON PREMISES’.

Jude provides us a brief history on the sign, she believes it is a throwback from the 80s when security was pretty loose on pharmacies – a time when it didn’t take much to break into a doctor’s office, which was often in the back of the house and grab a script pad or some drugs. Eventually they just tightened up their security. So where does this leave the sign? Is this just another way to segregate drug users from other patients?

Jude : “…if you did get in there'd be nothing there, so having a sign that says no cash or drugs on this premises just means that every time you go to walk in that door, you think, "Oh, fuck. They don't want me here, and they don't like drug users and they've judged us."

We explain the sign to one of our GPs David from Darlinghurst, that it can evoke a feeling of not feeling welcome, it may even be a deterrent from them coming into the surgery…

David : We don't actually have that sign here, but that sign really isn't directed at drug users per se. It's just directed at really petty crime. To be honest, I mean, in Darlinghurst we had a huge amount of break-ins in the '90s. It's actually dropped off a lot now, but I think that security issue is in no way directed at those patients, but I understand why they might be sensitive to those messages.

In this episode, we have explored what constitutes a ‘normal day’ for our drug users. We’ve heard that their day, peppered with stereotypes and negative stigma has the ability to not only make them feel uncomfortable in their surroundings, but often - less human. This feeling means they engage in covering up or passing to ensure they blend in rather than stand out, for something that may be seen as just a part of who they are, or a part of their day. Finally, we saw the effect of a simple plastic sign on a GPs door, how messages can have multiple meanings to different viewers, and for some, an interpretation that contributes to a feeling of not being accepted or welcome.

Throughout this series we are going to explore the nuances, the misunderstandings, miscommunications and just plain old personal preferences - and hope that healthcare professionals and drug users can find a common understanding, a happy place – a normal day. In the next episode, we will bravely open the door to the doctor’s surgery and enter the waiting room, here we will explore further drug use, the role of government and media in the positioning of drug-use and ask the question – well, why are drugs seen as so bad?

It's impossible to say for sure if there's any person who has never met a person who uses drugs because illicit drug use is incredibly common in Australia. The thing is, the majority of people who use drugs are what people would consider normal, every day, nothing extraordinary about people. They're just people trying to get by in their everyday lives.