EPISODE 2: A typical day in the waiting room

In episode 1 we heard from Jude and some of her peers who touched on stereotypes and prejudice. In this episode, we’re going to step into the waiting room, meet some of our other drug-users and healthcare professionals and delve into where some of these stereotypes were born and why they persist. We will attempt to answer the million-dollar question – why are drugs seen as so bad? Let’s kick off with Jude to help us put this in perspective, she’ll have the answer.

Jude : As I've worked in the field more and more and come to see that nobody knows anything, they're all guessing about why humans are and why humans do what they do, and then the state and other things have come into play that start prescribing what you can do and what you can't do. Now I've realised it's almost like a game that nobody knows what the rules are or what the end result is.

In our interviews, we’ve heard a lot about why people use drugs, we’ve also heard a lot about how the ‘why’ is irrelevant in the eyes of many drug users themselves. To help illustrate how some drug users feel they are perceived, we’d like to introduce you to some people in the ‘waiting room’.

In Episode 1 we first met Finn. He’s young and confident and when he strides into the trendy Newtown café for his interview with Kim, we notice his full, lustrous beard and his limp, the result of a motorcycle accident that had taken his leg several years ago.

Finn : I started using drugs when I was 13. I had a few run ins with the law and was scared that I was going to end up in gaol so I put myself in rehab just before my 18th birthday. 18 being the key number there, because once I got into trouble after the age of 18, I'd never be able to get a passport or anything like that, especially if it had anything to do with drugs. I wanted something out of life, I wanted to travel. So yeah, so I went to rehab and I pretty much stayed off drugs until I lost my leg.

Finn tells Kim with a sigh that is filled with taking responsibility for his own decisions - that he chose to use again.

Finn is definitely no stranger to stereotyping and discrimination. He tells us about a volunteer role he held supporting users through the needle exchange program. He tells us about the police reforms that were also being introduced at the time. These reforms were hailed the epitome of "zero-tolerance" policing and were held up as the reason for the dramatic reductions in the city's crime rate.

Finn : I got pulled up by the police, suspected of dealing because I had been seen with known drug users, and it was that I was actually handing them clean injecting equipment.

Taking the opportunity to explain what he was doing working with known drug users; their response was simply;

Finn : "Well don't do that here. Go down to Washington Square Park or something." They didn't want me in their neighbourhood giving out clean injecting equipment to known drug users. So you know they're there, it's not like I'm bringing them there.

…and then there’s Christian. He gets up every day and heads into work like the rest of us, it’s just that he needs a shot of crystal meth to do it. Christian has experienced multiple complex issues through his life including homelessness. He’s got a home now where he feels safe.

The reason Christian gives for taking crystal meth today is because of workplace bullying he experienced in an earlier role for another organisation, that has stayed with him.

Christian : There's nothing out of the ordinary about that, because things like psychotherapy, engagement with the justice system, and having the support of psychologists at GP, that still wasn't enough to deal with the trauma of waking up every day and realising that there is no justice in the world. That's a common experience for people who have gone through that bullying situation. Trying to work out how you can find the motivation to get up every day, I guess that's how I would explain my drug use.

Let’s just take a moment here to look back to where this source of stereotyping might have come from. Over time, drug use seems to have gone in and out of vogue, so, ‘were drugs ever seen publicly as a good thing?’ The short answer is – oh hell yeah.

Let’s meet Dr Lincoln, he’s is a GP in a small country town, which means he’s exposed to a broad cross section of society. In the country, he says, you see people in your GP clinic – but also in the emergency department that the local GP is generally covering. Dr. Lincoln it seems, gets to see the best and the worst of people. Right now though, he provides us with a brief history lesson over the phone, in his own words, of the irrational nature of what is acceptable regarding drug use over time.

Lincoln : I've got old newspapers that have adverts that Bayer, you know, big adverts. Bayer sold heroin at the turn of the last century in the early 1900s, as a cough elixir for children. Cocaine was used by soldiers right up until the First World War for stamina. But at those times, especially in the late 1800s, if you were caught with a bottle of scotch, you'd go to gaol. Tobacco was given to people, especially in times of war. A smoking soldier was a happy soldier. And now it's frowned upon and taxed to pieces. The fluctuating nature and changing nature of what drugs are legitimised by society, and what aren't, are quite irrational.

Jude expands on this and draws the connection between historic events and peaks in drug use.

Jude : If you look at Thatcher's Britain when she was closing down all the coalmines, that's when heroin use in England shot up. When people can't participate in the normal economy, they make their own economy, and they give themselves another way of living. "If I can't work, I'll do this." Because human beings need something to live for, to get up for. They'll go to what's ever available, and if you cut things off, they have to go to the ...

So where are we on the topic in these modern times? Christian provides us his view on society and how drugs are positioned and perceived today.

Christian : We live during a period where society still relies on things like fear and stigma as methods of social control. In this time, in this culture, we're still caught up in believing that the more we tell people something is wrong, the more convinced they are to not do it. We all know that that isn't true and it doesn't work. I guess society is like a big glacier; it moves really, really slowly.

Christian continues with his take on what affect this stigma of fear and control have on drug users and how they feel they are perceived by society as a result.

Christian : Throughout everyone's everyday lives, their encounters with people is somewhat optimistic. We give people the benefit of the doubt. We're open and friendly to strangers, generally speaking. We don't assume that any person that we come into contact with would have any reason to think any less of us. For someone like me, the assumption is the opposite.

According to the AIVL report into experiences of Stigma and Discrimination, ‘Stigma rather than being a specific ‘act’ that is done to you, like being directly discriminated against, could best be defined as ongoing negative labelling that causes problems. People who inject drugs, people with hepatitis C and those with HIV are very often stigmatised for not being considered a part of ‘normal’ society, and are commonly branded as being: deviants, diseased, unemployed, uneducated, and criminals.

Kim : There's not an overt stereotyping of drug users.

Jude : Absolutely, but they don't know sometimes that they're being made to feel that that person is a person of no value, when all of the ... That's just something that comes up, because that's what stigma does and prejudice, so while they're reading all these things about drug users and working out what they look like and all of those sorts of things, they're learning to despise them and to not to have anything to do with them, because they're not doing what the world says you should do.

‘Learning to despise them’, so what are these channels that educate or inform or seek to shape how we view drug use and users?

Tonya is an emergency registrar. we discover pretty quickly that Tonya gets to see more bad than good in her environment and as a result is leaning squarely towards the position of ‘drugs are bad’. We get it though - she has been punched in the face by a young drug user, and we’re pretty sure that wasn’t the first time she’s been on the receiving end of drug-related violence.

Kim : So, you’d be big on drug education then?

Tonya : As you know I often give a talk once a year at my kids school about methamphetamines. And I've actually got some videos, which are fairly light on compared to what I see at work, because I didn't want to terrify them too much, but they show a couple of what we call, "tweakers," people on methamphetamines who are fully into the meth cycle, and they're completely out of control. They've got no idea what they're doing, they're walking around a backyard with sores and injuries and injuring themselves, because they've just got no idea. And I believe that teaching the kids that this is what happens when you start on drugs. It's a slippery slope, you start doing more and more, and you end up like this.

It was highlighted to us that, ‘tweakers’ is an American term, and not one that is really accepted in Australia. So, we have the language we are exposed to, snapshot of our own personal experiences, and the information that we have available to us at the time. In our history lesson from Dr Lincoln, support for drug use came from advertising, medical professionals and the government – where now, our main source of information is the media, main stream news, and as Jude puts it, ‘The ones you see are the ones who are really struggling with multiple issues.’ There’s a form of – branding going on.

So how do we change these perceptions? Dare we raise legalising drugs? We hear from Tonya our Emergency Registrar.

Tonya : I have heard that theory before. The theory being that if the government controls it, we have more control over the problems associated with it. I must admit I'm not a big fan. I don't think it's a long-term solution, and I think there are multiple problems with that idea, that I wouldn't be happy with, yeah.

Christian gives us his view.

Christian : The difference between legalised and criminalised when it comes to use of any substance is that there's this misconception that if something's illegal, if something's in the black market, if you like, that it's unregulated. That's actually not true. All drugs, regardless of their legal status, are regulated, it's just that some drugs are regulated by things like practise, health, safety, sort of the public, science, research, those kinds of things.

Other substances are regulated by violence, coercion, stand-over tactics, profiteering. That's the difference between legal and illicit drugs is that the power dynamic of both, there exists one, of course. Standards that we would consider acceptable in general society, those are applied to legal drugs, and everything else as a way of controlling and regulating a market that people who use illicit drugs have to put up with.

Associate Professor Linda Gowing, Faculty of Medical Sciences at the University of Adelaide ponders the notion;

Linda Gowing : Look, I mean, that's entirely possible. It really depends on the situation and this is part of that public attitude where in general most people want drug users to stop using and they see abstinence as the only way to go. If someone is obtaining drugs without resorting to crime or violence and they are meeting their personal obligations and responsibilities if you like, then you can understand why they might feel that way.

According to Finn, as long as someone’s drug dependence is not hindering their ability to function, go to work, to be part of society - then what's the difference if you have a shot of heroin, or a smoke of ice, or a glass of wine? Your rent is paid, your bills are paid, the kids are fed, they've got clean clothes.

Finn : We're not supposed to discriminate against people because of their religion, or their sex, or their colour, why are we discriminating against people because of ... Everyone uses drugs, doesn't matter what it is, everyone uses something, whether it's tobacco, coffee, alcohol, marijuana. In Australia a lot of people smoke pot. Why are we then discriminating against people because of the particular drug that they take, because that's the way I see it, is everyone takes something, but we discriminate against people who use needles, or heroin, or ice, but the other drugs are okay.

Christian provides another view again, he lets us know that he can’t drink alcohol which is hard in a drinking culture like Australia – yet there is an expectation to be the life of the party and for young people that’s a lot of pressure.

Christian : That's the other complicating factor of whatever you want to call it, for me. I'm not able to drink alcohol so that's another way I kind of explain my drug use is when you think of all of the reasons why any person would consume alcohol, whether that is to cope with stress, to relax, to celebrate an occasion, to socialise, hang out with friends, meet people, all that kind of stuff. A person still needs to do all those things, but if they're unable to consume alcohol, we live in a culture that pressures people into finding alternatives.

Since we are talking about alcohol, from a slightly different angle we also just wanted to touch on the idea of choice, the choice to take or do something that may harm you. There was an interesting point in our conversation with Tonya where she mentions, ‘patients having heart attacks, strokes, having bleeding problems, really sick patients ...’

Tonya : The frustration is when we're really, frantically busy and we get ... We had six magic mushroom patients recently for example. Really busy night, we had full a resus. corridor, full of patients having heart attacks and things that ... I don't want to use the phrase they didn't bring on themselves, because there are some factors involved…

Tonya is clearly uncomfortable here,

Tonya : …but the frustration is you then get sick people who have chosen to go out and find random mushrooms, and eat them and have an overdose.

There seems to be a different set of rules for drinking alcohol, smoking cigarettes, even other drugs – we’ve heard that smoking pot is more socially acceptable than injecting heroin. But what about that heart attack patient? Does it means that their affliction is any more or less ‘self-inflicted’ than that of the drug-user? We also hear stories on the news of growing obesity, cholesterol – stress! Yet, there is a hierarchy of what is more or less acceptable. Jude, do you want to back me up on this?

Jude : I am who I am, I've never hurt anybody. It's not about being someone who's trying to ... It's just me wanting to live in the world, and I'm not going to apologise that to ... for anybody, and nor should anybody else and that's what we've got to get our community to believe.

In this episode, we entered the waiting room and heard our drug users talk about the variety of reasons they started taking drugs in the first place; from physical pain relief to psychological relief – to being their best at work. We explored the framing that has occurred through history regarding drug use by both government and the media. This was an introduction to thinking about where stereotypes are born and why they persist – and on the flip side what it feels like to be discriminated against based on this framing.

We also touched on solutions such as legalisation and we were surprised that there was just as much interest from healthcare professionals to decriminalise drugs. While this series isn’t about finding definitive answers, it is about providing views from both drug-users and healthcare professionals in hope, that we can continue these discussions and find our way towards a normal day for everyone.

In the next episode, we will step up to the beige tiered front desk – prepared for small talk, indirect eye contact and an encounter with – the gatekeeper.

You've got to be absolutely better than a general in a battle, strategizing about the best way to play that person so I can get to see my doctor.