Terms such as “drug user”, “addict” or the blatantly pejorative “junkie”, “dope head” or “stoner”, are loaded with moral bias. They suggest that people who consume psychoactive substances are mentally weak and dangerous – when in fact chemically altering the mind (the natural drive for “intoxication”) has long been a part of human biology and culture, most of which does not lead to any harm or crime.
A recent report by the Global Commission on Drug Policy (GCDP) – a group of drug policy reformers including political and business personalities such as Kofi Annan, Richard Branson and Nick Clegg – challenged the stigma surrounding widely held preconceptions about problematic substance use. Many prejudiced views are embedded in the everyday language we use around drugs.
Unpacking language and popular rhetoric might help us see that clean needle and syringe provision, opiate substitution treatment, drug consumption rooms and other interventions that mitigate the potential harms of drug use (“harm reduction” approaches) are more effective than futile, prohibition-focused wars on drugs.
The report was a much needed intervention for channelling the debate towards more rational ways of discussing drug problems, policy and programmes. In cases where people do develop drug-related problems, using neutral terms such as “a person who uses drugs” or “a person with drug dependence/problematic drug use/substance use disorder” can help dispel some of the myths and damaging stigma.
But tempting as it might be to hope that a cultural shift alone will ensure meaningful change, we needn’t forget that stigma is often rooted in unjust material conditions and power relations that societies must also address.
Classifying substances – and users
Much of the stigmatising language that equates drug use with moral failure is disseminated through the conservative parts of the mainstream media. However, as my recent research indicates, drug news reporting is not only a reflection of moral bias held against people who use drugs, but also of moral bias held against the lower classes.
I looked into over 800 news articles on new psychoactive substances (NPS), formerly known as “legal highs”, published by Romanian (two broadsheets and two tabloid dailies) and British (four tabloid dailies and a regional one) newspapers stretching from 2009 to 2017. Aiming to compare media stories in a postcommunist, relatively young democracy in Eastern Europe, and a more traditionally liberal society in the West, both cases revealed differences in the symbolic frames used to depict who the users were, and what drugs and the ways of taking them were understood to be.
NPS is quite a broad and fluid category, comprising existing and new, naturally-occurring and laboratory-processed classes of substances that could be used recreationally. But the associated harms were defined differently depending on the class connotations various NPS evoked.
In Romania, NPS were labelled “ethnobotanicals” or “ethnobotanical plants” – terms first used by head-shop entrepreneurs claiming to be selling for “research purposes”, widely picked up by journalists. When at first (2009-2011) this was perceived to mean synthetic cannabinoids (“Spice” products) used by otherwise “normal”, educated youths, media narratives mostly referred to the dangers these drugs posed to the user, as they gambled their future: drug-induced “self-harm”, “dependence” or “addiction”.
When later on (2012-2013), “ethnobotanicals” came to mean amphetamine-type stimulants (ATS) injected by poor, unemployed, sometimes ethnic minority (Roma) users, the narrative focused more on their increased visibility within public spaces, violent and antisocial behaviour, along with rising HIV-infection rates recorded on the side of unsanitary injecting practices. This was more about a potential contagion risk posed to wider society.
In the UK, mephedrone (a synthetic cathinone used as a stimulant party drug by what the media deemed “carefree”, “innocent”, “aspiring” and generally unsuspecting teenagers) went mainstream around 2009-2012. Newspapers framed it in terms of a game of “Russian Roulette” that not only threatened users’ own lives but also wider society whose future they represented.
When later (2016-2017) media attention moved from middle-class youths and mephedrone on to synthetic cannabinoids or Spice turning rough sleepers into “zombies” and wreaking havoc among prison inmates, headlines pointed to the abject spectacle of disorder displayed by such groups – “pale, wasted people”, “defecating in the middle of the day”, “swaying about” in “dystopian” settings. “Like a horror movie,” as described in one report.
Drugs, injustice and austerity
The concepts of “drugs” and “addiction” obscure the reality of social distinctions and deep inequalities; young, middle-class use is depicted as problematic because it threatens its subjects and the continuity of the “valuable” (and dominant parts of) society they represent, and low or underclass use because of its potentially polluting and contagious nature.
Changing the language of drugs alone might do little to ease the brutally felt violence of austerity and cuts in unemployment or housing benefits. Many of the homeless “Spice zombies” ridiculed in the media will have been the victims of the close to 120 landlord evictions carried out on an average day in England and Wales, in 2015. Close to half of the ever rising numbers of homeless people in the country use drugs and alcohol to cope with mental health problems, while accommodation and support services have been reporting massive reductions in funding.
Focus on language but not political action also diverts attention from the impact of prohibitionist legislation such as the Psychoactive Substances Act 2016, effectively a blanket ban on all NPS and head shops. This might have pushed products like Spice into street markets where they’re adulterated with other drugs and fuel overdoses and aggression, as academics and charity workers have warned.
In the absence of specific training and educational resources, health workers might just learn what is acceptable to say without changing long-held beliefs about patients who use drugs. But training is not a priority in an overstrained and understaffed NHS.
Aiming to change language alone without addressing the structural disadvantages and political issues that hide behind it might provide a narrative of action, but it could achieve next to nothing in improving the condition of the most vulnerable of people who use drugs. The widespread use of derogatory language shows it is naive to aim for fairer drug policies without aiming for fairer societies. One without the other is simply impossible.