lunedì 26 agosto 2013

Taking the Myth out of Meth di Jacqueline Sperling

Exaggerating the impact of methamphetamine by overstating its prevalence and consequences, while downplaying its receptivity to treatment, tends to obscure its nature while heightening horrors that promote a limited and inaccurate notion of the nature of methamphetamine addiction.

This essay will explain the criteria for moral panic and apply that framework to methamphetamine, and its users.  This will include a description of how this moral panic may actually blind people to the plight of its users, and hinder an addict’s recovery.  I will explain how a change in society’s attitudes towards methamphetamine, its users, and addiction across the board, could be a more effective form of prevention and treatment.

What is Methamphetamine?

In New Zealand, Methamphetamine is a class A drug under the Misuse of Drugs Act. It is a psycho stimulant of the phenethylamine and amphetamine class of psychoactive drugs. From a pharmacological perspective it is a Central Nervous System stimulant which acts to increase the amounts of the neurotransmitters dopamine, noradrenalin and serotonin in the central nervous system. Routes of administration are usually through intranasal sniffing, smoking, injection and swallowing.


What is Moral Panic?

A moral panic is a social condition that becomes defined as a threat to community values and whose nature is presented in a stylized and stereotypical fashion by the mass media. (Cohen, 1972). The official reaction to the social condition is ‘out of all proportion’ to the alleged threat. Reporting about a moral crisis involves a continuous exaggeration of the problematic aspects of the social condition and an ongoing repetition of fallacies. There are five criteria that are essential to moral panic.
                                  
Concern:             The first sign of a moral panic is a heightened level of concern about an issue.

Hostility:            Despite amphetamines being used for over a century to treat ailments such as narcolepsy, ADHD and obesity, the distinction between who uses meth as opposed to who uses amphetamines has been determined by a media interpretation of meth users. Popular descriptors of a meth addict are:
Crack head, P freak, Meth Head, Fiend, Tweaker...The following headline appeared in the New Zealand Herald in 2011. It describes Marijuana user’s calling Methamphetamine users “Losers” which shows that even users and addicts of other harmful substances stigmatise Methamphetamine users and addicts.



Consensus:        Consensus is achieved further by the declarations that meth    production is a threat to the environment, and that meth use victimizes children.  After all, everyone cares about the environment and everyone is concerned with child welfare.
Disproportionality:       Meth is seen as an epidemic while the harm attributed to other Drugs is minimised.  The alleged addictive quality of meth is a central element of the disproportionality of the claims (Armstrong, 2007). The following are quotes that have appeared in the New Zealand media by John Key, the NZ Prime Minister and other high profile New Zealanders.

"Meth's dangerous, it's devastatingly addictive, it leads to violence and it destroys lives,“ (John Key, 2008).

“Meth is a seriously addictive, viciously destructive drug” ( John Key, 2009 ).

“This deceptive and very addictive drug has no social boundaries. It is the modern day plague” (The Stellar Trust, 2009).

”It is the most addictive drug any generation has had to deal with” (Paul Holmes, 2009).

“People are talking about P, the drug epidemic that is going to steal our children, fry our brains, hollow out Kiwi society from the inside”(Fairfax Media, 2008).
Volatility:          The element of volatility indicates that moral panic erupts suddenly then subsides” (Welch, Price, & Yankey, 2002, p. 18).

The Politics of Fear

Fear is the primary tactic used by politicians to motivate voters to support the elected leader. This is achieved by the leaders generating or sanctioning a threat to the dominant group’s interests. The threat elicits a psychological ‘knee jerk’ reaction of support (votes) for the politicians. (Veno, Van Den Eynde, 2007).  While privately Richard Nixon (who was the first the coin the phrase “War on Drugs”) recognised that drug treatment was more effective than law enforcement, in the lead up to the 1972 election he turned to crime fighting rhetoric in order to boost his polls. New Zealand Prime Minister, John Key used the same tactic in the lead up to the 2009 election. One of the National Party’s most prominent 2008 campaign promises was in relation to waging a “War on methamphetamine” in NZ.
 

Social Stigma

“In one study of the stigma associated with drug addiction, the term ‘‘drug addict’’ evoked images of disoriented, unhealthy, thin, and low-class individuals with behavioural problems. In another study of public attitudes toward individuals who use illicit drugs, drug users were viewed as dangerous, unpredictable, and difficult to communicate with” (Semple et al. 2005).



3 Components of a Stigmatization Process


1.                   Culturally induced expectations of rejection is the first dimension of stigma. The addict experiences expectations of rejection, being devalued, and perceived as less worthy because they are identifiable by a particular characteristic (e.g.,  their drug use or mental illness). This type of stigma can occur without ever having experienced direct mistreatment by others.
2.                   Experiences of rejection represent the second dimension of stigma. Studies of drug users have reported rejection and discrimination in the workplace and in personal relationships with family and friends.
3.                  The consequence of expectations and experiences of rejection is the third dimension. Individuals will develop coping strategies for managing the threat of stigmatization.  Most drug users manage stigma by being secretive.  Other coping strategies for managing stigma involve seeking social support from individuals who are sympathetic and /or share the stigma (fellow drug users).  They will distance themselves from their non drug using family and friends and are less likely to seek treatment for fear of being labelled a “drug addict” (Link et al.  As cited by Semple et al. 2005, P. 638-369).


While public stigma is one part of the stigma issue, some people also learn to self-stigmatise whereby they believe the stereotypes and internalize the reactions of society (Crocker et al. 1998; Fortney et al. 2004). 

Effects of self-stigma include:
                                                                       Reductions in self-esteem
                                                                       Reduced self-efficacy
                                                               Reduced feelings of self-worth

 

Myth vs. Reality


To argue that the addictive nature and destructive consequences of methamphetamine have been overblown is not to argue that the drug is harmless. However, any discussion of effective strategies to treat methamphetamine addiction requires an honest and straightforward discussion of facts.
Methamphetamine is not instantly addictive for most people who use it. Not everyone that uses methamphetamine goes on to become addicted. Individuals differ substantially in regards to the quantity of use or time frame that it takes to become addicted (Leshner 2001). Far from untreatable, treatment for methamphetamine addiction is similar to that for cocaine and other stimulants and just as likely to succeed. There is also evidence that meth users respond as well to treatment as most other clients. Meth users had treatment durations and completion rates that were comparable to users of most other drugs (Brecht, Urada, 2011, p. 70).

The idea that meth is a new drug is fundamentally flawed and has activated a set of social responses that have a harsh impact on those designated as meth users. Amphetamine was first synthesized in Germany in 1887. Methamphetamine was discovered in Japan in 1919.
By 1943, both drugs were widely available to treat a range of disorders, including narcolepsy, depression, obesity, alcoholism and the behavioural syndrome called minimal brain dysfunction, known today as attention deficit hyperactivity disorder (ADHD). The earliest
cases of clandestine manufacturing of amphetamine and methamphetamine were
discovered in 1963.

Is Methamphetamine an Epidemic?


The term epidemic refers to a large number of people who have been infected with a disease, either in a community or more broadly. The word “epidemic” is emotionally loaded and lacks precision. Epidemic and scourge are judgment calls. There is no magic number of users above which we say there is an epidemic and below which we say there is none. Because methamphetamine and other drug use is illegal users, manufacturers, and distributors have strong incentives to hide their behaviour. This means the nature and extent of the problem are difficult to measure. The absence of any concrete data about the problem makes it easy to either exaggerate or diminish the impact of the drug on society (Weisheit, White 2009, p. 4).

De-stigmatising Addiction


One of the causes of social stigma in relation to any addiction is the perception that addiction is caused by making bad choices. It is seen as a moral weakness, associated with loss of control and lack of willpower.

The attribution–emotion model of stigmatisation suggests that because addicts are perceived as having brought their problems on themselves or as criminals, they are more likely to elicit a reaction of anger or irritation from others than someone who has no control of the onset of stigma, for example in the case of physical disability (Lavack 2007).
While an addiction may begin as a voluntary decision to try a drug, by the time a person reaches the point of problematic use or dependence, the drug use is no longer voluntary and has been characterised as a brain disorder (Leshner 2001).

 

Social Marketing to De-stigmatise Methamphetamine and Addiction | Four Ps of Social Marketing


Product:          The Product in this instance would be the understanding of how the stigma of methamphetamine and addiction effects our society. The objective would be to convince consumers (society) that it would be to their benefit to change their attitudes towards addiction.
Price: The price refers to the cost to society of giving up their pre conceived ideas regarding methamphetamine addiction. People must be shown the benefits of living in a society where addicts are unafraid to seek treatment, because they do not fear being confronted with an embarrassing stigma.
Place:                 This refers to methods used to reach people with the information or message that we want to share. The public can be reached with messages in various ways including the media, face-to-face interaction at community meetings, through posters in doctors’ offices, health clinics, and schools.
Promotion:   This involves the utilisation of tools such as advertising, public relations, media advocacy, and personal selling.  In the case of de-stigmatising addiction, communication would focus on creating awareness of problems associated with the stigma associated with addiction, and persuading the public that society would be improved by the removal of that stigma (Lavack 2007, P. 483-485).


How Can We Reduce Stigma and Promote Recovery?


                      Through improved public awareness of the scientific realities of methamphetamine addiction.
                      By encouraging people with drug problems to seek help early in the progression of their illness, when it is most treatable.
                      Creative campaigns to erase myths and stereotypes and to raise awareness about the realities of methamphetamine addiction and recovery.
                      Education and teaching people that addiction is an illness, not a moral failing. 
                      Dispelling the sense of hopelessness that is currently attached to methamphetamine addiction by promoting the fact that people who have been addicted to methamphetamine have successfully recovered and now lead healthy and productive lives.

My name is Jackie Sperling. I live in Auckland, New Zealand and am two thirds of the way through my Bachelor of Addiction Studies degree. I work to help addicts. I consider myself a harm reductionist and a prohibitionist. For some drug users, abstinence is not a realistic goal, therefor harm reduction may be beneficial as a transitional support, while working towards abstinence.  I believe in effectiveness of harm reduction in relation to the prevention and treatment of substance use and dependence, the prevention of overdose and the spread of blood borne diseases.
I do not support legalisation or anti-prohibitionist’s attempts to normalise the use of substances that are scientifically proven to increase risk of / cause mental illness and other adverse health consequences.
I believe that ending the war on drugs is about ending the stigmatisation of addicts and helping them make better and healthier life choices.














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