Cold+Turkey;+A+Closer+Look+at+Abstinence+vs.+Harm+Minimisation

Name: Elizabeth Souness Student Number: 08803501 Tutor: Dr. Jey Rodgers Lecturer: Dr. Julie-Anne Carroll

Artefact

‘Cold Turkey’ – John Lennon http://www.youtube.com/watch?v=OLlrH8q5d3M

The artefact I have chosen to represent the topic is John Lennon’s ‘Cold Turkey’. This song is a depiction of Lennon’s experience with heroin and his withdrawal from the drug. (The Beatles Bible, 2013). It was released as a single in 1969 and came about after Lennon became addicted to the drug in 1968. The song was banned on American airwaves due to their belief that it promoted drugs. (The Beatles Bible, 2013). The song lyrics depict the very raw reality of heroin withdrawal through abstinence and give an insight into how this approach differs to a harm minimisation based approach.

Public health issue

I have chosen to use this song to depict the topic of abstinence vs. harm minimisation approaches to drug withdrawal and recovery. It depicts the abstinence approach and the effects it has on a person. Abstinence and harm minimisation based policies have been used in many different countries as a way of tackling illicit drug use and their effect and success on the issue of drugs in society can be seen through the statistics they produce. It also represents the different approaches a drug dependent person may take when trying to recover from addiction. It gives an insight into the reasons why a person may or may not choose a certain approach.

Literature review

There has been a lot written by many people regarding the topic of abstinence vs. harm minimisation and how each have their supporters and opposers. In regards to harm minimisation, an article written by David M. Keepnews (2011), details the effect the safe injecting facility, known as Insite, had on the Canadian people and their beliefs. The centre opened in Vancouver in 2003 and provides injecting drug users with much help from clean needles to medical help and mental health facilities. The aim of the centre is to reduce the incidences of HIV and Hepatitis C within the community. The centre has, along with a safe injecting facility in Australia, provided support for the creation of these sites in other countries due to the reduced rates of blood borne diseases. However, as detailed in the article, the centre faced much criticism and backlash from the Canadian public. Another paper penned by Peter Bowal and Kelsey Horvat (2013), outlines the struggle Insite faced due to little government support. Many residents oppose the idea of safe injecting facilities because of their proposed locations, with many preferring the centres be placed within hospitals or other health care facilities, as they are mostly concerned with the amount of addicts that could be attracted to the area. The lack of support from the government also plays into the opposition of these centres by the public. The government that came into power after the establishment of the centre, claims to be acting on behalf of the concerned citizens and has stated it does not want to encourage addiction. According to the article, many people have also questioned whether condoning legal drug centres will pave the way for other currently illegal centres, such as sex workers. It is for these reasons that the plan to create more facilities has been rejected. Both of these articles highlight the struggles these facilities face when it comes to public judgement and the ideas of how it can affect the social order of things. However, it is clear that these facilities have an excellent effect on reducing diseases such HIV and Hepatitis C and should be allowed to continue their work with drug affected people.

Abstinence on the other hand, is quite often what harm reduction policies aim to achieve. However, as seen in C. J. Lennings paper on harm minimisation and abstinence in Australia (2000), it should be noted that this is a rather ideological approach to the drug issue faced in society. Although Australia employs a harm minimisation based policy to fight the effect drugs has on society, Sweden is a country that has chosen to work with an abstinence based policy. A report written by Christopher Hallam (2010), which appeared in The Beckley Foundation Drug Policy Program, outlines how Sweden has chosen to implement this policy. The government has chosen to criminalise not just the drug dealers and manufacturers, but also the people who use the drugs. This is because they see the addicts as the root of the problem. Were there no demand, the drug business would soon falter, leading to a collapse of the industry. This is why the Swedish government works so hard to get drug affected people into abstinence programs. In Dr Marcus Roberts (2009) report in Drugscope, he looks at the Great Debate held in 2008 which focused on harm minimisation vs. abstinence. It was shown that many people who are in favour of abstinence based programs view harm minimisation programs as a waste of taxpayers money and were angry over the fact that only 3% of drug addicted people left treatment clinics drug free in 2006/07 in the UK. Many felt that anything other than complete abstinence from drugs was a failed recovery and condemned methadone treatments.

In an article written by James Legge (2012), about Chip Somers, a former drug addict, he talks about why he sees abstinence as the base path to recovery. Somers states that, when he was an addict, he viewed methadone as free drugs and that you wouldn’t find a recovered addict campaigning for a harm minimisation policy. He states that he finds it rather offensive that the government doesn’t believe that drug addicts can recover without the help of more drugs. However, this being said abstinence based programs are rather expensive and there is quite a high rate of people relapsing into their addiction soon after they re-enter into society following a drug detox. All of these papers have shown that abstinence is a preferred method of treatment by society when it comes to treating the issue of drugs, no matter the expense of the programs or the benefits of harm minimisation programs. It is clear, through the literature, that many people prefer the abstinence-based programs due to the stigma surrounding drugs and their use in society. However, after listening to Lennon’s ‘Cold Turkey’, it is clear that abstinence is a difficult road to recovery and the chance of relapse is quite high.

Cultural and Social Analysis

The most significant social issue surrounding the abstinence vs. harm minimisation debate is moral panic. Moral panic, as defined by the oxford dictionary (2013) is, ‘ an instance of public anxiety or alarm in response to a problem regarded as threatening the moral standards of society’. Moral panic has arisen in relation to the recovery strategies, as a lot of people don’t understand the processes and the effects that these approaches have on society and health. In particular, a lot of people have a problem with the strategies utilised by the harm reduction policy, such as methadone treatment, needle exchange programs and safe injecting facilities. Many people believe that the safe injecting facilities will attract drug-addicted people to the towns where they are situated, creating petty crimes and increased drug problems. (Hunt & Brown, 2011). It has also been noted that people do not support the needle exchange programs because they believe it normalises drug use and shows people that it’s ok. (Hunt & Brown, 2011). This highlights how moral panic is reflected in this behaviour because people see drug use as socially and morally wrong and cant’ accept that these programs are a way of intervening and reducing the harm done by drugs, rather than encouraging the behaviour.

The issue of harm reduction strategies needs to be addressed so that people can allow themselves to be educated on it. Harm reduction programs are working towards reducing the amount of blood borne diseases, such as HIV and hepatitis C, within society. These programs focus on educating drug addicted people about the harm they’re doing and hope to work towards helping these people recover from the harm they are doing, or at least reduce it as much as possible. Creating safe injecting sites and needle exchange programs may indeed attract drug addicted people to certain areas but they have also been proven to reduce the rate of HIV, as seen through data related to Insite. In a study related to needle exchange programs in New York, it was shown that HIV rates had dropped from 4 to 1 in every 100 people since the program had been introduced, showing that the program clearly works. (Jarlais, Arasteh & Hagan, 2008). On another note, harm reduction policies should be taken seriously because of how cost effective they are to the community. In Canada, it coasts approximately $150 000 to give a HIV infected person care during their lifetime whilst infected. If Insite reduces the rate of HIV infected people to just 2 or 3 per 100 people a year, that means over 10 years, there will be a reduction of approximately 200-350 cases of HIV, saving the Canadian government a lot in relation to health care. In another study, it was shown that members of the public viewed drug addicted people with disgust and dehumanised them. This was proven that it made it harder for them to view addicts without any kind of sympathy and this was why the benefits of safe injecting sites and needle exchange programs were not taken into account. (Jarlais, Arasteh & Hagan, 2008). All of these are reasons why harm reduction policies are met with such strong resistance and why the issue needs to be looked at. In order to reduce the instances of drug related disease such as HIV, moral panic needs to be addressed and the public needs to be educated.

Analysis of the Artefact

I think the artefact represents a greater meaning than just the withdrawal of drugs. I think John Lennon created it to try and deter people using and getting addicted to drugs. It represents the hard road that has to be taken when one wants to escape from drugs. The lyrics detail the symptoms experienced by someone withdrawing from heroin. The lyrics, ‘Thirty-six hours, rolling in pain , praying to someone , free me again’, really represent the kind of struggle that comes with going through an abstinence based recovery. This song, as well as the review of the literature, has made me think that this may be why so many people relapse into their addiction after going through abstinence based recovery. Due to the amount of physical pain suffered during the recovery period, some people may see a methadone treatment, for example, as an easier road to recovery. I have learnt that the recovery process for drug dependent people is a lot harder than just quitting and a lot of people are involved in the process, whether it be an abstinence based recovery or a harm reduction recovery. I have learnt that both approaches are important to recovery from addiction and should both be utilised in the fight against drugs. I have learnt a lot about the different types of harm reduction strategies and also how the public views this approach. I can apply all that I’ve learnt regarding this topic to my future studies and career and I think it will benefit the way I look at and deal with certain situations.

=Reference List= Bowal, P., & Horvat, K. (2013). Constitutional rights to supervised drug injection facilities in Canada. //International Review of Law// //, 1// (3), 1-7.

Des Jarlais, D., & Arasteh, K. &. (2008). //Evaluating Vancouver’s supervised injection facility: data and dollars, symbols and ethics .// Canadian Harm Reduction Network. Canadian Medical Association.

Hallam, C. (2010). //What Can We Learn From Sweden’s Drug Policy Experience?// The Beckley Foundation Drug Policy Programme. London: The Beckley Foundation Drug Policy Programme.

Hunt, R., & Brown, S. (2011). //Drug injecting rooms: what do you think?// Retrieved October 29, 2013, from ABC Melbourne: http://www.abc.net.au/local/stories/2011/05/24/3225013.htm

Keepnews, D. M. (2011). Canada's Insite Decision: A Victory for Public Health. //Policy, Politics, & Nursing Practice// //, 12// (131), 131-132.

Legge, J. (2012, June 5). //Drug Addicts Need a Clean Break//. Retrieved October 30, 2013, from The Guardian: http://www.theguardian.com/society/2012/jun/05/chip-somers-drug-addicts-abstinence

Lennings, C. (2000). Harm minimization or abstinence: an evaluation of current policies and practices in the treatment and control of intravenous drug using groups in Australia. //disability and rehabilitation// //, 22// (1), 57-64.

Oxford Dictionaries. (2013). //Definition of moral panic in English//. Retrieved October 28, 2013, from Oxford Dictionaries: http://www.oxforddictionaries.com/definition/english/moral-panic

Roberts, D. M. (2009). //Drug treatment at the crossroads .// DrugScope. London: DrugScope.

The Beatles Bible. (2013). //Cold Turkey//. Retrieved October 20, 2013, from The Beatles Bible: http://www.beatlesbible.com/people/john-lennon/songs/cold-turkey/

Learning Engagement and Reflection Task

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