drug use – The Concordian

When I was a kid, I was told not to do drugs and the conversation ended there. If the “war on drugs” has taught us anything, it is that eliminating all drugs and forcing drug use into a specific box is both impossible and a drastic oversimplification. The rhetoric surrounding drug use currently leads to an unproductive and isolating conversation – a conversation missing one key player: drug users.

As reporters, storytellers and the ‘watchdogs of society’ we have failed time and time again at reporting on drug use. We reach out to medical professionals and policymakers, but there is a hole in this story. We wouldn’t report on someone’s art without reaching out to the artist or cover a house fire without speaking with homeowners, so why do we report on drugs without going to the source?

Harm Reduction Practitioner, Coordinator, Researcher and drug user, with the pseudonym A.C. Abbot, explains how media is missing the mark.

“The media basically doesn’t think of drug users as having opinions or expertise,” Abbot told The Concordian. They explained that we exist in a society where drug users are seen as “crazy” and “out of control.”

“The fact that drug users are denied authority and legitimacy when literally writing about drug use and drug users is telling,” added Abbot.

Journalists are feeding the biased narrative that authorities have painted for us. The media needs to approach the drug topic in a way that depicts the misconceptions of drug laws.

“Our system of drug laws is not based on scientific information about drugs,” Maia Szalavitz said, a writer from The Columbia Journalism Review. Jay Levy, the Deputy Director of the International Network of People Who Use Drugs (INPUD), explained that drug users are still being criminalized, without evidence that this attitude is in any way a productive one. Levy added that even though there are risks when using drugs, the main harm comes from laws and policies.
The judicial system, “along with their justificatory social construction and stigmas,” he continued, “are responsible for driving and worsening many of these avoidable harms.”

Portugal is often used as an example when talking about drug use and policy. The government decriminalised all drugs in 2001 and, according to the Guardian, “HIV infection plummeted from an all-time high in 2000 of 104.2 new cases per million to 4.2 cases per million in 2015.”

Although the change in law ignited a more productive conversation, it did not exist in a vacuum. Susana Ferreira, a Portuguese-Canadian freelance writer, explained that this recovery was more complex than just a change in the law.

“In many ways, the law was merely a reflection of transformations that are already happening in clinics, in pharmacies and around the kitchen tables across the country,” Ferreira wrote in a Guardian article in 2017.

A.C. Abbot thinks Portugal needs to go farther.

“It’s better to be stuck in a doctor’s office than to be stuck in a jail cell,” said Abbot, but then also explained that it’s important to be aware of the imperfect nature of medical care. Abbot said we must recognize that this environment can be a controlling one and does not always advocate for people’s autonomy. “The barriers are not only everywhere and holistic, but interweave and pulse with every other kind of prejudice.”

Although the world should be looking to Portugal in terms of drug laws, it’s crucial to continue to investigate the complexity of the situation.

“The questions aren’t just to transition from criminalization to medicalization, but it is to transition from stigmatization and problematization to autonomy,” said Abbot.

As a product of our society, I am guilty of stigmatizing drug users and drug addicts. I need to continue to push back against this stigma. This conversation leads to dehumanization and unfair treatment surrounding drug users and addicts. We must stop absorbing information at face value and learn more about the ethical discrepancies of the law. We must lean in and listen to harm reduction experts, drug users and others who are actively involved and affected by the drug stigma. We must let them lead the conversation.

Graphic by @sundaeghost

The science behind drug addiction, and how drugs affect the body

It’s said we are creatures of habit. Sometimes though, those habits can turn into addictions. In this edition of The Healthy Side, we are going to explore drug addiction and its real effects on the body.

Drug addiction is an organic disease of the body. Using addictive substances literally changes the brain’s chemistry, leading to a strong physical dependency on them.

The brain is a very complex organ, made up of billions of cells called neurons. The connections between these neurons is what enables us to think, move, feel, act and essentially process every conscious and unconscious intake of environmental stimuli and respond accordingly.

You may have heard that there is electrical current in the brain.

A neurotransmitter can be excitatory or inhibitory—that is, it may contribute to exciting the next neuron or inhibiting its excitation. For our purposes, we are going to talk about a well-known excitatory neurotransmitter called dopamine. Dopamine, along with a few other neurotransmitters, is responsible for making you feel good.

Once dopamine is released via transporters in the producing cell, called the presynaptic cell, it temporarily latches on to the receptors on the surface of its target, called the postsynaptic cell, and causes further actions to occur in that cell.

The dopamine itself is not taken in by the target cell—its binding is temporary and after a short period it is detached and taken back into the presynaptic cell.

Substances can affect and alter this natural pathway in three broad ways:

Overproduction of dopamine: the opioid family of substances such as heroin and fentanyl stimulate VTA to over-produce dopamine. This rush of abnormally large amounts of dopamine hits the user with a sudden and very strong feeling of euphoria. An unfortunate side-effect of opioids is slowing down breathing. This can be particularly dangerous if mixed with other substances that also slow down the body such as alcohol, anti-anxiety medications and other opioids. Current statistics indicate every 19 minutes, someone dies from accidental prescription drug overdose (most of them containing opioids).
Blockage of the transporters: drugs such as cocaine quickly enter the brain and bind to the transporters on the presynaptic cell, blocking dopamine from being taken back inside. This accumulates large amounts of dopamine in the space between these cells (called the synaptic cleft) and for longer. Constant presence of larger than normal levels of dopamine in the cleft causes the postsynaptic cell to be hyper-activated, leading to a prolonged feeling of euphoria. This establishes a powerful link between this feeling and the drug – which makes the user want to use it again.
Stimulation and blockage: amphetamine family of drugs behave both like opioids and cocaine. In lower dosage, meth acts like cocaine in blocking the uptake of dopamine back to the presynaptic cell. In higher doses, in addition to the blocking effect, meth stimulates the presynaptic cell to release even more dopamine. Because of this dual effect, the accumulation of dopamine in the synaptic cleft becomes extreme, leading to dangerously high hyper-activation of the postsynaptic cell. This results in an extreme feeling of euphoria making meth incredibly addictive.

Drugs alter how the reward centre communicates with the rest of the brain: affecting emotions, movement, reasoning and decision making. Repeated use of these drugs makes changes to the chemistry of the brain, which eventually prevents the user from experiencing the same euphoria when first using the drug: the user builds tolerance toward the substance.

Fardad is a science student here at Concordia. He wants to share his research and learning about the science field with the Concordia community.

Graphic by Florence Yee