Drink and Drugs News DDN February 2019 | Page 14

Letters and Comment DDN welcomes your letters Please email the editor, [email protected], or post them to DDN, cJ wellings ltd, romney House, school road, Ashford, Kent tN27 0lt. letters may be edited for space or clarity. It was refreshing to hear a dissenting voice on the orthodoxy around this issue. luxury items? cAckling conspirAcy I was very interested to read Nick Goldstein’s views on the ongoing consum - ption room debate (DDN, November 2018, page 10). It was especially refresh ing to hear a dissenting voice on – as he correctly calls it – the orthodoxy around this issue from the drug user side, as all too often, as with so many subjects in this polarised field, it comes down a black and white, us and them situation with little or no room for nuance. It was also interesting to hear a more considered take on the ‘ignorance-based nimbyism’ arguments that would usually be instantly dismissed in the social-media driven rush to judge and condemn that seems to taint all current discourse these days, whatever the subject. Consumption rooms remain a controversial issue – undoubtedly the right solution in some circumstances and locations, less so in others, and with serious legal obstacles in this country that are very unlikely to be overcome any time soon. And the rarely discussed elephant in the room, as he points out, is that a very sizeable proportion of injecting drug users would probably never go anywhere near one. If anyone from the other side of the fence had called consumption rooms ‘a luxury in an age of austerity’ they would have been burned at the Twitter stake, so all credit for sharing some honest, and persuasively argued, views. Alan Mulholland, by email. For a man who is so obviously accomplished and preeminent in his field, Professor David Nutt can often come out with some bizarre statements. ‘The main reason why drugs are illegal is because that’s what the media and politicians want,’ he says (DDN, December/January, page 16). This plays into the current narrative that the media is run by cackling Bond villains, determined to plant their evil lies into the minds of their credulous, malleable readership. Media owners are interested in one thing – making money. The Daily Mail, Express and so on sell millions of copies because they reflect the views of their readership. If their readers were all liberal progressive types who wanted drugs to be decriminalised or legalised and regulated, then that’s what these papers would be advocating. They don’t. And politicians, equally, are unlikely to go out on a limb to advocate for something that they know the vast majority of their constituents are firmly against, as any glance at the current news will attest. Paul Stansfield, by email 14 | drinkanddrugsnews | February 2019 /DDNMagazine @DDNMagazine www.drinkanddrugsnews.com A difficult stArt Finding out about a person’s trauma in early life can go a long way in helping them cope, says Andrew Bennett THE EFFECTS OF ADVERSE CHILDHOOD EXPERIENCES (ACE) can manifest in adulthood and have a cumulative effect – and are one example in public health where disadvantage stacks up. An ACE count shows how stress can affect young children. If there is a regular ‘drip drip’ effect, and if they are in constant fight or flight mode, it can affect young brains and might manifest in their behaviour. Children can become isolated at school, which can escalate and cause lifelong problems. Not only can this make it difficult for people to access help, but US research shows that people with an ACE count of six or more can die 20 years earlier. People with high ACE counts are much more likely to have problematic drug or alcohol use; as Gabor Maté has pointed out, many individuals with problematic drug use have roots in trauma – so trauma can be the gateway to drug use. Mark Gilman has also made the distinction between taking drugs for pleasure and taking them because life is unbearable. But your ACE count is not your destiny. It can be changed with the right support, and services can become ‘ACE aware’. Take an ACE lens to your service and see what difference this increased knowledge and awareness could make to your work. So how can we strengthen individual resilience? We need to understand the trauma that’s played out in people’s lives. We need to help people develop survival strategies and flip ‘what’s wrong with you?’ to ‘what’s happened to you?’. Make the case to routinely enquire about ACEs. We rarely ask about them, but it creates an opportunity to talk about problems and helps to empower people. Evidence shows that asking questions does not increase trauma. Sixty per cent of people with ACEs have never divulged them to a health practitioner before. It’s a straightforward process – four key steps to make a pathway to provide care. It’s important for services to have ACE awareness built into them. Andrew Bennett is an independent public health practitioner, currently supporting the National ACE approach to policing vulnerability programme in North Wales. This article is taken from his speech to the Hit Hot Topics conference Photography by nigelbrunsdon.com www.drinkanddrugsnews.com