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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
A difficult stArt
Finding out about a person’s trauma in early life
can go a long way in helping them cope, says
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
This article is taken from his speech to the Hit Hot Topics conference
Photography by nigelbrunsdon.com