THE DEATH OF Philip Seymour Hoffman from an apparent heroin overdose earlier this week is a tragedy on a number of levels. It is, first and foremost, a tragedy for his family; for his partner, his children, his relatives, his friends. More broadly, it is a tragedy for the acting community – he was a talented and highly regarded actor – an Academy Award winner – still active and working, and with much left to offer. More broadly still, it is regarded as a tragedy by the world at large. It has, not for the first time, brought the tragedy of death from ‘hard’ drug use into the wider public consciousness, both in Ireland and abroad.
The reality is that many people don’t have a friend or relative who experiences problematic heroin use. However, the death of a public figure from drug use always serves to challenge the stereotypes that people often have of drug users. And, at least for a short period, death from heroin overdose moves from the category of ‘things that will never happen to me or my friends’ to ‘things that can happen to anyone’.
And the reality is that the root cause of this tragedy, addiction, can indeed happen to anyone. Addiction is no respecter of status. In terms of negative consequences, death is, obviously, the extreme case. However, for every person who dies from an overdose, there are many others who will overdose and survive. There will be more still that will not overdose, but for whom drug use will be problematic, impacting negatively on their lives in some significant way. Many of these may not ever come into contact with addiction services. Why is this?
Isolated from mainstream society
Well, addiction is still stigmatising. Addiction to an illicitly obtained, controlled drug like heroin is even more so. It can be difficult to accept you have a problem yourself, much less ask society at large to accept that you have a problem. And the more we feel apart from mainstream society, the harder it can be to want to engage with that society. For many people, continuing to medicate themselves can feel like the only option. As Griffith Edwards has noted:
Dealing with drugs… is a matter of dealing with much else besides drugs. It must be about our choice of value systems… and what life can offer that is as good as, or better than, intoxication.
When you feel isolated from mainstream society, it can be difficult to see what life can offer that is, indeed, better than intoxication. And even if the cycle is broken, it can be easy to find solace in drug use again. Stopping using can be the easy part. As Tracey Helton Mitchell notes:
In the years I have been off heroin, I have struggled with depression, post-traumatic stress disorder and anxiety. Many addicts find that once the drugs are removed, the underlying cause to the use can be nearly as painful as the use itself… I dealt with these feelings without using heroin. However, the thought crossed my mind many times that relief can easily be found at the bottom of a spoon. That is part of my affliction.
Challenging views of what addiction is and who it affects
Philip Seymour Hoffman’s death is a public tragedy, but his addiction was personal. People choose to use drugs – and choose to stop using drugs – for their own individual reasons. There is a story in and a story out for everyone who has made that journey. Addiction is not the same for everyone – each person has their own individual experience.
So, what is to be done? Well, we need our responses to be accommodating of these experiences. We need to continue to be ‘client centred’; we need to provide services that are more accessible to people, not those which place often unmanageable preconditions to entry; and we need to be open – open to change in how we deliver services, and open to challenging our own views of what addiction is and who it affects.
Ireland has had a heroin problem since the late 1970s; more recently, heroin use has become more prevalent in areas outside Dublin, and dealing with addiction has become more complicated as polydrug use becomes the norm. Ultimately, to be effective in tackling this problem, we need to own it as a society – we need to recognise that people who use drugs problematically are not any different from anyone else.
In Ireland, an average of one person per day died by overdose in 2011, the most recent data available. That their stories were not news does not make them any less deserving of our empathy and respect. Continued stigmatisation will, unfortunately, lead to more isolation, more secrecy, more risk and more death – it is a path to be avoided.
Tony Duffin is the Director of the Ana Liffey Drug Project, a national addiction service working to reduce the harm caused by drug use in Ireland. Ana Liffey provided direct services to over 3,500 clients in 2012, many of whom are among the most marginalised from mainstream service provision. To find out more about the Ana Liffey’s services click here. To donate to the Ana Liffey, click here.