Showing posts with label death. Show all posts
Showing posts with label death. Show all posts

Saturday, October 2, 2010

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Why are some drugs legal and others not?

I bought a new book the other day on addictions counselling. It is quite good and has some useful information in it. It is the usual sort of thing reflecting mainstream thinking on the topic at the moment. In chapter two it makes a statement that one would not uncommonly find in such a document.

“Contrary to popular belief, most people who use substances do so in ways that cause them relatively little harm”
(end quote).

Why would this be so? Not that it causes relatively little harm but that it would be contrary to popular belief. Why would the wider community have a contrary belief to this?

There are a number of reasons for this which in part answer the question which is the title of this paper. The Australian Psychological Society (APS) has done a position paper on substance use. Now the guys that put these position papers together hard nosed MFs, who eat, sleep and s**t science. You can be sure they know the area very well, they are relatively free of any political pressure so you are going to get a pretty good statement about the science of the area under investigation.

To quote them:

“In Australian history, laws regarding the legality or illegality of certain drugs have been politically driven, and had little to do with the level of use or possible harms that the substances themselves might cause.” (p3)

girl whistle blower

This creates a problem for government because they say to the public that they are making some drugs illegal because they are dangerous to people’s health. They profess that it is a health issue and what they are doing is for the good of the public. Unfortunately this is not so. They are doing it at least in part for their own political well-being not for the good of the public.

To sell this to the public they then have to set about demonising illegal drugs. They have to exaggerate the dangers thus trying to convince the public that they are acting for their well-being and not for their own political survival.

Thus they demonise illegal drugs in all sorts of ways and hence one ends up with the contrary belief in the wider community that I mentioned earlier. The general public believe illegal drugs are much more dangerous than they actually are and the government has made them illegal to protect us.

Kermit man

From a pure lethality point of view consider this chart below. This was put together by two psychologists who work at Liverpool University in the UK. They looked at the official causes of death through the 1990s and then calculated the risk of death per 100,000 people. They came up with a chart that shows which things are risky for us and which things are less risky for us. Included in it are various drugs.

Very high risk
Tobacco, methadone, injecting drug use, BASE jumping, grand prix racing, cancer, heart disease, space travel

Quite high risk
Heroin, Morphine, barbiturates, alcohol, hang gliding, parachuting, motorbike racing, sudden infant death, working in mining, asbestos poisoning, strokes, prostrate cancer, shaking of babies, off shore oil work

Medium risk
Solvents, benzodiazepines, motor sports, water sports canoeing, diabetes, skin cancer, influenza, suicide, giving birth, helicopter travel, liposuction, working in farming, being in police custody, working in construction

Quite low risk
Ecstasy, MDMA, speed, cocaine, contraception pill, GBH, fighting sports, snow sports soccer & rugby, Asthma, AIDS. meningitis, cervical cancer, food poisoning, air travel, being murdered, chocking on food, electrocution, drowning, passive smoking, factory work

Very low risk
LSD, magic mushrooms, viagra, fair ground rides, swimming, riding sports, food allergies, syphilis, malaria, appendicitis, pedestrian crossings, clothes catching fire, falling out of bed, vaccination, abortion, storms, terrorism

Extremely low risk
Marijuana, cannabis resin, indoor sports, playgrounds, peanut allergy, measles, insect stings, copulation, starvation, dogs, lightening, nuclear radiation, police shootings

Negligible risk
Caffeine, nitrous oxide, ketamine, computer games, masturbation, small pox, leprosy, sharks, cats, meteorites, executions, volcanoes


Woman and gun

If the government was acting purely for the health of the community it would change the laws on which drugs were illegal. It would make tobacco and alcohol illegal and make marijuana, LSD and ecstacy legal. There is as much chance of dying from ecstacy as there is from choking to death on your dinner or being blown up in a plane by a terrorist. In addition as far as drugs go marijuana is the safest drug you are going to get.

Then some will argue that marijuana may not kill you but it can make you go crazy with a cannabis induced psychosis. Unfortunately as time rolls on the science has simply not backed up this hypothesis. Yes it is very unwise for a person with a propensity for psychotic symptoms to use marijuana and the vast majority of marijuana users will suffer no mental health problems at all. Hence back to the original quote from my newly purchased addictions counselling book and the APS position paper.

Is a government going to make such legislative changes with illegal drugs? I don’t think so. If they did they wouldn’t be in government for very long which is why they have to exaggerate the dangers of illegal drugs and thus mislead the public in this way. Pretend to act for the good of the public when they are actually acting for their own political survival.

However despite all the politics this does raise some interesting questions for the drug counsellor and indeed parents of children who may use drugs. Does a drug counsellor (or parent) use scare tactics with the client (child).


Black eye mask


One way to try and stop a person using drugs is to make such a thing very scary for them. Get them to believe that drugs are much more dangerous than they actually are so they get scared and don’t use. Commonly known as scare tactics.

To do this you have to lie to them even if only lying by omission. Is it OK and therapeutic for a counsellor to lie to a client? Most would argue no. To my mind you have to tell the drug user the truth even when you don’t like what the truth is.

If you tell them that marijuana can make people go crazy the first thing they will do is make their own observations. With the vast majority of marijuana users they will think - “Well I have smoked marijuana and I haven’t gone crazy”. Then they will look around at all their marijuana using friends and see that none of them have not gone crazy as well. After making these observations what is the drug user going to think - “My counsellor is lying to me”, as indeed he is.

As a result trust is broken, the therapeutic relationship is damaged and the counselling suffers, at times significantly. Besides this most drug users have heard it all before anyway. Their parents, teachers, the police, the press, the government and drug counsellors have all exaggerated the dangers of drugs to them many times before. So if you, the current drug counsellor comes along and tells the user the truth and the WHOLE truth they are going to be surprised and maybe even shocked by such a transaction from you. Thus the therapeutic relationship is placed on a much more robust footing and the drug counselling is more likely to be successful.

Drinking games
If you lie to the teenager can you expect them to tell you all of what they are doing?

In particular they are more likely to be truthful with you about what they are doing and why they are doing it. Can you really expect a client to be truthful with you, the counsellor, when you are lying to them in the first place. If you lie to them you have to expect them to lie back to you.

Graffiti

Saturday, September 26, 2009

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Prelogical thinking about death

I had a client say something today that was just very clear. You don’t tend to get such clear statements of this. She was reciting a situation when she was seven years old. She lived in a house with her parents and siblings and her aunt also lived there. Her aunt had an accident and died suddenly. She stated (This is pretty much as she said it):


“My aunt died and my parents did not want to tell me. I over heard them talking and they said that they were going to tell me that she had gone away to the country. But this was not a shock to me because I thought that dead people could come back”.


Not only did the parents little scam of not telling the child the truth not work as they were overheard, but the child would not have been distressed anyway because of her undeveloped understanding of the concept of death due to her age.


The truth?


It is sometimes noted that about the age of 8 years a child can get what is sometimes called “8-year anxiety” where they develop a pronounced fear of death. As Piaget has shown prior to age 8 the child is egocentric with magical thinking that involves prelogical thought. As a result of this children under 8 often think that death is reversible or that the dead can still see, hear and feel. At about age 8 the child’s thinking matures enough to allow it to understand that death is not reversible and thus it can hit that stage of “8-year anxiety” when it realises what is going to happen one day when it dies and when mummy and daddy die. In essence the child has an ‘existential crisis’ and has to come to terms with its own mortality for the first time at the tender age of 8 years which must be fairly hard for the little ones to do.


This woman’s statement was just so clear of this psychological phenomena that I noted it down and it does highlight one of the possible causes of childhood and adolescent suicide. The person at the point of making the suicidal act does not truly comprehend the consequences of what they are doing. In fact what they believe is going to happen maybe quite a distortion of the truth, such that death is reversible.


This is one of the four particular suicidal groups and I have called it the naive suicide group. Of course all adults also have a Child ego state. That is there is a four or five year old in all of us that remains until the day we die. For some people it can be quite pronounced and thus as an adult they can actually feel, behave and think in quite a child like manner. Thus part of them can believe at the age of 30 that death is reversible because they have a strong immature part where the Child ego state is quite influential. Such a person’s Adult ego state would know the facts about death but they also have a child feeling or understanding about it as well that is contradictory to the Adult facts.


Teenagers are in that twilight zone between

strong adult thinking and child like prelogical thinking.

At times they will oscillate between the two.


This phenomena is also particularly evident for some suicidal teenagers which makes suicide risk prediction particularly difficult for this group. The teenager may not show many of the usual indicators of suicide risk, especially the presence of the suicidal decision, the “Don’t exist” injunction, but still be at quite a high risk because of the reason I am just discussing as was highlighted by the woman’s comment. In suicide risk assessment I always feel much less sure when working with a teenager than working with an adult.


Graffiti