My web interview with Release / Talking Drugs

Available here and reposted below with permission.

An Interview with Monica Barratt

Monica Barratt is a Melbourne-based research fellow at the National Drug Research Institute, Curtin University, Australia. Her PhD thesis, which has just been passed, was a mixed-methods study of online drug discussion. Monica is especially interested in how the the internet and other digital technologies intersect with drug use and drug market trends. Follow her at @monicabarratt

Can you describe, in few words, the current Australian legislation on drugs and give us an idea of the history of drug addiction in Australia?

Australia is a signatory to the UN Single Convention on Narcotic Drugs, 1961, which commits countries to a drug prohibition approach. While we have historically prohibited the substances that the US prohibits (e.g., there was no documented cannabis use in Australia when we first prohibited it), we have also at times been ahead of other countries in implementing harm reduction both through services (e.g., needle/syringe exchanges in the 1980s, the medically supervised injecting centre in the 2000s) and through law reform (e.g., various states of Australia have decriminalised cannabis). Similarly to other parts of the world, Australia’s drug policy trajectory is affected by politics. The last 15 years of federal government in this country has been dominated by socially conservative politicians. In some cases, this context has hampered the implementation of harm reduction innovations, although in all cases, government support for vital initiatives such as the provision of clean injecting equipment has continued despite the conservative public rhetoric.

In your PhD thesis, you research the importance and implications of the online drug communities. Can you explain, briefly, the role of the online drug forums and communities in reducing or increasing the risks for young people?

My aim was to explore the role of online drug discussion for the specific sub-group who participate online. I only looked at public internet discussion forums where Australians who used ‘party drugs’ (that is, psychostimulants and hallucinogens) could be found. By examining the data (observations, survey, interviews) through different metaphors of the internet, I demonstrate how the internet is not just a tool through which people learn about drugs, it is also a place where they go and interact with other drug users, and for some, that online place becomes simply a part of their everyday (offline) lives. Using online forums to deliberately find a new social network could result in new avenues of drug supply as well as new networks of harm reduction information. On the whole, I found that the internet and online forums were more often used in order to reduce the harm of drug use and much less often used to directly enhance the drug experience (a practice which may involve increasing drug-related harms, e.g., learning how to take higher doses of a drug in order to increase the effects).

I think it is important to note that there is a specific sub-section of drug users that access and engage with online drug forums. It would be wrong to assume that my PhD findings apply to a more general audience of ‘young people’. Unfortunately for various reasons it took me a while to finish my thesis (any PhD students reading may relate!), so the data were collected in 2007-08, some time ago now. My feeling now is that online drug forums still only appeal to a niche group. However, even though the use of social media (especially Facebook) has increased dramatically since these data were collected, drug forums are still being used which indicates that they offer something people want. One of the advantages identified by my research participants was the ability to remain pseudonymous in online forums and to keep drug discussion separate from day-to-day life. This separation of identities has become more difficult in an age of Facebook and Google where ‘real name’ policies are increasingly implemented.

 In your presentation ‘PMA sounds fun’ you stressed that ‘pleasure and fun’ are often some of the reasons why young people take drugs. Do you think that these feelings are the real feelings expressed behind the urge for drugs, or do they cover other needs and complex feelings that need to be addressed?

Historically, humans (and indeed non-human animals) seek pleasure or positive affect from their activities and from substances. Most drugs, especially those that are popular recreationally, induce a positive state at least to begin with. I think the finding that young people enjoy drug experiences, gain pleasure from them, use them to enhance their social lives, should not really be newsworthy in and of itself if we remember that alcohol is a drug and that most of us can relate to drinking alcohol for pleasure and to enhance our social lives. The reason that it is newsworthy is that the place of pleasure in drugs has been obscured or silenced, perhaps because the presence of pleasure is erased by the pathology or deficit drug discourse, where it is assumed that all (illicit) drug use is a problem and that drug use occurs in response to a deficit either in the individual drug taker or in their environment. The pathology discourse is a dominant mode of thinking about drugs in Australia and internationally, but there are so many examples that challenge it, notably the existence of happy and healthy people who also use (illicit) drugs. This point is encapsulated well in the Release campaign ‘Nice people use drugs’ (which I loved! Thank you Release!). It is also worth noting that the dominant pathology discourse on drugs underlies policies of drug prohibition, so as we challenge this discourse, we bring into focus the potential for drug law reform.

To answer the question more succinctly, yes it is possible that for some people who describe their motivation to use drugs as about pleasure or enjoyment, there are other more complex reasons for their use, and that they may prefer to focus on the positive rather than the negative reasons in their presentation of self. It is also possible that people who say they take drugs for fun really do just take drugs for fun.

Do you believe that the anonymity and ‘pseudonymity’ of the online drug communities is a reflection of the stigma towards drugs and drug use in current societies? Can you expand on this?

The use of pseudonyms in drug forums is a protection against people finding out about the real identity of the individual drug user. Some forum users focused on the importance of avoiding stigma in their daily lives as a major factor whereas others were concerned more about getting into trouble with the law. Interestingly, not all of the people I interviewed who discussed drugs in public online forums were concerned about their privacy or about potential stigma if their friends and family found out about their drug use. Some people, instead of masking their identity, simply ensured that they never spoke about drugs in a way that could incriminate them – that is, they were vague or used coded language when discussing drugs.

I was fascinated by the wide variety of strategies used by drug forum participants to deal with the illegal nature of their activity in their public forum interactions. Given the diversity of responses and actions, we cannot assume that the internet is always valued by drug users due to its facilitation of anonymous communication.

In your presentation ‘Discussing drugs in public internet forums’ you emphasize that internet, technology and society shape each other mutually. What use of the media do you think that public and health policy should make in order to aim at an effective harm reduction strategy?

Good question! The mutual shaping of technology and society is an iterative, dynamic, ongoing process. We need to be careful not to state that technology affects society without also seeing that society affects technology. So, we could conclude that the anonymity afforded by internet forums allows drug users to talk to each other (technology affects society), but it is a crucial point to note that the societal context of drug prohibition sets conditions of stigma and punishment which generate the need for anonymity (society affects technology).

In terms of creating an effective harm reduction strategy, the first point for me is to come back to the participant’s view. From the drug user’s perspective, what are the harms they are experiencing, which harms are important to them, what are the strategies to reduce those harms, what is missing that others can provide that will assist? There is also the type of harm reduction strategy that focuses on the environmental factors, such as providing a safe space for injecting or policies that mandate police do not attend ambulances to encourage people to call for help without fear of prosecution. The internet and especially online drug forums can be useful to obtain the view of people who actually use drugs, by enabling engagement between policy makers and drug users in a safer setting, although as I’ve mentioned before, we can’t assume that online drug forum users represent the wider population. Media can also be used to disseminate campaign messages on a mass scale, but I find these mass media campaigns are generally anti-drug, do not involve any harm reduction, and are not aimed at people who use drugs (they are often put off by such campaigns).

An important emerging area is the use of social media for harm reduction interventions, where campaigns are run through Facebook and Twitter in interactive formats. I think harm reduction agencies should pursue these opportunities to better engage with their clients, especially if they are trying to attract young people into their interventions. In order to do it well though, agencies may need some support and guidance from experienced social media users. For example, in Australia, Hugh Stephens runs Dialogue Consulting, an organisation that specialises in upskilling non-government organisations and others in social media engagement of young people. Honing this skillset will likely be increasingly important for such organisations that work with drugs and young people.

 In assuming that drugs education and information provided on drugs and serious health risks do not stop certain people from taking drugs, to which direction should an effective drug policy turn to? Should the insights of disciplines like psychology and sociology be seriously employed by health and social policies?

Yes, I think health and social policies should be theoretically informed by psychology, sociology, anthropology, social theory, etc. and especially in the context of media and drug policies, these needs to also be informed by media/communications theory. The discipline Internet Studies was really helpful for me in formulating and interpreting my PhD data as it opened up new ways of thinking about how the internet and drugs intersect. I know that it’s not necessarily possible for public policy to access and use the insights from a wide variety of academic disciplines, as often this knowledge is difficult to access and difficult to interpret if you are looking in from the outside! This is one of the reasons I write my blog and post as much as I can in freely available places, but unfortunately there are many barriers to more open access to scholarly content within the system we work in.

To answer the question of which direction effective drug policy should turn to if providing information on drugs and serious health risk does not stop some people from taking drugs… we need to first acknowledge that people who choose to use drugs may be making an entirely informed decision. The assumption that all people will cease drug use if they had adequate information needs to be challenged. Meeting people ‘where they are at’ is a tenet of most counselling approaches. Similarly here, we should ask ourselves ‘why are we trying to stop certain people from taking drugs?’ Some people don’t want to stop. Instead of assuming they just need more information or a scare campaign to make them stop, we can meet them where they are at and ask if there is anything we (as public policy makers, clinicians, drug workers, researchers) can do which may assist them, and be prepared for the possibility that they don’t want our assistance. In my PhD, I found that the vast majority of drug users were interested in knowing how to reduce the harms associated with their use. I also found that there were some drug forum users who seemed to relish danger and risk, and labelled those who were trying to reduce risk as ‘weak’. It is also likely that people care more about reducing risks in some situations and relish danger in others. The problem is that scare campaigns that highlight the dangers of drug use may indeed make drugs more appealing to this latter group. Piloting such campaigns with different groups, or using social media to gauge the different reactions to these campaigns, could be useful tools for evaluation.

 In your opinion, why are more and more young people attracted to substances and what role do consumerism and capitalism play in this tendency?

I don’t agree that ‘more and more young people’ are attracted to drugs. Humans have always been attracted to changing our conscious state, whether through spinning around until we get dizzy as children, or through the ingestion of psychoactive substances. There is no evidence that I am aware of that young people are more attracted to drugs now than they have been in the past… if anything, the surveys in Australia indicate a reduction in drug prevalence, although it is unclear whether drug use has simply become more stigmatised and therefore less likely that people will report it within a survey.

Although I don’t think drug use among young people is increasing, I do think that consumerism and capitalism play a role in the meanings of drug use. We are now living in consumerist societies where our consumption choices are a vehicle for shaping our public selves. What I buy, what I wear, what I eat/drink/imbibe shapes how others see me (my identity), and this identity shifts (or identities shift) through different contexts and across time. Drugs are part of this consumption pattern. As well as their effects on the body, drugs are also symbols – using them in particular contexts identifies the user as a particular kind of person. Capitalism and globalisation are also macro contexts within which we all live and they therefore affect how drugs are used. One example is the ‘work hard play hard’ mentality of recreational drug use, where young adults with intense full-time jobs would let off steam on their weekends by taking drugs. Drugs, including alcohol, allow them to experience a controlled loss of control- a period of time in their week when they can relax and be themselves in a non-corporate space. To understand how people use drugs and the consequences of these practices, it is incredibly important to include the macro social and political contexts in our analyses.

Dangerous, manageable or hard-core?

The unfortunate death of a 20-year-old Sydney woman in 2007 provided a catalyst for my analysis of how online drug-using communities defined PMA and ecstasy. PMA or para-methoxyamphetamine is structurally similar to the phenylethylamines (MDxx) and mescaline. It is a hallucinogenic stimulant with a low threshold for overdose, making it definitively more dangerous than pure MDMA. Most, but not all, use of PMA is inadvertent, as the users believe they are consuming an MD derivative when they buy pills sold as ‘ecstasy’, but the pill actually contains PMA.

Annabel Catt’s death in 2007 followed her ingestion of ‘ecstasy caps’ which were later found to contain PMA. Her friends did call an ambulance but Annabel died later in hospital due to overheating and respiratory failure.

There were a range of public responses to Annabel Catt’s death. Police warned the public about the dangerousness of all illicit drug taking. Toxicology results were released indicating PMA in Annabel’s system and police released the testing results from seized capsules and pills indicating that there were PMA batches in circulation at the time.

Bluelight.ru and Pillreports.com issued warnings to their users about how to deal with pills sold as ecstasy and PMA. Australian Bluelight moderators wrote an email on the topic which was also distributed across many of the forums I was monitoring. The re-posted email generated much discussion across these different groups.

I identified three different discourses around ecstasy and PMA in these responses, as indicated in the title of this post: dangerous, manageable, and hardcore.

The first discourse ‘A dangerous drug’ is a familiar, dominant discourse that positions all illicit drug use as inherently aberrant. This discourse underpins prohibition and it disrupts attempts to reduce harm by denying any possible lower-risk drug use. The ‘dangerous drug’ discourse is problematic because within it, the notion of pleasure is absent, and all drug use, regardless of context, is positioned as problematic. This discourse was found mainly in the media and police public responses to Annabel Catt’s death.

The second discourse ‘harm reduction’ recognises that people will continue to use drugs, that some drug practices are riskier than others, and that people who use drugs can and should act to reduce risks. Drug-related harms are seen as manageable. The harm reduction discourse draws on notions of neoliberal self-responsibility; that is, individuals must look after themselves and ‘do the right thing’, especially in relation to keeping themselves healthy. There was also a communitarian ethic present in the harm reduction discourses around taking responsibility to look after your friends. The harm reduction discourse was the dominant discourse in the drug-user online settings involved in this project.

The third discourse redefined the ‘dangerous drug’ or ‘manageable risk’ as ‘fun’. Rather than being a reason to avoid PMA, the fact that it was described as a ‘strong psychedelic stimulant’ was seen as a positive or as a challenge. For the drug users employing this discourse, pleasure and fun were privileged above risks and harms. In fact, pleasure and fun may indeed derive directly from the riskiness of a drug practice. For these individuals, defining PMA as ‘fun’ or ‘hard-core’ can be seen as an act of health resistance and using PMA intentionally can be seen as an act of defiant consumption, and the rejection of neoliberal values and the health imperative. The ‘PMA sounds fun’ discourse was present in the responses to the Bluelight email re-posted to the numerous dance music forums involved in this project.

These three discourses illustrate that drugs are more than their pharmacology: their effects and meanings are under construction and online settings are one place where that ongoing negotiation of meaning occurs. The implication for drug policy is that we cannot assume that if people were ‘better informed’ they would choose not to use drugs. Pleasure and fun may be more highly valued than health in some cases. We need to think further about how to include people who are actually attracted to danger in our frameworks, rather than assuming that everyone is determined to look after themselves.

At the APSAD in Hobart, I presented a paper from my PhD called ‘PMA sounds fun’: Negotiating contested meanings of PMA in online settings. You can view the 15 minute vimeo here. This article is a shorter summary of this work: I am working on the full paper which will be submitted for peer-review in the next month. This article has also been reproduced at Global Drug Survey, where I am now part of the international advisory committee.