Remember to ask why

Pathways to societal healing

JEFFREY THOMS, MSW RSW

Substance use is one of the most polarizing topics in today’s society. It is often regarded through a moral lens, meaning it is either right or wrong, or the person is either good or bad. It can manifest as self-medication when substances are misused as an attempt to manage the troublesome symptoms of a mental health disorder or other chronic health condition. Although understanding the what of self-medicating is important, the more pressing issue is: why are more and more people using self-medication as a way to cope in today’s society?

We live in a world that often creates the condition of suffering.

Whether this is through lived experiences like intergenerational or personal trauma, societal woes like living through a global pandemic, war, layers of oppression and discrimination leading to stigma and bias, and/or the multiple inequalities that influence the social determinants of health, suffering can be found all around us. These stigmas can become deep rooted in an individual, leading to a drain on their mental health and overall wellbeing. Escaping from this felt experience can seem like an attractive option. Substances, early on, can be a potential pathway to escape, and may be an individual’s attempt to feel better. Unfortunately, remaining on this pathway can lead people to further suffering.

Addiction expert, physician, psychologist, and author Dr. Gabor Mate famously says the more important question we need to be asking people is not “Why the drug?” but “Why the pain?” If we can help an individual understand why they are running from their authentic self, we are in a better position to help them reconnect with themself and engage in the hard work of breaking the cycle of self-medication.

Self-medicating and substance misuse are often seen as an individual’s struggle. I believe that what is really needed to stem the tide of addiction is a shift to thinking about self-medication and substance misuse from the lens of societal recovery Examining the way that we are with each other, how we treat people, and how we are with ourselves may help us realize the truth in author Jonah Hari’s message: “the opposite of addiction isn’t sobriety, the opposite of addiction is connection.”

Adolescents, who are sometimes overshadowed in this discussion, are not immune to self-medicating. Adolescence can be a time of experimentation with a wide variety of experiences, one being the use of substances. The pressure youth face in adolescence is an exhausting list. Along with the perils of ‘normal’ adolescent development, it is also a time of longing to belong, and the development and redevelopment of personal identity that can be toppled by societal pressures. For some adolescents this can be a smooth transition that supports the development of resiliency and character. For others, this can take a toll on mental health and overall wellbeing.

Our brains are wired to remember what feels good, so we do not easily forget that dopamine gives us a little rush. If an individual feels miserable about themself, if their mental health is riddled with low mood and anxieties, if they have experienced chronic and complex trauma, the benefit of feeling good again through self-medicating might outweigh other considerations. Therefore, it is important to debunk the myth of ‘gateway drugs’ and turn the conversation towards gateway experiences

As psychologist and author Dr. Bruce Alexander discovered through his Rat Park experiment, it is not the drug itself, but a person’s cage that leads to struggle with addiction and/or self-medicating. Self-medication behaviours and strategies are a by-product of not being able to say aloud “I am struggling,” ‘I am not doing alright,” “I am not fine,” or “I need help.” I believe we need to expand our view on addictions to include the discussion around why people use and maybe when why some people develop struggles with addiction while others can remain as social or recreational users. It is time to start talking about pathways to the deconstruction of these cages so that we can move forward with societal healing.

JEFFREY THOMS, MSW RSW, is a mental health professional who works with young people and their families in Halifax, Nova Scotia.