The death of celebrities due to addiction: on helpful and unhelpful distinctions in destigmatising addiction

Philip Seymour Hoffman is dead. Probably due to an overdose of heroin. Hoffman didn’t have to die if he wasn’t so ashamed of his substance use that he did it in secrecy. Because he overdosed alone, no one could call an ambulance on him that would have probably saved his life. Some are using the media attention surrounding his death to push for better drug laws. Some want to treat heroin addicts with heroin while some simply want to draw attention to a secret demographic: high educated, rich, white, middle age heroin users. Both attempts try to destigmatise heroin use. In this blog I will argue that the deaths of celebrities will only further stigmatise substance users and outline how we should really try to reverse the stigmatisation of drug users.
The image most people have of heroin addicts is the one advocated by Dalrymple: even without their substance use, these people are the scum of society, cherishing anti-social values from the start, holding no regard for the harm caused to decent people. The revelation that highly respected actor Philip Seymour Hoffman used heroin, could adjust this image. Yet, this is doomed to fail, why? Because the other side of the stigma-coin is a romantisation of substance use, especially if these substances are used by an artist. There is still a lay view that important artists need substances for their creativity. In his wonderful book ‘Citizens without shelter’, Feldman describes the same double-sided stigmatisation of homeless people. Homeless people are either home-less: lacking something, detested, or they are viewed as home-free, saintly creatures that we secretly admire (oh the freedom of being without a mortgage, seeing the sun rise every morning). But in a way, both categories are beyond our realm and their flourishing or death is beyond our reach. For the most part, this means that those people can die without anyone trying to intervene.
A very funny dialogue can be found in Pulp fiction, where Jules sees the light and decides to swap his criminal career for a spiritual one, but Vincent is sceptical and claims that he is just going to be a bum.

Jules: I’ll just walk the earth.
Vincent: What’cha mean, “walk the earth”?
Jules: You know, walk the earth, meet people … get into adventures. Like Caine from “Kung Fu”.
Vincent: How long do you intend to walk the earth?
Jules: Until God puts me where he want me to be.
Vincent: What if he never does?
Jules: If it takes forever, I’ll walk forever.
Vincent: So you decided to be a bum?
Jules: I’ll just be Jules, Vincent – no more, no less.

Now this little anecdote is very informative, especially the last sentence. We should stop stigmatising or romantising substance use, but try to see it for what it is in the person’s life. We should stop thinking of addicted people as either bums or saints and see them as normal people. But how do we do that? Addiction neuroscience made the first move in stating what defines addiction is not bad morals, but changes in the brain. Everyone, regardless of class, colour and values, is susceptible to the influences of repeated substance use on the brain. On the one hand, neuroscience tries to destigmatise users by focusing on the brain rather than values or social class, but on the other, they say that substance users have deviant brains, and who wants to be held to have a deviant brain? Being classified as a deviant brain is a new form of stigmatisation.
I think we should shift focus to the distinction between substance use and substance dependency. We should destigmatise substance use in itself: indeed, many famous artists use illicit substances to aid their creativity, many middle class people use it to relax or party after a long week’s work, and many from disadvantaged backgrounds use substances to self-medicate. Many people do this for years, successfully. See for example this story. (Although recreational use of heroin tend to be a exception rather than a rule, in contrast to, for example, cocaine or alcohol).
This is the first point we should acknowledge: there is nothing wrong with substance use in itself, it all depends on the effect of the substance on the life of a certain person. At a certain point, substance use can cease to have the intended effect and have mainly negative effects. This is the point where people should stop, seek help or be helped, but where some fail. This is the point where substance use turns into substance dependency. In a memorial letter to Amy Winehouse, Russell Brand describes how substance use destroyed rather than enhanced her talent and made this incredible, roaring woman pathetic.
If more people were to seek help in time because of the destigmatisation of substance use, and we acknowledge that there is a thin line between responsible use and tipping over, more people will be cured of their addiction. As Professor Jon Currie from the Australian National Council on Drugs once said, people with cancer were once heavily stigmatised until the treatments improved. We are scared of people with incurable disease, but once we see more people successfully recover from their addiction, the stigma will reduce and more people will offer a helping hand to those who seek help or struggle with relapse, and more people will be motivated to seek help when they judge they need it.

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