Our responses to problems associated with alcohol and drugs are typically informed by three quite different traditions of thinking; traditions which bump up regularly against each other like large tectonic plates, crunching and grinding, leading at times to tremors of disagreement and culminating at other times in surprisingly antagonistic eruptions. The following scenario illustrates these tensions.

At a school in a middle-class suburb, three fifteen-year-old pupils have been caught with cannabis in their schoolbags. The school principal immediately consults with three people: the chair of the school’s board of governance, a teacher in charge of the health curriculum and a local community worker who has asked to speak on behalf of the boys.

As a parent himself, the board chair speaks passionately about the potential of pupils to be caught up in a negative spiral leading to the ultimate horror of drug addiction. The responses he promoted included expelling the three pupils, instituting random bag-checks and inviting in a police-initiated drug education program.

The health teacher expresses strong skepticism about such measures. She alludes to a large body of research that demonstrates the poor effectiveness of drug education in schools. She also points out how random blood tests would encourage distrust and secrecy and glamorize drug use by linking it to adolescent rebellion. She proposes temporary suspension with progressive reinstatement linked in with a series of meetings with the boys’ families.

The community worker contends that the adults involved should recognize that cannabis use is commonplace in their community and that, like many of the teachers, parents can be regular drug users. He also points out how the boys confined their use of cannabis to themselves; they were not selling it and not using it regularly, only experimenting. The community worker also argues that taking a hard line with the boys would have permanent negative effects on their future prospects. On their behalf, he proposes they return to school on condition they attend a peer-led youth resilience program currently running in the community.

Embedded in these recommendations are three different ways of thinking which I will refer to as personal growth, public health science and just society orientations.  

At the heart of a personal growth orientation is a commitment to practices that increase our quality of life and which require us to unpick and then to cast out obstacles to us realizing our full potential. Accordingly, some modes of living are viewed as sub-optimal; for example, the quality of lives overshadowed by severe depression, oppression or addiction are viewed as negative, obstructive and worthy of avoiding or changing.

This orientation is strongly represented in addiction counselling and psychotherapy, and in the twelve-step movement established up by Alcoholics Anonymous. In it, those who succumb to living with addiction are viewed as pursuing a life that, in many ways, is unrealized and unfulfilled; human authenticity is denied through deceptive interpersonal relationships, deteriorating social and occupational involvements and impoverished spirituality.

Central to a public health science orientation is a commitment to the careful application of scientific methods in testing out the effectiveness of an approach through constant hypothesizing, observation and measurement. This emphasis on research evidence has led to the development of what is generally referred to as “harm reduction”, an approach that puts to one side issues around the morality of addiction and focuses more on those approaches that can demonstrate they are, actually, able to reduce harm; harm to individuals, harm to communities and harms within broader society.

A core tenet of the just society orientation relates the fundamental power of people exercising choice, in other words, “people power”. The act of determining one’s own circumstances is strongly connected to opportunities for individual and collective wellbeing. On the flipside, restrictions on personal choice and the imposition of the will of others will contribute to disempowerment and a reduction in the opportunities for wellbeing. Accordingly, attention focuses on modifying the structural impediments to self-determination and in promoting environments in which people feel they have an influence over how they live.

Now, imagine the school principal inviting the three other people in the scenario to a meeting to discuss what to do. The three contrasting recommendations draw on these fundamentally different orientations and, because each person believes intensely and honestly in their orientation being correct, discussion at the meeting could go in two directions: it could spiral into tense disagreements with each party digging their toes in and ridiculing other viewpoints, or, alternatively, it could lead to a productive debate in which parties respect other orientations and where a compromise approach is negotiated.

To read more on how to avoid such discussion turning into bitter conflict, have a read of: Strange bedfellows: Meta-narrative traditions in the alcohol and other drug field (by PJ Adams, A. Prescott & R. Dixon)

Text by Peter J Adams  Image by P. Soham on Pixabay link