Sometimes using drugs makes sense

Gerd Altmann, Pixabay

One of my long-time friends has Dissociative Identity Disorder – what they once called multiple personality. Getting to know her and her people over many years has helped me to see that it’s not a mental illness at all, it’s a coping mechanism.

I see so many parallels with this thing we call addiction.

For my friend, dissociating was a sane response to an insane situation, which in her case was a long childhood of non-stop physical, sexual and emotional abuse. When her little-girl self couldn’t handle what was happening to her, she found a way to check out. Some other “person” that her amazing brain had created would emerge to take the pain and heartbreak, and then retreat deep inside with the memory to protect my friend from having to know it ever happened.

Being able to dissociate so completely as a child was a brilliant strategy for her at the time. She thinks it probably saved her life, allowing her to take repeated abuse that any fully present child could never bear. The coping mechanism she’d unconsciously developed helped her manage through unmanageable times.

But in adulthood, this tool that she’d relied on since she was a toddler started to become a problem. She was no longer living a life of abuse, but she still reacted to high-stress situations by falling back on that old coping mechanism. And things often went badly as a result.

Her “switching” wasn’t a conscious act, so sometimes the full-grown woman with years of work experience was gone and a helpless child was in her place, with not a clue how to do the job. Or an angry, drunk customer would throw hot coffee at her, and the hothead personality who existed to punch first and ask questions later would emerge and deck the customer.

Over time, this beautiful coping mechanism that had seen her through terrible years began to interfere with her ability to work. It affected her friendships and relationships. She self-isolated out of fear that anyone who learned the truth about her would reject her. Her dissociating left her highly vulnerable to all kinds of dangers; more than once, she woke up in strange places far from home, with no clue as to how she got there.

She owed her life to her ability to “switch.” But in a changed situation, it had become the thing that was causing her the most harm.

Consider substance use disorder through a similar lens. 

Technically, it’s also a mental illness, presuming that someone’s substance use meets at least three of the 11 criteria laid out in the DSM-V psychiatric manual. In fact, people whose primary “mental illness” is a substance use disorder now account for a quarter of the 30,000 cases a year in BC of people detained and treated against their will under the Mental Health Act.

But is it a mental illness? I’ve been spending a lot of time these past few months talking with people living homeless in our region, and the drug use I’ve seen looks very much like a coping mechanism to me. A sane response to an insane situation.

Who among us could live the dystopian life of a modern homeless person in an affluent society for more than a few days without turning to drugs as a way to check out of the misery? Not to mention all the misery suffered in the runup to homeless. Painful childhoods, histories of abuse, intergenerational trauma, brain injury, disability - off you go into a life of being constantly hated on, and these days hunted multiple times a day by bylaw officers intent on taking all your possessions away. 

If all that and more are going on in your life, drugs that take it all away for a bit make total sense.

Like my friend’s unconscious dissociating, however, what starts out as a useful tool to soothe a savaged soul can end up being your most obvious problem.

Using street drugs at a level that lets you check out of your life is definitely not compatible with jumping through the hoops that await anyone trying to get off the streets, for instance. It also makes the neighbours very unhappy, to the point that they’re soon supporting political initiatives to round everybody up and force them into substance treatment. 

The toxic chemical soup that's now the illicit drug supply adds a whole other layer of misery, bringing death, nerve damage and chronic infection. Soon enough, the only thing anyone is talking about is the need to force people to stop their drug use, like that's the only problem.

That’s how it was for my friend, too. She was poked, prodded and counseled by so many psychiatrists, all of them focused on eliminating her coping mechanism, as if all would instantly be well if she just quit using that tool she needed so badly. 

Nobody asked to help her explore why she needed that coping mechanism in the first place, or how she was supposed to manage in some future new life if she couldn’t fall back on it at times of high stress. Nobody said hey, girl, hurray to you for discovering a coping mechanism that kept you going through some really heavy stuff, but now let’s go find some new tools that won’t get in your way quite so much.

She had to do all that work on her own. (And she did.) It took many years, and many retreats back to the old ways before she was fully ready for a different way of doing things. 

These days, she’s still got a few of her people on hand if needed, but she’s got a whole range of new coping skills, too. She can still dissociate, but it’s no longer the only coping mechanism she has.

In theory, there’s a lot more services and systems to manage harmful substance use than there was for my friend and her Dissociative Identity Disorder, and a lot more people who do understand substance use as a coping mechanism. 

But there’s also a big chunk of the public – the ones with the biggest influence on government thinking, it appears – who believe that if people just didn’t use illicit drugs, there would be no crisis on our streets. They are easily swayed by political rhetoric that maintains that falsity, and messaging that blames, shames and criminalizes substance users for “choosing” to use unregulated substances.

Between the general lack of understanding and the deliberate political posturing, we’re in quite a state.

We’re stressing out about the drugs, but not about the underlying reasons for using them. We’re fixating and fighting over substances as if all the answers lie there, even while the crisis on our streets intensifies and the harmful shaming of people just trying to get through a hard day rages on. 

People living homeless have a lot of stuff to cope with. They use substances to cope. Whatever “treatment” there will be for that, it starts with the stuff underneath.

Half a millenium is long enough to know that what you're doing isn't working

I went looking for the origins of that phrase "the deserving poor" today. It turns out to be a 426-year-old term dating back to the Elizabethan Poor Laws, which aimed to reduce the devastating impact of a famine by providing alms to the deserving poor and a hard stint in the workhouse for the undeserving.

Modern anti-poverty policies would never word things like that, of course. But strip away the dressed-up language and that’s still what we’ve got. We’ve even lost the plot on “the deserving poor” at this point, with people now stranded out on our streets who actually would have been eligible for alms back in Elizabethan times.

Back in 1601, the Poor Laws divided impoverished people into three categories for the purpose of deciding how much help they qualified for.

“The vagrant” was undeserving and destined for the workhouse, where he would be punished daily doing work that was deliberately designed to be more unpleasant than even the worst of jobs outside the workhouse. The “involuntary unemployed” and “the helpless” qualified as deserving poor and could get some aid, albeit with a ton of strings attached.

Sound familiar? Almost half a millennium later, that basically describes our current anti-poverty approach. And as anyone with eyes may have noticed at this point, it’s not working so well.

We have many more fancily named bins to divide people into these days, and many streams of funding that make it look like lots of innovative new approaches are going on. But getting virtually any social support still largely comes down to whether the gatekeeper decides that the person at the gate is deserving.

You can imagine how well this system works for, say, a poor person who is actively using drugs. They’re the ultimate “undeserving,” what with drug use while visibly poor being a seemingly widely accepted signal that a person isn’t trying hard enough.

But in these modern times of scarcity, even “the helpless” can’t depend on qualifying for much support, and certainly the “involuntary unemployed” are having to fight for it nowadays. I’ve been out there a lot in the last couple of months for an Instagram project I’m doing, and it’s stunning to see just how many categories of people are being abandoned under the 2025 version of English Poor Laws.

Not so long ago, you’d never see people with intellectual disabilities - or freshly amputated limbs, or people released post-surgery from hospital an hour ago, or jail  – living homeless. You wouldn’t expect to find people in acute mental distress, being held involuntarily under the Mental Health Act in order to force them to take their psychiatric medication, yet still left to live homeless.

But none of those populations are even rarities out there anymore.

The deserving/undeserving framework encompasses the surprisingly common view that the only reason people live homeless is because they’re just too lazy to get jobs and a proper place to live. (Seriously, take a slow and observant walk down 900-block Pandora and then tell me if that’s still your opinion.)

This flawed belief fuels the modern city’s primary weapon for battling homelessness: a set of bylaws dictating where, when and how impoverished citizens will be prohibited from "loitering," "congregating," or all those other words for gathering that are applied only to people who look visibly poor, and that permit the state-sanctioned theft and disposal of homeless people's possessions.

Cities then use those bylaws, and millions in enforcement dollars, to chase people around town like pigeons being shooed away to a new roost somewhere out of sight. Alas, there is never anywhere to go but to some other street. Yet consecutive versions of city councils keep trying, as if there’s a magical pit that the "undeserving poor" will eventually fall into if chased for long enough.

Everyone has their opinions on how we’ve gotten to this point, with almost 1,800 people living homeless just in Greater Victoria, and 60,000 across Canada. 

But enough with the opinions. We are here now. There is a growing problem on our streets that serves nobody. It’s overlayered with a street-drug crisis of the likes we have never seen, fed by an ever-changing and toxic chemical soup that now makes up the street supply - and that continues to flow no matter how many weird ways politicians come up with to fight the unwinnable "war on drugs."

Meanwhile, business owners in the hot zones grapple with weird new challenges with no easy answers. I was in Wildfire Bakery the other day when a man clearly in some kind of altered state raged into the bakery, snatched food off the counter, and was gone. Or Allied Glass in Rock Bay, targeted repeatedly for vandalism by someone whose own altered state is telling him the business means harm.

I honestly wonder if we can even get back from this.

And yet here we are, still sticking with a shame-based approach put in place by British royalty facing a famine 500 years ago. How’s that working for us?