High (And Low) On Drugs

Unpack This offers deep dives as to how how society shapes and perpetuates ideals based on the writers experience as a social worker and therapist. Melissa covers dating, love, shame and guilt, therapy, white supremacy, intersectional feminism, trauma, and how difficult and weird it is to be a human.

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Growing up in the aftermath of the "Just Say No" era, I was steeped in the rhetoric that cannabis was a seductive and untrustworthy gateway drug, that one puff would lead to a steady decline into way worse shit. MDMA would poke holes in your brain and a back crack could resurface your last acid trip. Although these theories have been debunked, they were in keeping with how I was parented around drugs.

My father deferred to my straighter-edge mother to take a firmer stance against drugs, save for an Italian-American appreciation for wine with dinner followed by Sambuca-spiked espresso. My mom was a hard no on all drugs growing up, especially cigarettes, having witnessed both parents die from tobacco-related-illnesses. Cut to just last week, to my amazement, I received a text from her wanting to discuss the merits of MDMA-infused couples therapy. Same woman, two very different times.

The most powerful change mechanism drug and sex education had growing up was politicized fear and misinformation. We were told: If you have sex, you will get pregnant or become diseased and subsequently cast out of society or die. If you do drugs, you will face a similar fate. This form of “education” didn’t stop me from experimenting with drugs, but it did ensure a thin veil of fear, guilt, and shame while embarking on each new exploration. Imagine my surprise when I learned as an adult how hard it actually is to get pregnant in the same way that I learned that pot didn’t automatically put me on a steep decline into delinquency.

I grew up around differing levels of extreme wealth in Connecticut. My parents, raised at varying levels of poor and middle class in Brooklyn, moved my family when I was five. Our family wasn’t anywhere near the socioeconomic status of my Connecticut classmates. And yet, growing up adjacent to extreme wealth and whiteness sheltered me in a cocoon of privilege, allowing me to experiment with drugs from a young age with little to no repercussions. My friends could shamefully drive home high (and, on occasion, drunk) and, even if we were stopped by the police, be met with a friendly finger-wagging ‘kids-these-days’ energy, eventually sent on our merrily ignorant way. We thought we were powerful and in control of our destiny; we didn’t realize that the system itself was simply stacked towards us.

Fresh out of grad school at 22, I became a therapist in Brooklyn for families mandated by Child Welfare following an abuse allegation. Their choice was often: Do family therapy or their kids could be placed into foster care. A common presenting issue was substance use, often pot, alcohol and less often, harder drugs. I was tasked with treating it all, regardless of who was using - parents, kids or both.

Trained in a harm-reduction substance use model, we instituted relational and monetary rewards and consequences. If a kid got high because they desired connection from Mom, we’d limit connection from Mom next time they were high. If a kid abstained from smoking, Mom gave connection and I gave him $20 for each clean screen. Seeking to understand the reason behind the usage allowed us to ultimately replace the drug with a healthier coping skill that provided the same benefits. In private practice today, I ask a question based on this training: “What do you gain from using?”

What a mindfuck it was to tell a kid or a parent that they couldn’t smoke pot to deal with the immense stress of their life, having done the very same in many stages of my own. At the height of my C-PTSD, it was sometimes only cannabis that quieted my utterly fried nervous system. When my usage became too habitual, I brought more mindfulness to my choice, learning and failing and learning again to choose meditation instead of what had slowly become my first line of defense. How fortunate I was to not have a system breathing down my neck, observing my deeply imperfect road towards healing.

The cognitive dissonance didn’t only come from my imperfect healing journey, but the privilege that allowed me to imbibe with frivolity other times. Talking to an 18 year old about pot, I’d think back to how delicious it was to share a joint on Cortlandt Alley with a girlfriend that same age, for no other reason than we both wanted to and could. I’d remember going over friends’ houses in Connecticut, with their parent’s impressive selection of prescription pills in the medicine cabinets and, with no Child Welfare to speak of, began to reverse engineer the realization that families across all contexts deal with similar problematic behaviors.

Rejecting a moral high ground I could not in good conscience sit with, I began to see drug use as neither bad nor good but one downstream behavior within interlocking systems. Usage in a family known by Child Welfare was inherently riskier than usage shielded from the system, not because the usage was worse but because of the system’s mere presence. In this way, whiteness and classism were my main protective factors. Racism, both interpersonal and systemic, throughout so much of my clients’ lives, was the ultimate risk factor.

From then on, I contended with a sobering truth: If you were to plop some of my adolescent behaviors in a context with less privilege, I am likely not the person my privilege afforded me to become today. It’s like my own version of Back to the Future: If Marty’s parents don’t meet at the Under the Sea Dance, he ceases to exist. If my privilege didn’t afford me opportunities, resources and get-out-of-jail-free cards to augment my many mistakes, where might I have ended up?

Addiction specialists assess what happens before and after drug use in order to treat the pattern surrounding it. Dad berates kid for skipping school, kid feels ashamed and smokes pot. Pot is the symptom; the interaction is what needs the treatment. Often, the kids labeled as “the problem” are simply demonstrating the underlying familial dysfunctions. I cannot count the number of times I was told to treat a kid’s behavior, only to learn of the caregivers’ hidden struggles with domestic violence and mental health. Seeing the context surrounding use, allows one to swap out “drugs” for any number of vices. In this way, we all have our version of drugs. What do you turn to when you feel disconnected or ashamed? That’s your drug.

Moving to private practice, I kept treating clients while acknowledging the gross inequities that allow only some people to use without lasting impacts. I was never going to convince anyone to abstain by instilling fear or shame. Scared Straight programs failed because fear and shame-based motivation will only take us so far. Research backed compassion-based harm reduction. Switzerland went a step above clean-needle sharing and provided housing and employment, to wonderful outcomes. This strategy was based in the understanding that compassion and connection counteracts the biggest triggers for relapse: shame and isolation. I had heard a variation of the same struggle in sessions throughout the years: I feel alone so I use, which disconnects me from others, and then I use to deal with that feeling, too.

Now, I use this training with all types of vices from pot to porn, to work or Instagram. We seek to understand the meaning under the use, especially the benefits that sustain use. No one would seek out drugs if it was all drawbacks. Personally, some of my deepest healing has come from the ego-death that was brought on by psilocybin. I’ve done years of grief work in therapy and may have made the most transformational progress over the course of a two hour shroom-laden Sigur Rós concert.

Statistically speaking, one of the most harmful drugs is legal. Alcohol leads to both physiological problems as well as widespread social and public health issues like drunk driving and intimate partner violence. Drug theorists have made a stunning observation that the drug caffeine is so culturally accepted, companies not only allow for coffee breaks but enable our usage by bankrolling it within most professional spaces. The context here is capitalism, supportive of caffeine as it bolsters productivity.

Many people can use drugs like alcohol, caffeine and cannabis in ways that do not impact their functioning. Yet, each of our abilities to function is a moving target. You may have a functional relationship with a drug and, one day, crossover into the land of dysfunction. Over the course of COVID, many went from having a handle on their usage to rethinking the frequency with which they imbibe. When our stress levels increase, our usage of coping skills increases. When our coping skills are taken away (socialization, work/life separation, livelihoods, etc.) humans will find a way to get what we need to cope.

Let me be clear: I am not talking to folks who have become physiologically dependent on a drug. Those journeys requires specific and targeted medical intervention. For the rest, ask yourself what your own personal slippery slope towards dysfunction looks like and what your propensity is for lying to yourself. Ask yourself: How do you view your usage? What benefits do you get? Likely, it’s deeper than feeling high and connected back to your core values and desires: to connect, to feel free, to be independent, to relax, to forget. From there, you will not only learn about who you are but what you need and why.