Through my brother’s struggles, I saw the reality of drugs policy. Addicts need care, not prison
I found my old diary just now, from 2009. Stuffed inside it was an unfinished column about addiction, and the war on drugs. I never did finish it. In May 2012 my sister-in-law Eva died from an overdose. My brother hid her body in the bedroom, where she died, the room the housekeepers were banned from, inside an otherwise pristine town house. He had been prescribed enough morphine, we were later told, to kill a small horse.
I watched my brother and Eva decline, gripped by a vice, or a desire, beyond their control, entering a world where no one, in the end, could follow them. For us, their family, the sadness of their relapse was overwhelming. Their addiction became our project, a project of endless emails, phone calls, experts, meetings, strategies, agreements, disagreements. Every week brought a new crisis, new information, and new developments. But most of all, I remember the sadness.
Twenty-five years ago my brother came back from India, emaciated, pretending to have a stomach infection while he was painfully withdrawing in a hospital ward. He had cut his own hair then. His upper arms were thinner than his wrists, sharp hip-bones jutting out. We should have probably wondered why he came back from India so pale.
After one stay in a rehab (there were so many) he came to stay with me, for several months. He immediately relapsed; I didn’t know. I thought the way he lived – the plates with rotten food under his bed, the dirt under his fingernails – was just him. The dirt was heroin. I didn’t get it.
Eventually – still not getting it – I gently asked him to find his own place. He stayed for several more months, but remained, then, in his room – a second bedroom, a small room, accepting, or choosing, exile. When he left, finally, he disappeared.
My column from 2009 was about the war on drugs. I was agnostic then. There is a forgotten phone number scribbled in red at the top. Many sentences are crossed out. It ends, “It is a comforting thought that only about 5% or so of any given population are addicts, or potential addicts, but it is not, I think, a view which is supported by facts. Some societies are notoriously more alcoholic than others, even those where genetic differences are not relevant. Cultures can be alcoholic, just as cultures can be violent or peaceful. Decriminalisation of drugs might lead to the normalisation and legitimisation of a drug culture. I say might, because social predictions are notoriously difficult to make: we live in chaos, and even the beat of a butterfly’s wing can change the course of history.’
Since then I have become more convinced by the arguments in favour of decriminalisation. Drugs, of course, are dangerous, but I don’t think that the heavy hand of the state helps. Hans and Eva’s house was raided a few years ago. Several people, seeing Hans drive erratically, had called the police. By then he must, I think, have been known to them, because what they did, in that immaculate house, was to walk up the stairs and kick in the locked door to the bedroom.
Hundreds of doors, presumably, are kicked in every week up and down the country. The police must do their job, and they probably do it well, under difficult circumstances. They have, I imagine, a process for deciding when to kick in a door and when not. But I do wonder slightly if the people who formulate the policy on drugs know what that heavy hand, the war on drugs, feels like and looks like and sounds like.
Addiction is a mystery. There is some evidence for a genetic disposition, but it’s not straightforward. Genes do not map out one’s fate; they map out possibilities of fates.
Physical addiction, also, masks emotional illness. In fact the craving is more emotional than physical – it must be so, since the craving of a food addict or the anorexic act of deliberate starvation is, people say, as powerful as the cravings of a heroin addict. Every addiction has a particular profile; every addict has a drug of choice. But addiction to drugs, as opposed to food and alcohol, is also about small incremental steps into another culture. A transition. A conversion.
Possession alone is unlikely to send you to prison if you are wealthy, because you are deemed unlikely to be dealing. If you have not committed other crimes, you are mostly left alone. And there are, I now know, psychiatrists who are willing to prescribe you large amounts of methadone or morphine as part of a supposed “rehabilitation” programme. The line between legal and illegal drugs is finer than most people imagine. Wealthy addicts, gripped by paranoia, eroded by drugs, frantic to keep their supplies flowing, are almost untouchable. Families look on in despair, but the fact is that their addicts already live in a world where drugs are largely decriminalised. And it’s not a safe place.
In the US, addicts are often committed to care by criminal judges. It’s rare here, though it happened in the case of my brother. People often say that addicts have to want to get better before recovery can happen. But studies have shown that whether treatment is voluntary or not in fact has little effect on outcome – addicts committed to care apparently have as good a chance of recovery as addicts choosing care. Spending time in a culture of recovery, with other recovering addicts, in a community of solidarity and responsibility, is the best treatment: every addict in the room understands that whether you are there voluntarily or not makes not the slightest bit of difference. They have all hit rock bottom, one way or another. Giving up drugs, for an addict, is always an act of surrender.
But it’s important to remember that most drug-takers are not addicts, and that the human cost of the war on drugs globally is enormous. If addiction was more securely defined as an emotional illness, and more separated from the activity of taking drugs, it should be possible to decriminalise drugs. But at the same time it must be made easier to commit addicts at risk of dying to care.
A year ago, on New Year’s Day, I went to my brother’s house. Eva was away, and I had heard that she was overwhelmingly worried about him, that he was not in a good state. The housekeepers let me in. They hadn’t seen me for so long – I was, for reasons too sad to think about, banned from the house. The cat, a heavy white pedigree, was purring, pressing itself against their legs, watching me. “How is he?” I said. “Well, you know”, they said. “Not good.” We talked for a while, then I said I was going up. “You can’t go there,” they said. “Oh, don’t worry,” I said, “I’ll just go up and knock on the door.” Now I know I might have gone up in the lift, and reached him, but I didn’t realise that then.
I walked upstairs. I stood outside that still broken door. Something had been pushed against it, so it was jammed from the inside. I knocked and called into the silence. No answer. I knew he was in there. I knew he might be dead or dying. Where was the state then, as I stood outside that broken door? Our only option of outside help at that point was to have him committed, and that, we had learned, was almost impossible.
When he was finally arrested, we heard, the police gave him a paracetamol to help him as he was brutally detoxing on the floor of the police cell. That lack of medical care, someone said, might have killed him. Where was the state then?
Reading this again, I notice now that this is all hearsay. My only direct experience of the police was that same day, when I managed to reach by telephone one of the police officers at the house. He told me a little of what they had found. I am grateful still for the kindness of his voice and the quiet competence. And I am sorry, still, for what they had to see that day.
I have a little wooden koala bear, standing on a chest in our drawing room. My parents went to Australia and came back with presents; this was one of them. My brother and I – little kids – used to give it to each other for Christmas, on alternate years. I still have it, 40 years later. When it’s too painful to be reminded of him I put it away.
I remember my brother, his children climbing on him, laughing. I remember Hans and Eva together in their first flat, filled with hope after long hard years of addiction and recovery for both of them. How I wish that the beat of the butterfly’s wing had taken them somewhere else. Out of all the tragic endings we imagined – and there were many – we never imagined this.