Dr Adam R Winstock, founder and director of Global Drug Survey, at Drugs Live: The Ecstasy Trial
If you’re a drug user, chances are you smoke, swallow, drink or snort your chosen substance recreationally. Statistically, as long as you’re not taking stupid amounts of that substance, you’ll probably be alright in the long run. That said, it’s hard to know for certain what constitutes a “stupid amount”, as official guidelines on drink (“no more than 14 / 21 units a week”) and drugs (“don’t take any ever”) aren’t all that realistic in practical terms.
It’s exactly that – harm reduction for recreational, or “unproblematic”, drink and drug users – that the people behind Global Drug Survey (GDS) hope to address. Gathering feedback from a huge network of drink and drug users from around the world, they’ve devised the Drugs Meter and Drinks Meter, two interactive services (available online or in phone app form) that can tell you exactly how your usage compares to others around the world, as well as giving you peer-collected advice on how to take whatever it is you take.
There are also a couple of other features – one that shows you roughly how much you’ve spent on weed in the past year, for instance – designed to let you decide whether your intake is something that needs correcting. Finally, The High Way Code (HWC), published earlier this year by GDS, tells its users in no uncertain terms how to both enjoy their drugs and take them safely.
I recently spoke to Dr Adam R Winstock, founder and director of GDS, about how his organisation’s tools are changing harm reduction.
A chart from the Drugs Meter showing peer-collected advice for MDMA use
VICE: Hi Adam. First off, let’s talk about how your approach applies to alcohol. Why are British people actively ignoring official advice on drinking?
Dr Adam R Winstock: I don’t think it’s just English people; it’s everyone around the world. National drinking guidelines talk about the risks of longer-term harms, while people are more interested in short-term benefits. They’re based on good evidence and, if followed, people will be at far less risk of developing health problems related to alcohol. But many drinkers want to drink for short-term gain, i.e. getting a little bit – or sometimes quite a bit – drunk.
For many, the current guidelines are set out in a way that doesn’t acknowledge that getting drunk once in a while might be desirable. We need to think about more nuanced and reality-based drinking guidelines that are going to treat people like adults, as well as accepting that alcohol is a legal intoxicant that can be very dangerous.
How do you go about doing that?
This year we’re going to challenge existing guidelines and use people’s expert opinions to help formulate the world’s first “safer drink and drug-using limits”. We’ll ask people in GDS 2015 how much they need to drink or take to feel the effects and have fun, and what the risks are at different levels and frequencies of use. I think most people who use drugs will be far more sensible than everyone expects.
Right. So I guess that helps to explain why state-funded campaigns like Talk to Frank are so ineffective when it comes to reaching this group.
I think Frank can be very informative, but it’s not for people who like taking drugs. It’s like taking a vegetarian to McDonald’s. Talk to Frank, like many state-funded campaigns, has to toe the party line: “Drugs are dangerous and people shouldn’t take them and that’s why they’re illegal.” It’s therefore very difficult for them to have an adult conversation that clearly accepts the reality: that people who use drugs generally aren’t stupid, and that they want to do it socially without intentionally harming themselves or people around them.
That’s the reason GDS is an independent project. We’re not beholden to the government, because they don’t pay us.
Dr Adam R Winstock
Why else has harm reduction had comparatively little success in influencing the way people recreationally – or “unproblematically” – use drugs?
Well, no one gives a toss about recreational drug users because they’re not out there committing a huge amount of crime or ruining their lives. So this huge group of people [about 89 percent of drug users take their chosen substances recreationally] are missed.
There’s also a lack of funding and a lack of interest. Plus, harm reduction has been driven at reducing crime, deaths and mortality, and was initially kicked off with the need to reduce HIV. Yet, the problems facing most recreational users are not death or HIV. The government has found it difficult to figure out what to advise these people to do. They keep pushing the “don’t take drugs” narrative, leaving little room to acknowledge that the risks can be reduced significantly by changing drug-using behaviour and context.
Abstinence isn’t acceptable for the vast majority, for whom drug use is not a major problem. The advice just isn’t fit for the target audience, which is basically the general public, not a high-risk section of deviants.
Dr Adam R Winstock explaining the Drugs Meter
You say your harm reduction advice is “personalised”. How so?
The real personalisation bit is through the Drugs Meter and Drinks Meter, rather than the more generalised information given elsewhere. I’m not naive enough to think that because the GDS produced this pretty little app that people are just going to change the way they use drugs. That alone won’t change behaviour. What changes behaviour is for people to have an opportunity to reflect on how and what they do impacts on them personally, and how changing strategies will modify their own personal experience and risk of harm.
A feature on the drugs meter that can show you roughly how much you've spent on weed since you started smoking
How does it work exactly?
So there are four barriers, if you will, that all of us use to stop ourselves from changing what we do. The first thing we do is overestimate our personal invulnerability to harm. That barrier is challenged by the drink and drugs meters by, telling people how their personal and family history, medication they might be on and their personal pattern of drug use impacts on their personal venerability to harm. So people can’t go, “Well, this has nothing to do with me,” because it is clearly all about them.
The second thing we say to ourselves is, “Yeah, I might get a bit hammered on the weekend, but fuck it, all of my mates do as well and they’re all fine.” We take comfort in the herd – but of course our herd is very small. The Drugs Meter doesn’t just compare you to your 25 mates; it compares you to tens of thousands of people around the world who also use the same drugs as you. That social, normative feedback, I think, can make people feel uncomfortable. They might realise that doing two grams of coke on Friday and Saturday is not what most people who do coke do. Knowing what other people do can shift our behaviours in the right direction when it’s done smartly.
The third thing is that people are ambivalent – they like getting high. Our feedback thinks that’s fine – it’s not judgmental. But we tell people how they can go off and do what they want to do a bit more safely.
The final thing is that when people do recognise they’re engaging in behaviours that are harmful and they do want to talk to someone, they’re faced with issues of stigma and shame – some of which are made worse by drug laws and some of which are irrelevant. That’s why all our services are anonymous, independent and confidential.
Have you encountered many challenges while doing your work, given the kind of harm reduction advice you give?
Honestly, remarkably little. Mind you, properly considered, it’s not really that radical. If you have any common sense – if you understand drug use at all and you don’t subscribe to the moralism around intoxication – there isn’t anything in the HWC that’s notably contentious. It follows tried and tested peer education models derived from having adult conversations with people who acknowledge the facts.
We’re just saying, “Hey guys, this is what a shit-load of people who do the drugs you do happen to think is sensible. And by the way, it doesn’t seem to reduce the pleasure they experience, so you might want to think about these things.”
So it’s really gentle. It’s information sharing – that’s how I see our organisation, as essentially an information exchange agency. People tell us stuff and we give them information back. It’s rational, not radical.
Why do you think it took so long for someone to just ask drug users on a large scale for their knowledge and experiences? It seems like both pretty accessible and valuable information.
I agree, this ain’t rocket science. There’s been lots of people from the harm reduction movement who have been saying this for a long time, but it just takes time for that to filter through to people like myself, who are fortunate enough through the GDS to be in a position to help implement it. We’re really lucky to have the global network of researchers, media partners and users who have helped us make this happen.
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