Jake Woodhouse on Mental Health and the War on Drugs

PTSD is hot right now. It’s almost become de rigueur in TV cop shows and films. Where once

there was the alcoholic inspector, solving the case whilst battling the demon drink, we  now have conflict veterans and police diagnosed as suffering from varying forms of Post-Traumatic-Stress-Disorder. It’s gone so far that in Don Winslow’s Savages its even played as a joke; one of the characters, a returning Veteran from Afghanistan who is completely unfazed by the conflict he’s been involved with, is diagnosed by his closest friends to be suffering from extreme LPTSD, or Lack-of-Post-Traumatic-Stress-Disorder.

In one sense it’s good that PTSD is portrayed so widely, it’s made us more aware of the results of extreme stress and how that can impact on people, and therefore on society as a whole. But in another sense we’re running the risk that very ubiquity of it in fiction ends up belittling it in the process.

I’ve tortured my main character Inspector Jaap Rykel over the course of three books and for The Copycat I felt I needed to do something more; I needed to show the results of that torture. So I became interested in PTSD and after reading round the subject, mostly dry and academic, I decided to speak to the only people who could really tell me anything of note, the sufferers themselves. And what I found, time and time again, was that PTSD was something that they were having to treat on their own.

The majority of people found the medications prescribed did little to ease the symptoms and had such wide ranging and in some cases, devastating side effects, that they’d rather face the flashbacks and nightmares. The therapy sessions, if they were even available, were gone into with hope but soon transformed into something to be got through, a long hard slog with no real benefit. 

There is however an emerging acceptance of something which genuinely helps, is backed up by emerging science, and is incredibly cheap and side-effect free.  It just so happens that it’s also been a major enemy of a war waged for much of the twentieth century, the War on Drugs.

The postscript has yet to be written on the War on Drugs, mainly because it is still on-going today. This despite the fact that it’s widely acknowledged to be unwinnable and also, in the eyes of increasingly large numbers of people, and like so many other wars, one which should never have been started in the first place.  The sheer stupidity of such an approach, punishing people for their use instead of asking why they are using in the first place, will go down in history as one of the most damaging and inhumane policies ever put into force.

But propaganda is strong, especially when it aligns with the puritanical streak which, though sometimes hidden, nevertheless runs deep through western culture. Why should people be allowed to get ‘high’, it’s disgusting, think many whilst drinking their third or fourth glass of a lovely little white from the Loire valley, or a big fat Malbec from Argentina.

That’s certainly what the average Swiss citizen thought in the 1990’s. At the time Switzerland was in the grip of a Heroin epidemic, users were injecting in public parks, turning to crime and street prostitution to get money, money which would end up in the pockets of the dealers and ultimately the drug cartels. Stronger enforcement never seemed to work, so an incredibly brave and forward thinking woman put forward a radical idea. She argued that it wasn’t the heroin itself which was the problem, it was everything else around it. The lack of social support for those who needed it most as the real problem. 

What if heroin was made available for those who needed it, in a safe place with medical staff and clean needles? Would the street crime problems go away? It would be unthinkable for a politician, in twenty-first century Britain, to stand up with such a proposal in parliament even today, let alone enact such a policy. But in Switzerland it was enacted, because the woman with the radical idea was Ruth Dreifuss, who would go on to be the country’s first women President. 

Her proposal was to run a trial for five years and then hold a national referendum on whether to continue it or not. The critics called it mad, puritans up and down the cantons were disgusted by the idea and the general resistance was extremely high. Nevertheless, the trial went ahead and as promised five years later a referendum was held. The vote was almost unanimous; the trial was an astounding success and should be extended indefinitely. The people had spoken. 

So what changed the minds of so many Swiss who’d opposed it so vehemently when it was proposed? Maybe it was the fact that street crime plummeted, street prostitution disappeared, citizens could take their children to the park without the fear they’d jab themselves on a dirty needle, the black market for heroin virtually disappeared overnight. All of this in itself is enough to prove the war on drugs was deeply misguided. But there was more. And it has to do with mental health.

Because it turned out that once you stopped forcing people to go to the black market, and penalising them for using but instead allowed them to use in a safe place with access to medical facilities and a non-judgemental atmosphere, a large portion of the users found, and sustained, gainful employment whilst they were attending the heroin clinics.

Even more astoundingly, at least for many observers who’d been brought up with the propaganda that heroin would inevitably fry your brain – who can forget the ‘this is your brain on drugs’campaign where an egg was progressively scrambled in front of the viewer’s eyes – many users eventually weaned themselves off it all together. It needs to be said again; many users weaned themselves off it altogether.  This is astonishing, given the narrative surrounding heroin at the time. It has chemical hooks, we were told, once you started you’d never be able to stop. The rhetoric was endless and also, as the Swiss heroin clinics proved, completely, mind-bendingly wrong. 

What emerged was a different picture, one where heroin use was often to get them through a period of deep emotional stress which they were unable to cope with alone. They weren’t bad people, they were just in bad situations and had found a form of self-medication which helped them deal with it. Framed like this, what kind of extreme lack of compassion would we show as a society for punishing people who are down on their luck and need help? 

Which brings us back to PTSD. It turns out many suffers have found something to help with their particular bad situation, and that something is a plant in the rose family, and one which has a history as medicine stretching back centuries; Cannabis Sativa.

The whole sorry history of how this highly beneficial plant became illegal in the first place has been documented at length elsewhere and can’t be gone into here (see Johann Hari’s Chasing the Scream for an excellent and detailed investigation into this), but needless to say it had nothing to do with the plant being inherently dangerous or bad for you, it’s neither, and everything to do with racism entrenched in the US administration during much of the 20th Century. ‘Weed’ was the drug of Mexicans and Black people, both of whom the establishment hated, and the prohibition of Cannabis was in large part simply a tool to enable continued persecution, whilst claiming it wasn’t about race. 

In fact, medical research, hampered by so long because it was illegal, is gradually revealing just why Cannabis is so useful for so many conditions. The discovery in the 1980’s  of the endocannabinoid system which is both present and essential to all mammalian life (that’s right, you are ‘high’ on the endogenous cannabinoids flowing through your brain as you read this) has opened up new vistas in the treatment of a whole host of diseases which medicine is currently failing to make headway with.  The old arguments that it causes mental health issues, psychosis in particular, have not a single shred of compelling evidence which suggests causation. In actual fact, in an almost unbelievable twist of irony, Cannabis is now being studied for it’s anti-psychotic properties.

Turns out all those teenagers who went psychotic after ingesting the demon Skunk (Skunk, despite what the rabid tabloids are constantly screaming at us, is variety of cannabis with a particularly pungent aroma but which is no more powerful than any other variety) were actually self medicating an illness they most likely already had. But from the outsider’s point of view the equation was simple, Skunk equals mental health problems when in fact all those people were doing was, knowingly or unknowingly, self-medicating their illness the same way the heroin users in Switzerland were.

Which brings us back to Inspector Jaap Rykel in The Copycat.

He too has found a way to help deal with his PTSD, but when he’s compelled back onto the force to help on a case he’d closed years previously, his self-medication brings him into conflict with his peers and superiors. After all, he’s spent his life upholding the letter of the law, and now he’s forced, for his own mental health, to break it.