SENDING A MESSAGE
What is possible in private is not possible in public. On a secluded beach, things can be said and done, even by police, which are not possible in the blinding light of the media.
Media coverage of illicit drugs is dominated by death, disaster and downfall. As a journalist, I know this is not always by design; it is in part a result of the places where journalists get news. The fragments of life which make their way into news bulletins come via police press releases and court cases, or filter out through hospital emergency rooms and coronial inquiries. These stories rarely end well. And stories that do not end well have advantages for the journalist beyond their drama: dead people can’t sue for defamation, and nor can those being prosecuted in court if the proceedings are fairly reported.
Journalists are also under pressure to detect any new trends. In the case of drugs, this means pressure to uncover the next big scare, the crisis epidemic hitting ordinary families and leaving hospitals struggling to cope with the fallout. In recent times there has been crystal meth, then prescription painkillers, and then the stimulant referred to in the media as ‘meow meow’. These drug-trend stories serve two conflicting purposes: they allow parents to warn teenagers about the dangers, and they allow drug users to find out whether the latest sensation sounds any good and where they can get some. For reporters, pay dirt is when you find an upwardly mobile, shiny-faced young person driven to the brink by the drug. It always wrecks the story a bit when the only victims you can find are troubled junkie souls.
Then there are the celebrity scandals. The sportsmen who screw up on drugs have become cultural icons; their narratives of tragedy and redemption are great national soap operas. When high-profile people admit to drug use, it is generally because they are forced to. They are also forced to repent. There is no future for sportspeople in defending their drug taking, and certainly no money in it. Sponsorship dollars, a sporting future, depend on sucking it up and saying sorry, repenting the error of your ways. Failing to exhibit adequate remorse lands the high-profile drug user in trouble. Footballer Andrew Johns, for example, was condemned by critics for his failure to demonstrate adequate damage from his drug use.
Very occasionally a celebrity will break the rules. Singer-songwriter Paul Kelly spoke candidly about his years of heroin use when he was interviewed on the 7.30 Report in September 2010. He told Kerry O’Brien that he thought he ‘had something to say about heroin that was different to the usual narrative’ about tragedy or redemption. And the story was ‘[t]hat, you know, people do use hard drugs recreationally and not all the time. That people can use drugs like heroin without having a habit. I never did. And that, at some point, you weigh up the costs against the benefits and at some point you think, “The costs are getting too much; I’ll stop.”’ In Kelly’s case he found that the comedowns were taking much longer, and it was harder for him to come off it each time, so he stopped. He refused to put his usage down to the pop-psychology diagnosis of ‘self-medication’.1
But Paul Kelly is a rock star and society expects decadence from entertainers. It is far less accepting of drug use by other types of people. In an interview for ABC-TV’s Big Ideas in November 2010, the Sydney Morning Herald journalist David Marr made passing positive comments about his own drug experiences; these were duly noted in the Murdoch tabloid The Sunday Telegraph under the headline ‘My love of drugs: David Marr’. The newspaper reported that ‘Journalist and author David Marr has advocated illegal drug use, saying taking illicit substances was “marvellous” and a “typical mainstream Australian experience”’.2 No wonder people are reluctant to speak openly on this topic.
And there is another reason for the lack of candid discussion, a sincere reason: genuine concern about sending the wrong message to young people.
•
My generation grew up in the shadow of Anna Wood. Her lightly freckled face, smiling and fresh with only a touch of mascara, hair falling just to the collar of her school blouse and blazer, became an icon of the ‘Say No to Drugs’ movement. In fact, those words were printed beneath that same image on badges distributed to high school students after her death.
Anna was a fifteen-year-old schoolgirl who died after taking a single ecstasy tablet. It was a Saturday in October 1995 and she was two weeks away from starting her working life as a full-time beautician when she sat down to a home-cooked meal at her family home in Sydney’s Belrose. Once dinner was done, she was heading round the corner to spend the night watching videos at a friend’s place. At least, that’s where her parents thought she was going. In truth, her friends were waiting in a car outside to take her somewhere much further away.
It was after midnight when they made it to a rave at the Phoenician Club on Broadway, which was then a rundown strip of shops not far beyond the central business district. Milling about in the crowd out the front they found an older student from their school. She sold them ecstasy tablets for $60 each, which the girls swallowed whole before slipping inside, ticketless, when the bouncers weren’t watching.
Anna had taken ecstasy at least once before; she had tried marijuana and possibly speed as well. Some time before dawn her sense of euphoria gave way to something else—she vomited and ran to the bathroom. Then she threw up some more, uncontrollably.
Her friends carried her from the club into the street. No one called an ambulance. By this time she was disoriented, pale and numb, and they drove her back to the suburb where they lived, 40 minutes away. Upstairs in the bedroom of her friend—the bedroom where she was supposed to be staying the night—Anna drifted between sleep and delirium.
More time passed. The friends concocted a lie about her soft drink being spiked. By the time her parents were finally called, Anna was sweating, confused and soaked with urine. Finally, more than five hours after she fell ill, an ambulance was called; but by the time it arrived, she had stopped breathing. At the hospital, hope flickered, then died. By Tuesday she was pronounced brain dead.
The Coroner found that she had died from lack of oxygen to the brain, following acute water intoxication after taking ecstasy. Drinking too much water can be particularly bad after taking ecstasy because of the effect the drug has on the kidneys in some individuals, compromising the organ’s ability to rid the body of excess water. In such cases, drinking water dilutes the fluids of the body and causes its cells to swell, including the cells of the brain. This can put pressure on the base of the brain, in extreme cases causing breathing to stop.
Anna was killed by ecstasy. The Coroner’s report on the case stressed that urine analysis confirmed the presence of MDMA and found no other drug. Some argued it wasn’t the drug itself which killed her but that she died from drinking too much water, or not enough, or from the failure of her friends to seek medical help in time. Whatever the interpretation, one thing is clear—if she had not taken that pill, she would not have died. Ecstasy deaths are real but rare, or rare but real, depending on where you wish to place the emphasis.
Horror stories like those of Gemma Thoms or Anna Wood—or overseas equivalents, like British teenager Leah Betts, who also died in 1995 from water intoxication after taking a single ecstasy tablet—have their purpose. They serve as a warning to teenagers contemplating whether to experiment with illicit drugs. They serve as a warning to teenagers about risk more generally: you are not immortal; you have an obligation to seek medical help for your friends; some things are more important than your own fear of getting into trouble; when you take risks with your own life, you also gamble with the wellbeing of the loved ones who will grieve for you.
There is real value in discouraging drug use among teenagers and delaying the age when a person first tries drugs—the earlier someone starts, the more likely they are to end up with problems, whether with the law, addiction or mental health. However, horror stories only work on some people. Even when they work, it may only be for a limited time, if the horror stories are supplanted by positive personal experiences with drugs.
•
In an office at the University of New South Wales, Kari Lancaster sat down to read about drugs. A lot about drugs. She was part of a team at the Drug Policy Modelling Program, which was conducting the most comprehensive study yet on the way the media reports on illicit substances.3 She had to read 4397 articles published in Australian newspapers between 2003 and 2008. ‘I actually enjoy media content analysis. People think I’m a bit strange,’ Kari says. She was churning through 60 to 100 articles a day, fired up on the kind of wholesome beverage befitting a drug researcher: ‘We did a lot of juice runs down to the café.’
In spite of fears in some quarters that the media portray drug use positively, in a way which might encourage or pique interest in drugs, Kari and her colleagues showed it was extremely rare for newspaper articles to express approval for drug taking: their survey showed that articles with a ‘good’ moral evaluation of drugs accounted for only 1.9 per cent of the sample. Nor did the media coverage tend towards sensationalism and moral panic, with only 7 per cent portraying drugs as a crisis issue.
When the use of drugs by elites such as sportspeople and musicians was discussed in newspaper articles, the research team found that the tone was generally neutral. The social problems caused by drug use were discussed in 34.1 per cent of the articles, with legal problems addressed in 31.8 per cent and health problems in 24.3 per cent. ‘Despite concern about glamorous portrayals of celebrity drug use in the media, not one article in the sample cited beneficial consequences in association with drug use by elites,’ their report concluded.4
After looking at the way the media covered illicit drugs, the researchers then set out to determine the effect reporting had on attitudes to drugs. In a location in Sydney’s inner city, they set up focus groups of young people aged between sixteen and 24, who were shown a number of newspaper stories about ecstasy and cannabis, and then asked whether it changed their view of these drugs.
The most effective story in reducing pro-drug attitudes among the young people and making them reconsider future plans to take drugs was a story about Gemma Thoms, the Perth girl who died after taking three ecstasy tablets before the Big Day Out. It quoted her devastated friends and family.
‘I think that would convince me not to take drugs,’ explained a seventeen-year-old boy in one of the focus groups. ‘Just ’cause . . . I feel sorry for her . . . I mainly feel sorry for the parents honestly, ’cause I don’t want to see my parents, or any parents, or my friends to have to go through what they did.’ A 22-year-old woman also felt that the article was quite effective in deterring people: ‘I think it’s kind of effective . . . you don’t ever want to be that grieving person, you don’t want any of your friends to go through that.’5
Even for those who were not deterred from taking ecstasy, the researchers noted that for some of the young people the story was still valuable in sending a message of harm reduction about particular patterns of drug use: ‘I don’t think this makes people go, “I’m going to die after a small amount of ecstasy.” Like, “Ecstasy is going to kill me, full stop,”’ explained a 23-year-old woman. ‘I think it goes, “A lot of ecstasy at once is going to kill you.”’ A seventeen-year-old male took out a different message entirely: ‘I think that it would affect me because it says that there are authorities at Big Day Out, so I think I would learn not to take ecstasy pills at events like that.’6
But some of the young people actively rejected the message. ‘I don’t want to be disrespectful to the girl that died, but the article kind of just loses all its purpose and credibility just because it was kind of idiotic to take [three pills],’ said a 24-year-old woman. Another woman, a 23-year-old, suggested these sorts of stories work best on younger teenagers: ‘I must say, when I was younger, I found those emotive stories—like particularly that one about Anna Wood—really affected my views and the way that that was portrayed in the media totally shaped the way that I saw drugs. Whereas, like, as an older person, I guess I have a bit more of an understanding.’
•
Horror stories about blooming youth lost to the scourge of party drugs have some value in discouraging innocents from trying drugs in the first place. Though the stories may be less compelling for those who have dabbled happily already, they can still play a role in getting them thinking about ways to make future experiences as safe as possible, in getting them thinking ahead about what they would do if something went wrong with a friend. Horror stories can promote prevention on the one hand and, failing that, harm reduction on the other.
But this is not the only purpose to which horror stories are put. Sometimes the parents of the rare victims of recreational drugs become figureheads in the debate about drug laws, though their expertise lies in bereavement rather than drug policy. They are shielded from challenge or intense questioning by the rawness of their grief.
Anna’s Story, a compelling and beautifully written book by the late journalist Bronwyn Donaghy, has been a staple of high school libraries around the country for more than a decade. The tragedy of the Wood family is put to the purpose of warning teenagers against the dangers of drugs; it argues more broadly against any softening of drug laws.
Tony Wood explains in his own words the trouble with drug dealers: ‘Most of them are addicts themselves and because they are into it, they believe everybody else should be into it as well. If they were only destroying their own lives you could say it was their problem, not ours. But drug users don’t just harm themselves. They are ruining lives. Children are getting hooked. People are being killed on the roads. Families are being broken.
‘What’s wrong is the number of doctors and specialists and academics who are misguided enough to want to legalise this stuff throughout the world. We want nothing to do with that idea. We don’t support the legalisation of drugs in any way.’7
Through the power of print, the Wood family position moved into the bookshops, then into high school libraries, and finally into parliament. On 8 November 2007, on the floor of the New South Wales Parliament, Liberal MP Marie Ficarra rose to thank Anna’s parents for their work ‘in our community to prevent young people from going down the dark road of drugs’ and concluded: ‘Anna’s tragic death had a lasting impact on thousands. However, her death also inspired her amazing parents to dedicate their lives to ensuring that no other death occurs, and that kids and families know the dangers of illegal drug use.’8
•
Bereaved families and the spectre of dead teenagers are a powerful tool for those seeking to maintain and strengthen the prohibition of illicit drugs and to stymie rational debate about drug policy. Journalists, politicians and even scientists live in fear of speaking freely on the topic or expressing the slightest equivocation, lest it becomes the butterfly-wing flap that kills a teenager. The consequence of these fears is that political debate, even scientific debate, stalls at the level of talking to fifteen-year-olds.
Nowhere are the constraints on the debate demonstrated better than a case from Britain which ensnared a leading psychiatrist, brought into question the independence of scientists advising governments and underlined the risks those in positions of power face when speaking candidly about drugs.
David Nutt’s résumé does not lend itself easily to lurid tabloid coverage. He studied medicine at Cambridge, taught psychiatry at Oxford. He rose to the position of chairman of the United Kingdom’s Advisory Council on the Misuse of Drugs, the expert body which advises government ministers on the harms of various drugs and recommends suitable measures to address them.
Nutt was nearly a year into his role advising the government when his troubles began. The source of these troubles was an editorial he wrote in 2009 in the Journal of Psychopharmacology,9 a periodical which is neither racy nor widely read, especially not by impressionable teenagers.
The editorial was about the fact that the drugs debate ‘takes place without reference to other causes of harm in society, which tends to give drugs a different, more worrying, status’. He set out to prove his point by comparing the damage caused by ecstasy to the damage caused by a legal activity, horse riding. He coined the term ‘equasy’ to describe an ‘addiction’ to horse riding and gave the editorial the title ‘Equasy—An overlooked addiction with implications for the current debate on drug harms’. Then he detailed some of the worst consequences of acting on an ‘equasy’ addiction by jumping on a horse. He described a patient who was referred to him suffering the permanent effects of brain damage from a horse-riding accident. The woman was in her early thirties and had suffered a dramatic personality change as a result of the accident. She was irritable, impulsive. She suffered anxiety and had lost the ability to experience pleasure. In medical terms, she exhibited ‘a degree of hypofrontality and behavioural disinhibition’ that had led to many bad decisions in relationships. She chose her partners poorly and had had an unwanted pregnancy. Her tragedy was not simply a personal one; it had a cost to society as well: ‘She is unable to work and is unlikely ever to do so again, so the social costs of her brain damage are also very high.’
Nutt went on to explain that horse riding kills about ten people every year in the United Kingdom. Many more suffer permanent neurological damage. It is also associated with more than 100 traffic accidents annually.
A graph accompanying the editorial drew on previously published data to compare the relative harms of ecstasy and ‘equasy’. The data showed that ecstasy caused acute harms once in every 10,000 uses. Horse riding causes injury once in every 350 rides. While these figures were drawn from different sources and used different measures—injury and acute harm—the comparison nonetheless showed that ecstasy is not wildly more dangerous than sporting activities which are perfectly legal; in fact, it may be much less risky. Nutt questioned why harmful sporting activities are allowed, while drugs which are less harmful are not. The editorial concluded with a call for rationality. ‘The use of rational evidence for the assessment of the harms of drugs will be one step forward to the development of a credible drugs strategy.’
On this count he would soon be bitterly disappointed.
•
With many topics of public concern there is a tension between wanting to tell the truth and wanting to say things which will send the right message, a conflict felt by parents and journalists alike.
Drugs are not the only issue where this conflict arises. The same tension exists in the public discussion of suicide. Responsible media outlets strictly curtail the reporting of individual suicides on a day-to-day basis (although this principle seems to fall down when it comes to reporting the details of celebrity suicides). When I worked as a newspaper reporter myself, there were many times when, after we learned that someone had jumped to their death from a shopping centre car park or had thrown themselves in front of a train, such information never went any further than the floor of the newsroom. In the next day’s paper there would be no mention of the event, even though any other kind of death which was so shocking, public, or simply disruptive to the flow of peak-hour commuters would have rated at least a brief mention. In cases where an individual suicide does make the news, reporting guidelines drafted by mental health professionals ask that journalists avoid making detailed mention of the method used and ensure that the report does not glorify suicide, even in subtle ways such as calling an attempt where a person dies ‘successful’ and one where a person lives ‘unsuccessful’.
Constraints are placed on the reporting of suicide for good reason. The media has been given guidelines by mental health professionals based on sound evidence that the suicide rate can spike in the days after graphic reporting of a suicide, thanks to copycat attempts. In cases where individual suicides are reported, the Federal Government’s Mindframe National Media Initiative advises playing down the prominence of the story: ‘Consider whether the story needs to be run at all; position the story on the inside pages of a paper or magazines, or further down in the order of reports in TV and radio news.’
However, these constraints come with costs. Some psychiatrists have argued that they have distorted the public perception of the issue, making suicide appear much rarer than it actually is. This in turn has consequences for the public policy debate about suicide and mental health. The issue doesn’t seem so urgent when there are so few reminders of the problem, compared with other issues which can be reported freely, such as road accidents and cancer. There are regular reminders of the road toll, for example, with news reports tallying up the number of dead over holiday periods. Yet suicide kills more people—in 2008 there were 2191 deaths by suicide in Australia, compared to 1437 deaths on the road.
The tension that exists in the media reporting of drugs is not so different. On the one hand, there is a desire to send vulnerable members of the community, such as teenagers, warnings about the worst consequences of taking drugs, in the hope of preventing, limiting or delaying experimentation; on the other hand, there is the desire to paint an honest picture about drug use, including drug use which doesn’t conform to the public health warning message, in order to create a factual base for a rational debate about drug policy.
When the real range of drug-taking experiences cannot be publicly discussed, and the vague fear of sending the wrong message overwhelms rational discussion, the costs are great for the quality of drug policy and public debate.
•
On the other side of the world, David Nutt soon discovered the limits to what a person in a position of authority can say openly about drugs. The month after his editorial about ‘equasy’ was published, the media cottoned on. And once the papers had said something about it, politicians had to as well. In the House of Commons, Home Secretary Jacqui Smith stood to speak on the matter, saying she was ‘surprised and profoundly disappointed’ by the comments.
She said that Nutt’s comments sent the wrong message to young people about the dangers of drugs: ‘I made clear to Professor Nutt that I felt his comments went beyond the scientific advice that I expect of him as the chair of the Advisory Council on the Misuse of Drugs. He apologised to me for his comments and I’ve asked him to, as well, apologise to the families of the victims of ecstasy.’ She also said she was ‘sure most people would simply not accept the link that he makes up in his article between horse-riding and illegal drug taking . . . For me that makes light of a serious problem, trivialises the dangers of drugs, shows insensitivity to the families of victims of ecstasy and sends the wrong message to young people about the dangers of drugs.’10
Laurence Robertson, the Conservative representative for Tewkesbury, piped up. Perhaps channelling the concerns of his constituents in rural Bishop’s Cleeve, Twyning and Longlevens, he defended equestrian activity. Horse riding, he said, provided discipline, whereas drug taking ‘not only wrecks lives, and ends lives, but also fuels crime’.
The Home Secretary did not disagree with the Honourable Member for Tewkesbury on this count, as she explained: ‘I made completely clear my view that there is absolutely no equivalence between the legal activity of horse riding and the illegal activity of drug taking.’ Jacqui Smith said that would always be the basis on which she would make decisions about drug policy.
The lessons were many. Apparently the role of scientists in public life is to provide raw data for the media and politicians to manipulate at will; it is beyond the jurisdiction of scientists to try to take control of the message themselves, especially if it means employing creativity and humour. Anything that paints drugs as less than the worst thing ever affronts the memory of the dead.
In this way, it seems, drug deaths are different to other deaths. Campaigners fighting against covert speed cameras are not asked to apologise to the families who have previously lost loved ones to speeding drivers. Heavy drinkers who big-note about their exploits are not asked to apologise to the families of the victims of alcohol poisoning and cirrhosis. But grieving families who have lost loved ones to illicit drugs have a special place in the pantheon of grieving families: they have the power to control public policy and limit debate. This is a power that families grieving death from suicide, sporting accidents, drowning or cancer can only dream of.
For Professor Nutt and the Advisory Council on the Misuse of Drugs, the timing wasn’t great. They were on the point of releasing a paper arguing that the classification of ecstasy should be downgraded to a less serious category of drugs.
Nutt capitulated. That night he apologised, saying he had ‘no intention of trivialising the dangers of ecstasy’: ‘I am sorry to those who may have been offended by my article. I would like to apologise to those who have lost friends and family due to ecstasy use.’
Little did he know that this was only the beginning of his troubles.
•
In this climate, it is hardly surprising that occasional, functional users of illicit drugs rarely have a voice in the ongoing debate. Given the way the media deals with this issue, why would dabblers, with careers and families to protect, willingly put their reputation and future at risk?
A decade and a half has passed since the death of Anna Wood. The Phoenician Club ultimately closed down and a sandwich shop opened in its place, then an Asian bakery. Luxury apartments rose above it. Fashions changed. Baggy pants and tight tops gave way to the reverse. Party drugs moved beyond the rave scene and the very term rave came to conjure embarrassment, nostalgia. The parties moved from all night to all day. Outdoor music festivals became the thing, with security guards and first-aid vans, online ticketing and corporate sponsorship.
The gulf between the stories in the papers and the experiences of ordinary partygoers grew so wide that some people felt the stories had nothing to do with them. On the ground, things changed enough that it was easy to forget that the drugs were still illegal. Like, really, really illegal.