Stigma versus Science: How learning about drugs at university changed my career direction

March 24, 2023

Hi there!

I’m Lizzy, and my work in Cynefin is all things health!

Considering that I’m the biggest hypochondriac, this makes little sense to my friends and family.

I started out by studying Psychology at university, which gave me a great foundation for exploring why people behave the way they do, and how our minds actually work. But really it just meant that I signed up for a life of being asked if I can read people’s minds (I definitely can).

In my final year of uni, I took a module on drug use and addiction which turned out to be a pretty defining moment for the career decisions I ended up making. Not for the usual “don’t do drugs or you will die” message that health campaigns and legal systems love to promote.

But because the module was all about drug harm reduction. So instead of teaching us a whole lot of content on why drugs are bad and what awful things they will do to our minds and bodies, we were taught about how to make drug use a safer experience. Like safe injection sites. We learned about people who broke the law to create safe spaces for those suffering from addiction to inject themselves with sterile needles in a clean and safe environment. For example ‘the man and his illegal van trying to fix Glasgow’s drug problem’.

We also learned about services which set up mobile laboratories at huge festivals specifically intended to check if the drugs that people are carrying are actually the drug they think it is. Not with the intention of taking it off them, but just so they know exactly what they’re putting into their systems. It turns out, this is a lot more effective in actually reducing festival drug use than just banning it. In 2018, a harm reduction organisation called ‘The Loop’ offered this drug-checking service at 7 festivals across the UK and found that almost two-thirds (61.7%) of festival-goers got rid of their substances completely after being told that their drug wasn’t what they believed it to be.

All of this does something that is controversial and disliked by so many: it accepts that drug use is going to happen anyway (regardless of how strict laws are), and instead of condemning it, it helps those with addiction or those recreationally using to do so as safely as possible. Which by the way, is much more effective in reducing drug overdoses and preventable deaths.

This got me interested in the discrepancy between policies relating to health and the actual science behind the issue itself, and why the two don’t always support each other. The war on drugs is a classic example of this. It also highlighted to me how stigma presents such a huge barrier to overcoming ill health in populations. 

I decided I wanted to learn more about other health issues from a global lens, which led me to doing an MSc in Global Health at King’s College London where I sat in seminars with experienced doctors and healthcare professionals from all around the world (the impostor syndrome was real).

And that’s when I learned just how critical stigma is in preventing access to health services. Especially in mental health, drug addiction, eating disorders, and sexually transmitted infections, all of which are associated with this huge societal shame. This course gave me the chance to learn about how this plays out across different types of healthcare systems in different contexts of socioeconomic development. Stigma seemed to be a recurring theme, especially when it came to policy making and governmental attempts to influence health-related behaviour.

Just like how drug addiction is ineffectively tackled using criminalisation and punishment, the use of shame and guilt tactics to ‘promote’ healthy behavioural choices (e.g. quitting smoking, eating healthily, you name it) in media campaigns tends to have counterproductive impacts on population wellbeing, it just isolates people instead. For example, the fitness industry has been plagued with empty promises of quick fixes to lose fat and focus on being your slimmest self, rather than being your strongest and healthiest self (as a powerlifter, this particularly irks me).

It’s not just a simple solution of banning drugs, shaming people into dietary choices, or scaring people into taking vaccines. The complexity of human motivation for behaviour is so important to acknowledge when health-related policies and health campaigns are implemented. 

What we read, see and hear makes such a difference to our choices when it comes to managing our health. It affects help-seeking behaviour (or more accurately, the lack there-of). And as we’ve seen in the COVID-19 pandemic, it affects critically important behaviour such as vaccine uptake. For my MSc thesis, I investigated the role of health misinformation as a bioweapon in international politics, and how this has impacted the spread of vaccine hesitancy. I explored the tension between the human right to freedom of speech and the human right to good health; by means of being well-informed, a right which is violated by the spread of health misinformation. 

So, what seemed like a random decision at the time to take that addiction module at uni ended up redirecting my interests towards behavioural science and global health policy – and now I work in Cynefin’s health programme where we help clients around the world in the healthcare space conduct and deliver powerful research using SenseMaker that not only acknowledges the complexity of human decision-making, but also enhances the narrative of lived experience to guide the next steps in healthcare. 

Contant Lizzy: Email & Linkedin 

One response to “Stigma versus Science: How learning about drugs at university changed my career direction”

  1. […] The social aspects of science also need greater insight and new models of intervention – the recent post by our newest member of staff Lizzy raises really interesting questions […]

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The Cynefin Company (formerly known as Cognitive Edge) was founded in 2005 by Dave Snowden. We believe in praxis and focus on building methods, tools and capability that apply the wisdom from Complex Adaptive Systems theory and other scientific disciplines in social systems. We are the world leader in developing management approaches (in society, government and industry) that empower organisations to absorb uncertainty, detect weak signals to enable sense-making in complex systems, act on the rich data, create resilience and, ultimately, thrive in a complex world.

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