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Stephen Milgate - Executive Director, The Australian Doctors' Fund
"Drug Summit - What was not said - Impact on the Family!"
The Australian Family Association Conference
July 1999
Ladies & Gentlemen
In July 1998 I presented a paper at the International Drug Prevention Symposium entitled "Challenging Orthodoxy in Australian Drug Policy."
In essence this paper examined the impact of the policy of harm minimisation (ie a policy which says we must accept the ongoing inevitability of drug abuse and find practical ways, funded by taxpayers, of making drug abuse as safe as possible) and exposed some interesting contradictions over the last ten years by the authors and originators of harm minimisation policy in Australia.
Some of these contradictions are:
During my research I sought to get behind the debate about treatments and policy and identify those factors which were seen as causal to drug abuse.
Are we spending too much time debated the symptoms of drug abuse and not coming to grips with what could make us all at risk of addiction.
I asked the question "Are we fighting the right epidemic?" I made the assertion that the real epidemic driving the demand of addictive substances of all types in a relatively affluent societies is the epidemic of emotional depression driven by social isolation.
I pointed to key research to back this assertion.
The real epidemic driving the demand for addictive substances of all types in relatively affluent societies is the epidemic of emotional depression driven by increasing social isolation.
In 1970 a US Government sponsored survey found that:
"...people born in the second half of the 20th century are 10 times more likely to suffer depression than people born in the first half."
The World Health Organisation (WHO) is predicting that within 20 years
"depression will match heart disease as the world's largest debilitating illness."
I believe this to be true of Australia as well as other western countries.
In a recent Australian medical publication circulated exclusively to General Practitioners Russell Roberts, Director of Clinical Training, Griffith University Department of Applied Psychology said:
"By the time Australians reach the age of 18 years, there is a 25% chance they will have experienced a major depressive episode."
Dr Leanne Rowe, a Geelong General Practitioner and founder of Clockwork (The Geelong Youth Health Project) recently recognised by the AMA and the Victorian Government as an outstanding contribution to public health, recently reported in a national medical publication that:
"Despite the advances of health care in Australia and our lip service to the importance of young people, statistics show that the health of young Australians is getting worse."
To back her claim Dr Rowe cited research by Professor Glenn Bowes from the Centre of Adolescent Health in Melbourne which showed that high rates of depression were among a number of key factors driving declining health standards in young Australians.
Furthermore, I contend that Australia's high youth suicide rate is evidence that this epidemic of depression is more acute in our young people than we are prepared to admit.
In the adult population the phenomena of 'stress leave' from work would amuse if not anger our previous generations whose working conditions were often deplorable by today's standards.
Our divorce rate is now said to have reached one in two marriages. This is despite the fact that we are marrying at an older age and practising trial marriage on a wide scale. These are just some of the obvious signs that many Australians are a less happy group than their predecessors.
If these observations are correct, that is, that growing drug abuse is a symptom of growing unhappiness then we have reason to be optimistic.
By identifying and understanding the underlying causes that are driving the epidemic of depression, particularly among young people, we can build and implement an effective drug prevention strategy.
A study conducted by Dr Ronald Grossarth-Maticek in 1973 with a follow up 21 years later (1994) found that elderly residents of Heidelberg, Germany who scored highly on an index of feelings of pleasure and well-being were 30 times more likely to be alive and well 21 years later than those who had low scores.
A 30 year study by Prof George Valiant of Harvard University found amazingly strong correlation between the level of happiness and the level of physical health.
Social isolation has been clearly identified as one of the factors associated with sadness and depression.
Could it be that in our modern and often crowded society, with every possible means of communication available to us, that many of us have become more socially isolated than our forebears and as a result more unhappy and if so why?
We certainly have a lot more privacy than our previous generations. Smaller families give us more personal space, we now have more bedrooms per family. Some more affluent households have separate bathrooms for their children. In any event there are many more places to be private even in a crowded room. Watching television is essentially a private affair, as are computer games, videos, CDs, the Internet. These activities have replaced the family sing-song and the parlour games of previous years. Many children regularly eat in front of the television and not at the family dining table, which was the epicentre of conversation in previous generations.
More and more we go out to be private instead of social. Driving in the privacy of our motor vehicles with our CDs playing and our windows wound up. We are attracted to recreational pursuits, which although conducted in public, such as going to the movies, are essentially private.
The work scene has changed. Many workers now relate more to their PC screens than they do the their fellow workers. The danger in this growth of privacy has been its impact on the social isolation of individuals and in particular vulnerable individuals. Unemployment must rate as one of the worst experiences of social isolation.
We live in the age of uncertainty of employment and the era of the casual worker. I am not here to condemn our modern lifestyle practices, which is not without its benefits. Nor am I advocating a return to the family of ten children and picket fences.
No-one is suggesting that the causes of our epidemic of depression are not complex. Is society to blame or are we to blame? That is for others more qualified than myself to answer. However, the following observation I believe, touches on something important:
"Through the ages all people, except for the occasional outcast, have included an extended family or tribe within their boundary. Today we have a new concept which has been called 'the empty self'. Under this concept the self-boundaries stop at your own skin. All outsiders, including family members, are thought of as 'them' and are objects of competition.
This mentality is great for the economy because it precludes sharing. In fact buying things, overeating, drinking and drugs are all popular ways to fill the void created when healthy social connections are eliminated. Shopping and eating essentially 'feed' the empty self. By buying a better house or car than our neighbours, the empty self hopes to build up self-esteem. Unfortunately this never works for long, because real self-esteem must come from inside."
Privacy is good until it starts to feed social isolation, where we exclude those people who can help to reference our behaviour. What may be considered abnormal in the wider group, becomes easier to rationalise when the approval or disapproval of family or friends is diminished. No matter who we are, we are not very objective when it comes to controlling our own behaviour.
For this reason, I am not surprised that some of our senior sporting figures, and most newsworthy of late, our rugby league players, have turned to performance enhancing drugs.
Although not excusable, this situation was entirely predictable given the fact that in more recent years rugby league players and their families, like many sportsmen and sportswomen, have become tradable commodities between sponsors who finance the businesses which were once sporting teams.
On field success by individuals and teams is essential to maintain commodity value. Many sportsmen and women are tempted to try illegal shortcuts to maintain their commercial worth.
I was not surprised to read in a newspaper account that one sportsman who made the decision to use steroids, did so in agonising privacy, without any reference to his family, friends or team mates.
We are all lousy at rationally controlling our own behaviour.We need the active involvement of others through social interaction to check our denials and conflicts which can quickly lead to unhealthy attitudes and dangerous behaviour.
Understanding why even popular sporting figures often experience personal isolation in the midst of crowd adulation is the starting point for an effective prevention strategy to deal with illegal drug use in sport.
Thank you
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