Neurodivergence And Substance Use: An Under-explored Intersection [Part 2/4]

Following from part 1, Jay Cooper looks back on his adolescence, when everyone from family to school bullies seemed to agree he was somehow << different >>- and that this was a problem. With socially sanctioned paths to pleasure thus blocked, he beats a path toward the frontline…

By my early teens, multiple knowledgeable people (my primary head and SENCO, secondary teachers, NHS and private educational psychologists, doctors in London and abroad) told me or my parents I had Asperger’s syndrome or “high functioning autism”, two dated but still widely used terms. Some of these believed I had ADHD too, others being more sceptical here. I disagreed to the extent of writing a formal “rebuttal” explaining why I felt the DSM-IV criteria were not met, treating diagnostic labels like heinous charges against which I was a << pro se >> defendant. The expected developmental process of establishing a more independent identity got underway, and before I ever seriously considered using them myself drugs became an issue: a key locus of cognitive dissonance between the unyielding vituperation of my parents and the fact of unproblematic use in my new social group centering on a youth club and the skateboard-friendly environs of a library.

Of those who regularly smoked cannabis and had experimented with “harder” stuff, most were the older and more responsible cohort (age 17-19) who were doing well in education and holding down jobs while also having a much more extensive social life than me. I initially responded by condemning them and expecting some day they would suffer inevitable repercussions, but soon became convinced that my family’s hard line against recreational or officially disapproved substance use was simplistic to the point of being wrong.

I was unafraid to argue for my emerging position. I told mum of an interesting article on a science website, detailing clinical trials of opioid analgesic pills in people living with Asperger’s … unlike myself, I pointedly added. My aim was to challenge her thinking by apprising her of how if I had been correctly diagnosed as she insisted, there were some medical experts acknowledging one of the most stigmatized categories of controlled substances may have life improving potential for me.

Mum was NOT impressed. “Where’s that, in the States, I guess?” She’d guessed right. “Well YOU won’t be getting them, then,” she deadpanned. I fired back: “Maybe not from a doctor. There are other ways.” She gave me her trademark disapprobatory look and sighed, reconfirming her disgust with people who sell drugs – and distaste for her son even bringing up the possibility.

It would be shortly thereafter I made my debut in the world of illicit substance use. In spring 2009 I staked out the Boots pharmacy on London Road, midway through its precipitous decline from the M&A Pharmachem 24/7 safe supply hub with the nation’s best stocked DDA box shown to PBS viewers in the 1994 documentary ‘Heroin on Prescription’ to the empty shell sitting there ‘for rent’ now. Like my child self a decade earlier in a Boots a few miles beyond Liverpool city centre, I wasn’t there to buy anything in-store. Unlike them, I wasn’t there to draw pictures of colourful “women’s” cosmetics and try to pronounce the polysyllabic names of cough mixture ingredients… I was waiting for somebody who looked approachable to arrive at the segregated entrance for those collecting instalment prescribing and IV equipment. I picked out a man accompanied by his female partner; her presence inspired a sense of relative safety in me. I struck up a rapport with this couple, visited their home, exchanged contact details and secured cocaine powder for insufflation.

In addition to feeling warm inside and growing loquacious, which I expected, I found myself more able to tune out distracting sensory stimuli in my vicinity. Over the following weeks, I used the drug on weekday afternoons with a schedule of solitary GCSE revision and bedroom tidying more than for evening socializing. I was apprehensive about attending one friend’s birthday do, because my mother had reported me “missing” to police after I moved into my suppliers’ spare room, and she failed to let them know that I had reunited with her safe and well at Starbucks and told her what part of the city I was in. I snorted a fat line which calmed my nerves and turned up to a Catholic church hall hired out for the birthday celebration, which should have been followed by a night shift helping my hosts sell party supplies (including that which I was high on); alas, my sober misgivings were prescient.

A neighbour informed on me- fuck knows what he had in mind while dialling 999 and diverting officers away from genuine emergencies toward ruining my night, that I had been abducted, someone was hurting me, or just that I needed to be disciplined “for my own good”. That was academic when cops arrived to return me home against my will since I would not be 16 until autumn. Locked in the house with no end in sight, I threatened suicide and was confined to the secured children’s ward of Whiston Hospital over the long weekend. The consultant psychiatrist added a formal Asperger’s diagnosis to my medical records, wisely not telling me at the time as I was still pushing back against what I saw as a medicalised version of the insults my peers and occasional strangers would level at me, laughing at me and calling me “freak”, “special needs” and most of all “WEIRDO”.

The cruel, exclusionary culture that was dominant until so recently foreclosed on any more self-affirming identification with a neurotype others recognised from early in my life. Retrospectively, I see its influence both in the way I experienced cocaine use as clarifying focus – as a dopaminergic CNS stimulant which acts in some ways similar to methylphenidate and amphetamines, it served as unintentional self medication for ADHD- and in my unusual path to initiation, not by taking a drag on a spliff being passed round back of school or popping a “Gary” with friends at a festival but by directly connecting with the convenient social scapegoats who your average 15-year-old trying drugs for the first time would steer well clear of. (Gateway? What fucking “gateway”? I admire Jess Tilley’s response, trauma is the gateway- but not for everyone.)

From one perspective, non-neurotypical youth are tagged as “at risk” or “vulnerable” and indeed things could have gone wrong in approaching strangers in a public place. Yet risk is inevitable, << a fortiori >> in a context of repressive legislation and extreme social stigma. A counter frame more resonant to me acknowledges autistic people are somewhat insulated from peer pressure and social norms- for another positive byproduct of this, the higher rate of queer and especially trans/non-binary identity formation in autistic populations has been attributed to our greater resistance to restrictive conventions that inhibit self-actualizing expression.