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

In the final instalment of this essay, Jay Cooper reflects upon life as an experienced drug user and harm reductionist who has come to terms with his ADHD and autistic spectrum condition, offering a framework for greater understanding.

I had hoped that moving towards sobriety would improve my life and smooth a path to gainful employment via graduation, under the influence of prevailing discourses echoed by family and straightpeg friends, but it was getting me nowhere. This period experientially confirmed a phenomenon Azzy-Mae at ALPUD describes where cessation is in itself maladaptive for some people, or as Francis Cook once affirmed to me, “total abstinence can be every bit as fucked up as chaotic use.”

I forsook STEM career dreams and took up my place at university (sans any induction day drama) studying politics- coming closer than ever to mainstream success, but dropped out after submitting most of my work too late for it to count in 2020. COVID interfered with all academic routines, after I had struggled to get into that rhythm and reduced supports available. The periods when I worked best, attended most regularly and scored highest on assessments coincided with a safe , abundant drug supply. I was also involved in seeing that peers across the country were able to obtain reliable supplies in the context of extended lockdown disruption.

The years since a novel coronavirus began spreading out of control have been difficult for me, in which I am far from alone; the upshot of all I’ve lived through so far is that I’ve embraced a neurodivergent identity and an understanding of continuing substance use as a ‘technology of the self’, facilitating a more fulfilled existence in the context one finds oneself in- or put another way, granting serenity to accept the things I cannot change… some of which may be changed over the << longue duree >> by disciplined collective action, and others more permanent features of the human condition in all its glorious, protean variety.

What to make of all this? Would I still use drugs – in the same way, to the same extent, or at all- if I was navigating life as a neurotypical person? I can’t say, but truthfully it doesn’t matter. This kind of counterfactual has no practical impact, and a “quest for aetiology” too easily serves to legitimize pathologising judgments and one-dimensional constructions of meaning. User liberation advocates have tended to share my critical stance toward such lines of inquiry, taking inspiration from queer antipathy to investigations of “why people are (gay, trans, etc)” in a world where a deterministic cause fascinates those invested in “prevention” and/or “cure” and nobody with comparable social or academic capital is querying why cisgender heterosexuals exist… As Ailish Brennan, who shares points of intersection with myself and spoke excellently on them at Hot Topics 2023, would say ‘all too convenient for cisheteronormativity!’

The “technology of self” framing I felt validated by in a document deconstructing assumptions of popular “drug problem” narratives originated with the great proto-queer theorist, Michel Foucault, who insouciantly declared that it is no more appropriate for contemporary, postmodern humans to be “against drugs” than for us to be “against” music. I am therefore confident he would approve of how it was repurposed by INPUD’s Jay Levy and Eliot Ross Albers. In that same INPUD publication, the co-authors coin a term ‘narconormativity’ which encompasses the ways that society tolerates, approves or (as in the case of sectioned psychiatric patients) mandates certain behaviours related to drugs while penalizing or otherwise repressing transgressions of the limitations.

They intended it as an “overarching framework in which repressive drug laws, hate speech, stigma and discrimination can be theorized as human rights violations to be eliminated.” People in neurodivergent communities and the mad and patients’ rights movements have introduced me to another term, neuronormativity. Several definitions circulate (to clarify, not *dramatically* different.) My favourite is “the ableist belief in a single universal standard for ‘proper’ human brain functionality, composed of narrow well-defined parameters which have been ‘discovered’ via the dispassionate researches of experts” – along with its corollary, marking anyone who falls outside that exiguous range as << ipso facto >> ‘disordered’ and in need of treatment.

Both critiques of ‘normativity’ strike me as apt, if not vital, descriptive frameworks; almost certainly, neither would exist without the pioneering intellectual labour of queer activists. Queer identity and drug use are an underexplored intersection all to themselves; the work of Richard Elliott for the HIV Legal Network, barely a year old, is a good starting point for would-be spelunkers.

Neurodivergent people share with gender-expansive folx and people who use criminalized and stigmatized drugs an intimate, sharp end of the (needle) stick comprehension of how medicalisation is a double edged sword. To have a formal diagnosis, and accept participation in a practitioner-patient relationship where biopower is exerted asymmetrically, may be the safest or only method of accessing drugs and other therapeutic interventions that are affirming, pleasurable and enhance holistic wellbeing. Nonetheless, it can leave populations vulnerable to top-down (often politicized) changes in medical policy and practice, and reinscribe harmful discourses that posit something wrong with people who don’t fit into arbitrary boxes… neoliberal puritan Procrustean beds.

We need to understand a lot more, and condemn a lot less. Or as adrienne maree brown says in a discussion with fellow abolitionist Shiri Hassan, we need to replace judgement with curiosity: with a question. Whatever our individual relationship to drugs or current place on the spectra of mental and physical health, we would collectively benefit from this- as we would from redistributing power & resources toward the liberatory initiatives most conducive to wholeness.