"Drug addiction is a symptom of something else..."

You're dealing with mental health and substance abuse patients on a daily basis. What's the best way to help these people maintain some semblance of a "normal" life?

I would say you should treat them like normal people, which is actually much harder to do within the system than it sounds. I think there's a lot - especially with heroin addiction - of bending over backwards, sometimes, to help them, and you accept a lot of behaviours that you wouldn't do with normal patients. I don't think that in the long term that that is at all helpful, so I think if people shout at you, they should be asked to leave. The fact that they may be going into withdrawal, and will get worse if they don't get their heroin script is not our problem if they can't behave. I suppose it's just putting up the normal parameters around peoples behaviour. I can understand why you have to have these slightly shifted boundaries, because it's a different type of relationship and [addicts] have to feel they're able to open up to you, but then, conversely, I'm very strict with the idea that people have choices. Some people's choices are monumentally harder than others, but they are still a choice. Every time you choose to inject a drug, it's a choice. There are some people who, for whatever reason, decide to wake up one day and go "actually, I'm not going to use [heroin] anymore" and they will actually go through withdrawal, (which is harsh, but it doesn't kill you - it is horrendous though) and they'll just do it on their own. I wanted the readers to know that it is possible to do that, that if you're that determined, you can. Not to advocate it necessarily, because, you know there are easier and less painful ways of doing it, but I wanted to show it is still a choice, no matter how hard it seems. Also, the flipside of that, treating people as though they're just people, is also quite a nice way of doing it - it's quite a normalising, stabilising thing for them. Quite often patients would be quite surprised when you say "you just swore at me, that's not very nice" and they'll reply, "oh yeah, you're right" and almost be quite grateful that you're reminding them what it's like in society. So I think [the idea] has positive implications for lots of reasons.

I would say at the moment there's a preoccupation with the pharmacological side and, actually, what they need is psychotherapy. There's a particular drug called Subutex, which basically stops you having any buzz from Heroin, it blocks the receptors, and it stops the withdrawal. You'd put people on it and they'd come in and still be testing positive for heroin. You'd ask, "Why are you still taking it? You're not getting any buzz from it, and you don't need it". Then you'd realise it's more complex than addiction . . .

It's almost like a ritual.

Exactly! It's an expensive and really weird ritual to have. It's so fundamental for them, and all you've done is anaesthetise them a bit, but they're still going to do it because they've still got that ritualistic drive there. Things are so much more complicated and all of the best responses come from people who are seeking help for the physical withdrawal but also with the underlying psychological aspect.

What I realised working there is drug addiction is a symptom of something else. That's what I think most people fail to appreciate. There are other things going on that cause people to be addicted to drugs - people aren't stupid. They don't sit there going "Hey, I know! I'm going to inject heroin. I wonder what that's like? Oh shit. Now I'm addicted". It just doesn't happen like that.

Where do you stand on decriminalisation?

There are certain things I don't particularly have an issue with. People can do what they want, and the state should interfere as little as possible, but I think people as human beings have a moral obligation as to what they buy into.

Things like E - I don't actually have an issue with at all. It's mostly a cottage industry and I think it's quite a bit safer than other stuff like, well, alcohol to be honest. In a way by criminalising ecstasy we've created more problems, because now it just gets cut with crap. I think it's really interesting. Because GHB was left legal and so was plant food.