Say Why To Drugs: Everything you need to know about the drugs we take and why we get high by Dr Suzi Gauge

Overview

Say Why to Drugs by Dr Suzi Gauge (2020) is an A-Z primer on some of the most common drugs, including legal ones. It seeks to correct misconceptions about drugs and provide an overview of each drug. Each chapter is divided into sections: what the drug is, the short-term effects, the long-term effects, common myths about the drug, and what we don’t know. There are also cute little chemical structures of psychoactive compounds at the start of each chapter. A few chapters are more general, with titles like “Focus on: psychedelics” and “Understanding Stigma”.

I was scavenging in the library’s nonfiction section for science communication of all kinds and came across this book. The title grabbed me, as did the whole “debunking myths” shtick.

How to debunk a myth

Dr Gauge is very good at debunking and obviously has a background in it. The first thing to do when debunking a myth is to state the myth, for example:

“Myth: Nitrous causes intoxication by starving the brain of oxygen.”

Originally, it was thought that mentioning the myth would reinforce it. But this is not the case. Only stating the correction to the myth means that there is no link in a person’s mind between myth and correction.
“When nitrous is inhaled without oxygen, the risk of hypoxia, where the brain can be starved of oxygen, is increased. However, this isn’t what causes nitrous to have the effects that recreational users seek. If it was, maybe we could all hold our breath and get the same effect?”

What I liked: scientific uncertainty

I loved most things about this book. It contained a great mixture of harm reduction information, and all the science was very well-communicated. Dr Gauge deals with scientific uncertainty gracefully:

“Working out which of these is the true reason for the association between drugs and mental health is really hard. And I speak from personal experience here: my research is specifically trying to unpick this question, and I’ve been doing it for over a decade now – and I don’t have any definitive answers yet.” (page 152)

Acknowledging that there still is a lot we don’t know helps the reader to understand that science is an ongoing process, and that scientists don’t know everything – they are as human as we are.

What I liked: stigma still sucks

I also loved Dr. Gauge’s treatment of stigma and how important language is when discussing drugs.

“Language matters, and there’s a real risk that individuals who do experience problems with their substance use will be less likely to seek help, or get the help they need, if they’re stigmatised for their situation” (page 297-298)

YESSS PREACH
A lot of the myths Dr. Gauge debunks in this book have some pretty shitty stigma embedded in them, and she outlines how damaging this can be to people who use drugs.

What I didn’t like

I did have issues with some of the language used, and the fact that Dr Gauge decided the myth “weed is a gateway drug” was partially true (page 72). Her logic is that once people have tried weed, their dealer may know where to get other drugs. But a person doing cannabis doesn’t necessarily want to try other drugs, even if they know where to get them from.

The whole “gateway drug” idea came from some studies by Kandel in the 1970’s, which found that people’s pattern of drug use tended to go from alcohol to cigarettes and cannabis , to other drugs like heroin and cocaine. However, this does not mean that weed use causes people to try other drugs. Plus, there are again so many other factors involved when people decide to use drugs that it’s impossible to say whether weed is the cause.

There is a lot of science in this book, and if science isn’t really your jam it could become tedious.

I found the intro somewhat jarring, as nothing annoys me more than saying “[the book] is trying to be as dispassionate as possible and sticking only to what we’ve uncovered through scientific research”. One of the very first things you learn in science communication is that framing science as neutral and dispassionate is potentially dangerous because science itself is not neutral. The politics and attitudes of the time shape what things scientists choose to study, and the scientists in of themselves are still people. Although Gauge frames herself as neutral, you get the sense that she’s pro harm-reduction throughout the book. Which I guess makes sense, as harm reduction is scientifically proven to save lives. But harm reduction is also a political issue, so you cannot really be “politically neutral” about it.

I’m also sad that Gauge didn’t include a chapter on 2-CB, but I guess “2” isn’t part of the alphabet 🙁

New Zealand context

There is one (1) total mention of New Zealand as a country in Say Why to Drugs, when Gauge discusses the Dunedin study’s results on adolescent cannabis use and IQ (page 71). Drug checking is briefly mentioned, but limited to the Loop in the UK, which makes sense as Gauge tends to focus her studies on the UK and US.

Some of the drugs mentioned in the book are readily available in New Zealand, such as alcohol, MDMA, and methamphetamine. Others were less common: DMT, khat and kratom. Most of the information in this book is universal, although there are definitely New Zealand specific misconceptions around drugs that weren’t addressed. Amphetamines and meth were lumped together into one section, which means that a lot of NZ-specific information on meth was not included, although Dr Gauge does that the bulk of meth research is carried out in Australasia.

Conclusion

I really liked Say Why to Drugs. It’s a great balance of science, harm reduction information, and myth busting. Although it touches on some pretty science-heavy topics, Say Why to Drugs writing is accessible and entertaining. I’d recommend it to scientists, drug nerds, politicians, the media and anyone who is curious. It’s a great book no matter your background knowledge, there’ll still be something to learn.