Addiction Photo Essay Template

‘Nyaope. Everything you give me my Boss, will do’ is a photo essay by Lindokuhle Sobekwa, supported by a written essay by Sean O’Toole. The series was created during Lindokuhle’s participance in the Of Soul and Joy project; a long-term art initiative undertaken in 2012 by Rubis Mécénat cultural fund in Thokoza (Southeast Johannesburg). The project aims to expose the students of Buhlebuzile Secondary School to photography as a new way of expression, as a vocational skill and as a means of engagement for future opportunities. It acts as a visual platform and skills development programme through workshops led by renowned photographers.

Nyaope. Everything you give me my Boss, will do

The Unflinching Witness by Sean O’Toole

South Africa has a long tradition of news reporting. It is worth briefly recounting as a way of contextualising Lindokuhle Sobekwa’s essay on township drug abuse. The country’s first newspaper, a pro-government mouthpiece, was established in 1800, although it was only 24 years later with the launch of the SA Commercial Advertiser that an independent press was born. During the years of high apartheid (1948-90) news reporters and photographers often found themselves at odds with government. Partly this had to do with the muckraking traditions of reporting here, but it was also an outcome of witnessing the impoverished material circumstances of everyday South Africans against the backdrop of a cruel system. Despite his youth, Sobekwa undoubtedly slots into this vigorous and unapologetic tradition. His essay on nyaope users unflinchingly witnesses the complexities of present-day South Africa, where the country’s youth face bracing poverty and widespread unemployment.

Youth unemployment is a major social problem in South Africa and is a key socio-economic challenge. Around 3.2 million youths are unemployed. This represents nearly two thirds (63%) of the productive workforce aged between 15 and 34, a 2014 report by the Brookings institution revealed. Tellingly, given the somnolent action depicted in Sobekwa’s essay, these very high figures include youths who are not actively looking for a job. They are sometimes referred to as “discouraged work-seekers”. With economic growth sluggish, prospects for future work remain slim, leaving many youths to improvise.

Informal work is however perilous and, without a family network for support, youths from impoverished circumstances are forced to live contingent lives. Sobekwa’s essay offers a study of personal collapse seen against the backdrop of larger economic circumstances. Although set in Thokoza, where he was born and schooled, the situation Sobekwa depicts is commonplace across many urban and poor black settlements across South Africa. This statement needs clarification. Despite South Africa’s transition to a non-racial democracy in 1994, many facets of formal apartheid remain in place, notably the quarantined living circumstances that still define South African cities. In a 2013 speech president Jacob Zuma referenced many of these communities during a sombre appraisal of the country’s social problems.

“Alcohol and drug abuse in particular are slowly eating into the social fibre of our communities,” Zuma told a gathering in Newcastle. It was youth day, nominally a day of celebration, although the subject of speech suggested otherwise. “Drug and substance abuse have serious implications for the millions of citizens because they contribute to crime, gangsterism, domestic violence, family dysfunction and other forms of social problems.” Parents, he added, were at a loss and in pain as children as young as eight were being snared in the net of drug abuse. But what drugs? According to the 2014 world drug report, cannabis remains the most common illicit substance used in South Africa. It also noted that there has been an increase in the use of methamphetamine and heroin, a low-grade variant of the latter is typically mixed in with cannabis and antiretroviral drugs to make nyaope.

But drug abuse is merely part of a complex set of problems defining life in Thokoza, an apartheid-era settlement created in 1957 outside Alberton, Southeast of Johannesburg. Sobekwa was born in 1995 in Natalspruit, a settlement just North of Thokoza. His father, who died in 2004, was a carpenter. His mother continues to work as a domestic help. He spent his early childhood living with relatives in the Eastern Cape, a rural Xhosa-speaking enclave, before returning to Thokoza in 1999 to pursue his schooling. He attended Buhlebuzile Secondary School in Thokoza. Uninterested in football, he joined the choir and participated in Zulu dance classes. Although born five years after the violent clashes initiated by Zulu-speaking hostel dwellers on largely Xhosa settlements in Thokoza and Katlehong, Sobekwa says aspects of his neighbourhood’s “previous predicament” continue to endure.

He witnessed them first-hand at school, mostly as clichés spread around the schoolyard. “Xhosa people are liars and Zulu people are cowards,” he offers as an example. But, he adds, for the most part, calm prevails. Conflicts in Thokoza, as elsewhere across South Africa, now tend to focus on national rather than local ethnic identities. The larger Ekurhuleni region – an amalgamated metropolitan area established in 2000 that encompasses Thokoza – is a notorious hotbed of anti-immigrant violence. But neither these two social problems, ethnic rivalry and xenophobia, are the focus of Sobekwa’s essay. Rather, it is the scourge of low-grade drug abuse that has increasingly beset black settlements across South Africa.

While its constituent elements of nyaope are hardly new, the origins of this drug are hard to track. The first reliable mention of nyaope is from 2006, by journalist hazel Friedman who writing under a pseudonym in the book Hijack!, describes nyaope as “all the rage with the youngsters in Soweto, mamelodi, Soshanguve and atteridgeville,” black settlements surrounding central Johannesburg and Pretoria.

Also known as “whoonga” and “taiwan”, Sobekwa heard of nyaope in 2009. His decision to focus on this addictive street drug grew out of an encounter with a nyaope user on a Thokoza street in 2013. Already a participant in the Of Soul and Joy photography project initiated by Rubis Mécénat a year earlier, Sobekwa was walking with his camera when a neighbourhood youth asked him to take some photographs with his crew.

“I was nervous, but I told myself if they try anything I would run away with my camera,” says Sobekwa. “I held my camera very tightly.” That evening, reviewing his photographs, he was struck by the access he had been given. “I showed them to my mentor who said it could be a good project.” Central to the success of this essay is the unrestricted access Sobekwa was given to a shack owned by a youth named Mabuthi. His makeshift dosshouse is a place of retreat, of narcotic pleasure and fitful sleep. It is also where the users photographed by Sobekwa return after days spent begging for money and foraging for scrap metal to sell. Sobekwa quickly learnt that working with his subjects required improvising. When they wandered off, so did he. When they said no, he left. “You can’t work according to a pre-planned schedule,” he says.

Mabuthi first started smoking nyaope after his family abandoned him. Not everyone shared his impoverished circumstances. One user, Lukhanyo, comes from a stable family without any financial problems. “Now he looks like a street kid, like this abandoned person, a social outcast,” says Sobekwa. Although many of his photographs focus on the uncomplicated domestic habits of drug users – idleness, argument, drug use, and collapse into narcotic sleep – he also followed them around Thokoza’s flat industrial landscapes. Along the way he met a white drug user, Jerry, who he also photographed (but did not include in this essay). The repetition of the routine, of constantly entering and exiting Mabuthi’s shack, created a bond of sorts between the photographer and his subjects, a bond of intimacy not dependency. “I learnt a lot from those guys, not just how bad they are,” says Sobekwa.

Urban drug abuse is not a new phenomenon in South Africa, but during the apartheid years its frequency was heavily policed and localised. As a result, there are no significant bodies of photographic work locally portraying the degradations that come with sustained drug abuse. Still, Sobekwa’s candlelit interior studies possess affinities to earlier studies of social hardship. I think particularly of drum magazine photographer Jürgen Schadeberg’s 1955 photograph of a four young gamblers squatted on a street corner in Sophiatown, a former slum in central Johannesburg. Sobekwa’s work evidences the same attention to mood, pose and lighting.

Photographs of drug addiction share with pictures of poverty a certain generic sameness. Bare circumstances mirror bare lives. A key difficulty for any photographer here is avoiding repetition and sameness. Photographers essaying drug abuse have found various ways around this. Nan Goldin, for instance, chose to hone in on particular protagonists, notably Greer Lankton and Cookie Mueller. In the manner of Larry Clark in Tulsa, Sobekwa’s Thokoza essay is defined by its focus on a fragile family, a family created by circumstance rather than biology. But, in distinction to both Goldin and Clark, Sobekwa’s essay ‘nyaope’ is not an autobiographical portrait. He is not implicated in these photographs; he is not a nyaope user. Rather, and this is crucial, he considers himself a dispassionate observer, a documentarian motivated by a belief that his photographs might have an educational value.

“I hope people, especially youth, will learn a lot from the project: how dangerous this drug is,” he says. The twinning of photography with social purpose is hardly new. In South Africa, members of the Afrapix collective of photographers, active during the 1980s, viewed photography as a means to express solidarity with social activism. Lewis Hine is an older expression of this belief. “Photography has always been a tool to teach people about life,” says Sobekwa. “I learnt history through photographs. Mandela. June 16. I believe that photography can be a tool to teach people.” Working with his mentors, he purposefully set out to produce an essay that would not only teach but also dissuade. “Don’t do drugs. It is hell. I have seen a lot of ugly things that happen when people use nyaope.” Although compelled by an anti-drug message, Sobekwa’s work is not propaganda. His photographs speak of the subtle complications of circumstances in a community he personally knows and lives in. Perhaps it is this that accounts for his essay’s defining quality: the raw dignity he allows his subjects.

Look out for more photo essays by Of Soul and Joy participants in the upcoming weeks.


Of Soul and Joy


Photo Essays


LindokuhLe SobekwaSean O'Toole

Sarah started using heroin when she was 16, and soon after that she left home to live with her dealer. Heroin was one of the ways he had power over her. He was older than her, and often unfaithful. Over the three years that they were together, they frequently fought, sometimes violently. She would end up staying with friends or on the streets. She would steal to get money for heroin until he convinced her to return, partially through the promise of more drugs. Eventually she was arrested for shoplifting and sent to prison. Her boyfriend ended the relationship while she was in custody. In response, Sarah cut her wrists. It began a lasting pattern of self-harm through cutting.

Sarah received treatment for her addiction in prison, and had frequent contact with mental health professionals, but she has never successfully gone without heroin for more than a few days, despite repeated efforts. She funds her habit through state benefits, loans from her mother, and theft. Her father died when she was three. Her mother raised her on her own, working two jobs to make ends meet. Her mother was and is her only stable source of support. Sarah hates herself deeply.

This is a fictional case study, based on the real addicts I come across in my work. But when you picture Sarah, who do you see? One person might imagine a violent and depraved young woman, who has chosen to live on the edge of society and is responsible for her drug use and crimes. Another will see a suffering soul, someone who can’t control her desire for heroin and can’t be held responsible for the harm she perpetrates on herself or others. Of course, both images of addiction are stereotypes that a moment’s reflection should dispel. They polarise and capture our collective imagination. In reality they stop us from facing hard truths about why people become addicts.

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I am a philosopher and I am also a therapist within the National Health System in the UK, and I often see patients like Sarah. They suffer from a range of related conditions, not only addictions but also anxiety, mood and personality disorders. Before I started working clinically, I had known people who had ‘problems’ with drugs and alcohol, and come across popular stereotypes of addicts in books and films. I didn’t know how to break the hold of these opposing images of addiction: the addict as perpetrator or as victim.

But actually working with people who suffer from these conditions has started to teach me how to see beyond the stereotypes. What I began to realise was that most chronic addicts are not just addicts. They also suffer from other psychiatric disorders and come from backgrounds of adversity and deprivation, both economic and emotional. We need to think seriously about what drugs and alcohol do for people who find themselves in these circumstances.

Addiction is a burden to us all, not just to addicts. It’s associated with violent crime both in the home and on the street. Forty per cent of violent crime in the US, according to the Bureau of Justice Statistics on Alcohol and Crime, is committed under the influence of drugs or alcohol. Then there are the economic costs of addiction, of drug and alcohol related crime and policing, social and psycho-educational initiatives, and medical treatment. And finally there are the terrifying personal costs of addiction – lives dominated by drugs and alcohol, at the expense of work, friends, family, and the addict’s own sense of self-worth. Addiction also affects the addict’s friends and family, who suffer alongside the addict in frustration and sorrow as they helplessly watch someone they care about destroy their life.

If we focus on the associations between addiction, violent crime and the socio-economic burden to society, it may be the depraved criminal that we’re more likely to imagine. This image is bolstered by historical attitudes towards addiction. For a long period in Western culture, addiction was considered a moral failing, a sign of having succumbed to the temptations of pleasure, sloth and sin. If, however, we focus on the personal costs and its effects on relationships, we’re more likely to see the suffering soul. This image of addiction is relatively recent, bolstered by our contemporary understanding of addiction as a brain disease, diagnosable by both physical and psychological symptoms.

Addicts are often in denial about these symptoms, and refuse to acknowledge that they have a problem. Physical symptoms of addiction include both an increased tolerance to drugs or alcohol (so that more and more needs to be consumed to achieve the same effect) and unpleasant withdrawal symptoms if the addict stops. Psychological symptoms include cravings and an all-consuming focus on obtaining and using drugs or alcohol, alongside persistent, unsuccessful attempts to control use. More often than not, however, as time goes on and the addiction and its effects worsen, the addict becomes intensely aware of their problem, but continues to use drugs and alcohol in spite of this knowledge. It’s a cliché that the first step to recovery is to acknowledge your addiction, but it’s a cliché that doesn’t quite ring true.

Although the brains of addicts are indeed affected by long-term drug use, this doesn’t mean that addicts have no control

Chronic addicts continue to use drugs despite attempting to control their use, and in spite of recognising the effects of drugs on their lives. So it has come to seem natural to think of addiction as a brain disease. Normally, when people know that their actions have destructive consequences and that they can act to avoid these consequences, they do. Yet this is precisely what addicts don’t do. It’s understandable that we try to explain this puzzling behaviour by saying that they simply can’t. Given that we know that long-term drug and alcohol use affects the brain, altering many underlying neural processes involved in motivation and action, it’s easy to jump to the conclusion that the brains of addicts have been ‘hijacked’ by drugs — it’s their brains that make them do it. This makes it look as if addicts really can’t control their use or be held responsible.

The problem is that there is considerable clinical evidence that addicts can control their use. Although the brains of addicts are indeed affected by long-term drug use, this doesn’t mean that addicts have no control.

Throughout human history people have used drugs and alcohol, sometimes in truly astonishing quantities, both for pleasure and in the belief that these substances provided physical and psychological health benefits. There is evidence of opiate use as long ago as the Neolithic period. In ancient Greece, drinking to excess was condemned, but opium was used to help people sleep, provide relief from pain, sorrow, and disease, and possibly even soothe colic in infants. By the early modern period, laudanum, a mixture of alcohol and opium or morphine, was viewed as both a wonder drug and the height of sophistication, prescribed by doctors to the aristocracy for a range of ailments and in high doses. In the late 19th and early 20th centuries, pharmaceutical companies marketed heroin as a cough suppressant, alcoholic syrups for the nerves, and cocaine for toothache.

We still use drugs and alcohol for much the same reasons. We take stimulants such as coffee and tea to keep us alert and focused. We have an alcoholic drink after a stressful day to help us relax. We take opiates for pain, which are available as codeine over the counter as well as on prescription. Almost all of us have tried alcohol and cigarettes, and 50 per cent of people in the US and UK have tried illicit drugs at least once. Many of us have had ‘problems’ with drugs or alcohol at some point in our lives, although it is only a small proportion of users who qualify as full-blown addicts. According to the US National Survey on Drug Use and Health about 5 per cent of those who have tried drugs or alcohol at least once become alcoholics, and between 2 per cent and 12 per cent become addicted to illicit drugs, depending on the choice of drug (rates for cocaine addiction are at the low end, while rates for heroin addiction are at the high end). Usually this happens in late adolescence or the early twenties. But most of those people who are addicted as young adults have kicked the habit by their thirties — on their own initiative, without psychiatric treatment or clinical intervention. It seems that they ‘mature out’ of addiction as the responsibilities and opportunities of adult life take hold. Such large-scale, spontaneous recovery would be surprising if addiction truly was a brain disease that destroyed the addict’s capacity for controlling drug use. Rather, it seems that addicts who ‘mature out’ are able to stop when they have strong reasons to do so.

The minority who never overcome addiction typically suffer from additional psychiatric disorders and come from a background of adversity and poor opportunity

Twelve-step programmes and most other forms of treatment for addiction also require addicts to decide to stop and then see that decision through. What they offer is community support, practical tips, sympathy and understanding throughout this process, in order to help the addicts resist temptation, however strong or persistent. The effort and difficulty that abstinence costs addicts should never be underestimated, but there is no treatment that can do this work on behalf of addicts or obviate the need for them to do it themselves. One of the most encouraging new treatments actually offers immediate but small monetary incentives for abstinence to help addicts remain clean. Contingency management treatment (CM), which is widely used in the US but has been tried in the UK only in recent years, offers vouchers, money, or small prizes to addicts who produce clean urine samples. Samples are submitted three times a week, with increasing monetary value offered as a reward for each clean sample. Whether you approve of the ethics of this treatment or not, CM significantly reduces the risk of disengagement from treatment, and increases periods of abstinence compared with other treatments.

The majority of addicts can control their use when they have a powerful enough reason, and are able to choose to quit if they want to. It’s only a small minority for whom addiction is a chronic condition — something they never overcome, and might even ultimately die from.

Who is this minority? Strikingly, they are usually people like Sarah, who suffer not only from addiction, but also from additional psychiatric disorders; in particular, anxiety, mood and personality disorders. These disorders all involve living with intense, enduring negative emotions and moods, alongside other forms of extreme psychological distress. Moreover, these disorders are in turn also associated with various forms of adversity, in particular low socio-economic status, childhood physical and sexual abuse, emotional neglect, poverty, parental mental illness and parental death, institutional care, war and migration. There are, of course, individual exceptions to these large-scale generalisations. Yet the minority who never overcome addiction typically suffer from additional psychiatric disorders and come from a background of adversity and poor opportunity. They are unlikely — even if they were to overcome their addiction — to live a happy, flourishing life, where they can feel at peace with themselves and with others.

Most of us use drugs and alcohol to some extent or other, and it is a slippery slope from socially sanctioned use to addiction

A now infamous experiment called ‘Rat Park’, conducted by psychologists at the Simon Fraser University in British Columbia in the 1970s, offers some explanation as to why this minority doesn’t overcome drug addiction. Caged, isolated rats, when addicted to cocaine, morphine, heroin and other drugs, will self-administer in very high doses, foregoing food and water, sometimes to the point of death. But when placed in a spacious, comfortable, naturalistic setting, where both sexes can co-habit, nest and reproduce, these rats forego drugs and opt instead for food and water, even when they experience withdrawal symptoms. Recent well-controlled experiments support this early finding. The majority of addicted rats will choose not to self-administer drugs if provided with alternative goods. In other words, if we give addicted rats the option of a happy, flourishing rat lifestyle, they take it.

But the minority of addicts for whom addiction is a chronic condition are not given the option of a happy, flourishing human life just because they stop using. In the meantime, using drugs or alcohol might offer some relief from life’s miseries. This function is common parlance in our culture: we ‘reach for the bottle’, ‘drown our sorrows’ or get ‘Dutch courage’ when in need. For addicts who suffer from additional psychiatric disorders, drugs and alcohol offer a way of coping with the extreme psychological distress, as well as an escape from the broader hardship of life. And of course, distress, and hardship are made worse by the addition of addiction to their list of struggles. Yet without any real hope for a better future, there is unlikely to be any genuine long-term incentive to give up the short-term relief on offer through using drugs. To return to Sarah’s story, imagine what her life would look like without heroin — the emotions and moods she must live with, the loneliness and anger, the self-harm, the problematic relationships, the utter lack of any self-esteem or hope for the future. Does this life give her any reason to quit?

So, which of the images of addiction is ultimately real — the depraved criminal or the suffering soul? The answer, of course, is neither. Addicts do not simply suffer from a brain disease that removes control. They are responsible for making choices that affect their own lives and those of others, sometimes in truly terrible ways. But, given the social, economic and psychological truths of what life is like for most chronic addicts, we should pause before judging them harshly for continuing to use. To stop using drugs and alcohol once you are addicted is very, very hard, even for those who are highly motivated to do so and who have a wealth of alternatives and opportunities available. For those who do not, why would they choose to endure the hardship of quitting, alongside all the other hardships they face?

Both stereotypes of addiction cast the addict as an outsider — different from the rest of us, by choice or disease. But the truth is that most of us use drugs and alcohol to some extent or other, and it is a slippery slope from socially sanctioned use to addiction. Rather than condemning or pitying addicts, we should ask ourselves who we would be, and what choices we would make, if we had the same personal histories, or suffered the kinds of psychiatric disorders associated with addiction.

The solution to the problem of addiction cannot rest only with addicts themselves. It rests with all of us, as a society, in how we fight poverty, protect children from growing up in harrowing conditions that predispose them to addiction and other psychiatric disorders, and respond to the suffering of fellow human beings — even those who make poor choices, for which they themselves are responsible.

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Hanna Pickard

is a philosopher of mind at the Oxford Centre for Neuroethics, and a therapist at the Oxfordshire Complex Needs Service.

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