The Opioid Crisis Lookbook, (OCL) is the provocative title of a magazine started in 2022. Even without reading the magazine itself, the Instagram account is just as – if not more – divisive. OCL balances grungy editorials – pale faces, dark visuals – with good old American anti-drug PSAs and 12-step quotes. It’s as much of a social commentary as a fashion magazine, poking fun at abstinence campaigns whilst asserting its own distinct aesthetic. Often a contrast between collages that we could consider visual overkill, and quiet, empty liminal spaces – stamped with bold captions: “you can only kill us once” or “if addiction is a choice, so is cancer” to name a few.
The OCL’s founder, Dustin Cauchi, commented that the magazine’s mission as being a way to return the conversation about the American opioid crisis back to those who used these drugs and their experiences, rather than leaving it to journalists, who often interact little with its daily reality. He’s described some of his magazine’s editions as “violent,” “guilt-free,” “saddening,” “comforting,” and “empowering.”
Despite its jarring imagery, the OCL is a reminder that although harm reduction invests a lot of time on reforming the language around drugs, the visual language of substances also needs to be explored, understood, and critiqued.
With some drug policy reform changes happening worldwide, change is still primarily led and designed by policy-makers – rather than those most impacted by these policies. What several decades of drug prohibition have shown is that this approach has treated drug-related deaths as, first and foremost, a criminal matter, rather than a public health crisis. This has only not only exacerbated drug harms, through increasing the number of dangerous contaminants in drug supplies and unprecedented rates of addiction, but also created an aesthetic of prohibition, promoting certain images of drug use and its consequences.
The aesthetics of prohibition
One of the most persistent debates in aesthetics is about experiential art and its value in communicating experience and bridging gaps in empathy. Often, we consider art that does this as ‘good.’
And the OCL certainly has its own opinion on what falls under this bracket. Instagram will sometimes take a moment to poke fun at the aesthetics of prohibitionist media projects – which usually found use as Public Service Announcements (PSAs), massively broadcasted media messages against drugs.
For example, an advertisement from the Montana Meth Project: a stereotypical meth user pictured hunched over in a dingy motel room whilst a suited shadowed figure disrobes in the background. The caption reading: ‘I once had a daughter, I now have a prostitute.’
Obviously, you can understand why this is worth the ridicule. Not only does it play into offensive stereotypes, but it is incredibly dehumanising. It does not concern itself with the feelings of the woman, but of her invisible family. It minimises her worth, and projects shame onto both sex workers and people who use drugs.
Advertising like this is not uncommon and not new. Drug PSAs are known for their eeriness and, often, misguidedness.
One of Russia’s most notable drug PSAs from the early 2000s, ‘The Hanging,’ shows a man hanging himself, likening it to drug use. Clearly this is an insensitive and ill-proportioned comparison. It frames a behaviour that is, for many, the basis as their survival as the direct opposite. But such an extreme aesthetic does appear to align with Russia’s extreme relationship with drugs; the country is infamous for its harsh drug punishments and its practice of framing addiction as the moral failing of a nation rather than a public health crisis. Simultaneously, it criminalises treatment options like methadone, and does little to prevent bloodborne virus transmissions between people using drugs.
Another example is Japan, another country that’s extremely strict with drugs. However what distinguishes it from Russia is its cultural relationship with criminality, morality, and drugs. ‘Kitchen Mother’, a PSA from the 1980s reflects this relationship.
It depicts a mother asleep as her child cries for her to wake up. She wakes up briefly to shoot up and immediately puts her head back on the table, either to sleep or die. As this unfolds, the background fades away, with on-screen text exclaiming that not only do drugs harm yourself, but those around you – specifically addressing housewives.
All of these advertisements seem to be united in their eagerness to separate the person that uses drugs from their identity as an individual to their identity within society – leveraging that societal role to produce a feeling of shame. In the case of Kitchen Mother, she is shamed for not being able to be a ‘good’ mother. In Montana, the woman is ‘failing’ to be an exemplary daughter. The Hanging is the most extreme example – with the person seen to fail society as a whole by removing themselves from it.
PSAs are also often united by their joint ‘creepy’ legacy, and it’s no wonder why. Despite the fact that the OCL, similar media, or even established harm reduction services like Street Cats, have an explicitly dark, grunge-adjacent aesthetic they are rarely put under the same umbrella – and I believe this is because prohibitionist content is often too explicit in conveying separations. Us and them, you-now vs your future-self, and so on. Such division mongering doesn’t go unnoticed and feels puppeteered, eerie even.
The efficacy, (or lack thereof,) of this kind of advertising is evident. Russia still has one of the highest rates of intravenous drug use in the world, with only small victories for the harm reduction movement. Japan’s drug-use rates are increasing, and the USA is undergoing a fentanyl epidemic as its next chapter in the opioid crisis.
There’s evidence that PSAs – such as MMP – rarely work. They become the subject of ridicule – perceived to be just as fictious as horror movies – and are often ousted for more engaging autobiographical media, such as Trainspotting, Christiane F, or even the OCL.
So, what about autobiographical media and its aesthetic resonate so much more with people when it comes to encouraging harm reduction or honest conversations about drugs?
Simply, art and social movements are successful when they centre the voices of those that comprise either the experience it is trying to depict, or the people it is trying to serve. Just as feminism and feminist media should centre the voices of women, so too should harm reduction; they should focus on the voices and experiences of those using drugs, not the interests of policymakers and their contracted marketing experts who often reduce those using drugs to pejorative constructs: prostitutes, criminals, junkies, et cetera.
Art shapes ideas
Even if art does not have a direct role in guiding policy, it does advance our cultural understanding of an issue. It can motivate people to break out of archaic mindsets and shape new ideas. We’ve seen this trend in modern drug history: Trainspotting strongly contributed to conversations on addiction and society in a post-Thatcher economy. The Wire prompted a conversation about incarceration and drug-policing with then-president Obama. Good art examines the past, resonates with the present, and influences the future.
But this power is only evident with authenticity. Not centring the voices of the effected allows for a false narrative to be crafted, one that rarely benefits them. It discourages empathy and uses shame and fear as a vehicle for control.
The OCL is only one piece of media that asserts authenticity in this manner, and perhaps that is why we find it so brash. But, despite brashness, that does not mean it does not provide policymakers with something invaluable. Obscenity is a visual indicator that we have let a voice get too quiet.
