DR MAX PEMBERTON: Working with addicts has taught me addiction is a choice

You don’t have to be a One Direction fan to recognize that Liam Payne’s death at the age of 31 is a tragedy. Any young life cut short, especially like his was, is deeply saddened.

And the impact on his family is immeasurable, not least on his seven-year-old son who will now grow up without a father.

I’ve seen so many young adults like Liam lose their lives to addiction and it’s heartbreaking. It’s such a waste.

According to Argentine media, the autopsy revealed that he had consumed a cocktail of drugs, including something called “pink cocaine” – which contains methamphetamine, ketamine and MDMA – along with crack cocaine and benzodiazepine.

Since Liam’s untimely death, there has been a sudden interest in ‘pink cocaine’. However, for those of us who have worked in emergency rooms or substance abuse services, this drug is not new. It is a dangerous substance made from a combination of two or more drugs, meaning users have no idea what is in it or in what concentration.

Despite the name, it usually does not contain cocaine. Using this drug is like Russian roulette in terms of what you get – and what the experience is like. I have seen several people end up in the hospital with severe psychosis and others who have stopped breathing or had seizures.

If we can learn anything from Liam’s shocking death, it is an increased awareness of the dangers of this harmful, unpredictable substance.

For me, the real tragedy is how Liam fought his addiction for so long, only to succumb. While some can cope with all kinds of turmoil in their lives, for others there is a lifelong quest for reprieve from their demons, and drugs, I’m sorry to say, give the illusion of offering just that.

I have worked in substance abuse services for many years and yes, I am tough when it comes to addiction. You can be kind, considerate, and compassionate while also recognizing that addiction is a choice.

In my clinics we can explore reasons why you might be addicted, but these are not excuses. I am firm with my patients, but I recognize that once addiction takes over, it can have such a strong grip that many cannot imagine ever being freed.

I understand that an addict’s family wants to believe that their loved one was targeted by dealers. That they are the innocent victims and would be clean if it weren’t for others.

But to me, this shows a misunderstanding of addiction. Drug dealers rarely target these types of people. You have to look them up. Dealers are business people, say no a few times and move on, especially if there are plenty of other willing customers.

And let’s not forget the peer pressure, the so-called friends cheering you on. Every addict wants someone else to share their drugs or alcohol. It helps them deny that they have a problem.

When you are rich, others often see you as a cash cow – a way to finance their own habits. But again, the hangers-on quickly disappear if you don’t produce the goods – they are addicts after all and all they are really interested in is their next fix. The problem is that the addiction is still there, and if someone comes along to offer a solution at the wrong time, boom, you can be right back where you started.

This is the real tragedy: people desperately trying to break free from the iron grip of addiction, but ultimately succumbing. To truly escape, the reality is that you need to understand why you became addicted. Here’s what I tell patients and their families: Getting clean is just the beginning.

Once you stop using substances, the real work begins. This often involves intensive and long-term psychotherapy, in which you investigate why you wanted to anesthetize yourself. It is a painful process, bringing up and confronting things that people have buried for years.

Often a person will abstain, but then the next step becomes too painful and upsetting. But if you fail to exorcise the demons underlying the addiction, you are destined for a terrible journey of rehabilitation, withdrawal and relapse.

Every addict I’ve met wishes they’d never started. If anything good can come from Liam’s tragedy, it’s that a generation of his fans will see the horror of addiction and think twice before saying yes to illegal substances.

Chris Hoy’s prostate cancer diagnosis at the age of 48 has shocked many. Are we taking prostate cancer seriously enough? More men die from breast cancer than women every year. Yet breast cancer research has more than doubled the financing.

I’m tired of dealing with gangsters

All those politicians and celebrities who defended gangster Chris Kaba should be ashamed now that the details of his criminal past have been published.

Throughout my career I have worked in inner-city London ravaged by gang violence (including the 67-year-old gang of which Kaba was a member) and currently have a number of former members as patients.

I spend a lot of time working with them to address the trauma they have not only committed, but witnessed and been exposed to. Gang violence is an absolute scourge, but it seems that too few people in power really want to tackle it. Instead, it’s left to clinicians like me to help people clean up the pieces. I’m sick of it.

Gangs destroy communities and kill and maim young people. Almost all of my ex-gang patients have been stabbed. Most have lost friends, sometimes under horrific circumstances.

Hundreds of young men are stabbed, shot and murdered every year. Enough is enough – it is criminals like Kaba who deserve shame, not the police.

Bruce Springsteen has said he thinks Trump is “mentally ill.” Many other people on social media seem to agree. I wish people would stop invoking mental illness when they disagree with someone and their views.

Nowadays everyone seems to think he’s a psychiatrist. Forget a medical degree and years of specialist training, a quick Google should do it, right? You can imagine how much this irritates me.

It’s not just the fact that these armchair doctors have the arrogance to think they know what they’re talking about when they clearly don’t, it’s also deeply insulting to those who are mentally ill.

The suggestion seems to be that if Trump can be proven to have a mental illness, he is unfit to be president. What an awful tosh! The reality is that mental illness does not, nor should it, prevent anyone from holding public office. It’s just an idiotic shorthand for “I don’t like this person” and is particularly abhorrent because it relies on the stigma and fear of mental illness to do so.

Dr. Max prescribes online help

The new NHS project ‘Get Your Mind Plan – Every Mind Matters’ aims to help people with problems before they become full-blown mental health conditions.

I was involved in the production of part of it: a tailor-made personalized action plan with tips on managing stress, anxiety, sleep and feeling more in control. I hope it helps. Search for ‘NHS Every Mind Matters Mind Plan’.