SOCIAL PERCEPTION AND DISAFFILIATION IN ADOLESCENT SEXUAL OFFENDERS

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Scotlands Futures Forum
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Drug use and harm

• Dr. David Shewan
• Research Director
• Glasgow Centre for the Study of Violence
• Glasgow Caledonian University

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Drug use and society

• Psychoactive drug use - including alcohol and
  tobacco - is widespread within most societies.
• Problems associated with drug use, and particular
  drugs, are primarily focused upon health and
  crime these can seriously and tragically affect
  the individual user, family, friends, loved ones.
  
• Drug problems can affect local communities,
  criminal justice systems, health services,
  employment and economic productivity at a global
  level the illegal drug trade can have a negative
  impact on entire countries.

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Drug Use and Society

• Most drug use is relatively non-problematic,
  causing little harm to self and/or others.
• This involves a number of protective factors,
  ranging from personal to societal. A distinction,
  albeit not straightforward, can be made between
  controlled and addicted use.

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A Scottish newspaper, 14/7/07

• I OVERDOSED ON 14 CUPS OF ESPRESSO
• DEALER'S BABY PLEA IS REJECTED
• CRUEL DRUNK KILLED PUPPIES
• TEETOTALLERS GET STONED
• ROBIN WILLIAMS BACK ON THE WAGON
• DESPERATE SCOTLANDS POOREST KIDS

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A Scottish newspaper, 17/06/06

• Homophobic thugs jailed for 28 years over
  murder
• Two army psychiatric casualties every day in Iraq
• Wife-killer dies in prison
• Suspect charged in shooting incident
• Boy held over womans death
• Pub glass ban could make drinking more
  dangerous
• Hunt after sleeping girl seen locked in car
  boot
• Girl, 3, targeted by paedophile in McDonalds
• Domestic abuse helpline calls soaring

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Same Scottish newspaper, same day

• Good response to appeal over schoolgirl attacks
• Eight-year-old among 500 Scots children in drugs
  rehab
• Golden eagle found poisoned with banned pesticide
  bait on Deeside
• Youngest mother to be taken into care
• Bomber hid explosive in his shoe
• Slums spread as more people become city dwellers
• Pentagon excludes press from Guantanamo
• Snipers claim four more killings
• Ship evacuated after bomb hoax
• Wifes severed head found at crash site

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The relationship between risk, drug user,
drug use, and drug-related outcome is
heterogeneous and complex
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The Medical Model of Substance Addiction

• Assumes detrimental effects to the individual and
  society.
• Assumes that drugs do things to people and make
  them behave in certain ways.
• Psychological factors are seen as secondary, and
  social and cultural factors are mainly just
  referred to.
• Treatment is usually necessary to stop further
  deterioration.

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Drug, Set, and Setting

• DRUG - the pharmacological action of the
  substance.
• SET - underlying and learned psychological
  aspects of the user (and the influence of genetic
  and biological characteristics).
• SETTING - situational factors, and the wider
  social and cultural context.

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Set

• Many problematic drug users also have (other)
  mental health problems.
• These could be underlying health problems, they
  could be exacerbated by problematic drug use,
  they may be the result of problematic drug use.
• There is strong and increasing evidence that many
  problematic drug users are seriously traumatised
  (c.f. The Barlinnie Project).

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Can you pass the Acid Test

• On Becoming a Marijuana User (Becker, 1963).
  Arguably one of the earlier modern day examples
  of harm reduction advice
• To learn how to take the drug to recognise the
  effects to interpret the effects as pleasant.
• Becker also applied these principles to LSD use
  in the 1960s.
• As predicted, after an initial flurry of novice
  LSD users entering hospital, these numbers
  drastically reduced.

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Set - in denial?

• A paper by Phillip Murphy, Liverpool John Moores
  University presented data from 328 ecstasy users
  and reported that even after two years regular
  use most still felt positive about the drugs
  effects and wished to keep using for this reason.
  His conclusion
• It is likely that some users come to prefer the
  person they are, and the world they experience,
  under the influence of the drug. This may be seen
  as a form of psychological dependence, even
  though they are not physically addicted to it
  (Quoted in The Observer, 2004).

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At the top of the hierarchy of harmful drugs of
misuse heroin.

• The opiates are drugs of addiction anyone who
  takes an opiate for a long enough time will
  become addicted. (Edwards, 1984).
• Although
• People who use heroin are highly disposed to
  having serious personal and social problems
  before they touch heroin heroin is a worse
  drug only because worse people use it.
  (Robins, et al. 1980, 2005).

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At the top of the hierarchy of harmful drugs of
misuse heroin.

• And it has been argued
• Their addicts heroin use is anything but an
  escape from life. They are actively engaged in
  meaningful activities seven days a week. They are
  always on the move and must be alert, flexible
  and resourceful. (Preble and Casey, 1969).
• Some patterns of heroin use can be non-intrusive
  to the user and society. A more integrative
  theoretical understanding of drug use does not
  rest on assumptions about the causal effect of
  simply taking a particular drug heroin (Shewan
  and Dalgarno, 2005).

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Setting

• The Rat Park Experiments (Alexander, et al.,
  1994)
• These involved creating an environment in which
  to carry out these experiments which in an
  experimental psychology context closely resembled
  as practically possible a natural environment.
  As described by Alexander (1994)
• Rat Park, as it came to be known, was airy and
  spacious, with about 200 times the square footage
  of a standard laboratory cage. It was also
  scenic, (with a peaceful British Columbia forest
  painted on the plywood walls), comfortable, (with
  empty tins, wood scraps, and other desiderata
  strewn about the floor), and sociable (with 16-20
  rats of both sexes in residence at once).
  p.24.

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Setting

• Nothing that we tried instilled a strong
  appetite for morphine or produced anything that
  looked like addiction in rats that were housed in
  a reasonably normal environment. p.27.

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Crack Babies

• Long-term American research with crack babies
  has indicated that these children are impaired,
  however this impairment has little to do with
  prenatal cocaine exposure and a lot to do with
  social exclusion most crack babies have heard
  gunshots by age 7. Such findings are unpopular
  for many obvious reasons poverty is harder to
  tackle, less easy and popular to campaign
  against, than drug use (Stanton Peele, website).

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Shewan and Dalgarno, (2005) Controlled Heroin
Use

• Participants were recruited through social
  networks and must have
• Illicitly used opiates at least ten times in each
  of the preceding two years.
• Never been in treatment for any drug (including
  alcohol).
• Never served a custodial sentence.
• 126 people living in Glasgow. 75 were male, 25
  female, the mean age was 28.5 years.

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SES, Education, and the general population

• Occupational status (I highest)
• SES category I II III IV V
• Heroin sample 9 29 53 9 0
• UK population 5 23 48 18 6
• At the time of the study, levels of the
  population currently in higher education in
  Scotland, was recorded at 47 of the general
  population (Universities Scotland, 2001).
• There were no significant differences between the
  controlled heroin use sample and the general
  population on either of these variables
  possibly the most important finding in the study.

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Cocaine

• 65 of those who had used cocaine had used it in
  the six months prior to interview
• The mean years of use for cocaine was 8 years
• 52 of those who had used cocaine had used it
  with opiates the main reason being to enhance
  the effects of both drugs.

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Availability and motivation

• 84 of the sample reported that for them heroin
  was very easy or easy for them to obtain.
• 98 of the sample rated heroin as very
  enjoyable to use.
• These questions werent asked about cocaine, but

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Injecting and sharing

• 25 had ever injected 15 had injected within
  the two years prior to interview.
• Ongoing regular injecting was confined to 5 of
  the sample.
• 10 had ever shared injecting equipment 3 had
  shared in the two years prior to interview.
• No participant had tested positive for HIV. One
  participant had tested positive for hepatitis C.

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Research outcomes

• At the conclusion of the study, 7 (6/85) of the
  follow-up sample had entered specialist treatment
  for their drug (heroin) use.
• No participant had died.
• No participant was serving a custodial sentence.
• One participant had gone to Amsterdam, had a sex
  change operation (and seemed happy enough).

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Implications

• Drugs assumed to be addictive may not necessarily
  be used in an addicted way (e.g. heroin,
  cocaine).
• Drugs assumed to be harmful may not be
  necessarily so. Drugs assumed to drive criminal
  behaviour may not necessarily do so.
• Researchers require to collect data from hidden
  populations and not rest primarily on assumptions
  about the causal effects of simply taking a
  particular drug.

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Drug, Set, and Setting

• Acknowledges the complexity of drug use and
  addiction provides a model for comparing factors
  associated with problematic versus
  non-problematic drug use.
• It is a valid framework to predict and explain,
  for example, controlled versus addicted heroin
  use.

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A medical approach

• Can be overstated.
• But, it can be argued, has a range of practical
  values - an improvement in treatment and
  interventions more sympathetic approach from
  family, employers, the criminal justice system.
• But does a focus on drug help in this respect?

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Drug, set, and setting

• Acknowledges the complexity of drug use and
  addiction.
• Provides a model for comparing factors associated
  with problematic versus non-problematic use of
  particular drugs.
• As a theory it requires appropriate sampling.
• It is a useful framework to predict and explain,
  for example, controlled heroin use. Or, chaotic
  use of name drug.

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Visible harms, unobtrusive users

• Typically, controlled drug users have jobs, are
  well-educated, and are law-abiding and productive
  members of the community.
• They also happen to use a lot of drugs, including
  the most harmful. But as drug users, they were
  indeed unobtrusive.
• So, what would be the ethics of criminalising
  this group because of their drug use? Would this
  be the greater harm?

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So what do you do?

• Help people with problems, including their
  problems with drug misuse provide the full range
  of treatment and care options.
• Education, prevention, harm reduction.
• Generally, leave people alone who seem okay, and
  dont have problems with the drugs they use.
• From whatever angle, what use the Misuse of Drugs
  Act?

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The Delphic System

• Your expert views please, on
• Smoking it heroin, right, youll maybe just
  get a little buzz, but if you inject it then
  youre phewww bingoed! So then, of course if
  they tried smoking it and theyre not getting
  their hands on enough of it, which they probably
  arenae, then they try injecting it like whoa
  what a difference!, ken?. So then theyre
  injecting it. Why? Because it works better than
  smoking it. You understand what I mean? male
  prisoner.