Cocaine in Scotland Cocaine Identities

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Cocaine in ScotlandCocaine Identities

• 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 are primarily
  focused upon health and crime these can effect
  the individual user, family and friends, 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 factors, ranging from
  personal to societal. The direct effects of
  particular drugs are also considered an important
  factor.
• A distinction, albeit not straightforward, can be
  made between controlled and addicted use.

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Addiction and controlled use

• Cocaine (A Very Greedy Drug, Ditton, 1991) has
  the potential to be used in ways that lead to
  huge problems, at personal, social, and societal
  levels.
• It is widely regarded as a highly addictive drug
  there is strong evidence for this.
• But can it be used in a non-addicted,
  controlled way?

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Cocaine headlines

• Dirty deals - pushers insist heroin addicts buy
  crack first (2003)
• Cocaine now cheaper than a glass of wine (2005)
• Crack cocaine crime plague (2005)
• Killer Coke (2006)

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Cocaine headlines

• Now crack spreads to Scotland (1986)
• COCAINE CROSSING with America saturated, drug
  traffickers have set their sights on Europe
  (1989)
• Cut-price cocaine floods in as U.S. loses drugs
  battle (1989)
• The cocaine explosion story of an 80s plague
  (1989)

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A realistic approach

• We have tangible evidence of a significant
  increase in cocaine use and cocaine-related
  problems in Scotland.
• We need to assess requirements of drug service
  availability, and of harm reduction information.
• We dont need a return to War On Drug
  rhetoric.
• We do need to tackle unpalatable truths

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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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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 rarely referred
  to.
• Treatment is 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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Shewan and Dalgarno, (2005).

• 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
• Current sample 9 29 53 9 0
• General 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).

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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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Set

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

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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 vs. addicted cocaine use.

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The Medical Model

• Can be challenged empirically.
• 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.
• How to balance theory with practice?

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Ethical issues policy and intervention

• 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
  cocaine. But as drug users, they are indeed
  unobtrusive.
• So, what would be the ethics of criminalising
  this group because of their drug use?
• Most drug research, especially heroin research,
  accepts sample bias by relying solely on
  populations of problematic users. As bad science,
  is this ethical?