'It's there own fault for taking drugs' Professorial Lecture Glyndwr University 21st May 2009
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Exploring the way in which we construct and understand legal and illegal drug use and dependence.
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'It's there own fault for taking drugs' Professorial Lecture Glyndwr University 21st May 2009
- 1. WWHHIILLEE YYOOUU WWAAIITT PPLLEEAASSEE TTEESSTT YYOOUURR KKNNOOWWLLEEDDGGEE BBYY CCOOMMPPLLEETTIINNGG TTHHEE QQUUIIZZ Professor Julian Buchanan Inaugural Professorial Lecture Thursday 21st May 2009 Glyndwr University “It’s their own fault for doing drugs” WWHHIILLEE YYOOUU WWAAIITT PPLLEEAASSEE TTEESSTT YYOOUURR KKNNOOWWLLEEDDGGEE BBYY CCOOMMPPLLEETTIINNGG TTHHEE QQUUIIZZ
- 2. Personal Reflection: An unexpected journey Shared journey Shared achievement Opportunities and support Widening access
- 3. Professor Julian Buchanan Inaugural Professorial Lecture Thursday 21st May 2009 Glyndwr University “It’s their own fault for doing drugs”
- 4. Government warnings about drugs ‘evil of drugs’ ‘fight against drugs’ ‘crime it breeds’ ‘blights communities’ ‘destroys families and young lives’ ‘get drug dealers off our kids’ backs and into prison’ ‘Fuels crime’ ‘Wont tolerate the menace of drugs’ ‘causes misery’ ‘costs lives’ HM Treasury (2001) £300 Million Boost For Communities Against Drugs, Press Release, 49/01 09 April 2001
- 5. UN Political Declaration “Drugs destroy lives and communities, undermine sustainable human development and generate crime. Drugs affect all sectors of society in all countries; in particular, drug abuse affects the freedom and development of young people, the world’s most valuable asset. Drugs are a grave threat to the health and well-being of all mankind”. UN Declaration http://www.un.org/ga/20special/poldecla.htm
- 6. Issue 22/97 14 October 1997 STATISTICS OF DRUG ADDICTS NOTIFIED TO THE HOME OFFICE, UNITED KINGDOM, 1996 by John Martin Corkery
- 7. Drug Use Today Almost 11.5 million people in England and Wales between ages 16 to 59 have used illicit drugs at some point in their life. Just under 3 million people are estimated to have used illicit drugs in the past year Around 1.7 million have used illicit drugs in the past month Hoare, J. & Flatley, J. (2008) Drug Misuse Declared: Findings from the 2007/08 British Crime Survey, HMSO, London, p.7
- 8. Hoare, J. & Flatley, J. (2008) Drug Misuse Declared: Findings from the 2007/08 British Crime Survey, HMSO, London, p.34
- 9. Hoare, J. & Flatley, J. (2008) Drug Misuse Declared: Findings from the 2007/08 British Crime Survey, HMSO, London,
- 10. CAFFEINE "We have seen several well-marked cases of coffee excess.... The sufferer is tremulous, and looses his self-command; he is subject to fits of agitation and depression; he looses colour and has a haggard appearance. The appetite falls off, and symptoms of gastric catarrh may be manifested. The heart also suffers; it palpitates, or it intermits. As with other such agents, a renewed dose of the poison gives temporary relief, but at the cost of future misery'. Sir T.C. Allbutt and H.D. Rolleston A system of medicine 1909.
- 11. Benzodiazepines Drug A This is a physically and psychologically addictive drug. Withdrawal of from this drug is said to be worse than any other drug. Common withdrawal symptoms include: insomnia, nightmares, depression, anxiety, panic attacks, agoraphobia, excitability, jumpiness, restlessness, poor memory and concentration, dizziness, light-headedness, weakness, “jelly legs”, tremor, muscle pain, stiffness in limbs, back, neck, jaw, head, sweating, night sweats and palpitations! These withdrawal symptoms can continue for months. Some suggest withdrawal may take one month for every year of drug taking. So someone with an 8 year habit could suffer withdrawal symptoms for 8 months.
- 12. Drug B Once hooked users find it very hard to stop. Every day they wake up they feel like they must get hold of the drug. If they don’t get hold or use this drug at some point in the day they often become irritable, preoccupied and moody. This drug is believed to kill more people than any other drug. Tobacco
- 13. Drug C This depressant drug can affect mood and behaviour negatively. It is physically addictive and withdrawal is particularly unpleasant – in some of the worst cases drug users suffer epileptic seizures and hallucinations when withdrawing (turkeying). This drug is strongly linked to aggression and violence. Alcohol
- 14. Drug D This stimulant drug is psychologically addictive. These drug users feel that they can’t face life unless they have their fix. Most of these drug users have to take the drug at least once a day. If they can’t get hold of their drug these users become edgy, irritable and restless. Heavy users suffer palpitations, dizziness, headaches, migraine and insomnia. Caffeine
- 15. Drug E This drug is taken because of perceived health benefits but research indicates this drug can cause internal bleeding, serious stomach and intestinal problems resulting in ulcers and gastric bleeding. Aspirin
- 16. Drug F These drug least every in different equipment. Tobacco users tend to have to take their drug at day. Although the drug can be taken ways – a popular way involves These drug users sadly have a habit of discarding their ‘works’ (this is a drug using term for equipment used to take a drug). This is not only unpleasant for the public and risks causing serious harm to non users – it can be life threatening to others. Every year a number of innocent people are killed.
- 17. Reductionist Framework Users of Legal Drugs Users of Illegal Drugs DIVIDE
- 19. Adapted from ‘Development of a rational scale to assess the harm of drugs of potential misuse’ by David Nutt, Leslie A King, William Saulsbury, Colin Blakemore, Lancet 2007; 369: pp. 1047–53 Now Classified C Re-Classified B
- 20. A more rational framework? LSD user Cannabis user A Cannabis user B Alcohol user A Alcohol user B Cocaine user Tobacco user WWee aarree aallll ddrruugg uusseerrss Low risk High risk
- 21. 7 additional risks exacerbated by tough enforcement Has no idea of the strength of the drug - it could be so strong it could result in risk of overdose or death. Has no guarantee about the purity or indeed content of the drug - it could contaminated or even mixed with toxic ingredients that could cause serious harm even death. Has to buy the drug ‘underground’ - exposing the person to the vagaries of a potentially dangerous criminal underworld. Buying, using and sharing illegal drugs puts the person at risk of serious criminal sanctions such as a community sentence with a drug rehabilitation requirement or even imprisonment.
- 22. 7 additional risks exacerbated by tough enforcement (cont.) A person using an illegal drug risks acquiring a criminal record for a drugs offence - which could have lifelong consequences upon employment prospects, opportunities for world travel and housing. Has to use the drug in secret. For some people this may mean using in an isolated location which could be potentially dangerous especially when intoxicated - such as a condemned building, under a railway bridge, a canal etc. Has to hide the use of illegal drugs making it more difficult to manage and harder to seek help, support or advice if a problem arises.
- 23. Bifurcation Process Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
- 24. Tougher Approaches Drugs Act 2005 enables: • drug test suspected drug offenders on arrest, rather than on charge • suspected to have swallowed an illegal substance remand in police custody upto 192 hours. • If that person refuses without good cause, to consent to an intimate body search, x-ray or ultrasound scan the Act allows the court or jury to draw an adverse inference. • Can be placed on new ASBO equivalent to get drug treatment
- 25. Tougher Approaches: welfare and work
- 26. Focus on Problem Drug Users Drug use PDU
- 27. expanding prison population 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 1985 2007 UK Prison Scotland’s only all-female prison, 94% of the women on admission tested positive for illicit drugs HMIPS, HM Inspectorate of Prisons for Scotland. (2001). Report on HMP and YOI: Cornton Vale, Edinburgh
- 28. Prison (per 100,000 pop.) Total Prison Population Possess/Supply Drugs Latvia 288 6,548 9.2% Estonia 259 3,467 9.6% Lithuania 234 7,866 4.6% Czech Republic 182 18,901 8.0% Spain 160 73,787 27.4% Luxembourg 155 745 42.1% England & Wales 151 82,240 15.5% Bulgaria 134 10,271 5.6% Romania 123 26,350 3.3% Portugal 102 10,830 27.3% Netherlands 100 16,416 18.9% France 96 59,655 13.6% Malta 95 387 28.1% Belgium 93 10,002 14.3% Italy 92 55,057 29.4% Germany 89 73,203 14.9% Cyprus 83 671 27.5% Ireland 81 3,653 14.4% Sweden 74 6,770 23.0% Slovenia 65 1,317 10.9% Finland 64 3,370 15.2% Denmark 63 3,448 23.9% Adapted from: Bewley-Taylor, D., Hallam, C., Allen, R. (2009) The Incarceration Of Drug Offenders
- 29. Prison (per 100,000 pop.) Total Prison Population Possess/Supply Drugs USA 756 2,293,000 19.5% state 53% federal Latvia 288 6,548 9.2% Estonia 259 3,467 9.6% Lithuania 234 7,866 4.6% Czech Republic 182 18,901 8.0% Spain 160 73,787 27.4% Luxembourg 155 745 42.1% England & Wales 151 82,240 15.5% Bulgaria 134 10,271 5.6% Romania 123 26,350 3.3% Portugal 102 10,830 27.3% Netherlands 100 16,416 18.9% France 96 59,655 13.6% Malta 95 387 28.1% Belgium 93 10,002 14.3% Italy 92 55,057 29.4% Germany 89 73,203 14.9% Cyprus 83 671 27.5% Ireland 81 3,653 14.4% Sweden 74 6,770 23.0% Slovenia 65 1,317 10.9% Finland 64 3,370 15.2% Denmark 63 3,448 23.9% Adapted from: Bewley-Taylor, D., Hallam, C., Allen, R. (2009) The Incarceration Of Drug Offenders
- 30. The disproportionately impact “US drug policies … have a disproportionate impact on minority groups. … if white males were incarcerated at an equivalent rate as their black counterparts, there would be over 6 million people in America’s prisons and jails.” Dave Bewley-Taylor, Chris Hallam, Rob Allen (2009), The Incarceration of Drug Offenders, Report Sixteen, The Beckley Foundation, Drug Policy Programme p.13
- 31. ‘Hardening’ of cultural norms ‘Drug misuse can ruin individual lives, tear open families and blight whole communities with the menace of dealers and crime driven by drug abuse… more drug dealers – people who profit in the misery of others – behind bars… more addicts into treatment…further powers for police to drug test suspected addicts on arrest… vicious circle of drugs and crime …dealers will face harsher sentences where they prey on children … Drugs are a scourge on the world, Caroline Flint, Home Office Minister quoted in drink and drugs news 10 January 2005 p.7
- 34. Smoking was once an approved and promoted cultural norm
- 36. Pendulum of opinion Smoking is no longer an approved cultural norm Smoking is stigmatised People who smoke are marginalised Some may receive ridicule, harsh treatment - even hostility
- 38. Focus on Problem Drug Users Drug use PDU
- 39. The Dominant Framework Physical Tackling Problem Drug Use Psychological Legal
- 40. Adding a social component Problem Drug Use Legal Health Psychological education employment social & life skills discrimination self esteem/confidence routines/habits lack of non drug using networks reintegrating in local community Social
- 41. Problem drug users & disadvantage The majority of problem drug users were over 26 years old and had been taking illegal drugs for over 7 years. 52% of the known problem drug users left school before reaching 16yrs Buchanan J & Young L (2000) The War on Drugs the War on Drug Users Drugs: education, prevention and policy, Vol. 7, No. 4
- 42. Problem drug users & disadvantage Over half had been unemployed for the past 5 years - One in seven had never been able to secure a job 52% of the sample had no qualifications (academic or vocational)* *NB Each year only 6% of pupils leave school with nnoo qquuaalliiffiiccaattiioonnss hhttttpp::////wwwwww..ddffeess..ggoovv..uukk//ppeerrffoorrmmaanncceettaabblleess//sscchhoooollss__0011..sshhttmmll Only two people were currently in employment (out of 200). Buchanan J & Young L (2000) The War on Drugs the War on Drug Users Drugs: education, prevention and policy, Vol. 7, No. 4
- 43. At–risk index of PDU 1. Contact with drugs 2. Lack of identification with the mainstream (through family, friends or peers) 3. Sense of alienation caused by unresolved bereavement or trauma 4. No suitable ally or pastime to provide emotional support and positive feedback 5. A blocked future educational, employment and relationship opportunities inhibited Young R (2002) From War to Work Drug treatment, social inclusion and enterprise, The Foreign Policy Centre, p.45
- 44. Stigma and exclusion ‘They look down on me as scum of the earth and as someone not to be associated with’ `I feel the odd one out, I’ve nothing in common with them. I start to get paranoid’ `I used to avoid them like the plague. I used to be scared of what they might think’ `I feel nervous in case I slip up, I know they would look at me in disgust’
- 45. Buchanan, J. (2006) Understanding Problematic Drug Use: A Medical Matter or a Social Issue, British Journal of Community Justice – Volume 4, Issue 2 pp. 387–397
- 46. Mixing with Non Drug Users ‘I feel a bit beneath them, they make you feel like that’ ‘I’ve got to watch what I say so I don’t land myself in it. They blame smack heads for everything.’ ‘I feel labelled … like they thought I was dirt’ ‘They look down on me as the scum of the earth and as someone not be associated with’
- 47. How do other people see you? ‘They see me as a drug addict, a smackhead and they think I’ll rob them’ ‘Some people don’t want to talk cos of being on gear they just think ‘smackhead’. They don’t realise just how hard it is to get off’ `I feel nervous in case I slip up, I know they would look at me in disgust’ `I never really mixed with people who have never taken drugs’
- 48. Internalising prejudice ‘Discrimination has led many problem drug users to internalize and blame themselves for their position. This loss of confidence and self-esteem is a serious debilitating factor. They feel themselves to be labelled, discarded and isolated from mainstream society.’ Buchanan J & Young L (2000) The War on Drugs the War on Drug Users Drugs: education, prevention and policy, Vol. 7, No. 4
- 49. PDU & social exclusion links 73% drug users Average age 28yrs 47% didn’t complete educ. 59% no qualifications 0% had A level + 51% unemployed 11% unable to work Survey of 1884 males in 2000 who had recently been sent to prison. (Liriano & Ramsay 2003 HORS 267) Average age 32yrs 54% excluded from school 20% been in care 64% had been in prison age first time use 16yrs age drug problem 21yrs Jones S, Drainey S, Walker L & Rooney J (2004) Collecting the Evidence: Clients views on drug services, Addaction N=550 73% drug users 60% unemployed prior to custody 54% didn’t complete educ 32% been in care Survey of 529 male prisoners in 2000 (Bullock T 2003 HORS 267)
- 50. Arrestees who used crack and heroin 50% said they had left school before they were 16 58% said they had been temporarily excluded 36% permanently excluded from school only 1 in 10 were in employment (compared with almost half of other arrestees); 29% had been in local authority care at some time almost a quarter had slept rough in the past month Reducing Drug Use, Reducing Re-offending March 2008 The UK Drug Policy Commission (UKDPC) pp20-21
- 51. The Barrier of Exclusion ‘it is evident that the anti-drug campaigns over the past 20 years have added to the isolation and marginalization of the discarded working-class youth …. In addition to having to overcome their addiction, one of the biggest hurdles they have to face is breaking through the barrier of social exclusion. JULIAN BUCHANAN & LEE YOUNG The War on Drugs -a war on drug users? Drugs: education, prevention and policy, Vol. 7, No. 4, 2000
- 52. Coping Without Drugs ‘When considering treatment and rehabilitation it must be recognised that many problem drug users have had such limited options in life, that they lack personal resources (confidence, social skills and life skills) and have limited positive life experiences to lean upon or return to. This client group need social integration not social reintegration, they need habilitation not re-habilitation – it seems that many have never really been able to get started in life in the first place. This makes living without drugs a very tough option indeed.’ Buchanan, J. (2004) ‘Missing links? Problem drug use and social exclusion’ Probation Journal, Special Issue: Rethinking Drugs & Crime, Vol 51(4): 421–431
- 53. The struggle for reintegration Adapted from Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework, pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth press Free article download from http://epubs.newi.ac.uk/siru/1/
- 54. Barriers to Integration ‘Many socially excluded dependent drug users in the UK struggle to break out of a drug centred existence, - even when they become physically drug free and display an abundance of psychological insight and self-motivation. These drug users face a more difficult challenge of overcoming the many layers of discrimination and social exclusion’ (Buchanan 2004 p124). Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework, pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth Press
- 55. Summary ‘It’s their own fault for doing drugs’ 1. We all take drugs and the legal ones are not particularly safe. 2. Making a drug illegal significantly increases the dangers posed by the drug. 3. The division between legal drugs and illegal is not rational 4. Criminalisation and tough enforcement upon selected drugs has created considerable additional problems. 5. The majority of the people who develop drug problems had significant difficulties before they began taking drugs and few legitimate options. 6. The war on drugs and the associated discrimination and exclusion can be a bigger hurdle than the drugs. 7. A move away from a drug centred lifestyle and reintegration with mainstream society poses an enormous challenge. 8. Approaches to drugs have been dominated by the physiological and psychological aspects of problem drug use - these people need major personal, social and practical support
- 57. Thank you for your time If you want more information please email me: Email now: julian.buchanan@vuw.ac.nz …time for a drink in the Foyer?
Editor's Notes
- Although I’ve spoken at numerous events and places this is a rather unusual experience to give a lecture with friends, family, colleagues and member of the public altogether. Now I know what it feels like to be Peter Kay and have your mum in the audience! Good to see you mum! Before I begin my Inaugural Professorial Lecture I want to acknowledge that this achievement and indeed the journey becoming Professor is one that hasn’t been achieved alone. There are lots of people I owe considerable thanks and appreciation to for inspiration, encouragement, opportunities and support. In the early days seconded by MPS to do a Master degree Steve Collet now Chief of Cheshire Probation was my line manager – his debates, questioning and sharp mind started the academic ball rolling – and we’ve continued that since then as members of the PJ editorial board. It was an unexpected journey from Anfield a rough working class area of Liverpool as one of 5 children having left school at 16 (having originally failed more o levels than I passed. I started work at 17 as clerical officer. It’s fitting to make that unexpected journey to Prof at Glyndwr University (via employment with L’pool Social Services, MPS, The University of Liverpool and UCLAN), because like my journey this university is committed to being ‘open to all’ to giving people the opportunity, taking people from non-traditional routes. People need chances and opportunities and that will be a theme of this lecture. Glyndwr University helped me enormously by providing me with a sabbatical secondment to Oxford University to work of completing my PhD Investigating the social context of problem drug use. I’d like to thank Prof Paul Senior SHU for constant encouragement as my PhD Supervisor and colleague, for Prof Odette Parry for all I’ve learnt from her over the years as colleagues in SIRU (Odette pulls no punches in her critique!), to Prof Ros Carnwell for giving me the opportunity to edit a book together (such a reliable colleague to work with) – now in its second edition. To my CJ colleagues Nat, Martin, Sarah & Caroline – great friends who have a passion to do a job well. To my dad who although he died when I was 12 left a powerful legacy by his political involvement in the Trade Union movement and passion for justice and a fairer world –and to my mum whose instilled individually, free thinking and vision in us all and who despite the financial and practical struggle managed to bring up 5 kids on her own 18month – 16years old. To my brother Nick in particular who has often read and critiqued my articles and book chapter and always given great encouragement. Most of all to my wife Gill, and my sons Graham and Matthew – always understanding, they’ve put up with my disappearances in my role as father and husband as I formed a new relationship with a new partner in 1990 - the Amstrad 1512 PC - I have to confess there have been many other PCs after that one too! I think a divorce is overdue –from the PC that is! My artistic sons have been telling me for a while now to start a relationship with a Mac!
- ‘It’s their own fault for doing drugs’ – popular sentiment for people who get into a mess on drugs - but one that I hope to illustrate is a little misguided
- There is a mantra about drugs – these comments are extracted from a Government Press release READ
- The slogan for the UN’s 10-year strategy of 1998 was: “A drug-free world—we can do it!”, But is it really that simple –is it really all to do with the all consuming and pervasive power that drugs possess? That we have identified substances that exist in the world that inevitably drive people to death, destruction and threaten the well being of humankind Drugs can indeed be dangerous and damaging for some – but I want to illustrate that some of these issues are not so much to do with drugs but are connected with the way we see drugs, the way we manage drug, the way we see drug users and the way we treat drug users.
- Let’s take a look a brief the growth and extent of drug use today. It’s no coincidence that the rise in problem drug use coincide with the recession, mass unemployment, deindustrialisation that hit cities that were once reliant upon coal mines, ship yards, factories, and heavy industry. Many of these areas became awash with heroin in the mid 1980s. The popularity and preference of particular drugs may have changed but the links between discarded working class areas and high levels of problem drug use remain. Since the 1960s anyone with a drug problem seen by a GP or Psychiatrist had to be registered with the Home Office as an ‘Addict’ a terrible label but the process at least provided consistent evidence of the growing drug problem – until the notifications ceased in 1997.
- It has been argued that drug use today has become a normalised activity –there is much debate over what this actually means but we can say that drug use is certainly not confined to a tiny minority READ Clearly if we wage war on drugs we are waging war on 11.5million people who have used an illicit drug or at least 1.7m who used in the past month. Should these people be regarded as a threat, are they addicts?
- So how widespread is drug taking? Here we can see from the most recent BCS the % of people in the different age groups who have used a drug at some time in their life, past year or past month. Over 50% of 25-29 admit to using an drug at some point in life. Around 1 in 5 people 16-24 used a drug in the past month. It would be misleading to suggest that 20% of our 16-24 years have a drug problem. In 30 years time this same survey will show that over 50% of people between 55-59 have used an illegal drug compared to 17% at present. This may have implications for future drug policy as the gap between generation and their experience narrows.
- This graph again shows the difference in drug use by age –generally with the younger age brackets at the top and the older at the bottom. On the left is the percentage of that age group who have used drugs in the past year. We see 1 in 4 young people 16-24 compared to 1 in 10 30-34 yr olds But what this chart also show is a gradual decline over recent years – this is interesting because there was concern that when cannabis was downgraded to a Class C drug in 2004 many were concerned that drug use would actually increase. The opposite has occurred but as you probably know earlier this year Cannabis was reclassified and upgraded to a B classification So we know that relatively a lot of people are using drugs particularly the 16-25 years olds But what do we know of the risks posed by drugs? Hopefully you have a quick guess at the risks and harm of drugs earlier on your sheet you have. If you haven’t I’ll give you 2-3 mins now just to write down a quick guess! No worries you can keep your answers a secret they wont be collected in or marked! My students are expected to know all the answers and not to tell others!
- This drug is very physically and psychologically addictive and withdrawal can take months. The symptoms are really very unpleasant. Any guesses? BENZOS TRANX, SLEEPING TABLETS – they are depressant drugs, useful for a limited period in certain situations, but they do have some nasty side effects
- This is a stimulant drug. Quite addictive. The key to identifying this drug is that it’s by far the biggest killer out of every drug taken. Any guesses? Yes Tobacco – which kills around 110,000 people every year in the UK, and is also linked to other problems such as poor circulation and amputations. A very dangerous drug According to Drugscope Illicit drug related death in 2004 totalled around 1427* http://www.drugscope.org.uk/resources/faqs/faqpages/how-many-people-die-from-drugs.htm
- It’s a depressant drug that the vast majority of people in this room use. It’s linked to 50% of murders, 45% of those arrested for assault test positive for this drug, around 15% of all road deaths are related, it cited in 30% of divorces Up to 150,000 hospital admissions per year are associated with abuse of this drugs. http://www.alcoholconcern.org.uk/files/20040312_160130_Statistics%20for%20Strategy%20release.pdf Alcohol our favourite drug is a toxic substance (one that I personally enjoy) but it damages the heart the liver, the brain. Yet we have culturally embraced it as a cultural perception of pleasure – you’ve passed your exams –go out and celebrate –you’ve on your hen night go and have a good time, even when you pass your driving test you might receive a card with champagne bottles on suggesting a drink of this dangerous drug that has caused so much damage might be a good thing. The term celebrate is used by many to communicate getting intoxicated with alcohol. It’s strange when pharmaceutical heroin unlike alcohol doesn’t cause any lasting damage to the body. How irresponsible would it sound if you heard people encouraging one another to go out and celebrate with heroin, or cannabis. What is it then about our culture that ‘celebrating’ by getting drunk with alcohol is somehow culturally approved and promoted? What I am suggesting here is that we need to explore this false but firm distinction between legal and illegal drugs. Can I ask you to raise your hand if you have some of this dangerous drug stashed away at home? Should those of us who have confessed to having dangerous drugs at home be ram raided by the Police tomorrow morning about 6am? Why shouldn’t that happen – we know that alcohol is linked to all sorts of crime and violence. Maybe you rightly feel that you are a responsible safe user who poses no problems to yourself or others.
- This drug is found in chocolate, lemonade, tea, coffee, pills such as pro-plus and energy drinks like red bull, - it’s a stimulant drug – like amphetamine, khat and cocaine. These stimulant drugs depress the appetite so are used to lose weight. They also depress the need for sleep so people can keep going. A relatively harmless stimulant drug but one that does cause some problems to some people. One drug that we probably all use.
- Any guesses on the mild painkilling drug –
- I’m not sure anyone will get this – apart from my students. These users can chew the drug, that can place it on their body and absorb it But this drug is often smoked - sometimes in pipes mostly often these drug users use spongy filters to inhale their drug and when they have finished their smoke they often drop them on the floor. This is unpleasant for non users – when say on the beach in the hot sunshine lying on a sun bed and you pick up a hand full of sand let it run through your fingers and then discover a handful of cigarette buts. More seriously it has proved fatal for others and has resulted in house fires. The Bradford FC fire disaster in which killed 56 people was thought to have been caused by a tobacco user. King Cross fire disaster which killed 31 people was believed to have been caused by a tobacco user discarding a match. So did anyone get them all correct? What do you notice about these dangerous drugs?
- I began with the horrors claimed about ‘drugs’ people were referring of course to illicit substances and not legal drugs. In fact we hardly ever hear people refer to alcohol, tobacco or caffeine as drugs –but make no mistake they are drugs with some quite serious risks too. But this graphic illustrates the way we are encouraged to view drugs. There appears no rational basis for this distinction.
- What do we see here? Culturally we use language like celebrating, having a laugh, having fun, relaxing, out enjoying themselves, having a good time? The consequences and risks of legal drug use are often overlooked and perceived altogether differently to illicit drug abuse.
- Let’s take a closer look at scientific evidence published in the medical Journal The Lancet. Basically this research involved a group of drug specialists from various disciplines to rate the risks posed by all drugs using a matrix of harms posed. The results here are the overall mean scores produced in a league table of potential harm –the drugs perceived most harmful on the left –led by heroin and cocaine. The colour coding indicates the classification under the MDA 1971 red maroon color being the most serious drugs that carry possible life imprisonment for supply. In contrast the blue represent legal substances. Rational thinking would assume that if the MDA was a good reflection of harm all the A drugs (reddish colour) would be on the far left, followed by the Class B (pale pink) Class C purple and the legal drugs (blue) on the far right. But look where Alcohol is 5th most dangerous and tobacco 9th and see we have some class A drugs way down the list. Maybe this experts view is a lot more helpful than an over simplified division between legal and illegal drugs
- This framework I think offers a more rational approach to drugs. We are all drug users. We take drugs for pleasure albeit caffeine, alcohol whatever. We should avoid an oversimplified dichotomous framework that presents (safe) legal pleasures and (dangerous) illegal drugs Also while drugs do have generalized properties, risks and effects, we cannot create a hierarchy that puts a drug at a particular place on the continuum because the impact of a drug varies from person to person. For one person alcohol is high risk, to another it’s low risk, same could be said of cannabis. What is important is that we see ourselves together on a continuum and recognize that ALL drugs carry risk legal and illegal. It seems clear from the evidence that some legal drugs can be much more dangerous than some illegal drugs. This raises questions about our pre-occupation with waging war on illicit drugs and the distinction we’ve made in that we fail to recognise our legal consumption as drug use.
- But all illegal drugs are in some ways always inherently more dangerous than legal drugs because making drugs illegal makes them more dangerous. Let me explain. READ
- In the use in the 1920s/30s prohibition of alcohol offered a great example of how a drug pushed underground breeds sub cultures of deceit, crime, violence, money laundering, basically it creates crime and provides a lucrative playground for gangsters This division is based upon cultural norms more than any rational assessment. Illegal drugs under the MDA are ‘controlled’ drugs – but by being illegal they are actually under very little control
- But instead of a more inclusive approach we are seeing a tougher approach to illicit drugs
- These approaches wont just catch people who have problems with drugs they’ll catch all users. Maybe many might feel they are a responsible safe users who pose no problems to themselves or others.
- The vast majority of people who have taken or take illicit drugs are not problem drug users – just like the vast majority of drinkers don’t end up with drink problems. But a small proportion do. It’s those I want to concentrate upon. Although it could be argued that every illicit drug user does have a problem because they are engaged in an illegal activity and if they get a criminal record for a drugs offence it could seriously damage their future in terms of insurance, housing, employment, welfare and ability to travel abroad. This doesn’t illustrate the dangers of drugs its socially constructed harm that illustrates the impact of tough criminalisation and enforcement. Our tough enforcement on drugs is leading to an ever increasing rise in the prison population.
- We can see as we have pursued a war on drugs so our prison populations have increased significantly. It costs around £33,000 every year to keep someone in prison –we now have around 83,000 people in prison that adds up to £2.7 billion per year
- We lock up more than most EU countries and those with more than us tend to be from the Eastern block with a history of greater use of prison. The key figure is not the overall total in prison but the column that indicates the prison population per 100,000 population. This gives an idea of the proportion of people locked up. The column on the far right indicates 15% of offenders are in UK prisons for specified drug offences (Possession or supply) the figure for drug related will be much bigger. As an advanced democratic country we should be concerned by excessive use of imprisonment. So let’s have a look at outside Europe at The USA who have traditionally championed the war on drugs.
- Can you see here that not only does the USA incarcerate 2.3 million people it locks up a staggering proportion of people - 756 per 100,000 of the population. More than any other country in the world.
- Dr
- But thus far we are pressing ahead following the US model and continuing the rhetoric against illicit drugs. Sadly the fight against drugs often results in an attack on drug users. This stigmatisation of illicit drug users reflects cultural norms more than it reflects rationale or reason
- Cultural norms shift over time – opium was once widely available in the UK from the corner shops and used as a tonic for a wide range of ailments. Opium had some eminent regular users including the Lakeland Poets! Opium hasn’t changed our attitudes have. Doe this people look like heroin users?
- I was asked to speak at a conference in Glasgow on stigma –and drug use last year – so I did a quick search on the way drug users where portrayed in the local press. It was very revealing of prejudice and distain towards drug users –addict appears to be the preferred word READ These are dreadful tale of abuse and harm to often vulnerable people but where all these crimes and events motivated and instigated because of drug addiction – I doubt it. I suspect these are very damaged and sometimes very bad people who also take drugs –perhaps drugs help hide their unpleasant nasty reality. Change the word ‘addict’ for Hoodie, Schizophrenic, homeless youth, Epileptic, Immigrant, Muslim, Asian and it rightly feels very uncomfortable and objectionable. But clearly recreational use of opium no longer has any place in UK society.
- Glamorous, cool, sophisticated, sexy, sociable - tobacco use was once everywhere you looked
- These recent images reflect the shift towards stigmatising tobacco use. Like the war on drugs has led to a war on drug users The overt pro-active stigmatisation of particular drugs has often resulted in the stigmatisation of drug users.
- Having set the context for drug use lets look closer at those people who develop drug problems – often referred to as the problem drug user. As well as coping with the consequences of a war on drug user and stigmatisation these are the people have developed social, psychological, physical and legal problems as a consequence of drug use that has got out of control.
- Many problem drug users felt rejected and stigmatized by the non-drug-using population: How do other people see you?
- Problem drug-using offenders are a group with particularly complex and intractable problems, which means they will be more challenging to treat, rehabilitate and reintegrate into society.
- Finally some good news after years of following the US on their War on Drugs … the tide appears to be turning
- Thanks for listening