Reconceptualising Drugs, Drug Use and Problematic Drug Use

School of Social and Cultural Studies Seminar Paper 20th April 2011

Dr. Julian BuchananAssociate Professor

Institute of Criminology

julian.buchanan@vuw.ac.nz

School of Social and Cultural StudiesVictoria University of Wellington

Te Whare Wananga o te Upoko o te Ika a Maui

Reconceptualising drugs, drug use and problematic drug use.

This seminar will explore our understanding of, and reactions to, ‘problem drug use’. Populist discourse perceives physiological and psychological dependence upon drugs as key drivers that perpetuate ongoing ‘addiction’. However, drawing upon 25 years experience of working in the drugs field (as a practitioner then researcher) I will explore the links between the war on drugs and the difficulties faced by problem drug users, and suggest that by-products of this ‘drug war’ (stigma, discrimination and exclusion) are more influential in keeping people trapped in drug centred lifestyles.

Delicate questions

1. What % of people in this room have tried drugs?

2. What % of people are still regularly taking drugs?

Keypoint: Drugs and cultural context

Drug misuse is a social construct Drugs have come in and out of fashion Drugs are sometimes culturally embedded Drugs are sometimes demonised

Thestigmatization

oftobacco

users

Keypoint: Drug use & society

We have a war on (particular) drugs but the vast majority of people who use illicit drugs do not have drug problems nor do they cause others problems

We all use drugs for pleasure

UK Drug Use 2010

One of the highest rates of drug use in Europe 43% of young people (16-24) have used an illicit drug Bifurcated approach to drugs allowing legally approved

drugs to slip under the radar Alcohol related deaths 6.7 per 100,000 pop. in 1992 by

2008 the figure had risen to 13.6 with 9,031 deaths

NZ national household survey Lifetime use

The age ranges from random digit dial (RDD) 15–45 years old. Trends in population drug use in New Zealand: findings from national household surveying of drug use in 1998, 2001, 2003, and 2006Chris Wilkins, Paul Sweetsur (2008)

Journal of the New Zealand Medical Association, 23-May-2008, Vol 121 No 1274

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Focus on small minority 3-7%

Keypoint: Overlooking social context

We emphasis the importance of overcoming addiction we concentrate upon personal commitment, becoming drug free, regaining control

Drug testing results in an over emphasis upon physical dependence risks overlooking underlying personal and social need

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The dominant framework to understand drug addiction

PHYSICAL

TacklingProblem

DrugUse

PSYCHOLOGICAL

CRIMINAL BEHAVIOUR

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Cycle of Change Prochaska, Di Clemente & Norcross (1992)

Maintenance

PreContemplationTermination

Action Preparation

Contemplation

Relapse

Adapted from Prochaska & DiClemente’s Cycle of Change

Shifting the focus upon agency

WALL OF EXCLUSION

Focus is upon the drug use

Keypoint: PDU as a lifestyleNo legitimate constructive lifestyle to return to or recall

Limited social capital, support or resources

Ascribed identity of PDU they become morally and culturally bankrupt – and shunned by society

A drug centred lifestyle becomes a (perverse) solution not the problem

Buchanan J (2008) Understanding and engaging with problematic substance use, in Addressing Offending Behaviour – Context, Practice, Values. pp.246-264, edited by Simon Green, Elizabeth Lancaster and Simon Feasey, Willan Publishing.

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Isolation & SeparationMany problem drug users felt rejected and stigmatized by

the non-drug using population.

`They look down on me as scum of the earth and as someone not to be associated with’.

`They see me as a drug addict, a smackhead and they think I’d rob them’.

`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’.

`I never really mixed with people who have never taken drugs’.

Buchanan J & Young L (2000) The War on Drugs the War on Drug UsersDrugs: education, prevention and policy, Vol. 7, No. 4

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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, by-products of the governments’ rhetoric and policy on drugs.’ (Buchanan 2004 p124).

‘At the very time when recovering drug users need assistance and support from the non-drug-using population to establish alternative patterns of social and economic life, they are often prevented by the wall of exclusion’ (p.134)

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

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A Social Dimension to Recovery

Education Preparation for employment Developing social/life skills Tackling discrimination/marginalisation Improving self esteem confidence Establishing new routines/habits Developing non drug using network Reintegrating within local community

Keypoint: War on Drugs

War on drugs is not evidenced based Not rational It’s hypocritical It demonsises sections of society Creates new dangers worse than the actual

drugs It results in spiraling prison populations

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

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Drugs & Increasing Prison Population

drug policy and drug treatment are locked into the criminal justice system … As illicit drug use becomes a mainstream activity, drug policies that lean heavily upon the criminal justice system to wage war on drugs are creating a spiralling prison population and a growing concern regarding human rights violations

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

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The US & UK War on Drugs - locking up drug users?

In 1996 the US prison population was 1,630,940

By Dec 2008 the US prison population had risen to 2,290,000

the highest prison population rate in the world, 756 per 100,000 people

In 1985 the UK (England & Wales) prison population was 47,500

By Dec 2008 the UK prison population had risen to 83,392

153 per 100,000 people

World Prison Population List (eighth edition) Roy Walmsley 2009

Keypoint: Drug users as the enemy within

Legitimises discrimination at a personal, cultural and institutional level

Become a suitable and convenient enemy and scapegoat

Waging war against the enemy within

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Enemies Within? Othering PDU’s

‘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

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Enforcement Approaches

DTTOs Abstinence Orders CARAT Tougher Sentences Changes to 1971 MDA ASBOs CJIP (DIP) Drugs Act 2005

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

Keypoint: Drugs-Crime assumptions

Illegal drug use causes crime Abstinence leads to desistance from

crime Problem drug use is about drugs Illegal drugs are different to legal

drugs

More Complex Relationship

Crimes committed while intoxicated Crimes committing to fund drug habit Vast majority of crimes are fuelled or

indeed defined by a drug prohibition Most drug users are recreational users

and commit no crime except that of possession

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Drugs/Social Exclusion Downward Spiral

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Links between se & pdu

The majority of problem drug users were over 26 years old and had been taking illegal drugs for between 7 and 13 years.

55% defined their current drug use as `stable’ a further 18% said they were drug free,

52% of the known problem drug users left school before reaching 16yrs

52% of the sample had no qualifications (academic or vocational)*

Over half had been unemployed for the past 5 years - One in seven had never been able to secure a job

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

*NB Each year only 6% of pupils leave school with no qualifications http://www.dfes.gov.uk/performancetables/schools_01.shtml

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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

Wall of exclusion

Keypoint: Stigmatised Spoilt Identities

Internalise embrace identity of an ‘addict’

Forced to live in a drug ‘ghetto’ with acquaintances

Self, interaction with others shaped and defined by the way others treat them

Makes recovery and reintegration extremely difficult

‘Sterilising junkies may seem harsh, but it does make sense’Comment, Ian O’Doherty, Irish independent, Friday February 18 2011

‘feral’

‘worthless scumbags’

‘if you can even call these people’

‘I hate junkies’

‘If every junkie in this country were to die tomorrow I would cheer’

‘these vermin’

‘they are worthless'.

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Impact on Confidence

‘I don’t have any confidence’

‘I feel I have to make up for being on drugs. I have to be at my best. I don’t want people to look down on me so I make everything look perfect’

‘I have a clear head, people still view me as a smackhead. I feel I need confidence to deal with people’s attitudes, to let them know that I am changing in a positive way.’

Institutionalised Discrimination

Internalised Self esteem Expectations Opportunities & Social Capital

Housing Friendships Support from family Education and training Employment

Keypoint: PDU need inclusion

Opportunities Support Habilitation –not rehabilitation Intergration – not re-iontegration Help to tackle array of underlying issues

Education, self esteem, basic life skills, employment, alternatives to a drug centred lifestyle

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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

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Vocational rehab‘Recovering drug users and ex-users face considerable barriers when

they attempt to abandon the drug-oriented lifestyle and look for work. They are often hampered by the consequences of events in their early history at home and at school that have led to their use of drugs and their subsequent dependence on them. The decline into social exclusion brings with it further disadvantage if they resort to crime to fund their drug habit. A criminal record adds another barrier to social acceptance that is equally difficult to overcome. Unemployment for months or years brings with it financial deprivation, poor living conditions and a further lowering of self-esteem. Lack of school qualifications, training and work experience then become obvious when they are faced with the prospect of active job-seeking. Support at this time is critical to their ability to overcome the multiple disadvantages and gain success. p vi

Klee, H., McLean, I. and Yavorsky, C. (2002) Employing drug users Individual and systemic barriers to rehabilitation Joseph Rowntree Foundation 2002

Beyond the wall of exclusion

WALL OF EXCLUSION

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Coping without drugs and without social capital

‘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

…thanks for your time and attention

Comments, feedback, observations and questions welcome

julian.buchanan@vuw.ac.nz