The Normalisation of Recreational Drug Use, Part 2

Continues to look at British youth culture and the role of drugs and alcohol among adolescents during the 1990s. (952 words)


Parker and colleagues described four distinct drug pathways that young people in their study had taken during their adolescence.

Abstainers held anti-drug attitudes, had never taken a drug, and never intended to. Former triers held fairly negative attitudes to drug use and whilst they had tried or used illicit drugs, they had no intention of doing so again.

Those in transition held fairly positive drug attitudes, most had tried drugs, and all felt they might use drugs in the future. Current users held pro-drug attitudes, used one or more drugs regularly, and expected their drug careers to continue into the future.

By reflecting on and reviewing their attitudes to drugs, young people could switch pathways. As young people in the study moved into adulthood, there was an increase in the proportion who became current users and a reduction in the number of abstainers. Young people in transition were more likely to use the ‘softer’ drugs such as cannabis, whereas current users had a larger drug repertoire, including amphetamines and ecstasy.

However, the researchers noted that:

‘Whilst current users have the most florid, risk-taking antecedents, including early smoking, drinking and sexual experiences, they do not have strong delinquent tendencies nor fit into any typology of abnormal development.’

‘… today’s young drug takers are of both sexes, come from all social and educational backgrounds and are in most other respects conventional.’

Parker and colleagues used in-depth interviews to build on the pathway analysis, by providing a perspective of the actual experiential journeys their drug triers and users took during adolescence.

The vast majority of the drug users had gotten their drugs via friends or friends of friends. Direct contact with professional dealers was rare. In terms of drug initiation, interviewees stressed personal curiosity and the support, sometimes encouragement, occasionally ‘pressure’, of friendship networks.

Most first time experiences were with cannabis and were benign. LSD and amphetamines and, in late adolescence, ecstasy, were occasionally more problematic.

The researchers argued that most young people were drug wise and they differentiated between the range of drugs readily available on the youth market in terms of their effects, both positive and negative. 

Nearly all of the sample rejected heroin and cocaine out of hand, as drugs with dreadful reputations because of their addictive potential and the world of dealers. Cannabis was viewed as a fairly safe drug, whilst amphetamines, LSD and ecstasy were more equivocally defined.

The decision to take a drug involved assessing the balance between risk and possible costs against personal enjoyment from taking a particular drug. The risk assessed were in terms of stigma and risk societycensure by parents, partners, friends, teachers, criminal justice system. Personal relationships and career opportunities might be damaged. However, whilst immediate health risks were assessed, long-term health risks were rarely assessed.

In their excellent book Illegal Leisure: The Normalization of Adolescent Recreational Drug Use [1], Parker and colleagues argued that the nature of the experience of growing up had changed in the world of the 1990s. Rapid social changes in so many aspects of everyday life had resulted in growing up ‘feeling’ far less secure and more uncertain for far longer than had happened prior to this time. ‘To grow up today is to grow up in a risk society.’

‘The unprecedented increase in recreational drug use is deeply embedded in these other and social processes since such drug use is both about risk taking but also about ‘time out’ to self-medicate the impact of the stresses and strains of both success and failure in ‘modern’ times.’

The researchers emphasised that the UK drug strategy, being embedded in a ‘war on drugs’ discourse, missed the point. It was based on many misconceptions about young people and drugs.

The first misconception was that young drug takers would become addicted to or disinhibited by their drugs, and become young offenders spiralling out of control into a life of crime and disorder. However, only a small minority of persistent offenders committed crimes and took drugs. Many of these young people also drank too much alcohol, grew up in care, were excluded from school, and needed psychiatric help. What was the cause of the crime? Many also committed crimes before having problems with drugs.

The vast majority of young people who took drugs did not follow this path. Also, there were few signs of dependency in the recreational scene of this study.

Another government misconception was that young people were pressured into taking drugs. However, participants in this study insisted that they made their own drugs decisions for which they took responsibility. The notion of peer pressure was a source of resentment to many young people when expounded by adults delivering drug education.

Parker and colleagues also argued that young people’s drug use had become entangled in the wider moral panic about, and blaming of youth, for society problems. They emphasised that continuing the ‘war on drugs’ and ignoring the reality of young people’s drug taking was resulting in a neglect in dealing with reducing the harms and risks of drug use.

They pointed out the need to:

  • accept that drug use occurs and treat the user as a citizen
  • try and help assure that street drugs are quality tested
  • help young people share information and experiences about drugs, in particular bad experiences
  • create a situation where young people trust the information (including scientific) on drugs provided by older people
  • create a situation where young people feel that they can come forward and talk about their drug problem without censure.

Endnote:

[1] Illegal Leisure: The Normalization of Adolescent Recreational Drug Use by Howard Parker, Judith Aldridge and Fiona Measham: Routledge, 1998.

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The Normalisation of Recreational Drug Use, Part 1

British youth culture and the role of drugs and alcohol among adolescents during the 1990s. (874 words)


Only a small minority of people who try an illicit drug develop a problem. Many people who try an illicit drug do so on one or a few occasions and decide the experience is not for them. Some may use one or more illicit drugs on a periodic basis, whilst others may use more regularly, but still their use is recreational and controlled.

The use of illicit drugs has increased greatly over the past forty years, in particular during the 1990s. As an example of this change, a large-scale annual survey by the University of Exeter’s Health Education Unit (involving 30,000 children from 150 schools in England and Scotland) revealed that the proportion of 15- and 16-year olds who reported ever having tried an illicit drug rose from 10% in 1989 to 40% in 1996.

In 1991, Professor Howard Parker and his colleagues initiated a unique piece of research which tracked a large sample of young people (14 – 18 years old) from the North West of England over a five-year period. The study confirmed the widespread recreational use of illicit drugs, and provided essential insights into British youth culture and the role of drugs and alcohol among adolescents.

This study took place against the backdrop of a ‘youth-drugs-crime-danger’ message both from media and politicians. When John Major, the then Prime Minister, announced his new drug strategy (Tackling Drugs Together) in a speech to the Social Market Foundation (9 September 1994), he chose ‘yob-culture’ as the soundbite he wanted the media to highlight.

Tackling Drugs Together was about offenders and crime, indeed ‘no single crime prevention measure would be more significant than success on the front against drugs.’ One premise of the strategy was that young people were ‘at risk of drug abuse’ and succumb because of peer pressure. The second premise was that drugs are dangerous and a menace. The third was that because drug use leads to crime, local communities are at risk from drug users.

The war-on-drugs rhetoric of the Tory Government, and the desire to link drugs and crime, was later hijacked by the Labour Party in opposition. It was continued once Labour came into power.

In their book Illegal Leisure: The Normalization of Adolescent Recreational Drug Use [1], Parker and colleagues emphasised that this political discourse has an:

‘… energy of its own. It promotes public fear and anxiety about crime, drugs and youth which in turn it then uses to interfere simplistically, and with apparent public consent, in drugs and criminal justice policy and practice. This process, because it can barely be challenged, thus spins along reinforcing itself.’

But this simplistic rhetoric ignored the question as to why the majority of young people try illicit drugs and a significant minority continue to use them regularly. In trying to understand this situation, Parker and colleagues emphasised that that the very nature of adolescence was changing—the context and the conditions in which young people were growing up was very different to generations before.

The research study involved a sample of over 700 14-year olds being tracked annually for up to five years. Each year, they were asked about their personal and family circumstances, their disposable income, use of leisure, and perspectives on personal and social relationships. They were asked in detail about their use of tobacco, alcohol and illicit drug use.

As they matured, more complex issues were pursued, including their attitudes towards drug use and drug users, their assessment of health education they received, and their experiences at parties and nightclubs.

Five annual self-report surveys were undertaken, and 86 interviews were conducted when respondents were 17 years old. Eight co-educational state secondary schools in the North West metropolitan area of the UK were used. The questionnaires were distributed in the classrooms with teachers absent.

The overall aim of the study was to assess how ‘ordinary’ young people growing up in England in the 1990s developed attitudes and behaviours in relation to the unprecedented ready availability of drugs, alongside other consumption options such as alcohol and tobacco.

The findings suggested that recreational drug use had become widespread amongst British youth. Over 36% of the sample had tried an illicit drug by age 14, and this increased to 51% by age 16, and 64% by age 18. Over 60% and 90% of the sample had received drug offers at age 14 and 18 years, respectively.

The most commonly tried drugs by age 18 were cannabis (59% tried), amyl nitrites or “poppers” (35%), amphetamines (33%), LSD (28%) and ecstasy (20%). Only 6% had tried cocaine and l0.6% had tried heroin.

Females were almost as likely as males to have tried an illicit drug by age 18, and there were no differences between youth from working and middle-class backgrounds. At age 18, nearly one-quarter of the sample had tried an illicit drug in the past week.

The study also revealed that young people reported many more positive experiences of drug use than negative outcomes.

By age 14 years, 90% of the sample had tried alcohol, with 30% claiming to drink on a weekly basis. This percentage rose to 80% in 18-year olds, with a mean consumption of ten units on the last drinking occasion. At age 18 years, just over a third of the sample were current smokers.

Endnote:

[1] Illegal Leisure: The Normalization of Adolescent Recreational Drug Use by Howard Parker, Judith Aldridge and Fiona Measham: Routledge, 1998.

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The Drug Experience and Beyond: Amphetamine

The experience of taking amphetamine, including the subjective pleasurable experiences of initial use, amphetamine-induced anxiety and psychosis, and withdrawal symptoms following long-term use. Also includes a brief consideration of the various factors that can influence the amphetamine experience. (964 words)


The ‘drug experience’ produced by a particular psychoactive substance depends on both drug and non-drug factors. Drug factors are the chemical properties or type of drug used, the dose, route of administration, and presence or absence of another drug. Non-drug factors include personal characteristics of the user (e.g. biological make-up, personality, previous experience), and the context or setting in which the drug is taken.

A person will first try a drug because of social or intrapersonal factors, such as curiosity about the effects of a drug, or the fact that their friends are taking it. They will probably have certain expectancies about the effects of the drug from conversations with experienced users and/or because of media exposure.

Once a person has taken a drug, the drug experience creates cognitive expectancies which become another factor that influences subsequent drug-taking. A person may continue to take the drug to increase his psychological comfort or change his level of consciousness.

Low doses of amphetamine produce a number of subjective effects: feelings of euphoria; heightened alertness; increased energy and excitement; increased feelings of well-being, confidence and power; increased ability to concentrate and stay awake; increased sociability and friendliness; a feeling of being less bored or tired; hyperactivity, talkativeness, and a rapid flow of ideas; a suppression of sexual inhibitions; lack of desire for food; nervousness and anxiety.

With higher drug doses, there are other effects. These are much more likely to occur when the drug has been taken repeatedly rather than on a single occasion. The user may experience repetitive (stereotyped) thought patterns and show repetitive behaviours, e.g. continually take apart and re-assemble some object, or pick continually at their skin. They may show restlessness, irritability, and various types of anxiety condition, including panic states.

The person may develop suspiciousness, paranoia (delusions of persecution), and experience visual and auditory hallucinations. This is known as amphetamine psychosis, which resembles paranoid schizophrenia.

Amphetamine psychosis is usually seen with chronic use of drug, but can be seen after an acute administration. The incidence of amphetamine psychosis increases greatly when the user switches to intravenous drug administration.The psychosis is transitory and usually terminates after drug use is terminated. Long-term amphetamine use can sometimes lead to sudden and intense acts of aggression and violence.

The subjective effects of amphetamine and similar-acting substances are not fixed. The amphetamine-like stimulant methylphenidate (Ritalin) is, paradoxically, used to treat hyperactivity in children. Some adults report the drug exerting a calming effect, allowing them to cope better.

In well-controlled laboratory conditions, under conditions where neither subject nor experimenter knew whether drug or placebo was administered, a fixed dose of amphetamine produced either euphoria or anxiety in different subjects.

Once a person has tried amphetamine, they may use the drug on a recreational basis, even over an extended period of time. They may keep a strict adherence to a particular pattern of drug use so that the drug is only used on certain occasions (e.g. weekends). The user retains control over drug use and there may be no medical or social complications—however, there is the possibility of legal sanction. Of course, a person may try amphetamine once and never do so again.

However, the pattern of drug-taking may intensify and a number of changes may occur. For example, a person may switch from oral or intranasal use to intravenous use. Drug effects will intensify when such a change occurs.

In another pattern of use, the person initiates repeated ‘runs’, taking amphetamine for hours and sometimes days. They may snort new lines of drug whenever they feel the drug effects wearing off. This pattern of drug-taking is more evident with cocaine, which is a much shorter–acting drug.

In yet another pattern of use, they may chronically abuse amphetamine in combination with depressant drugs. They may drink large amounts of alcohol whilst under the influence of amphetamine.

Users may use depressant drugs (benzodiazepines, alcohol, opiates) to take ‘the edge off’ the stimulant, and help them feel less anxious. Research suggests that users who abuse stimulants and depressants experience more psychological and physical problems than those who only abuse stimulants.

Tolerance develops to many of the psychological and physical effects of amphetamine, e.g. euphoria, anorexia, hyperthermia and hypertension. This tolerance may develop within hours to days. However, there appears to be little tolerance to the anxiogenic effects of the drug. In fact, repeated use of amphetamine may sensitise individuals to amphetamine psychosis.

The effects of a single dose of amphetamine lasts 2 – 4 hours and generally leaves the user feeling tired after the drug’s primary effects are over. It may take as long as a couple of days to feel normal again. With chronic drug use, feelings of tiredness, lethargy and irritability become stronger and may have a more dramatic onset following the wearing off of drug effects.

The user may want to keep taking drug to avoid these feelings. Tolerance develops with regular use and higher doses will be required. Eventually, ‘what goes up must come down’. The ‘withdrawal’ effects are even stronger when a user has completed repeated ‘runs’ over a period of days. Amphetamine produces a withdrawal syndrome, which not only includes tiredness, but also anhedonia (an inability to feel pleasure), depression, anxiety, dysphoria, sleep disturbances, and a strong craving for drug.

The person may experience terrible mood swings as he oscillates between periods of drug-taking and withdrawal. He may experience periods of paranoia and anxiety when taking the drug, and periods of deep depression when not taking the drug. The impact of this on psychological well-being can be considerable.

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The Harms and Risks of Substance Use

Reflections on the harms and risk factors related to drugs, alcohol and solvents. (979 words)


There is much discussion about the harms and risks of drug use, particularly in the popular press. The relative harms of different drugs are compared, and the law tries to operate a control system with drugs purportedly graded by their dangers, albeit with alcohol and tobacco forgotten.

Heroin and cocaine are considered to be particularly dangerous. And yet, there are people that have taken cocaine or prescribed heroin for many years and have suffered no physical harm. There is no given in the world of drugs—except that all substances (even water) can kill if given in sufficient quantity.

In his excellent book Matters of Substance: is legalization the right answer – or the wrong question [1], the late Griffith Edwards points out:

‘With drugs nothing is always. Their use does not carry a guarantee of danger, but neither is their safety guaranteed. What one needs to ask about any substance is not whether in absolute terms it is safe, but rather the degree of risk which may attach to its use.’

The harm caused by substance use needs to be considered in a variety of ways. Use of drugs, alcohol and solvents can carry risk to different aspects of life. They may threaten physical or mental health, social circumstances, educational and employment status, and may put a person at risk with the criminal justice system.

Substance use may also affect the safety and welfare of others. Other people may be affected negatively by the transmission of blood borne viruses through sexual contact with an infected drug user, through violence committed by a person who is drunk, or by someone who is driving while under the influence of a sedative prescription drug. The harmony and happiness of families can be disrupted, and in the extreme whole communities can be affected.

Harm done by substance use can be major or minor. It can also be a one-off or chronic. Harm may be caused directly by the drug itself, and/or by the lifestyle associated with use of the drug, for example, with street heroin.

For some harm, an increasing risk is associated with longer-term and heavier substance use. However, for other types of problems, the risk can be much more random: the twentieth experience with ecstasy or a solvent may trigger some reaction leading to death; the first injection of heroin may lead to infection with hepatitis C which kills the person years later; the heavy drinking session may lead to the person tripping on the pavement into the path of an approaching vehicle.

With illicit drugs, there is the possibility of contaminants in the drug which can cause illness and even death. In one example, heroin users in California injected unknowingly a synthetic drug known as MPTP, which produced symptoms of Parkinson’s disease. This movement disorder, caused by a massive depletion of dopamine in the brain, mostly occurs in people over 60 years old. In this case, young heroin users developed the symptoms within 24 hours of taking the drug. The condition was irreversible and could only be alleviated by l-Dopa or neural grafts of foetal tissue [2,3].

The particular harm caused by substances is also dependent on the route by which they are administered. Injecting drugs can lead to the transmission of blood borne viruses, smoking can cause lung damage, and drinking of alcohol to cancer of the gullet. Accidental overdose is more likely to occur following injection than ingestion of tablets. Users of illicit heroin are also unaware of the purity of the substance they purchase—an unusually pure, or contaminated, batch of heroin can cause overdose.

One of the dangers of drugs and alcohol is their propensity to cause addiction or dependence. In simple terms, addiction can be seen as an impairment in a person’s ability or power to choose. The drug becomes more important to the person than other aspects of their life, which the majority of people would consider as essential. Addiction drives forward heavy and persistent drug use, ultimately increasing the likelihood of self-harm.

The particular effects of a drug, and the development of addiction, are influenced not only by the intrinsic properties of the drug and its route of administration, but also by the previous drug experience of the user, their physical and psychological characteristics, and the setting in which the drug is taken. Therefore, these factors can influence the harm caused by drugs.

Overdoses are more likely when a heroin user leaves prison, since he is likely to forget or not understand that his body has lost its tolerance to the drug. Amphetamine psychosis will be more likely to occur in an individual with a propensity to schizophrenic symptoms. Alcohol-induced violence is more likely to occur in certain environments than in others. Life-threatening seizures can occur when a person withdraws from long-term use of the prescription drugs Valium and Librium.

Finally, and not least, is that the dangers of many substances can be exacerbated by taking another at the same time. For example, the likelihood of overdose after heroin is increased if the person is also drinking alcohol.

Psychoactive substances have been used in society for thousands of years. They will remain with us for as long as mankind wishes to change his state of consciousness, for whatever reason. These substances—be they legal or illegal—will always have harm and risks associated with them.

What is important in today’s society is to keep people well-informed about the potential harms of drugs, alcohol and solvents and the circumstances in which they can be dangerous. We do not need media hype or campaigns that over-exaggerate the risks. We need to be objective and realistic.

Endnotes:

[1] Matters of Substance: is legalization the right answer – or the wrong question, Griffith Edwards, Penguin, 2005.

[2] MPTP, Wikipedia.

[3] The MPTP Story, J. William Langston, Journal of Parkinson’s Disease, 7, S11-S22, 2017.

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The Regulation and Control of Drugs, Part 2

Continues to look at the development of laws regulating recreational drug use, in particular in America, which has influenced world drug policy so strongly. (881 words)

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Should Recreational Drug Use Be Criminalised? (Part 1)

Explores the regulation and control of drugs by looking at philosopher Douglas Husak’s views on the justice of US drug laws. (909 words)

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Should Recreational Drug Use Be Criminalised? (Part 2)

Continues to look at Douglas Husak’s arguments about prohibition and its consequences. (907 words)

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The Regulation and Control of Drugs, Part 1

Describes factors that have influenced the development of laws regulating recreational drug use, in particular influential happenings in America. (912 words)

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Historical Perspectives: Cocaine

Traces the history of cocaine, linking the Incas, Freud, Thomas Edison, Sherlock Holmes and Coca Cola. (880 words)

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Drugs, Chemicals, the Brain and Behaviour

How psychoactive drugs influence chemical and electrical events in the brain, and how these changes may relate to their effects on behaviour. (1,047 words)

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Historical Perspectives: Opium, Morphine and Opiates (Part 3)

Concluding a brief history of the opiates by looking at the massive increase in heroin use that occurred in America and the UK during the later parts of the 20th century. (1,012 words)

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Historical Perspectives: Opium, Morphine and Opiates (Part 2)

Continues a brief history of the opiates, which includes describing the different responses of the United States and Britain to opiate problems in the earlier parts of the 19th century. (880 words)

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Historical Perspectives: Opium, Morphine and Opiates (Part 1)

Traces the history of the opiates, from use in Summarian and Assyrian civilisations through to the Opium wars between China and Britain and the cultural impact of opium smoking by Chinese in the Californian gold fields. (915 words)

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Psychoactive Drugs: From Absorption to Elimination

Factors that can influence indirectly the way that psychoactive drugs impact on the brain and influence behaviour. Describes examples of individual differences in drug response that can arise from these factors. (924 words)

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Drug, Set and Setting

The effects that a drug has on a person are not just dependent on the drug itself, but also on factors related to the person (the set) and the physical and social setting. (838 words)

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Psychoactive Drugs and the Drug Problem

Introduces psychoactive drugs and describes a simple classification of drug type based on their major mode of impact on the mind. The multitude of factors that influence the way that a drug can affect a person, and ultimately can contribute to a drug problem are influenced. (999 words)

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Drugs in Society

On the one hand, we tell our young people not to take psychoactive drugs and to keep away from people who are selling drugs. On the other hand, doctors and others are constantly encouraging us to take psychoactive drugs produced by the pharmaceutical industry—some of which are addictive—for a variety of conditions. (1,109 words)

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Drug Choices… and the Loss of Choice

Various factors contribute to the initiation and early use of drugs and alcohol. As time passes, other factors also influence whether substance use continues. The vast majority of people who use drugs or alcohol do so without any problems. However, long-term drug or alcohol use can lead to addiction in a significant minority. (944 words)

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Alcohol Dependence

Looks at the cluster of seven elements that make up the template for which the degree of alcohol dependence is judged. (900 words)

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