Drug Use
A sample article from the Routledge
‘Encyclopedia of the Developing World’ (2006) written
by Alan Dearling and entitled ‘Drug Use’.
What people mean when they refer to a ‘drug’ can
be very different depending upon the cultural, social and geographical
context in which the term is being used. In reality there are
many thousands of drugs available in the world. The taxonomy (classification)
of a drug is problematic, so any list of drugs, description, or
the use of the term may have an ideological and interpretive element.
Similarly, the use of drugs and their effects is highly dependent
upon set (the mood of the user) and the setting (where and with
whom they are used).
Traditionally, the source of most drugs was the plants, shrubs
and trees growing wild in the fields and forests of the world.
However, with scientific and pharmaceutical preparation, many
drugs are now synthesised – produced in some sort of laboratory
– manufactured into medicines and treatments for illness,
or for illegal use. Finally, there are a variety of drugs such
as tobacco, alcohol and caffeine-based drinks that are prepared
for consumption by humans for relaxation or recreation. The legality
or otherwise of specific drugs is a societally determined issue,
and frequently this has more to do with power, trade and commercial
exploitation than the positive or negative effects of the drugs
themselves.
According to the United Nations International Drugs Control Program
(2001):
180 million people worldwide – 4.2 per cent of people
aged 15 years and above – were consuming drugs in the
late 1990s, including cannabis (144m), amphetamine-type stimulants
(29m), cocaine (14m) and opiates (13.5m including 9m addicted
to heroin)
However, figures at a worldwide level are very much ‘guesstimates’,
given that many countries, especially in the developing world
do not collect drugs use data. Also, much of what is known is
based on the perceptions of authorities in the various countries
and international organizations and will reflect such sources
as police statistics, drugs seizures, reports from social welfare
organizations and even media reportage.
The 'problems' associated with drug use (or abuse) are given
different prominence according to particular commentators' personal,
political or organisational convictions. These problems fall
into a number of categories. Principally these are identified
as:
- Health and social problems caused by use, especially when
the user is a habitual or addicted user.
- Problems of criminality associated with the use of drugs,
for instance, violent behaviour to others, self abuse, or
theft and robbery.
- Secondary problems such as those experienced in developing
countries where intravenous use of drugs without an available
needle exchange has abetted the spread of the number of people
who have AIDs, hepatitis or who are HIV positive. There are
also problems of corruption, intimidation and extreme violence
connected with the drug trade, particularly in predominantly
peasant, agricultural economies where illegal drugs constitute
the major cash crops and overseas income, such as Colombia
and Bolivia (coca and opium) and Afghanistan and Iran (opium).
This problem has also spread over into countries on the supply
routes such as Jamaica, Nigeria, Cote d'Ivoire and Turkey.
In the last fifteen years, the countries predominantly involved
in production and trafficking have continued to change, usually
in response to proactive interventions by outside countries,
especially the USA, and international organisations. (see
Drug Trade)
Today, the worlds' politicians, crime and drug and health experts
are divided on how to respond to these problems, and substantial
debate continues concerning the effectiveness of policies designed
to tackle supply and demand for drugs. The same is true regarding
the strategies seen to be appropriate or effective. These range
from prohibition and zero tolerance through to legalisation and
harm minimisation. For a flavour of this controversy it is worth
referring to South, 1999, and the web sites and various publications
from the United Nations International Drug Control Program (UNDCP),
World Health Organization (WHO), Lindesmith Center, and the European
Monitoring Centre for Drugs and Drug Addiction (EMCDDA).
Where this leaves developing countries is reflected in a United
Nations' publication for 'Africa Recovery':
(At the 1998 UN General Assembly on the development of a global
anti-drug strategy, and following Executive Director, Pino Arlacchi's
call for the world to 'create a drug free 21st century')
...there was nevertheless a lack of agreement
about solutions to the world drug problem with developing countries
often pitted against developed ones. For the latter, as principal
consumers of narcotics, the paramount issue is stopping supply
through police measures such as seizures, arrests and crop eradication.
In the developing world the focus is typically on enhanced infrastructure
assistance, rural development and poverty reduction. (Neal, 1998)
An historical perspective
During the evolution of man up to the third millennia CE, much
of the globe was a natural environment, with the inhabitants living
close to nature. With their very existence being based on hunting
and gathering, the indigenous inhabitants’ knowledge and
understanding of plants and natural preparations was far greater
than now exists. Indeed many scientists and pharmacologists are
only now beginning to collect and examine the properties of plants
in the remaining rainforests of the world.
Historically, drug use has played a major part in every day life,
providing natural sources of food, a means of relaxation, out
of body experiences and medication. For instance, in the Daintree
rainforest in Far North Queensland in Australia, the local Aborigines,
the Kuku Yalanji, used the sap of the candlenut tree to cure fungal
disorders. Ginseng is an Asian plant, which has an ancient history
in Chinese medicine, but which has recently been rediscovered
by the West as a drug made from ginseng roots for allieviating
headaches, exhaustion and possibly kidney disorders. Cannabis
Sativa, now banned in many countries, was the main analgesic used
in 19th century America and until 1937 was recommended in the
American Pharmacopoeia as being useful in curing over 100 illnesses.
Sigmund Freud called cocaine, extracted from coca leaves, a ‘wonder
drug’ which was widely used as an anti-depressant before
amphetamines became widely available in the 1930s. Opium–based
medicines were freely available even to children in 19th century
Europe and America, and laudanum, opium in an alcohol solution,
was regarded as major medicine. (Williamson, 1997).
However, it must be noted that unlike in synthetic drugs, it
is hard to generalise from any analysis of drugs made from fresh
or dried plants, since each one has unique properties and potency,
affected by soil conditions, propagation, location, sunlight and
many other variable factors. Similarly, it has been found in analysis
that the active ingredient of a drug, usually an alkaloid, may
weaken quickly or may not have much efficacy when separated from
the rest of the plant.
The seventeenth century was the time when herbalism was at its
height with both John Parkinson (1630s) and Nicholas Culpeper
published pharmacopeias, listing over 3,000 plants from around
the world and their uses. Thus, herbal drugs were the precursors
of much modern medical pharmacology, but their association with
astrology, magic and the arcane left their legacy largely discredited
until relatively recently. In fact, it is possible to trace drug
use in different cultures and at different times through a pattern
of use in magical rites, religion, science and latterly hedonism
and recreation. These patterns of use are said to ‘socially
situated’ or ‘socially created realities’ which
must be seen in the context of specific societies, their ethnicity,
beliefs, cultural lives, and often by age and gender.
Many tribes throughout the world have also used plant extractions
as a means of intoxication. One of the most common is the chewing
of the betel nut, which are actually the seeds of the areca palm.
This habit is practised by up to a tenth of the world’s
population, in a broad range of countries stretching from Tanzania
in Africa, across the Indian subcontinent to the western Pacific
islands. The betel nuts are usually mixed with lime in a leaf
and chewed, which produces a red coloured saliva. Despite its
common usage, the exact effects of the nine alkaloids present
in the betel/lime mix are not precisely known, but includes creating
a sense of well-being and euphoria, suppression of hunger, and
in heavy users, some hallucinations. Arecoline is believed to
be the most active alkaloid.
Whilst betel chewing has a long history in many developing countries
as a drug of the masses, other drugs used have a much stronger
connection with ritual and initiation rights. Amongst the many
examples, the use of peyote and kava are two well documented psychotropics.
Ritual Kava use was particularly widespread across Melanasia in
the western Pacific, and especially in New Guinea. Kava is a species
of pepper plant growing up to 4 metres tall. Women and children
traditionally chewed the roots and lower stems and spat the residue
into a large bowl into which water was added. The resulting infusion
was then drunk by elite men, the elders or initiates of the tribe,
as part of their rites, usually in conjunction with a ritual regime
of fasting, dancing and chanting. It is still available by mail
order in many parts of the world as a ‘legal high’.
Peyote and the closely related mescal derived from cactus plants
(lophophora williamsii) in Mexico and South America are, along
with magic mushrooms (including aminita muscaria/fly agaric),
probably the best known of the ritual hallucinogens used in the
celebration, shamanistic religion and more recently as a route
to mind altering states for artists, writers, musicians and disaffected
youth. The use of peyote in religious ritual amongst the Huichol
Indians of Mexico is believed to pre-date the Spanish Inquisition’s
arrival in Mexico in 1571. In the Andean region, chewing coca
leaves, again coated with a lime paste to release the active alkaloids,
is used as a stimulant, and the average intake by the Indian population
is estimated to be two ounces of dried leaves (about 0.5 gms)
(Emboden, 1979). The use of coca is seen as an essential part
of the Andean cultural heritage, for social and medicinal purposes,
not to be confused with the patterns of use of cocaine in Western
nations (Burrows, 2001).
The perception of different drugs and their uses continues to
change with each century, especially so in the new age of globalisation.
Before looking in more detail at some aspects of current drug
use around the world, it is worth reflecting that in mid 19th
century France, many of the most notable writers and artists of
their day including Alexander Dumas, Victor Hugo, Charles Baudelaire,
Gerald de Nerval, Honoré de Balzac, Theophile Gautier and
Jean Moreau formed the highly revered and influential, Le club
Des Haschischins, inspired by the hashish eating Isma’ ilis,
also known as the Assassins of Saracen times. This club’s
members ate copious amounts of hashish from a spoon, in the form
of green jam or paste, claiming that it allowed them to enter
Paradise and have free access to the in-between land where external
life ends and internal life begins (Abel, 1980).
The legality and use of drugs
The earliest recorded prohibition of drugs was probably made
by the prophet Mohammed in the seventh century CE, who forbade
his followers to use alcohol, because of its centrality in Christianity,
where wine represents the blood of Christ in the sacrament. This
prohibition still exists in many Islamic states. In more recent
times, Christian missionaries brought alcohol along with a new
religion to many indigenous cultures including the native Americans,
the Aborigines of Australia and the Maoris of New Zealand.
The world’s developing nations are both consumers of a
variety of drugs and the major producers/primary supply sources
of many drugs – both those deemed illegal and legal. However,
the ‘danger’ of drugs in humanitarian and health terms
is perhaps not the main determinant of which drugs are legalised
or banned. The industrialised nations, mostly led by the United
States of America have frequently looked to apportion the blame
for the problem of drugs on producers, traffickers and users.
Inevitably this has meant that much of the ‘war’ on
drugs has been focused on the developing nations (see Drug Trade).
It has also meant that there have developed huge disparities of
opinion over whether prohibition and regulation of drugs use actually
have a positive effect on the people of the world, either in terms
of whole countries that may produce banned drugs as primary crops,
or individuals who can be criminalized as well as potentially
suffering from ill health through their use of drugs such as cocaine,
heroin, cannabis, ecstasy, and LSD.
Drug use in developing countries
Developing countries that are involved in the production and
trafficking of drugs are the most affected with the problems associated
with illegal drug use. The World Bank (1997) has brought together
a lot of information about the prevalence of drug use in developing
countries, but it must be treated with caution, since the data
comes from many sources over a period of approximately ten years.
It is likely that much of the data consists of estimates, and
some countries may not have had any research undertaken on issues
such as the prevalence of injecting drug use. However, it remains
the best indicator of the patterns of use in developing countries.
According to this source, injecting drug use has been spreading
globally and is especially high in Thailand, Argentina, Puerto
Rica, Hong Kong and Malaysia and some parts of India. Heroin is
the main drug injected in Asia, and cocaine in South America.
The availability of cheap, relatively pure refined heroin or cocaine
in areas of primary production and along trafficking routes appears
to coincide with centres of drug use. The move from smoking unrefined
brown sugar heroin in India and China to injecting refined heroin
again mirrors the changes in the production, though smoking is
still more common in areas close to the poppy fields in areas
such as Myanmar. It is also thought that because injection is
a more efficient form of administration that this may have led
poorer users to utilise the most economic means of use.
Law enforcement programs against drugs around the world have
caused considerable displacements of both primary suppliers and
of traffick routes. For example, the World Bank (1997) report
states:
...in the mid to late 1980s, Thailand began to
vigorously pursue law enforcement efforts against opium and heroin
production, and crop-replacement programs in opium growing regions
in the northern hill areas. These policies have resulted in decreased
production of heroin in this country (though not decreased trafficking)
Drug users in the developing countries are typified as being
more than 75 per cent male and relatively young, mostly from 20-40.
Information has mostly come from drug clinics in urban areas,
therefore may not reflect rural drug use. As might be expected,
the social and economic characteristics of injecting drug users
varies from country to country. In Manipur in India and Bangkok,
over 70 per cent are employed, whereas users in Brazil and Thailand
are mostly classed as 'deprived' and unemployed. In relation to
the potential spread of AIDs through infected needles, there is
evidence that 72 per cent of the users in both Rio de Janeiro
and Bankok have shared needles.
The future
The European Monitoring Centre for Drugs and Drug Addiction,
based in Lisbon, Portugal has noted a likely trend towards the
use of more synthetic drugs such as ecstasy, LSD, ketamine and
amphetamines in the West. Meanwhile, cannabis is still the most
used drug in developed countries. Partly this reflects the growth
in party and dance culture in the late 1990s and early 21st century
and its members' affinity to using pills for a quick 'high'. But
it also has probably resulted from shifts in production, since
it is easier for laboratories to be set up close to demand centres,
and since synthetic drugs are mostly simple to produce this has
resulted in cheap supplies of such drugs particularly in the Netherlands,
Belgium and the UK. Whether these drugs will also become the focus
of production and use in the developing countries is too early
to speculate.
Perhaps the words of one of the twentieth century’s prophets
still offer a realistic assessment on the recreational use of
drugs in the twenty-first century:
That humanity at large will ever be able to dispense
with artificial paradises seems very unlikely. Most men and women
lead lives that are at the worst painful, at the best so monotonous,
poor and limited, that the urge to escape, the longing to transcend
themselves if only for a few moments, is and always has been one
of the principal appetites of the soul. (Huxley, 1951)
Alan Dearling
Websites
These are in no way exhaustive, but will provide a good portal
into the subject with both factual information and debate. Factual
data and opinions shift quickly, so this is one of the best mediums
to use to keep informed.
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA):
www.emcdda.org
- Lindesmith Center: www.soros.org/lindesmith
- United Nations International Drug Control Program (UNDCP):
www.undcp.org
- World Health Organisation: www.who.int
References
Abel, E., Marijuana, The First 12,000 Years. New York: Plenum
Press, 1980
Blickman, T., Caught in the cross-fire: Developing Countries,
the UNDCP, and the War on Drugs. London: Transnational Institute
and the Catholic Institute for International Relations, 1998
Burrows, J., Coca: an Andean Tradition. New York: Center for
World Indigenous Studies, 2001
Emboden, W., Narcotic Plants: Hallucinogens, Stimulants, Inebriants
and Hypnotics, their Origins and Uses. London: Studio Vista, 1979
Huxley, A., The Doors of Perception. London: Penguin, 1951
Neal, R., "Africa backs UN anti-drugs fight," Africa
Recovery, vol 12. No 1, 1998
Rudgely, R., The Alchemy of Culture: Intoxicants in Society.
London: British Museum Press, 1993
South, N., editor, Drugs: Cultures, Controls & Everyday Life.
London: Sage, 1999
United Nations International Drugs Control Program, World Drug
Report 2000. 2001. Oxford: Oxford University Press, and at: www.undcp.org/bin/printer_friendly.cgi
Williamson, K., Drugs and the Party Line. Edinburgh: Rebel Inc,
1997
World Bank, Patterns of Drug Use in Developing Countries. 1997.
At www.worldbank.org |