The Library of Drug Abuse and Crime

Citation

Day, M. (2013), "The Library of Drug Abuse and Crime", Drugs and Alcohol Today, Vol. 13 No. 2, pp. 153-156. https://doi.org/10.1108/DAT-03-2013-0016

The Library consists of three volumes. This is the review of Volume 1: Drugs of Abuse: The International Scene: ISBN 978‐0‐7546‐2769‐2. The other two volumes to be reviewed in future are Drugs and Crime and Drug Abuse: Prevention and Treatment.

When I received an e‐mail requesting volunteers to review the three volumes of The Library of Drug Abuse and Crime, I was intrigued. Here, for only 140 quid per volume, was alleged to be a compilation of “essays […] (that) highlight drug abuse as a worldwide problem […]”. Immediately the language police who live in my head flashed me a warning “Oh my! – people are abusing themselves”.

Thus intrigued by the combination of price and my prurient interest in the methods of abusive behaviours my fellow humans were engaging in, I submitted my name as a potential reviewer and was selected. There were some issues regarding the provision of a review copy and then the cost of posting to the Caribbean, where I make my home, but eventually this fine set of volumes arrived, nicely bound but with no dust cover. I collected them at the post‐office as they had arrived by ships mail, hearkening back to pre‐internet days when all information was paper and everything arrived by ship. I thought, how quaint. Little did I know that the mode of transport would be more than indicative of the time warp that characterised the content of most of the papers contained therein. The package required a customs inspection, for revenue more than contraband, and was opened by customs at the GPO which gave me my first look at these lofty tomes. I was immediately disappointed. The contents, with the exception of the series preface and the introduction, were made up of reprints of previously published papers. It was not that they were “reprints” that was the cause of my disappointment: it was that the papers were reproduced in the exact format as their original journal paper[1]. Papers that originally appeared in large page format journals have been reduced down to a 7″×5″ format making them virtually unreadable. Most of the footnotes and references suffer the same unread‐ability. Those papers that I wished to read, but could not muster the eyesight required, I resorted to Google. Every paper I searched for was easily found. If only the editorial material was so easily available electronically.

I must say that my second impression was also a disappointment. In the second paragraph of the preface, the editor uses the word “abuse” as a descriptor for the act of using a substance which is banned for distribution without a physician's prescription. The use of the word “abuse” speaks volumes to me: of a particular context propagated and proliferated by the USA and the philosophical cornerstone of their 30 year “War on Drugs”. That one word, “abuse”, conjured up images of an American crusade of righteous indignation at the self‐inflicted abuse that the weak and morally corrupt subject themselves to. Within that frame, I delved into the first volume: “Drugs of Abuse: The International Scene” as open‐mindedly as possible. Volume 1 is divided into four sections: “Drug Abuse in the Developing World”, “The Emergence of New Drugs and Poly Drug Use”, “The Normalization Thesis and Gateway Drugs” and finally “Methodological Developments in Researching Drug Abuse”.

Part 1, “Drug abuse in the developing world” is a fair collection of papers from around the globe. Given the preponderance of research into the use of syringes as the route of administration of opioid‐based substances, there is a well thought‐out selection of papers on injecting drug use describing the environments in: China's Yunnan Province (2001), Pakistan, (2007), Egypt, Kenya, Mauritius, Nigeria, South Africa and Tanzania (2006). The most current paper in the series was the only paper that focused on youth drug use, based on research conducted in the Czech Republic (2007). Given the disproportionate impact substance use has on young people, the adequate coverage of the topic truly demanded the inclusion of at least one additional paper originating in the developing world. Two papers would have allowed the reader to compare youth substance use in two very different contexts.

The recognition of the need to include data on the context of stimulant use in various countries was welcome by the reviewer. This is an area that remains understudied in a field that tends toward the opioid centric. There are three papers, the first outlining ecstasy use in South Africa in the period 1997‐2001. The second paper reviews the 2001 Brazilian Household Survey on drug abuse involving 107 major cities. Both papers are fascinating from a historical perspective as the focus is derived from 1990's data. This poses the question “Of what value is this data?” “Little,” I would say other than to establish base lines for use in future research. This is a much understudied population, people who use stimulants, yet they are the second largest group of people who use drugs, when grouped by substance of choice, after cannabis users. The newest data presented here is five years old already. This is no indictment of the content, the rigours of the studies selected, or the authors (many who I call friends), but in an age of instant data retrieval and the ability to get data as it is published, this just calls in to question the purpose of the exercise.

As an example the third paper: “Trends in production, trafficking, and consumption of methamphetamine and cocaine in Mexico” was published in a journal in 2006. The research informing the paper was collected prior to the Calderon presidency and the initiation of the war on drugs in December 2006. I point this out not as a deficiency in the paper itself but as yet another example of the static nature of the medium that is print.

The second section “The emergence of new drugs and poly drug use” is a selection of North American centred papers drawing on research from the 1990s and early 2000s on the emergence of new drugs and poly drug use. This is an important topic as one of the unintended consequences of the intense attention to drug interdictions in the pre‐9‐11‐2001 period. During that time rigorous eradication exercises directed toward the plants from which the most popular substances were derived led people to seek out synthetic substances with psycho‐active properties that had yet to be criminalised and could be made locally rather then imported. Little is known about the long‐term biological effect on humans so the inclusion of this work represents a valuable acknowledgment that more information is required on this topic. There has been much attention to this subject in the recent years and updated data is available on line to augment what you read in this volume. Despite the inclusion of this section, the editor states in the introduction of Volume 1 that “New forms of existing drugs have been developed” and cites as her example “smokeable ‘crack’ cocaine”. This is an exact quote. As crack has existed since the 1980s this is hardly an example of a new synthetic drug. The editor had no lack of examples of a new synthetic drug to name as an example. I dare say any example could have been cut and pasted directly out of the titles of the papers selected for inclusion in this section. It is just another indication that the philosophical underpinning is stuck in the drug “context” prevalent in the 1990s. The editor would have been wise to have synthesised and referenced current research in her commentary.

All but one of the papers in this section originate from US‐based studies. The lone foreign contribution is a paper on the outcomes of a multi‐site opioid study in Canada. The Canadian paper offers a welcome change of context, tone and tenor, which conveyed the Canadian drug perspective prevailing at the moment, indicative of a softer, more tolerant federal government in Ottawa. This paper and the present reality in Canada is a good illustration of the shifting of a drug policy that was tolerant and public health oriented to a more criminal justice and zero tolerance attitude. This transition to the American model began with the election of the first term of the Harper government and the development of a bromance with George W.

The decision to group the topics of normalisation thesis and gateway drugs together, in Part 3, is nothing less then an abomination. The ordering and sequence of the topics gives illusion to the theory that normalisation leads to greater drug use and then on to the use of more dangerous drugs. I assume they were grouped as such to lead a “naïve reader”, one who may see “truth” in the idea that normalisation increases “drug abuse” and any “drug abuse” leads ultimately down the path only ending in addiction.

Of the three papers selected two were UK based and one from Hong Kong. Nothing was included on the great experiment in Amsterdam at drug normalisation and drug market separation or that of Portugal's de‐penalisation. An paper on the 2001 findings of the Ganja Commission in Jamaica would have been welcome. But these three examples are where normalisation has been successful and has shown not to increase consumption. Normalisation has also contributed to reductions in the incidence of “substance switching” due to the supportive policies enacted that encourage drug market separations.

That normalisation leads to “drug abuse” is one of the most unsubstantiated statements one could make. It's unsupportable and therefore cannot be made. The grouping together and the ordering conveys a subliminal context that propagates an inherently flawed, ideologically driven message about the nature of substance use.

The other half of the section is about the “gateway theory” of drug use progression in a linear fashion down the road of “drug abuse”. Better to use their language as it drips with disdain for people who use drugs. This is yet another attempt to offer up proofs to legitimatise a failed theory that is more ideologically driven then scientifically proven. It is just incredible to me. That there is no mention of “exposure opportunity” in this section is a serious omission. The concept of “exposure opportunity,” first described by W.H. Frost and then applied to drug use initiation, was published in 2002. Viewing “substance use” and “substance switching” with the lens of “exposure opportunity” presents a much more realistic explanation of the phenomenon. This material has been in the literature since 2002 and yet is ignored here. One wonders if the “game altering” nature of “exposure opportunity” that discredits the concept of the “gateway theory” contributed to its omission. Nonetheless, regardless of the motivation, the omission of “exposure opportunity” is a serious gap in this work.

Part IV is a review of methodological developments in researching “drug abuse” and covers the innovative and cutting edge research methodologies of the 1980s and 1990s where qualitative research was beginning to be accepted as a valuable way to initially add richness to the quantitative data but gradually recognised as a stand alone way of explaining “what is going on”. The editor has included a broad selection of papers panning different tested and validated research methodologies such as those described in the papers by Hay et al., Ditton et al. and by Basu et al. There are also some interesting discussions on the integration of qualitative data into quantitative research (Clatts et al.; Stipson et al. on RAR).

I have a difficulty in rationalising paper books, let alone paper books that cost 420 pounds sterling. Which of course begs the question I have asked myself since seeing the price: for what purpose were these volumes actually produced? Surely not for access to content, which could have been accomplished with a much smaller carbon footprint with a hyperlinked bibliography and a database of freely accessible papers? In the introduction the editor points out that “an enormous amount of drug‐related research has appeared in print”. As the Americans are always quick to say: “the USA funds 85% of the world's drug research”. The papers selected were mostly produced using American funds and were basically in harmony with the most basic of American ideals, that if one rains war upon a problem it will eventually be solved. The reign of terror in this case is that the criminalisation of people who use drugs will somehow solve the public health issues associated with drug use including those created by the very solution designed to eliminate them. The root cause of the vast majority of health, social and economic consequences of drug use is the legislation that enshrined zero tolerance by requiring mandatory minimums and “3 strikes you’re out” as the final solution to the drug problem.

So I believe these volumes stand as a symbol of the further exportation of a misguided ideology that continues to champion the “War on Drugs”. These books appear to be a monument to the American ability to apply an ideologically based response to the question of personal choice and privacy. I do not recommend purchasing them on a number of levels but primarily because I see them as a subtle almost subliminal endorsement of American drug imperialism.

Note

Reprints were reproduced exactly from the journal original reduced to 7×5 and less the publication date and original journal banner but with the original journal page numbers.