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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

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