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Drug use in modern society: A medical, criminal or social issue?

RUN2016 SA Drug Policy Week
by

Julian Buchanan

on 2 February 2016

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Transcript of Drug use in modern society: A medical, criminal or social issue?

Julian Buchanan
Drug use in modern society:
A medical, criminal or social issue?

The Drug Apartheid
How we then respond and control 'drugs'
Living with drugs
Socially Constructing 'Drugs'
Understanding and responding to addiction
Policy harms, contradictions and misinformation
A psycho-social approach
Happy 18th!
Happy New Year!
You've passed your exam!
A new baby!
You've got engaged!
You've got married!
It's your anniversary
You've passed your driving test!
A new house!
Starting university
A new job
It's Friday!
Class A
Alcohol
Tobacco
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
"Drugs" are a western social and cultural construct, founded in racist ideology, ignorance and misinformation.
Privileging and promoting social use of particular (hidden) drugs while
policing and severely punishing all
engagement with other (outed) drugs
The drug apartheid policy results in a misplaced trust in legal drugs, a misunderstanding of the real harms posed by illegal drugs and a policy that makes all illegal drugs inherently more dangerous.
The cultural accommodation and promotion of
legal
drugs as expressions of celebration, pleasure, leisure and socialisation, occurs at almost every occasion.
We conveniently conflate
drug
'use' with problematic drug use or 'addiction' depending on the drug and who uses it
illegal
'drugs'
Legal medication
or
pharmaceuticals
Legal
high
'drugs',
or
NPS

Bolivia has petitioned the UN to overturn a provision of the 1961 UN Single Convention on Narcotic Drugs, which requires countries to eradicate the chewing of coca leaf.



1998 UN Declaration http://www.un.org/ga/20special/poldecla.htm
Drugs are
a grave threat to the health and well-being of all mankind”.

The social construction of 'drugs'



1998 UN Declaration http://www.un.org/ga/20special/poldecla.htm
[
Drug
policy is
]

a grave threat to the health and well-being of all mankind”.
Shaky foundations of drug law, policy & practice
Drug apartheid
Research into negatives only
Punitive populist led policy
1950s based knowledge & ideology
Misinformation, ignorance & propaganda
Vested interest of legally approved drugs
Racism
Social construction of 'drugs'
The instantly addictive drug
The instantly addicted brain
The enemy within
With drug driving we conflate presence with impairment


As an experienced addiction researcher,
Prof Michael Gossop
(2000:4) singles out the medical profession’s role in influencing contemporary attitudes towards drugs:

'
Society would like us all to believe that our good drugs are all safe, or at least comparatively safe, whereas the bad drugs should all have sinister and dangerous effects. In this way, scientific questions about the actual effects of a particular drug become entangled with issues of personal morality and subjective beliefs.

This has led to some quite absurd pronouncements on the part of otherwise respected scientists and physicians: the need to justify their belief in the badness of certain drugs seems to have been so powerful that they have lost the ability to think straight on those matters.
By presenting personal opinions and moral views in the guise of incontrovertible scientific fact they have done more than anyone to perpetuate the myths and misconceptions about drug taking.'

cited in Boland 2008 pp. 181-182
Angus Bancroft 2009 p.8
"The number of drivers with marijuana in their system grew by nearly 50 per cent"
Testing presence not impairment

Identifying
possible
use not problematic use or addiction
HOW DRUG POLICY MAKES DRUG USE MORE DANGEROUS
NIXON LAUNCHES US LED - DRUG WAR
Extracted from:
Buchanan J (2009) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
1. Promoting
abstinence
,
intolerance
and
fear
towards use of particular drugs.

2. Targeting and punishing particularly
Black and minority ethnic groups, the poor, and indigenous people

3. Making it more
difficult to fund research
and gain acceptance for medical benefits of illicit drugs.

4. More difficult to promote and implement needle exchanges, naloxone take home, injectable prescribing, heroin prescribing, maintenance prescribing, drug consumption rooms and other
important and scientifically effective harm reduction strategies.


5. Making it
more difficult
for people who use or have used illicit drugs to be
accepted, trusted and respected
.

6. Irrationally
ascribe
illegal drugs with
innate pharmacological powers
to enslave - some instantly.
Unnecessary socially constructed risks caused by criminalisation
We uphold a (culturally based) drug apartheid that is intolerant towards particular drugs - depending largely who uses them, punishing severely its users, yet the vast majority of people who use these illicit drugs do not develop drug problems, nor do they cause others problems.



DRUG ALCOHOL ABSTINENCE COURTS
Rat Park - Prof Bruce Alexander
deprivation
alienation
poverty
hopelessness
few alternatives
The Globalization of Addiction: A Study in Poverty of the Spirit (2010)
The damage from an enforcement approach
Addiction is not a criminal justice problem, but neither is it best understood as a pharmacological or medical problem, if anything it is more of a psycho-social problem.

Drug law, policy & practice
Drug apartheid
Research into negatives only
Punitive populist led policy
1950s based knowledge & ideology
Misinformation, ignorance & propaganda
Vested interest of legally approved drugs
Racism
Social construction of 'drugs'
The Instantly addictive drug
The instantly addicted brain
The enemy within
Drug Apartheid
We all use drugs for pleasure
BANNED
Zombie man eating bath salts
Reefer madness & schizophrenia
Just one E kills
P (Tik) - instantly addictive
Crack babies mentally disabled
Opiate baby disabilities
Flesh eating Krokodil
Cannabis/Dagga deadly lung cancer
Cannabis/Dagga the gateway drug

Responding to Addiction
julianbuchanan@gmail.com
Legal and
commercially promoted
substances not generally perceived as 'drugs' embedded in most expressions of leisure, pleasure & occasion
HIDDEN DRUGS
Instead of
ideology, fear and moral panics
we should look to
science, research and evidence
to inform drug law, policy and practice
Public Perceptions (UK)
Science
Buchanan, J. (2009)
Understanding and misunderstanding problem drug use: working together
, in Ros Carnwell & Julian Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
"Recovery from chronic drug dependence is hard enough in itself, but when combined with discrimination,
social exclusion and stigma, and further exacerbated by austerity measures, people with dependency issues may feel they are neither welcome, nor accepted as citizens, and this may make the process of recovery insurmountable, perpetuating personal isolation and social exclusion."
Roy, A., & Buchanan, J. (2015) ‘The Paradoxes of Recovery Policy: Exploring the Impact of Austerity and Responsibilisation for the Citizenship Claims of People with Drug Problems’ Journal of Social Policy and Administration, Early View
"stigmatizing stereotypes about people who use illicit drugs, embraced by the wider community, not only diminish opportunities, but become internalized by
those with drug problems and this significantly impedes recovery"
"there is a palpable need to re-politicize drug debates and recognize the systemic, structural and demographic factors which underpin chronic drug dependency, as well as general health and social inequalities"
(Roy & Buchanan 2015)
Taylor, S., Buchanan, J., & Ayres, T. (forthcoming 2016) ‘Prohibition, Privilege and the Drug Apartheid: The failure of drug policy reform to address the underlying fallacies of drug prohibition’ Criminology and Criminal Justice, An International Journal. Sage.
substance
set
setting
Zinberg (1986)
Opportunities, support , inclusion and social reintegration are crucial but more difficult in an era of austerity and growing divide
Context of PDU
Recovery is severely hindered by stigma and discrimination rooted in a hypocritical and misinformed 'Drug War'
The people who struggle to recover often have damaged lives before addiction
Addiction has much more to do with set & setting rather than substance
policy
(Roy & Buchanan 2015)
Othering
Psilocybin mushrooms
http://www.unodc.org/wdr2015/
http://www.drugwarfacts.org/cms/Crime#sthash.Ehdge1Np.dpuf
Total Annual Drug Arrests in the US, by Type in 2014

Of the 1,561,231 arrests for drug law violations

83% (1,297,384) were for possession of a controlled substance

17% (263,848) were for the sale or manufacturing of a drug

“exposure model” of addiction
Wilson (2015) A qualitative study investigating the association between social exclusion, stigma and long term problem drug use in a New Zealand town
https://researcharchive.vuw.ac.nz/handle/10063/4169


Abstinence

vs.
Harm Reduction
Nutt DJ, King LA, Phillips LD; Independent Scientific Committee on Drugs. (November 2010). "Drug harms in the UK: a multicriteria decision analysis" Lancet 376 (9752): 1558–65
https://julianbuchanan.wordpress.com/
Full transcript