Smokin Moose
Fallen Cannabis Warrior & Ex Moderator
International Journal of Drug Policy Volume 12, Issues 5-6, 1 November 2001,
Abstract
This article analyzes psychosocial issues related to social exclusion created by the illegality of cannabis. The paper is divided into three parts. First, it provides a historical portrait of the penal approach to this social exclusion while focusing on the main recommendations of various international commissions in respect of cannabis consumption and the importance of social ties. Second, it explores how coffee shops in the Netherlands constitute a space where cannabis consumers can be, to a certain point, demarginalized and in which social ties can be createdwithout punishment or incarceration. Finally, the paper suggests some conditions for empowerment and invites social practitioners to pass from a psyho-relational to a psychosocial therapeutic system in order to avoid negative social labeling and social exclusion.
Introduction
There is no consensus concerning the analysis of the phenomenon of addiction itself or the management of related social problems (Schaffer; Nadeau; Room; Anthenelli; Breggin and Brisson). Profound differences of opinion appear as soon as the question of the traditional disease discourse versus a psychosocial approach, the etiology of drug problems and the social control methods that should be promoted, are considered ( Suissa and Weinberg). Major paradoxes continue to fuel the dominant discourse when it comes to determining whether dependence on a prohibited substance (cannabis) constitutes a crime or an illness or whether it is more closely linked to the relationship between the individual, the substance and the social context. Whereas dependence on non-prohibited substances in Western cultures (alcohol, tobacco, prescription drugs) generally perceived as disease, dependence on substances that are foreign to Western cultures is more often associated with deviance and criminality ( Szasz, 1989).
Cannabis constitutes a striking example of these paradoxes insofar as current laws place consumers in a position of deviance and exclusion, even imprisonment. Apart from some cases of tolerance of consumption for health reasons, especially in the case of persons with AIDS, cancer and glaucoma, this is still the status quo in Canada, even though half of all citizens in Quebec, for example, are ready to decriminalize the consumption of cannabis for personal use (Nadeau and Nolin). According to recent figures from the Canadian Centre on Substance Abuse ( CCSA, 1998), half of the 63851 cannabis-related offences recorded in 1995 were cases of simple possession. While the Canadian authorities responsible for applying the law track down less than 1% of all cannabis consumers each year, over 2000 Canadians are imprisoned for cannabis possession, at a cost of $150 per day, and 92% of all persons found guilty of this offence continue to consume the substance during the following year. Also, a considerable number of these offenders are likely to have been jailed for defaulting on payment of a fine. This is an important issue as this type of offense often involves individuals from the lower socio-economic stratum. The last report of the National Council of Welfare (2000) untitled Justice and the Poor, demonstrates clearly that the criminal justice system is unjust as it discriminates more against the poor, the richer people and corporations can pay their fines while the poor are more oriented toward the prisons. From a Realpolitik point of view, this reality is generally combined with penal and social control measures applied more among lower socio-economic groups, these groups representing a certain potential for deviancy and social disorder. This penal approach results in the exclusion of thousands of people and their social networks. What are the foundations underpinning this type of social control? What are the social factors, which influence this kind of response to social problems related to dependency?
Faced with these profound questions, this paper attempts to highlight certain contradictions in the application of penal methods of social control as applied to cannabis. This is achieved through a critical analysis of the addiction phenomenon. To this end, we will first consider the historical and social context in which cannabis is consumed. We will then illustrate the founding principles of the penal perspective on social control, which contributes to the exclusion of consumers. As an alternative to the undesirable psychosocial effects associated with penal approaches, the case of coffee shops in the Netherlands will be considered to show how spaces where consumption is tolerated help to reduce exclusion and bring the strengths of social ties to bear on the implementation of Dutch drug policies. Finally, some practical benchmarks for support workers will be suggested in order to avoid obstacles that work against the empowerment and social management of persons popularly visued as deviant.
Cannabis: historical milestones in penal approaches to social exclusion
Over the last century, several international commissions have considered the use of drugs, and cannabis in particular, for non-medical purposes (Government; Government; Government; Government; Roques and Nolin). According to the United Nations World Drug Report (2000), it is estimated that some 180 million people worldwide––4.2% of people aged 15 years and above-were consuming drugs in the late 1990s; this figure includes 144 million consuming cannabis. Cannabis is the substance for which there are the most cases of incarceration in Canada and throughout the Western world ( Erickson; Bertrand; Beauchesne; Michka; Roques and United). In Canada, 70% of all of all drug offences that occurred in 1995 were offenses involving cannabis with a significant variation among regions, particularly with regard to urban and rural areas. As an illustration, the cannabis possession offence rate per 100000 for British Columbia is 246, compared with 92 for Ontario and 52 for Quebec ( CCSA, 1998). Offenses involving cannabis are the only category of drug offenses, which started to climb from 1991 on, and they are, therefore, responsible for the overall increase in drug offense numbers since 1991 in Canada. During the same year, 14% of the Canadian prison population was in jail for drug offenses
Scientific studies carried out both under government authority and independently have concluded that the moderate use of this substance has no injurious effects on health (United Nations World Drug Report, 2000). It is important to distinguish between moderate or recreational use from a pattern of abuse and misuse, cannabis abuse can, in fact, produce negative health consequences. According to the CCSA (1998), the most important of these are the following: respiratory damage, physical co-ordination impairment, problems during pregnancy and post-natal development, memory and cognition and finally some psychiatric conditions. But even as these studies recommend the decriminalization of cannabis when consumed moderately, there has been a complete failure to act on the part of the governments concerned, despite the very high rate of imprisonment. This situation is reflected in the criminalization of thousands of citizens, which belies the claim promoted in the media that these prohibitive laws target primarily criminal networks. The majority of people in prison are there for simple possession rather than trafficking.
The same logic applies in the United States, even with the highest rate of imprisonment in the world. According to Solliciteur and Service, the general admission rate is 129 per 100000 in Canada, while it is 645 per 100000 in the United States. Close to 1300000 people are being held in US prisons, one-third of them for drug-related offences ( Schlosser, 1994). Since 1980, this type of socio-penal control and the strengthening of the law related to cannabis have resulted in the arrest of over 4 million individuals, who were given sentences of varying severity. The difficult conditions affecting order and social control are reflected in a lack of space in prisons, forcing the American states to release a significant number of inmates. This paradox is even clearer when one considers the substantial increase in the number of Federal Narcotics Bureau agents, from 300 in 1967 to 3400 in 1991, and the fact that costs have reached $1.3 billion whereas the budget was only $88 million in 1967 ( Schlosser, 1994). Even though some American states (California, Colorado and Arizona) have opted to decriminalize cannabis for medical purposes, resistance to change is very strong, since these measures continue to be viewed as leading de facto to the general decriminalization of the consumption of psychoactive substances ( Beauchesne and Magner).
Yet, as early as 1979 Jessor (1979) psychosocial research on cannabis in the United States revealed that cannabis use was being described increasingly in terms of abuse and less and less in terms of simple use. This research also showed that use was primarily determined by the fact of having friends who were users or spending time in places where the substance was available, rather than individual psychopathology. In the same vein, a scientific review of the literature on the topic a few years later revealed that no psychopathological effects could be attributed to simple or moderate consumption of cannabis ( CCSA and Fehr).
On the other side of the Atlantic, in France, the latest report submitted to the Secretary of State for Health showed that, out of 70000 people questioned by the police and appearing before the courts, 80% were there for cannabis-related reasons (Roques, 1998). This report, which was issued by a scientific commission of 11 foreign consultants, highlighted a number of findings including, cannabis is practically harmless; the neurotoxicity is zero and the risks of physical and psychological dependency and the social dangers are low. In parallel to these recommendations, the commission emphasized that recourse to imprisonment is an aberration, since prison only aggravates the problem by separating thousands of individuals from the wider community and creating a more drastic break between incarcerated persons and their primary social networks including families, loved ones, friends and significant others.
In light of such evidence, one is entitled to wonder whether the war on drugs is not in fact a war on citizens. In his book La Guerre Chimérique, Côté (1994) examines these contradictions, and compares this struggle to the major ideological wars of history such as the Inquisition and the prohibition of alcohol. If the wisdom of a law is generally judged in practical terms––that is, the costs imposed on society versus the benefits it generates––the legislation governing cannabis raises fundamental questions concerning the extraordinary social and judicial costs in light of the still outstanding issues of criminalization and imprisonment for the medium and long term.
According to a number of researchers (Kaplan; Cormier; Rico; Erickson; Roques and Nolin), by attributing deviant social values to this substance and its use, we have a priori problematised our relationship with this substance by associating it with a negative lifestyle that must be controlled. By not distinguishing use from abuse/misuse, this political context of social control directly places consumers in a situation of deviance, by temporarily disrupting their lives, often exposing them to harsh conditions in prison, and alienating them from the rest of society. Moreover, over 30% of prisoners require treatment for substance use even inside prison, which raises the specter of a deterioration in living conditions rather than an improvement, especially considering the alarming public health problems related to the significant increase in cases of HIV infection and AIDS (Cohen and Institute).
This reality questions the legitimacy of the law, insofar as the only legitimate exercise of power by a civilized society against one of its members is to prevent harm to another (Teff, 1975). And it should be noted that this type of control is more likely to apply to the underprivileged in society, inasmuch as these groups are already the focus of other related control methods in the overall community ( Blum; Gusfield; Horwitz; Laberge and National). Understood in this way, the question of social ties and the exclusion of a large proportion of the population is contrar to issues related of penal control and the negotiation of a more inclusive social order.
The penal perspective on social control
When understood as one form of social control among many (Horwitz and Laberge), the penal perspective falls within an integrationist vision of social relationships considered as problems of deviance. In other words, recourse to penal measures is mainly centered on an attempt to mark what constitutes "citizens' distance and disengagement in their relations to the overall social space" ( Spierenburg, 1984). From this perspective, a drug addict who is socially distant will be more vulnerable to the penal response than one who is more integrated into society. This reality is well translated in courts where the judges asserts the capacity of readaptation to society through the level of support a social network can provide. In this logic, the question of strong social ties versus weaker ones constitute an important platform in regard to justice in general and to application of measures in particular. In an attempt to define what is a social tie, many authors underline the fact that a social tie cannot be defined through a unique level of socialization, it has to be studied at different levels without isolating it from the global society dynamics. From interpersonal, intimate and family relations to institutional and informal forms, social ties may be defined as the means, visible or not, that enable us to establish an equilibrium between the "I" our personal identity and the "We", with the larger social environment.
According to Rieder; Horwitz and Laberge, close social ties constitute not only the cornerstone of all social reaction but also a choice that should be favored in developing control policies and measures. According to these authors, the forms and styles of control vary depending on how the people in power conceive of deviance, the capacity of the social and familial environment to solve conflicts, and the intervention and disciplinary methods preferred in the social management of persons considered to be deviant. At the centre of these issues, various practices come into conflict and are developed in accordance with the specific circumstances at a given time and place ( Conrad, 1995). In short, we may say that recourse to penal control by those in power not only indicates the existence of inequalities in the social power structure, but also demonstrates a certain failure on the part of their attempts to maintain stable social regulation systems.
Even though many cases combine the penal and therapeutic responses simultaneously, it remains the case that social distance and social ties play a central role in the processing of the type of response. For example, one might think of populations considered to be too socially distant by the system in place (drug addicts, homeless people, prostitutes or delinquents), who are sometimes treated as criminals and other times as sick people, depending on the offence committed, the perpetrator's personality, and the presence or absence of social ties (Higgins and Laberge). Given this logic, we may deduce that the greater the social and relational distance, the more likely there is to be a process of labeling and punishment. As for social status, a therapeutic perspective appears to be more acceptable among privileged classes than among those underprivileged ( Goldberg and C). In the latter group, there is a tendency to define problems as resulting from illness or personality problems, whereas among the upper and the upper middle classes they are more likely to be seen as the result of emotional or interpersonal difficulties.
Other benchmarks in the control of social ties
All societies transmit social values and standards that they consider to be important in maintaining social order. These include respect for the law and the value of work as a tool for integration, competition and personal success. Since the cannabis consumer's behavior is related to the consumption of illegal substances, as soon as it becomes publicly known, it is generally categorized as deviant by the existing institutions and becomes subject to control methods. Two conditions are at the centre of this institutionalization of consumption as deviance. First, the behavior in question must be deemed undesirable. Secondly, it must be subject to social judgement labeled as delinquent or deviant. This triggers a chain of social reactions to the act of consumption that will primarily depend on the nature of the social ties maintained by the consumer. Is he or she a lonely or socially isolated person? Is he or she is she surrounded by family, friends and other people on whom he or she can count? Does his or she class occupy a social position with a privileged status in society? Is he or she a member of an organized group that has power in society? These questions are important because insofar as the consumer's social environment can be considered an active agent in the social readaptation process. The stronger social ties, the more likely it is that the response to that offence will be therapeutic; the weaker a person's social ties, the more likely it is that penal measures will be selected. It is undeniable that the consideration of social ties is a key factor, not only in the process of socialisation in general, but also in the choice of methods and the intervention likely to be favored.
With regard to the phenomenon of addictions, it should be specified that, setting aside the issue of whether cannabis creates dependence among consumers, each individual develops a dependence for specific, personal reasons (Suissa, 1998). This aspect is important, since the substance itself has little to do with the addiction process; rather, interpretation and personal experience will determine whether or not the cycle of dependence will be triggered ( Becker; Weil; Peele and Suissa). In other words, it is not the substance as such that will determine the cycle of addiction but the relationship that one establishes with it. From this perspective, it is not the act of consumption as such that determines the nature of the problem and its solution, but the penal or therapeutic social reactions to the act.
Dutch coffee shops: a space that contributes to counteract social exclusion
In the Netherlands, a coffee shop is an outlet where soft drugs are sold under certain conditions. Soft drugs are deemed to be products derived from cannabis/hemp, that is marijuana and hashish. Among the conditions imposed on the sale of these products by the Dutch government in its latest report (1995), we should note the prohibition on the sale of over five grams of cannabis, in order to combat sales destined for export; and the prohibitions on selling hard drugs, advertising drugs, creating disturbances in the vicinity, selling drugs to youths less than 18 years old, and opening a coffee shop near a school or hospital. The authorization of coffee shops as controlled retail outlets has several objectives.
1. It creates a separation between the markets for hard and soft drugs.
2. It prevents consumers of soft drugs from coming into contact with hard drugs.
3. It protects these consumers from the criminal world of drug traffickers.
4. It facilitates the arrest of "narco-tourists," such as foreigners who see coffee shops as supply centers.
In accordance with the recommendations of various international commissions of inquiry targeting the decriminalization of the personal consumption of cannabis, the main authorities in the Netherlands (courts, police, health ministry, municipalities) agree that the use of soft drugs does not create a significant risk for consumers' health. This reality should be emphasized because, even though some studies highlight the injurious effects of cannabis on health (Kalant et al., 1999), it is important to note that the use of any substance must be distinguished from its abuse/misuse. Not everyone misuses drugs; rather specific psychosocial conditions are required for a consumer to start misusing and enter the cycle of addiction ( Suissa, 1998).
According to Bieleman et al. (1995), there are 712 coffee shops located in 116 municipalities in the Netherlands. These establishments enable consumers of soft drugs to share a social space, up to a certain point, without being imprisoned or otherwise punished. This approach, therefore, prefers to focus on the creation of social spaces while forbidding the sale of drugs in the street or at people's homes. Nevertheless, in North America and many European countries, the dominant discourse continues to present illegal substances as one of the greatest dangers, whereas the damage caused by the duo of alcohol and tobacco far exceeds that resulting from all illegal drugs combined.
From a critical perspective of the Dutch policy regarding cannabis and coffee shops, a former prime minister of The Netherlands (Van Agt, 1999), pinpoint some developments considered more difficult. A very important one is the emergence of in-house production of cannabis (Nederweit) where the growth of home production is reaching 100 tons/year. A second one is that coffee shops have not been kept in check and the restrictions imposed on their operation have not been effectively enforced. Also, the strategy against the sale of hard drugs has not been sufficiently determined and consistent. Considering these facts, Van Agt underline the fact that there is no convincing evidence that countries like United States and France are markedly more successful in their endeavors to "clean" society of drugs.
Unlike a laissez-faire policy, the Dutch drug policy is based on pragmatism rather than utopian idealism. Instead of aiming at a utopian, drug-free society (prohibitionism), the Dutch policy favors the harm reduction approach, based on the importance of social ties in developing solutions other than incarceration. Furthermore, in the case of injection drug users (IDUs), 80% of Dutch users have social ties whereas in America the reverse situation obtains, with 80% of IDUs being excluded from social relationships (Marlatt, 1996). The context of illegality in which several thousand individuals find themselves actually contributes to the corrosion of their relationships with institutional and social values, and consequently produces unwanted effects and significant paradoxes, such as discrimination, ethical problems, high social and health care costs.
With regard to discrimination, according to Silvis et al. (1992), consumers are discriminated against insofar as the universal and human rights of persons incarcerated for consuming illegal substances are often neglected. In other words, discrimination leads to the suppression of rights, whereas rights represent exactly what consumers most need in order to gain respect and undertake the social reintegration process. From this point of view, the cannabis user is judged harshly by society, since the act of consumption is considered to be a personal choice and is associated with deviance, and even with individual pathology.
From the point of view of ethics, Roy (1997) sees this situation as a tragedy as it feeds the conflict of inequity between persons who are valued more as human beings and those who are vulnerable and marginalized. According to a harm reduction approach, drug addicts must be considered as fully-fledged citizens, who are indeed in trouble, but who need help rather than being labeled as criminals, as deviants and as sick. Unlike the zero tolerance and war on drugs model, this type of policy considers drug users as an integral part of the wider community who must consequently be protected within this community rather than isolated or excluded.
As for social and health care costs, when one considers the cost-benefit ratio that society must manage in connection with drugs, every dollar invested in treatment makes it possible to save almost four dollars in social costs (Single et al., 1997). In other words, the overall costs related to the structures of repression and criminalisation––incarceration, police, prisons, courts, probation and parole services, victims of crime, prevention, replacement of goods and property, injuries––far exceed the amounts invested in prevention and treatment ( Hankins, 1997).
From a social and historical perspective, it is clear that drugs are here to stay. The use of legal and illegal drugs has always existed and is inevitable in all human societies. The failure of current Canadian policies focusing on repression has shown us that drugs will not be eliminated from our society and that the effects of this repressive and moral approach are injurious to thousands of consumers, as well as their families and social networks. Even though the majority of consumers use drugs moderately and safely, intervention strategy continues to emphasize access to substances (supply and demand) and measures of repression and criminalisation. However, current drug policies can no longer be based on a utopian belief that drugs will eventually be suppressed; rather, they must also consider the perverse and harmful effects on consumers, their friends and families, and the community. Viewed from this angle, a harm reduction approach, which favors accepting the reality of drug use as just one potentially risky social behavior among many, constitutes an opportunity very valid option for strengthening social ties and supervising people who have dependence problems.
Labeling problems through deviance: some challenges for social practitioners
The relationship between any consumer and social practitioners is fundamentally centered on a dynamic of power in as much as the counselor generally has the power to define the situation and, up to a point, to manage the therapeutic process with the aid of an institutional mandate. Understood in this way, intervention is not a neutral process but part of a complex relationship in which many factors play a role. Although social intervention is often conceptualized as a helping relationship, reinforcing the image of two persons, the helper and the helpee, the fact remains that the therapeutic relationship also constitutes a meeting of two psychosocial systems. In other words, neither actor is an isolated individual, but rather each represents a set of specific social relationships and values. This reality may be reflected in a dialectic in the therapeutic process insofar as the counselor has the option of orienting the intervention towards the client's potential, support network and power, yet on the one hand, towards social control focused on individual's deficiencies.
It is important to emphasize that the perception social practitioners have of their clients and their social and family networks directly affects the actions they will take during the intervention process. In order to avoid such communication difficulties and to better assess the services needed, it is imperative that counselors free themselves of some personal and professional prejudices when they are exposed to lifestyles that differ from their own. Rondeau and Suissa, remind us that the perception we have of a group of people necessarily orients our definition of their needs and consequently determines the actual services provided. Furthermore, there will be an explicit or implicit attempt to isolate the problems experienced within the domain of psychopathology, concentrating on visible symptoms to the detriment of working on the structures that may have created the problems in question. For example, if we intervene with drug users who are on social assistance and we attribute any deficiencies or deviance to their status as welfare recipients, it will be difficult to create ties leading to cooperation and partnership, since we will to some extent have created a logic of intervention oriented towards the control of this deficiency or deviation, which must be reduced or eliminated.
It is this kind of slippage, which unfortunately is frequent in the process of intervention with individuals and families, that Ausloos (1995) attacked in his book La compétence des familles. Ausloos, a psychiatrist and systems specialist by training, proposes that social practitioners should accept a postulate of competence and deconstruct their own social labels, which generally identify behaviors in terms of difficulty, weakness, lack of skill, or even deviance. Considering this attitude to be a snare that obstructs the transfer of any kind of power to people in difficult situations, Ausloos proposes that one should instead emphasize people's competencies if one wants them to become empowered. In other words, the challenge of transferring power to people who are living through a crisis or in a vulnerable condition can only be possible if we really succeed in perceiving them as competent. Once these methods of empowerment are integrated into our field of vision, we will be able to reduce the social prejudices that are generally applied to people based on their status (drug addicts, single-parents, families, welfare recipients, immigrants, various minority groups, etc.). As the philosopher Robert Musil said, one may gain at the level of detail but one loses overall when one focuses primarily on weaknesses rather than the strengths that lead to empowerment (Musil, 1984).
Conclusion
We have noted that the social trend towards penal control of persons who consume cannabis is part of a general tendency towards increased incarceration, leading to the marginalization of more and more people. In parallel, we find that the efficacy of behavior change interventions among drug users is strongly linked to the existence and nature of a primary social network and social ties (Prochaska and Di Clemente, 1992). For example, a Gallup poll carried out in 1990 (also cited in Peele, 1991 revealed that problem-solving depends greatly on the support given by friends (14%), parents, children and siblings (21%), and husbands, wives or other loved ones (29%), and much less on the support provided by doctors, psychologists and psychiatrists (6%) for all professions together).
One of the main unwanted effects of exclusion based on the current legal situation is the elimination of all reference to psychosocial and cultural factors and the recognition that addiction is an impersonal and non-discriminatory reality. Faced with this pressure to criminalise behavior as a form of social control, social practitioners must acknowledge how this personal and institutional labeling undermines people's capacity to empower themselves through the creation of significant social ties. What happens to the challenge of social change in our society when intervention takes place within a continuum of social control? How long can social practitioners in the area of addictions remain in a psycho-relational instead of a psychosocial one when social? Can one intervene with dependent persons by promoting their empowerment and strengths rather than their weaknesses? In response to these questions, we have to acknowledge that working to strengthen social ties remains one of our best hopes for prevention and for the empowerment to people already labeled as "bad or as deviant". For instance, As an illustration, when working with families and communities, an empowerment perspective allows the practitioners to reduce, even eliminate, individual blame while intervening more with the familial and social structures. In addition, more people are involved in the therapeutic process who otherwise would not be included. If we succeed in helping families today, they will generally be more competent in the future. It is our view that the success rate in the helping process is intimately related to our capacity to create the strongest social ties possible in order to give people back some power over their lives.
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J. Suissa
Department of Social Work, Université of Quebec in Hull,
Abstract
This article analyzes psychosocial issues related to social exclusion created by the illegality of cannabis. The paper is divided into three parts. First, it provides a historical portrait of the penal approach to this social exclusion while focusing on the main recommendations of various international commissions in respect of cannabis consumption and the importance of social ties. Second, it explores how coffee shops in the Netherlands constitute a space where cannabis consumers can be, to a certain point, demarginalized and in which social ties can be createdwithout punishment or incarceration. Finally, the paper suggests some conditions for empowerment and invites social practitioners to pass from a psyho-relational to a psychosocial therapeutic system in order to avoid negative social labeling and social exclusion.
Introduction
There is no consensus concerning the analysis of the phenomenon of addiction itself or the management of related social problems (Schaffer; Nadeau; Room; Anthenelli; Breggin and Brisson). Profound differences of opinion appear as soon as the question of the traditional disease discourse versus a psychosocial approach, the etiology of drug problems and the social control methods that should be promoted, are considered ( Suissa and Weinberg). Major paradoxes continue to fuel the dominant discourse when it comes to determining whether dependence on a prohibited substance (cannabis) constitutes a crime or an illness or whether it is more closely linked to the relationship between the individual, the substance and the social context. Whereas dependence on non-prohibited substances in Western cultures (alcohol, tobacco, prescription drugs) generally perceived as disease, dependence on substances that are foreign to Western cultures is more often associated with deviance and criminality ( Szasz, 1989).
Cannabis constitutes a striking example of these paradoxes insofar as current laws place consumers in a position of deviance and exclusion, even imprisonment. Apart from some cases of tolerance of consumption for health reasons, especially in the case of persons with AIDS, cancer and glaucoma, this is still the status quo in Canada, even though half of all citizens in Quebec, for example, are ready to decriminalize the consumption of cannabis for personal use (Nadeau and Nolin). According to recent figures from the Canadian Centre on Substance Abuse ( CCSA, 1998), half of the 63851 cannabis-related offences recorded in 1995 were cases of simple possession. While the Canadian authorities responsible for applying the law track down less than 1% of all cannabis consumers each year, over 2000 Canadians are imprisoned for cannabis possession, at a cost of $150 per day, and 92% of all persons found guilty of this offence continue to consume the substance during the following year. Also, a considerable number of these offenders are likely to have been jailed for defaulting on payment of a fine. This is an important issue as this type of offense often involves individuals from the lower socio-economic stratum. The last report of the National Council of Welfare (2000) untitled Justice and the Poor, demonstrates clearly that the criminal justice system is unjust as it discriminates more against the poor, the richer people and corporations can pay their fines while the poor are more oriented toward the prisons. From a Realpolitik point of view, this reality is generally combined with penal and social control measures applied more among lower socio-economic groups, these groups representing a certain potential for deviancy and social disorder. This penal approach results in the exclusion of thousands of people and their social networks. What are the foundations underpinning this type of social control? What are the social factors, which influence this kind of response to social problems related to dependency?
Faced with these profound questions, this paper attempts to highlight certain contradictions in the application of penal methods of social control as applied to cannabis. This is achieved through a critical analysis of the addiction phenomenon. To this end, we will first consider the historical and social context in which cannabis is consumed. We will then illustrate the founding principles of the penal perspective on social control, which contributes to the exclusion of consumers. As an alternative to the undesirable psychosocial effects associated with penal approaches, the case of coffee shops in the Netherlands will be considered to show how spaces where consumption is tolerated help to reduce exclusion and bring the strengths of social ties to bear on the implementation of Dutch drug policies. Finally, some practical benchmarks for support workers will be suggested in order to avoid obstacles that work against the empowerment and social management of persons popularly visued as deviant.
Cannabis: historical milestones in penal approaches to social exclusion
Over the last century, several international commissions have considered the use of drugs, and cannabis in particular, for non-medical purposes (Government; Government; Government; Government; Roques and Nolin). According to the United Nations World Drug Report (2000), it is estimated that some 180 million people worldwide––4.2% of people aged 15 years and above-were consuming drugs in the late 1990s; this figure includes 144 million consuming cannabis. Cannabis is the substance for which there are the most cases of incarceration in Canada and throughout the Western world ( Erickson; Bertrand; Beauchesne; Michka; Roques and United). In Canada, 70% of all of all drug offences that occurred in 1995 were offenses involving cannabis with a significant variation among regions, particularly with regard to urban and rural areas. As an illustration, the cannabis possession offence rate per 100000 for British Columbia is 246, compared with 92 for Ontario and 52 for Quebec ( CCSA, 1998). Offenses involving cannabis are the only category of drug offenses, which started to climb from 1991 on, and they are, therefore, responsible for the overall increase in drug offense numbers since 1991 in Canada. During the same year, 14% of the Canadian prison population was in jail for drug offenses
Scientific studies carried out both under government authority and independently have concluded that the moderate use of this substance has no injurious effects on health (United Nations World Drug Report, 2000). It is important to distinguish between moderate or recreational use from a pattern of abuse and misuse, cannabis abuse can, in fact, produce negative health consequences. According to the CCSA (1998), the most important of these are the following: respiratory damage, physical co-ordination impairment, problems during pregnancy and post-natal development, memory and cognition and finally some psychiatric conditions. But even as these studies recommend the decriminalization of cannabis when consumed moderately, there has been a complete failure to act on the part of the governments concerned, despite the very high rate of imprisonment. This situation is reflected in the criminalization of thousands of citizens, which belies the claim promoted in the media that these prohibitive laws target primarily criminal networks. The majority of people in prison are there for simple possession rather than trafficking.
The same logic applies in the United States, even with the highest rate of imprisonment in the world. According to Solliciteur and Service, the general admission rate is 129 per 100000 in Canada, while it is 645 per 100000 in the United States. Close to 1300000 people are being held in US prisons, one-third of them for drug-related offences ( Schlosser, 1994). Since 1980, this type of socio-penal control and the strengthening of the law related to cannabis have resulted in the arrest of over 4 million individuals, who were given sentences of varying severity. The difficult conditions affecting order and social control are reflected in a lack of space in prisons, forcing the American states to release a significant number of inmates. This paradox is even clearer when one considers the substantial increase in the number of Federal Narcotics Bureau agents, from 300 in 1967 to 3400 in 1991, and the fact that costs have reached $1.3 billion whereas the budget was only $88 million in 1967 ( Schlosser, 1994). Even though some American states (California, Colorado and Arizona) have opted to decriminalize cannabis for medical purposes, resistance to change is very strong, since these measures continue to be viewed as leading de facto to the general decriminalization of the consumption of psychoactive substances ( Beauchesne and Magner).
Yet, as early as 1979 Jessor (1979) psychosocial research on cannabis in the United States revealed that cannabis use was being described increasingly in terms of abuse and less and less in terms of simple use. This research also showed that use was primarily determined by the fact of having friends who were users or spending time in places where the substance was available, rather than individual psychopathology. In the same vein, a scientific review of the literature on the topic a few years later revealed that no psychopathological effects could be attributed to simple or moderate consumption of cannabis ( CCSA and Fehr).
On the other side of the Atlantic, in France, the latest report submitted to the Secretary of State for Health showed that, out of 70000 people questioned by the police and appearing before the courts, 80% were there for cannabis-related reasons (Roques, 1998). This report, which was issued by a scientific commission of 11 foreign consultants, highlighted a number of findings including, cannabis is practically harmless; the neurotoxicity is zero and the risks of physical and psychological dependency and the social dangers are low. In parallel to these recommendations, the commission emphasized that recourse to imprisonment is an aberration, since prison only aggravates the problem by separating thousands of individuals from the wider community and creating a more drastic break between incarcerated persons and their primary social networks including families, loved ones, friends and significant others.
In light of such evidence, one is entitled to wonder whether the war on drugs is not in fact a war on citizens. In his book La Guerre Chimérique, Côté (1994) examines these contradictions, and compares this struggle to the major ideological wars of history such as the Inquisition and the prohibition of alcohol. If the wisdom of a law is generally judged in practical terms––that is, the costs imposed on society versus the benefits it generates––the legislation governing cannabis raises fundamental questions concerning the extraordinary social and judicial costs in light of the still outstanding issues of criminalization and imprisonment for the medium and long term.
According to a number of researchers (Kaplan; Cormier; Rico; Erickson; Roques and Nolin), by attributing deviant social values to this substance and its use, we have a priori problematised our relationship with this substance by associating it with a negative lifestyle that must be controlled. By not distinguishing use from abuse/misuse, this political context of social control directly places consumers in a situation of deviance, by temporarily disrupting their lives, often exposing them to harsh conditions in prison, and alienating them from the rest of society. Moreover, over 30% of prisoners require treatment for substance use even inside prison, which raises the specter of a deterioration in living conditions rather than an improvement, especially considering the alarming public health problems related to the significant increase in cases of HIV infection and AIDS (Cohen and Institute).
This reality questions the legitimacy of the law, insofar as the only legitimate exercise of power by a civilized society against one of its members is to prevent harm to another (Teff, 1975). And it should be noted that this type of control is more likely to apply to the underprivileged in society, inasmuch as these groups are already the focus of other related control methods in the overall community ( Blum; Gusfield; Horwitz; Laberge and National). Understood in this way, the question of social ties and the exclusion of a large proportion of the population is contrar to issues related of penal control and the negotiation of a more inclusive social order.
The penal perspective on social control
When understood as one form of social control among many (Horwitz and Laberge), the penal perspective falls within an integrationist vision of social relationships considered as problems of deviance. In other words, recourse to penal measures is mainly centered on an attempt to mark what constitutes "citizens' distance and disengagement in their relations to the overall social space" ( Spierenburg, 1984). From this perspective, a drug addict who is socially distant will be more vulnerable to the penal response than one who is more integrated into society. This reality is well translated in courts where the judges asserts the capacity of readaptation to society through the level of support a social network can provide. In this logic, the question of strong social ties versus weaker ones constitute an important platform in regard to justice in general and to application of measures in particular. In an attempt to define what is a social tie, many authors underline the fact that a social tie cannot be defined through a unique level of socialization, it has to be studied at different levels without isolating it from the global society dynamics. From interpersonal, intimate and family relations to institutional and informal forms, social ties may be defined as the means, visible or not, that enable us to establish an equilibrium between the "I" our personal identity and the "We", with the larger social environment.
According to Rieder; Horwitz and Laberge, close social ties constitute not only the cornerstone of all social reaction but also a choice that should be favored in developing control policies and measures. According to these authors, the forms and styles of control vary depending on how the people in power conceive of deviance, the capacity of the social and familial environment to solve conflicts, and the intervention and disciplinary methods preferred in the social management of persons considered to be deviant. At the centre of these issues, various practices come into conflict and are developed in accordance with the specific circumstances at a given time and place ( Conrad, 1995). In short, we may say that recourse to penal control by those in power not only indicates the existence of inequalities in the social power structure, but also demonstrates a certain failure on the part of their attempts to maintain stable social regulation systems.
Even though many cases combine the penal and therapeutic responses simultaneously, it remains the case that social distance and social ties play a central role in the processing of the type of response. For example, one might think of populations considered to be too socially distant by the system in place (drug addicts, homeless people, prostitutes or delinquents), who are sometimes treated as criminals and other times as sick people, depending on the offence committed, the perpetrator's personality, and the presence or absence of social ties (Higgins and Laberge). Given this logic, we may deduce that the greater the social and relational distance, the more likely there is to be a process of labeling and punishment. As for social status, a therapeutic perspective appears to be more acceptable among privileged classes than among those underprivileged ( Goldberg and C). In the latter group, there is a tendency to define problems as resulting from illness or personality problems, whereas among the upper and the upper middle classes they are more likely to be seen as the result of emotional or interpersonal difficulties.
Other benchmarks in the control of social ties
All societies transmit social values and standards that they consider to be important in maintaining social order. These include respect for the law and the value of work as a tool for integration, competition and personal success. Since the cannabis consumer's behavior is related to the consumption of illegal substances, as soon as it becomes publicly known, it is generally categorized as deviant by the existing institutions and becomes subject to control methods. Two conditions are at the centre of this institutionalization of consumption as deviance. First, the behavior in question must be deemed undesirable. Secondly, it must be subject to social judgement labeled as delinquent or deviant. This triggers a chain of social reactions to the act of consumption that will primarily depend on the nature of the social ties maintained by the consumer. Is he or she a lonely or socially isolated person? Is he or she is she surrounded by family, friends and other people on whom he or she can count? Does his or she class occupy a social position with a privileged status in society? Is he or she a member of an organized group that has power in society? These questions are important because insofar as the consumer's social environment can be considered an active agent in the social readaptation process. The stronger social ties, the more likely it is that the response to that offence will be therapeutic; the weaker a person's social ties, the more likely it is that penal measures will be selected. It is undeniable that the consideration of social ties is a key factor, not only in the process of socialisation in general, but also in the choice of methods and the intervention likely to be favored.
With regard to the phenomenon of addictions, it should be specified that, setting aside the issue of whether cannabis creates dependence among consumers, each individual develops a dependence for specific, personal reasons (Suissa, 1998). This aspect is important, since the substance itself has little to do with the addiction process; rather, interpretation and personal experience will determine whether or not the cycle of dependence will be triggered ( Becker; Weil; Peele and Suissa). In other words, it is not the substance as such that will determine the cycle of addiction but the relationship that one establishes with it. From this perspective, it is not the act of consumption as such that determines the nature of the problem and its solution, but the penal or therapeutic social reactions to the act.
Dutch coffee shops: a space that contributes to counteract social exclusion
In the Netherlands, a coffee shop is an outlet where soft drugs are sold under certain conditions. Soft drugs are deemed to be products derived from cannabis/hemp, that is marijuana and hashish. Among the conditions imposed on the sale of these products by the Dutch government in its latest report (1995), we should note the prohibition on the sale of over five grams of cannabis, in order to combat sales destined for export; and the prohibitions on selling hard drugs, advertising drugs, creating disturbances in the vicinity, selling drugs to youths less than 18 years old, and opening a coffee shop near a school or hospital. The authorization of coffee shops as controlled retail outlets has several objectives.
1. It creates a separation between the markets for hard and soft drugs.
2. It prevents consumers of soft drugs from coming into contact with hard drugs.
3. It protects these consumers from the criminal world of drug traffickers.
4. It facilitates the arrest of "narco-tourists," such as foreigners who see coffee shops as supply centers.
In accordance with the recommendations of various international commissions of inquiry targeting the decriminalization of the personal consumption of cannabis, the main authorities in the Netherlands (courts, police, health ministry, municipalities) agree that the use of soft drugs does not create a significant risk for consumers' health. This reality should be emphasized because, even though some studies highlight the injurious effects of cannabis on health (Kalant et al., 1999), it is important to note that the use of any substance must be distinguished from its abuse/misuse. Not everyone misuses drugs; rather specific psychosocial conditions are required for a consumer to start misusing and enter the cycle of addiction ( Suissa, 1998).
According to Bieleman et al. (1995), there are 712 coffee shops located in 116 municipalities in the Netherlands. These establishments enable consumers of soft drugs to share a social space, up to a certain point, without being imprisoned or otherwise punished. This approach, therefore, prefers to focus on the creation of social spaces while forbidding the sale of drugs in the street or at people's homes. Nevertheless, in North America and many European countries, the dominant discourse continues to present illegal substances as one of the greatest dangers, whereas the damage caused by the duo of alcohol and tobacco far exceeds that resulting from all illegal drugs combined.
From a critical perspective of the Dutch policy regarding cannabis and coffee shops, a former prime minister of The Netherlands (Van Agt, 1999), pinpoint some developments considered more difficult. A very important one is the emergence of in-house production of cannabis (Nederweit) where the growth of home production is reaching 100 tons/year. A second one is that coffee shops have not been kept in check and the restrictions imposed on their operation have not been effectively enforced. Also, the strategy against the sale of hard drugs has not been sufficiently determined and consistent. Considering these facts, Van Agt underline the fact that there is no convincing evidence that countries like United States and France are markedly more successful in their endeavors to "clean" society of drugs.
Unlike a laissez-faire policy, the Dutch drug policy is based on pragmatism rather than utopian idealism. Instead of aiming at a utopian, drug-free society (prohibitionism), the Dutch policy favors the harm reduction approach, based on the importance of social ties in developing solutions other than incarceration. Furthermore, in the case of injection drug users (IDUs), 80% of Dutch users have social ties whereas in America the reverse situation obtains, with 80% of IDUs being excluded from social relationships (Marlatt, 1996). The context of illegality in which several thousand individuals find themselves actually contributes to the corrosion of their relationships with institutional and social values, and consequently produces unwanted effects and significant paradoxes, such as discrimination, ethical problems, high social and health care costs.
With regard to discrimination, according to Silvis et al. (1992), consumers are discriminated against insofar as the universal and human rights of persons incarcerated for consuming illegal substances are often neglected. In other words, discrimination leads to the suppression of rights, whereas rights represent exactly what consumers most need in order to gain respect and undertake the social reintegration process. From this point of view, the cannabis user is judged harshly by society, since the act of consumption is considered to be a personal choice and is associated with deviance, and even with individual pathology.
From the point of view of ethics, Roy (1997) sees this situation as a tragedy as it feeds the conflict of inequity between persons who are valued more as human beings and those who are vulnerable and marginalized. According to a harm reduction approach, drug addicts must be considered as fully-fledged citizens, who are indeed in trouble, but who need help rather than being labeled as criminals, as deviants and as sick. Unlike the zero tolerance and war on drugs model, this type of policy considers drug users as an integral part of the wider community who must consequently be protected within this community rather than isolated or excluded.
As for social and health care costs, when one considers the cost-benefit ratio that society must manage in connection with drugs, every dollar invested in treatment makes it possible to save almost four dollars in social costs (Single et al., 1997). In other words, the overall costs related to the structures of repression and criminalisation––incarceration, police, prisons, courts, probation and parole services, victims of crime, prevention, replacement of goods and property, injuries––far exceed the amounts invested in prevention and treatment ( Hankins, 1997).
From a social and historical perspective, it is clear that drugs are here to stay. The use of legal and illegal drugs has always existed and is inevitable in all human societies. The failure of current Canadian policies focusing on repression has shown us that drugs will not be eliminated from our society and that the effects of this repressive and moral approach are injurious to thousands of consumers, as well as their families and social networks. Even though the majority of consumers use drugs moderately and safely, intervention strategy continues to emphasize access to substances (supply and demand) and measures of repression and criminalisation. However, current drug policies can no longer be based on a utopian belief that drugs will eventually be suppressed; rather, they must also consider the perverse and harmful effects on consumers, their friends and families, and the community. Viewed from this angle, a harm reduction approach, which favors accepting the reality of drug use as just one potentially risky social behavior among many, constitutes an opportunity very valid option for strengthening social ties and supervising people who have dependence problems.
Labeling problems through deviance: some challenges for social practitioners
The relationship between any consumer and social practitioners is fundamentally centered on a dynamic of power in as much as the counselor generally has the power to define the situation and, up to a point, to manage the therapeutic process with the aid of an institutional mandate. Understood in this way, intervention is not a neutral process but part of a complex relationship in which many factors play a role. Although social intervention is often conceptualized as a helping relationship, reinforcing the image of two persons, the helper and the helpee, the fact remains that the therapeutic relationship also constitutes a meeting of two psychosocial systems. In other words, neither actor is an isolated individual, but rather each represents a set of specific social relationships and values. This reality may be reflected in a dialectic in the therapeutic process insofar as the counselor has the option of orienting the intervention towards the client's potential, support network and power, yet on the one hand, towards social control focused on individual's deficiencies.
It is important to emphasize that the perception social practitioners have of their clients and their social and family networks directly affects the actions they will take during the intervention process. In order to avoid such communication difficulties and to better assess the services needed, it is imperative that counselors free themselves of some personal and professional prejudices when they are exposed to lifestyles that differ from their own. Rondeau and Suissa, remind us that the perception we have of a group of people necessarily orients our definition of their needs and consequently determines the actual services provided. Furthermore, there will be an explicit or implicit attempt to isolate the problems experienced within the domain of psychopathology, concentrating on visible symptoms to the detriment of working on the structures that may have created the problems in question. For example, if we intervene with drug users who are on social assistance and we attribute any deficiencies or deviance to their status as welfare recipients, it will be difficult to create ties leading to cooperation and partnership, since we will to some extent have created a logic of intervention oriented towards the control of this deficiency or deviation, which must be reduced or eliminated.
It is this kind of slippage, which unfortunately is frequent in the process of intervention with individuals and families, that Ausloos (1995) attacked in his book La compétence des familles. Ausloos, a psychiatrist and systems specialist by training, proposes that social practitioners should accept a postulate of competence and deconstruct their own social labels, which generally identify behaviors in terms of difficulty, weakness, lack of skill, or even deviance. Considering this attitude to be a snare that obstructs the transfer of any kind of power to people in difficult situations, Ausloos proposes that one should instead emphasize people's competencies if one wants them to become empowered. In other words, the challenge of transferring power to people who are living through a crisis or in a vulnerable condition can only be possible if we really succeed in perceiving them as competent. Once these methods of empowerment are integrated into our field of vision, we will be able to reduce the social prejudices that are generally applied to people based on their status (drug addicts, single-parents, families, welfare recipients, immigrants, various minority groups, etc.). As the philosopher Robert Musil said, one may gain at the level of detail but one loses overall when one focuses primarily on weaknesses rather than the strengths that lead to empowerment (Musil, 1984).
Conclusion
We have noted that the social trend towards penal control of persons who consume cannabis is part of a general tendency towards increased incarceration, leading to the marginalization of more and more people. In parallel, we find that the efficacy of behavior change interventions among drug users is strongly linked to the existence and nature of a primary social network and social ties (Prochaska and Di Clemente, 1992). For example, a Gallup poll carried out in 1990 (also cited in Peele, 1991 revealed that problem-solving depends greatly on the support given by friends (14%), parents, children and siblings (21%), and husbands, wives or other loved ones (29%), and much less on the support provided by doctors, psychologists and psychiatrists (6%) for all professions together).
One of the main unwanted effects of exclusion based on the current legal situation is the elimination of all reference to psychosocial and cultural factors and the recognition that addiction is an impersonal and non-discriminatory reality. Faced with this pressure to criminalise behavior as a form of social control, social practitioners must acknowledge how this personal and institutional labeling undermines people's capacity to empower themselves through the creation of significant social ties. What happens to the challenge of social change in our society when intervention takes place within a continuum of social control? How long can social practitioners in the area of addictions remain in a psycho-relational instead of a psychosocial one when social? Can one intervene with dependent persons by promoting their empowerment and strengths rather than their weaknesses? In response to these questions, we have to acknowledge that working to strengthen social ties remains one of our best hopes for prevention and for the empowerment to people already labeled as "bad or as deviant". For instance, As an illustration, when working with families and communities, an empowerment perspective allows the practitioners to reduce, even eliminate, individual blame while intervening more with the familial and social structures. In addition, more people are involved in the therapeutic process who otherwise would not be included. If we succeed in helping families today, they will generally be more competent in the future. It is our view that the success rate in the helping process is intimately related to our capacity to create the strongest social ties possible in order to give people back some power over their lives.
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J. Suissa
Department of Social Work, Université of Quebec in Hull,
