Who Uses Drugs, And Why

MOST drug users live in the poor world, not the rich. Countries such as
China and Pakistan in the case of heroin, and Colombia (South America's
second most populous country) in the case of cocaine, have local traditions
of drug use and vast uprooted urban populations to provide expanding
markets. In future, growth will be concentrated in developing countries and
the former Soviet Union.

At present, the markets with the big money are in the rich world, where the
mark-ups between import and sales prices are highest. Here, not
surprisingly, most people buy the drugs that have the fewest side-effects
and are least likely to cause addiction. In that respect, drug users seem
to behave as rationally as other consumers.

Everywhere, the most widely used drug by far is cannabis. At some point or
another, about half the people under 40 in America have probably tried it.
In time, as many adults in the rich world may have sampled cannabis as have
tried alcohol. In many social groupings, especially in large cities, using
cannabis has already become more or less normal behaviour. "The last time
anyone offered it to me," recalls Paul Hayes, a senior British probation
officer who has just become head of a new drug-treatment agency, "was after
a primary school parent-teacher association disco, in the home of a Rotary
Club member, and the person was a detective-sergeant in the Metropolitan
Police. If that's not normalisation, I don't know what is." Prudently, Mr
Hayes refused.

Other drugs are becoming part of the normal weekly pattern of life in some
social circles. Amphetamines and cocaine, like cannabis, are mostly taken
sporadically, and are used far more heavily by the young than by the
middle-aged. Simon Jenkins, a former editor of the Times and member of an
inquiry into drugs and the law under Lady Runciman, argues that London's
vibrant clubbing scene is clear testament to the profusion of drugs
available there: how else would people have the energy to dance all night?

Most drug users, like those clubbers, are occasional dabblers. A 1997
survey of western German drug users sets the tone: just under 80% of
cannabis users take the drug no more than once a week, and almost half take
it fewer than ten times a year (see chart). With ecstasy and cocaine, users
indulge even less often.

With drugs, as with alcohol, a minority of users tends to account for the
bulk of consumption. In America, for instance, 22% of users account for 70%
of use. Heroin use is probably even more dominated by frequent or dependent
users. Most drug users, it seems, understand the risks they are taking, and
approach them rationally. Of Europe's adults, at most 3% are likely to have
tried cocaine; fewer than 1% have ever sampled heroin.

Most drugs do not appear to be physically addictive. Views on this may
eventually change: in laboratories all over the United States, unfortunate
rats are being put into drug-induced hazes as the National Institute on
Drug Abuse (NIDA ) spends its hefty budget on a mass of research on the
impact of drugs on the brain. Recent work on people who give up a heavy
marijuana habit seems to show that they suffer anxiety and loss of appetite.

However, for the moment, the evidence suggests that neither marijuana nor
amphetamines are physiologically addictive. Many people find it hard to
abandon crack cocaine once they have tried it a few times, but when they
do, they do not appear to become physically ill, as they would with
heroin--or indeed nicotine or caffeine. "Heroin is a true addiction, with a
recovery rate of 40-50%," explains Giel van Brussel, who has been head of
Amsterdam's addiction care department for many years. "With cocaine, the
recovery rate is around 90%, so we don't see it as such an enormous
problem." That is rare sanity from a policymaker, but then Dutch
policymakers are saner than most.

Even with the most addictive illegal drugs, only a minority of users seems
to get hooked. With heroin, according to figures from America's National
Household Survey on Drug Abuse, one user in three is dependent.
Alarming--but not compared with nicotine, which appears to be the most
addictive drug of all: one study quoted by America's Food and Drug
Administration found that 80% of cigarette smokers were addicted (see chart
2, previous page). David Lewis, professor of alcohol and addiction studies
at Brown University in Rhode Island, reckons that the relapse rates for
those who try to give up are higher than those for heroin or crack cocaine.
If the aim of drugs policy were to prevent harmful addiction, the main
target of drugs enforcement agents would clearly be tobacco smokers and
their dealers.

Studies of the routes by which people come to take up drugs have had a huge
impact on policy. Most influential has been the "gateway" theory,
suggesting that soft drugs lead on to hard drugs: if cannabis is the path
to crack cocaine, then clearly the sooner that path is blocked, the better.

Guesswork About Gateways

In fact, this turns out to be nonsense. Certainly, most people who take
"hard" drugs have usually first smoked marijuana. But, as Lady Runciman's
excellent report on the misuse of drugs in Britain argued last year, for
the "gateway" theory to be proved correct requires not just that cocaine
and heroin users are highly likely to have taken cannabis; it also requires
that cannabis users are highly likely to move on to cocaine or heroin. Yet
the vast majority of cannabis users do not graduate to these more dangerous

Moreover, there is no reliable evidence indicating that taking marijuana
pharmacologically disposes people to later use of heroin. But work at Johns
Hopkins University shows that children who drink and smoke in their early
teens are disproportionately likely to progress later to marijuana. And a
study in Britain found that the probability of 11-to-15-year-olds using an
illicit drug is strongly related to under-age smoking and drinking. Beer
and cigarettes seem to be gateways to marijuana, but marijuana does not
seem to be a gateway to other drugs.

Whether somebody becomes a heavy drug user seems to depend on other
factors. Heredity may play some part, and so may social conditions: recent
American research has found that drug use is 50% more common in households
that are welfare recipients than in those that are not. And family
circumstances may interact with personality. Mr Hayes, after a long career
in the London probation service, sees a typical user as "someone who is a
risk-taker--whose lifestyle involves bending rules." Part of the lure of
drug-taking seems to be the sense of danger. The question is how far people
should decide for themselves whether to take such risks, and how far the
government should make that decision for them.

Newshawk: Beth
Pubdate: Thu, 26 Jul 2001
Source: Economist, The (UK)
Copyright: 2001 The Economist Newspaper Limited
Contact: letters@economist.com
Website: http://www.economist.com/
Details: http://www.mapinc.org/media/132
Note: Part 6 of 12