Pharmacology is not Destiny: The Contingent Character of Cocaine Abuse and Addiction

Drug Use Control Perception and Strategies in General and Clinical Population in a Spanish City

Background: This article evaluates the perception of drug use control and strategies in Valencia City (Spain) in a general and clinical population, in two independent studies. Material and Methods: 1071 people participated. In Study 1 (n = 924) the entire sample came from the general population (GP), and in Study 2 (n = 147), 68 were drug users being treated in an Addictive Behavior Unit (ABU), and 79 people of the GP. The drug use control perception and strategies in both subgroups were compared. The participants filled in the Drug Use Strategies Scale and a Drug Use Survey. Results: A high level of perception of drug control in the GP was obtained (72.7% in Study 1 and 67.5% in Study 2), and 32.5% in the ABU subgroup. People in the GP and drug users in treatment differ in some control strategies. A predictive profile of the perception of control was obtained for Study 2. Conclusion: The high degree of perception of controlling drug use in the GP, and partially in drug users being treated, and the specific control strategies reported suggests that moderate use and drug control strategies are a great value alternative to bear in mind compared to abstinence.

Risk management strategies of synthetic cannabis users

Purpose

The purpose of this paper is to explore the various ways users of synthetic cannabinoids (SCs) managed the dangers associated with the consumption of this substance.

Design/methodology/approach

This paper is based on a parent study of the use and market of synthetic cathinones (also known as “bath salts”) in New York City, Houston, Galveston and New Orleans. Focus groups were conducted in all four cities with a total of 20 individuals who identified as users of SCs. Grounded theory was used to analyse focus group transcripts.

Findings

Participants were aware of drug-related risks and implemented strategies to reduce harm to health. Protective measures fell into two broad categories: marketing and consumption. They noted the instability of SC products and consumer manipulation through packaging. Harm reduction (HR) strategies included: carefully selecting SC sources; sticking to one brand; handling their own SC; managing amount of K2 consumed in one sitting; controlling the pace.

Originality/value

Given the small amount of data on user experience with SCs and its risk to health, it is important to learn from users themselves how they create methods to keep themselves safe. This is one of the first studies recording HR practices of SC users and can contribute to intervention programs and organisations serving substance users.

Evidence for controlled heroin use? Low levels of negative health and social outcomes among non-treatment heroin users in Glasgow (Scotland)

OBJECTIVES

This longitudinal study focused on 126 long-term heroin users who had never been in specialist treatment for use of any drug. The primary aim of the study was to assess whether this 'hidden' population resembled heroin users identified with drug treatment agencies, or alternatively, to test whether heroin could indeed be used in a controlled, non-intrusive fashion for an extended period of time.

DESIGN AND METHODS

Recruitment was achieved through chain-referred purposive sampling methods, and data were collected through two semi-structured interviews. 67% of participants were re-recruited for follow-up.

RESULTS

Participants had levels of occupational status and educational achievement comparable to that in the general UK population, and considerably higher than typically found in heroin research. At the conclusion of the study, six participants had entered treatment. While there was evidence of intensive risky patterns of drug use among the sample, there was equal evidence for planned, controlled patterns of use. Some drugrelated negative health and social outcomes had occurred on a lifetime basis, but ongoing problems were rare, and heroin was not a significant predictor in either context. In contrast to typical samples of heroin users, high levels of negative health and social outcomes did not appear to be inevitable within this sample. Frequency of heroin use was predicted by attributional items, indicating the importance of psychological factors in drug use and addiction.

CONCLUSIONS

Drug research should more fully incorporate previously hidden populations to more fully inform theory and practice. The pharmacological properties of specific substances should not be assumed to inevitably lead to addictive and destructive patterns of drug use.

Misadventures in the drug trade

Dan Waldorf was a research sociologist who worked in the field of drug use and abuse for 27 years. Most of that time was either in San Francisco or New York City. He wrote two books, three monographs, and 38 articles on the subject--with this being his final article. Fate intervened because this article is autobiographical. Dan's work and his life were intertwined in ways that provided unique insights into drugs and addict lifestyles. The focus of much of his work was "to attack and demolish myths about drug users and heroin addicts" (his words). Dan's legacy is broad ranging, including historical accounts of morphine users and the federal response to close down morphine clinics in the first quarter of this century; he made snowball sampling methods respectable; he saw rationality in the actions of heroin addicts and demonstrated this drug was not all-consuming; and he performed a similar service for cocaine. He struggled to maintain his career as a drug researcher, often without the support of federal monies. As recently as two years before his death, he traveled around the country to document the history of underground needle exchange programs that were developing--using his retirement savings. This article documents his many scientific contributions to our understanding of drug use in general, and the interface of drug use and crime in particular. Dan led a simple yet ever so rich life because he never shied away from telling the truth, and the wisdom of his vision helped so many others of us to see. That is his greatest legacy--and his gift.

The influence of alternative reinforcers on cocaine use and abuse: a brief review

This report reviews experimental studies conducted with nonhuman and human subjects demonstrating that: a) cocaine's abuse liability is, in part, a function of its positive reinforcing effects, b) cocaine use is operant behavior, c) the degree of behavioral control that cocaine exerts as a reinforcer is malleable and dependent on environmental context, and d) increasing the availability of alternative, nondrug reinforcers can significantly disrupt the acquisition and maintenance of cocaine use and abuse. Implications of these observations for effective prevention and treatment of cocaine abuse are discussed.