Session 14 - Drug
use: Regional Epidemiology [<
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c) Changes in drug use among Cardiff club
goers: The emergence of heroin use.
Carol Handy & Richard Pates
Inroads Drug Project, 43 Lower Cathedral
Road, Riverside, Cardiff, CF1 8LW, UK
Phone no: +44 (0)29 20 407 407 Fax
no: +44 (0)29 20 236 136
E-mail: inroads@net.ntl.com
Introduction
A survey about the
use of drugs in dance culture was undertaken over a 12 month period
between the years of 94/95, and was published in 1998.
500 people were interviewed
to identify what drugs they were using and 389 acknowledged they
were using ‘ecstasy’. Some 5 years later the development in different
drug use is being considered within this group.
Out of 500 people,
389 acknowledged ‘ecstasy’ use, mainly in a club or rave environment
although some used it in their own home. Amphetamine was used by
a great percentage and cocaine was mentioned, mainly cocaine powder
as opposed to ‘crack’ cocaine. The majority of respondents used
cannabis in a variety of settings and LSD was also mentioned. Other
drugs were used in small numbers: 5% used Ketamine, GHB and ‘magic
mushrooms’.
The study did not look
at heroin use because it was not a concern at that time. The
clubbers were strongly anti-heroin and would not in any way associate
themselves with the use of opiates.
In the early days The
Cardiff Community Drug Team produced matches which advertised needle
needle exchange schemes. Distribution of materials advertising NES
was frowned upon by both clubgoers and managers and as such was
not considered appropriate for the club scene. This was quite reflective
of the views of the group at that time.
Stimulant use in South
Wales has always been high, although cocaine use has been less common.
Previous findings identified that cannabis was used in the home
after attending dance events and consuming stimulant drugs. One
may consider the use of Cannabis at this time, as a panacea to reduce
the ‘come down’ from using Ecstasy or Amphetamines.
Other surveys
In 1992 Gilman discussed
the typology of drug users in Britain and suggested that there were
at least two distinctive groups. Group A consisted of dependants
who were mostly in clinical services. Group B are recreational users
for whom drugs were an adjunct to their night life. Group B drug
users at that time did not inject and were not dependent on their
drugs of choice. Gilman concluded that the most pressing task was
to keep the groups as far apart as possible.
However, in 1998 Parker
et al reported a concern about the increase of heroin use in Britain.
He reported that it was supply lead, with major importation of heroin
from Southwest Asia. There was a fall in price, good availability
and high purity. It was available in £5 and £10 deals and it was
actively marketed and smoke-able. In South Wales the drug treatment
agencies had become aware of the increased use of heroin, especially
‘brown’ heroin, with the cheaper street prices and the possibility
that some users did not know that brown was in fact heroin. Many
users were smoking it and this carried with it the perception that
smoking heroin is not addictive and therefore is not a risky activity.
Shewan et al conducted
a survey in Scotland in 1998 into a group of heroin users who are
not in treatment. This sample group of 74 had never been in touch
with services, had never served a custodial sentence and had started
their heroin use at a relatively late age, which was around 22.
A proportion of the sample were reportedly heavy users with high
levels of dependence but there was also a significant minority of
the sample being relatively new users of opiates. It was also suggested
that opiate use may be increasing among users of dance drugs.
In a multi-centred
European study in 1998, Calafat et al. looked at nightlife and recreational
drug use in nine European cities. There are reported increases in
heroin and ‘crack’ cocaine use, but only largely unsubstantiated
anecdotal reports of this use within the dance scene. He also found
reluctance to admit to opiate use amongst peer groups within the
dance scene. In this study 92% of people had never used heroin or
opiates, whereas 7% had tried it but the majority claimed sporadic
use, and only 1.2% of the group took it daily. However, there are
reports from one of the reporting centres in this observatory of
an increase in its use in European countries, and that most synthetic
drug users and other youth populations up until now have not had
any contact with the substance.
The Cardiff Heroin
Survey
It was rumoured locally
in Cardiff that clubbers were using ecstasy and then ‘brown’ to
help with their come down. In his report Parker et al found some
evidence that heroin was being used as a ‘chill out’ drug by young
clubbers, that is used after clubbing, not in the club. It was considered
as occasional heroin use, also identified by Powell (1973) and Zinberg
(1984). Many heroin users do not become dependent, nor do they commit
crime to feed a habit. Therefore they do not come to the notice
of treatment or law enforcement agencies. They remain a hidden population.
Due to these factors they are also difficult to study and to engage
in research.
The question of whether
this phenomenon is happening in South Wales seemed important to
ask. The pilot study was carried out to try to answer this, and
also whether the users of ‘brown’ were becoming dependent. The knowledge
and experience of conducting previous research within this scene
did not initially consider the personal reluctance from respondents
to engage in research regarding the use of heroin. The situation
arose when the research was conducted with those known to
be using heroin. Therefore other methods had to be used.
It was found that it
would not be possible to do a prevalence study, given the limited
resources and the difficulties of contacting what was essentially
a hidden population.
It was decided that
a snow-balling technique would be employed. Contacts made over a
considerable period of time, within the Cardiff club scene were
approached to make further contacts within this hidden group of
heroin users. The respondents were asked to complete a very short
questionaire which required little personal information and therefore
helped to protect their anonymity, which was a major concern for
those involved
The aims of the survey
were threefold:
- To ascertain whether the people
known as clubbers were using heroin;
- Whether they knew that ‘brown’ was
heroin;
- Whether they were expecting problems
of addiction.
The interviewees were
contacted either by the Safer Dancing Service or by posters in a
non-statutory drop-in drugs agency in Cardiff. It was explained
that to take part in the survey, participants needed to have been
part of the club scene or the free party scene and to have used
heroin. All respondents were guaranteed anonymity and no names were
used in the questionnaire. Knowledge and use of ‘brown’ was asked
about separately and before asking about other drugs, including
heroin. The respondents were not paid for their time.
In total 17 males and
11 females were interviewed. The males’ ages ranged from 17–34,
with the mean age of 25.5 years. The females’ range in age was from
19-36, with a mean age of 27 years. Of the males 11 were employed
and 6 were unemployed. Of the females 5 were employed, 1 was in
the sex industry, 4 were unemployed, 1 did voluntary work and 2
did not respond to this question.
All of the respondents
admitted using ‘brown’ and were aware that brown was also heroin.
The entire male sample
admitted using heroin, cocaine, ecstasy, amphetamine, valium and
cannabis, and 16 had used methadone, ‘crack’, cocaine and LSD; 15
had used ‘poppers’; 13 had used di-hydracodeine; and 12 had used
Ketamine. Self-reported dependency in the male group identified
dependency in the following numbers and range of drugs: 9 said that
they had been dependent on heroin; 3 on cannabis; 3 on cocaine;
2 on ‘crack’ or amphetamine; and 1 on methadone, valium and ecstasy.
The entire female sample
used heroin and cannabis, whilst 10 had used cocaine, amphetamines,
valium, ‘poppers’ (amyl nitrate), LSD; 9 had used ecstasy, ‘crack’
or di-hydracodeine; 8 had used methadone and 6 had used ketamine.
Self-reported dependency was noted in 9 out of 11 females with the
following drugs stated: 9 stated dependency on heroin; 4 on cannabis
or amphetamine; 3 on valium; 2 on di-hydracodeine ‘crack’ and cocaine;
and one on methadone.
4 possible reasons
for use could be given and some responded in more than one category:
8 males and 8 females said they "wanted to try it"; 1
male and 4 females said "it was suggested by another person";
6 males and 4 females said "it helps with the come down from
‘ecstasy’"; and 5 males and 1 female said they did it for "other
reasons".
One ‘other reason’
was stated: 1 male reported use after a break up with his girlfriend,
and 4 said "they saw their mates doing it and they wanted to
try it" (contrary to research findings which highlighted the
necessity to reinforce the personal choice element). Of the female
respondents, 1 stated that she had used heroin to deal with the
bereavement of her dog. She had, however, been using heroin previous
to the death of her pet.
Other reasons were
also given:
"My friends
were starting to smoke ‘smack’ so I gave it a try and I found that
I really liked it";
"I started
to use it more and more until I became dependent";
"I saw other
friends doing it and it looked good";
"All my mates
were doing it and I wanted to try it";
"I first went
to heroin because friends around me were using it";
"Not all of
my friends were using it and some were even against it and it was
my decision to try it after partying and clubbing on 15 Es";
"I used to
get a bit down on Sunday after I had been out clubbing on the weekends
so me and a few of my mates clubbed together and bought half a gram.
We went around to one of my mate’s flats and we all had a go of
smoking it out of foil. It made me vomit the first time but it made
me feel really chilled. I would not inject it though and I would
not do it through the week but it is okay just doing a bit".
Conclusions
There is evidence to
suggest that certain clubbers are using heroin as a ‘comedown’ drug.
This group of people are not a random group of clubbers, and it
is not suggested that their drug use is typical of those on the
club scene. However, the group that was previously researched were
noticeably not heroin users and, as Gilman pointed out in 1992,
the two groups of drug users were separate. Clubbers were recreational
users who did not use opiates. It may be that this is now changing
and with the wider use and availability of heroin the two groups
may at some point cross over.
It was clear that all
those questioned knew that the ‘brown’ they were taking was heroin,
and that they were taking it in the knowledge of what it was and
the reputation that it had. This group were poly-drug users, who
were into a wide variety of drugs, especially stimulants. 16 out
of the 28 were employed and may have had more disposable income.
The older age range may also reflect on the club scene and the fact
that the women were older may reflect that they started their clubbing
later. It is not really any specific group on the club scene.
Many of these people
are not in contact with statutory services in the city, which could
be because they feel they do not have a problem; they are scared
for their jobs. There is also a sense of shame from some of them
because of previously held negative opinions of heroin, and in Cardiff
this is probably the predominant group of youngsters currently on
the club scene.
This was a pilot study,
which tried to look at a situation that remains hidden and is very
difficult to access. The results of the study cannot be generalised
in terms of making claims for a problem with heroin. However, the
fact that among this group 28 people were interviewed in only two
months, suggests that it is worth doing further research with a
larger group of people, and asking them more detailed questions.
There were no questions about intravenous use and no reliable ways
of estimating respondents’ own perceptions, which were self-reported.
This is a group of
people, however, who are using a wide range of drugs, some of which
have been avoided in the past because of the stigmatisation around
the use of opiates and possibly the unavailability within those
groups. It may be that these are a group of people who previously
avoided accessing traditional drug services and consider this a
necessary gesture to maintaining anonymity.
We may also be seeing
a greater spread of opiate drugs into a scene that traditionally
was mainly involved in recreational use of stimulants. In view of
these findings it is important that services do not discriminate
against these users. Services may regard these findings in the provision
of appropriate, accurate and effective information to minimise the
potential for harm. Few of the respondents involved in the research
perceived themselves as being in need of traditional service provision.
However, future developments should regard club based services as
appropriate and necessary avenues for disseminating information
on potentially dependency-forming drugs. This will enable those
involved in this culture to feel secure in accessing appropriate
interventions to meet their needs.
References
1. Handy C, Pates R, Barrowcliffe A
(1998) Drug use in South Wales, Who uses Ecstasy Anyway? Journal
of Substance Misuse, vol 3 no2, pp. 82-88
2. Gilman M (1992) No more junkie heroes.
Druglink, May/June pp.18
3. Parker H, Bury C,
Eggerton R (1998) New heroin outbreaks amongst young people in England
and Wales, Crime Detection and Prevention Series, Paper 92, Home
Office, London.
4. Shewan D, Dalgarno P, Marshall A,
Lowe E, Campbell M, Nicholson S, Reith G, McLafferty V, Thompson
K (1998) Patterns of heroin use among a non treatment sample in
Glasgow (Scotland) Addiction Research 6 (3) pp.215-34.
5. Calafat A, Bohrn K, Monserrat J,
Kokkevi A, Maalste N, Mendes F, Palmer A, Sherlock K, Simon J, Stocco
P, Tossman P, van de Wijngaart G, Zavatti P (1998) Nightlife in
Europe and Recreative Drug Use, Sonar 98, IREFREA & the European
Commission, Palma de Mallorca.
6. Powell DH, (1973) A pilot study
of occasional heroin users, Archives of General Psychiatry, 28,
586-594.
7. Zinberg N, (1984) Drug set &
setting the basis for controlled intoxicant use, Yale University
press, New Haven, Con.
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