Wales on Drugs II: Who takes drugs and why?

(Title Image: fantazia.co.uk)


Who takes drugs?

The 2013 Crime Survey for EnglandandWales outlines data regarding personal and household characteristics in relation to substance misuse (spreadsheet Tables D1 & D2).Demographics

  • 8.2% of 16-59 year olds say they’ve taken an illegal drug in the year 2012-13 (2.7million people).
  • In addition, 16.3% of 16-24 year olds say they’ve taken illegal drugs, compared to 6.2% of 25-59 year olds.
  • Men (11%) are more than twice as likely to take illegal drugs than women (5.4%).
  • Drug use is highest amongst mixed-race people (16.9%), and lowest amongst Asians (3.8%) and Chinese ethnicities (3.3%). White ethnicities (8.9%) have higher drug use rates than non-whites (5.7%).
  • Wales (7.8%) had lower levels of drug use than England (8.2%), with London (9.9%) and NW England (9.1%) having the highest rates. 7.8% of those aged 16-59 in Wales (total 1.74million) works out as approximately 135,700 people based on the 2011 census.

Socio-economic factors
Drug use is:
  • highest amongst the unemployed (14.7%), full-time students (13.7%) and long-term sick (12%). Employed people (7.5%) are significantly more likely to take drugs than the retired (1.4%) and homemakers (3.6%).
  • highest amongst those with at least A-Levels or an apprenticeship (10%), but there’s no major difference between those with or without qualifications.
  • highest in households with incomes under £10,000 per year (11.9%), but there’s no big difference in higher income brackets, with spikes amongst households earning £20-30,000 per year (8.1%) and £40-50,000 per year (7.4%).
  • significantly higher amongst the “urban prosperous” (13%) and “hard pressed” (9.4%) ACORN groups (details here pdf). It’s lowest amongst “comfortably off” (6.7%) and “wealthy achievers” (6.3%).
  • higher in the top 20 most deprived areas (9.4%), compared to the 60% middle areas (8.2%) and 20% least deprived areas (6.9%).

Lifestyle factors
  • Visiting nightclubs regularly correlated with higher illegal drug use, with 29.3% of people visiting for 4 or more nights a week taking drugs, compared to 6.1% for those who don’t go to nightclubs.There’s a similar trend for pub visits too.
  • Drug use is highest in cities (13.3%), constrained areas (10.6%) and multicultural areas (10.6%). It’s significantly lower in prosperous suburbs (5.4%).
  • You’re significantly more likely to use drugs if you live in a flat (13.8%) or terraced house (9.2%) than if you lived in a detached home (5.7%).
  • Private renters are the most likely to use drugs (12.8%); compared to social renters (9.8%) and homeowners (5.7%).
  • Households with children (6.9% single parents, 5.7% couples) are significantly less likely to use drugs than adults without children (9.8%).

Some stereotypes associated with drug use are true – nightclubs, urban areas (especially big cities with lots of flats), the young, students, predominantly men.
In terms of socio-economic background, drug use is perhaps more spread out that people might like to think. It’s not something exclusive to deprived areas, even if it’s more likely to happen there and the deprived are more likely to see drug use turn into a drug problem.
It certainly spikes amongst the deprived, and dips amongst the comfortable and secure. Amongst those in the middle though – including students, young professionals and those who prefer city living in general – drug use appears to be broadly similar to deprived areas.
Although drug use may well be linked to deprivation and economic inactivity, it also seems to be linked to growing up, socialising and youth in general.

This hints that drug use doesn’t decline until people have found a level of personal or financial security – whether that’s a steady stress-free job, children/family, home ownership, nice house in a nice suburb etc.

Many high-earners with a good education don’t have any of that either. There are no barriers to drug use based on income or professional background.

In fact, there’s a huge problem with substance abuse amongst professionals and higher socio-economic groups – and it’s an open secret.

Prof. David Nutt controversially suggested in 2013 that the 2008 financial crisis may have been contributed to by excessive cocaine use by bankers – cocaine’s effects include arrogance, excessive self-belief and overconfidence. Meanwhile, amongst those professions with the highest risk of developing a drug addiction or alcoholism are….doctors!

Putting legal drugs like alcohol, tobacco and caffeine aside, if you did a drug swab test at the National Assembly or Westminster I’m willing to bet it would be as bad as a nightclub toilet – AMs and their staff having either taken illegal substances or coming into contact with them. Time to cause heart palpitations and cold sweats in Cardiff Bay.

They have, and I know they have.

No, nothing like that. I’m not breaking news of a scandal – sorry to disappoint you all. But drug swabs have been taken at the Assembly causing red faces all round.

The thought of William Graham or Edwina Hart hitting a bong or rolling a fat blunt in order to enjoy an evening with Electric Wizard gives me a warm glow.

Unfortunately, the positive test doesn’t mean they’re space cadets….though it might explain a few things. It just underlines how sophisticated monitoring tests have become, and how ubiquitous illegal drugs are in Wales – even if you don’t come into direct contact with them.

With a better picture of who takes drugs, it’s worth looking into the reasons why people take them.

To have fun

It goes without saying, doesn’t it?

People enjoy what drugs – even legal ones like alcohol and nicotine – do to them. They can get a neatly packaged and readily accessible way to produce the sorts of intense physiological response they would usually have to get through physical experience – whether that’s sex, intense exercise or a feeling of achievement.

So it perhaps boils down to that great human failing – laziness. People don’t want to work hard to earn the “natural” brain rewards, or take time to chill out, so take the short cut. It could also be about attempting to de-stress as a result of personal or professional problems – hence the problem amongst doctors and groups like the unemployed.

Drugs are often relatively cheap. Druglink research from 2012 (pdf) suggests a quarter ounce of average strength herbal cannabis was worth £37 – enough for around 10 joints (~£3.70 per joint, competitive with alcohol). Heroin was priced at just £11 per bag, while ecstasy was £6.30 a pill – if you want to stay up all night I’m sure that sounds like a bargain.

Drugs also act as a “social lubricant”, reducing social anxieties and making people more sociable than they otherwise would be.Research published via the Royal College of Psychiatrists suggests that amongst substance abusers, phobias were present in 22% of men and 45% of women, and anxiety disorders amongst 10% of men and 22% of women. There were similar figures for alcoholism.

Inspiration & Creativity (….and to cheat)

People don’t like to think of drugs this way, but it’s arguably true.

Some of the psychological side-effects of drugs can be intense. They might make you see the world differently and provide a Newtonian-style “apple dropping on your head” moment, but all inside the mind. It’s what research has described as a “creative chaos” where something new is created from a “heightened sensitivity to stimuli” (here).

The list of great works of poetry, literature, visual art and music that have been (or believed to have been) created under the influence of drugs is practically endless, and perhaps in modern times stemming from the 1960s, popularised by the likes of The Beatles.

Black Sabbath used to have cocaine delivered in washing up powder boxes by private jet. If there were no amphetamines, there would’ve been no Motörhead and no thrash metal. That’s notwithstanding what bands in the late 80s/early 90s got up to.

It’s reached a point where I’d be more surprised if artists and musicians (in certain genres) don’t take drugs. You pretty much have to be on drugs to listen to dubstep, while the more cultured among us listen to genres that don’t require drugs, like doom metal and grindcore, eh wot.

It’s not confined to the arts either. Carl Sagan – one of the greatest scientific minds of the 20th century – was a habitual cannabis user. Francis Crick, who co-discovered DNA, used LSD – as did Apple’s co-founder Steve Jobs and Microsoft’s Bill Gates. Thomas Edison and Sigmund Freud both took cocaine. And that’s before mentioning politicians.

However, none of that means drugs “inspired” them.

There are more nefarious uses of prescription and illegal drugs – in particular cheating in sport (doping). It’s worth a closer look in itself another time. Although it’s a lot harder to get away with now with testing methods improved, it still happens.

I mentioned anabolic steroids in Part I, but other widely-known performance enhancing drugs include erythropoietin (EPO) which increases the number of red blood cells, obviously improving endurance and athletic performance as a result.

It’s very hard to detect, and it’s believed some sport clubs use blood transfusions to dope athletes. There was major scandal in Spain involving blood transfusions, and doping is endemic in cycling. It’s not without its risks either as EPO – often used “legitimately” as a cancer treatment – has been linked to an increased risk of strokes and heart attacks.

Obviously, this has its toll. If the list of works inspired by drug use is endless, so are the number of artists and sports stars left with permanent damage or as corpses as a result. The most recent high-profile example being Philip Seymour Hoffman.

All this could, however, be a delusion. Take a look at this example of drawing under the influence of LSD. You can argue that it becomes more abstract as the LSD kicked it, but the better picture was the first one. All of that is subjective though and depends on personal taste.

People might think they’re “more creative” as a result of taking drugs – it’s hard to tell if that’s true or not; it’s subjective. What they might actually be doing is a form of self-medication for underlying problems they’re unwilling to address….

Self-medication

There’s a solid link between drug use and self-medication for depression and other mental health disorders, with research (here, here, here) suggesting that early intervention in mental health or the education system might prevent substance use becoming substance dependence.

It’s also perhaps why some prescription medicines are as dangerous – in terms of addiction – as “street drugs”. People who “self-medicate” – that is, treat their own illnesses without consulting a medical professional – are at a higher-risk of drug abuse, with a particular prevalence amongst those with social anxiety disorders, as mentioned earlier.

It goes without saying too that those with serious long-term illnesses might consider taking illegal drugs as a form of pain relief they can’t get from prescription drugs. This might explain the relatively high numbers of people in the statistics with a long-term illness.

For example, cannabis can be used to treat spasms, chronic pain like rheumatoid arthritis, multiple sclerosis and glaucoma (because it reduces eye pressure). However, as it isn’t an “official medicine”, it’s very hard to do pharmacological or epidemiological research on restricted drugs, so it’s unclear what – if any – risks outweigh the benefits.

So in some cases substance abuse is a symptom of, or prolongs, an underlying physical or mental illness – but isn’t the trigger of the illness itself.

Boredom

Drugs can distort perceptions of time, providing an escape for those who don’t have much to do, with Colombia University research from 2003 citing boredom as a key trigger for drug use amongst teenagers. As highlighted further up, drug use is higher amongst the unemployed and long-term sick – who have often long days of nothing ahead of them.

It’s perhaps an even more pronounced problem amongst the homeless, for example, who don’t have access to most forms of entertainment and pretty much have nothing to do but try and survive. I’m sure if you’re living on the streets, a day can feel like a week.

Home Office research from 2003 (pdf) showed 95% of the young homeless interviewed has used drugs, and 23% of them had overdosed. A fifth reported some sort of long-term health effect as a result of substance abuse, while half of offences the young homeless said they committed were related to drugs.

Peer pressure, experimentation and rebellion

Again, this goes without saying, and probably accounts for some of the drug use amongst the young and students. Young people will be naturally inclined to experiment in order to find their place in the world and flesh out their personalities, and that extends to risk-taking behaviour. Research from the Journal of Genetic Psychology (here) suggests aggression and defiance early in childhood is a precursor to drug use.

Participating in something deemed illicit could well be considered exciting, or be considered an act of defiance in the face of authority. There’s conflicting evidence regarding the impact of peer pressure – friends or choice of friends influencing behaviour – which could either be overestimated (here , here and here) or make drug use more likely (here).

The truth is, we probably don’t know, as there’s also evidence that young people might overestimate drug use amongst peers (here) and think it’s more common and acceptable as a result.

In relation to drugs, there’s a danger that natural risk-taking behaviour and rebellion which leads to experimenting with drugs could cause significant physical harm. That’s true if those using them don’t fully understand the risks involved, or don’t fully know what they’re taking. That’s where schemes like WEDINOS come in.

They’re addicted (Part IV)

I’ve covered the statistics for drug treatment referrals in Wales in a little detail in Part I, and I’ll return in more detail in Part IV.

It’s a fact that people can easily become addicted to drugs, of any kind and of any strength.

Persistent use will result in changes to neurotransmitter production or suppression, meaning a person becomes tolerant to unnaturally-high or unnaturally-low levels. When levels reach their “natural” state, this results in physical and psychological symptoms – known as withdrawal. This is common to all drugs – even the likes of caffeine.

The person will then seek out their drug of choice, taking bigger and bigger doses, and in case of some drugs – like heroin – putting themselves at risk of overdosing, developing long-term physical health problems and even premature death.

Different drugs have different potentials for addiction. LSD and ecstasy are less addictive than alcohol, while heroin and nicotine are towards the top of the scale (Part V).

One common concern about drug use is that users of “softer drugs”, like cannabis, might seek out a “harder drug” like cocaine or heroinas they become tolerant to cannabis’s effect – going down the road to drug addiction.

At the moment, the concept of a “gateway drug” is a fuzzy hypothesis, and research has suggested (pdf) there could be multiple explanations for moving from soft to hard drugs. That might include the fact both drugs are sold at the same place on an illicit market, peers might use harder drugs and introduce users of softer drugs to them, or using drugs as an adolescent has a heightened “gateway effect” compared to a fully-grown adult.

Other research (here) suggests regular use of “softer” drugs like cannabis really is “associated with an increased risk of using other illicit drugs” – though this risk declined with age, and it’s unclear if cannabis itself was the cause.

In fact, alcohol might be the major “gateway drug” – not cannabis.

Drug addiction is not only dependent on the addictive potential of the drug itself, but there’s research (here and here) that suggests a genetic basis for addictive behaviour. That doesn’t just cover drugs (legal or illegal), but compulsive gambling, the underlying causes of eating disorders, pornography, tanning, …..you name it, someone’s probably addicted to it.

I’d argue, for example, that Football Manager is crack with spreadsheets.

Part III looks at what drugs people use, and the make up of the “drugs market” – including how it’s supplied both globally and locally.