Risk and Substance Use

Framing Dangerous People and Dangerous Places

Susanne MacGregor, Betsy Thom

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781351033480
• Edition: 1
• Topic: Social Sciences
• Subtopic: Global Development Studies
• Index: Social Sciences

This interdisciplinary collection examines the role that alcohol, tobacco and other drugs have played in framing certain groups and spaces as 'dangerous' and in influencing the nature of formal responses to the perceived threat.

Taking a historical and cross-national perspective, it explores how such groups and spaces are defined and bounded as well as the processes by which they come to be seen as 'risky'. It discusses how issues of perceived danger highlight questions of control and the management of behaviours, people and environments, and it pays attention to the way in which sanctions and regulations have been implemented in a variety of often inconsistent ways that frequently impact differently on different sections of the population.

Bringing together a range of case studies drawn from different countries and across different periods of time, the chapters collected here illustrate issues of marginalisation, stigmatisation, human rights and social expectations. It is of interest to a diverse audience of historians, philosophers, human geographers, anthropologists, sociologists and criminologists interested in substance use and misuse, deviance, risk and power among other topics.

1 Introduction

Risk and substance use

Betsy Thom and Susanne MacGregor

The aim of this collection of essays is to cast light on controversial issues by comparing across substances and across time, countries and cultures.

The book is concerned with the role of substance use (alcohol, illicit drugs and tobacco) as a key element in the framing of groups and spaces as ‘dangerous’, influencing the nature of responses to perceived threats. Case studies, drawn from different, mainly high-income countries, illustrate the processes through which a group or space is identified, defined and framed and the impact of such framing on informal responses as well as legal and regulatory responses, policies and practice. We consider framing processes against the wider context of economic, political, cultural and social environments and discuss how these processes change over time.

The chapters illustrate how, in the contemporary period, developments in social research methods, especially the rise of epidemiology, and their accompanying measurement techniques, by operationalising the concept of risk, have facilitated identification and characterisation of dangerous classes and dangerous spaces and have influenced policy and practice responses. They examine the roles of the media, advocacy and research, which have all played a part in building perceptions of dangerousness and risk regarding specific population groups and spaces. At the same time, there is resistance to, and avoidance of, negative stereotyping among affected social groups: several chapters look at how individuals and groups have developed alternative frames of understanding, devised strategies to deflect attention from their behaviours and create ‘safe’ spaces in which to live their lives as they choose. Issues of marginalisation, stigmatisation, human rights and social expectations are discussed and illustrated in the chapters.

Each chapter is based on theoretical perspectives and methodological approaches appropriate to the topic and the research data presented in the argument. However, ‘framing’ provides the main theoretical approach adopted throughout the book, and the concepts of ‘frame’, ‘framing’, ‘risk’ and ‘danger’ underpin each chapter. There is a vast literature around each of these concepts and, in the following sections, we can only touch on some of the main perspectives, arguments and critiques as they relate to the chapters in this book.

What do we mean by ‘frame’ and ‘framing’?

To frame is to select some aspects of perceived reality and make them more salient in such a way as to promote a particular problem definition, causal interpretation, moral evaluation and/or treatment recommendation for the item described (Entman, 1993).

It is important to distinguish between ‘frame’ – a static state of knowing and understanding – and ‘framing’ – a process whereby a particular way of knowing or understanding comes to emerge, develop, fade away or re-emerge in an altered way of knowing.

Rein and Schön (1991) describe frames as providing guideposts for knowing, analysing, persuading and acting and for making sense of an amorphous, ill-defined, problematic situation. Frames are a central part of culture: they represent the ‘taken-for-granted’ and the beliefs and assumptions that guide everyday behaviour; they help us to define problems, diagnose causes, make moral judgements and suggest remedies. Frames are often – but not always – shared within a social group or culture: they can be widespread within a society or culture and can persist over long periods of time; and they serve to draw boundaries around the acceptable and the unacceptable, the included and the excluded. De Kock (Chapter 7), for instance, notes how the creation of ethnic boundaries can induce processes of ‘othering’ that frame seemingly static characteristics of populations as ‘risk factors’, with moralising consequences. This impacts on service providers, services and health systems and members of the same ethnic community, thereby influencing problem use, access to services and quality of care among (potential) clients.

Individuals may be framed in more than one way and the groups of interest in this book frequently suffer from intersecting negative labels. As Stengel describes (Chapter 6), Roma women, labelled as ‘junkie Gypsy prostitutes’, were seen as a triple threat to mainstream Hungarian social and moral values. Sanders, Antin and Hunt (Chapter 11) draw attention to the role of tobacco de-normalisation in creating a stigmatising smoker frame: ‘The smoking body has come to be viewed, treated, and governed as a dangerous body, marked as a bearer of death and disease, of health risks, and of poor health’. In the case of lesbian, gay, bisexual, transgender and queer (LGBTQ) people, this negative smoker frame intersects with and compounds other stigmatising frames applied to those groups. Nicholls and Berridge (Chapter 2) discuss how race, space and class coalesced in anti-immigrant legislation in the UK in the early twentieth century.

While negative frames are more often attached to poor, immigrant or otherwise marginalised people and the spaces they inhabit, Hallam (Chapter 4) provides an example of negative framing applied to upper-class women in the interwar years in London; drug use and ‘deviant’ sexuality drew police surveillance and framed the women as a ‘dangerous class’, sometimes associated with ‘the oriental’ and the promiscuous mixing of races.

Once a characterisation of an issue, value, place or group of people is accepted, the frame can become institutionalised (Björnehed and Erikson, 2018); that is, it undergoes a process over time – often including a struggle between different frames of understanding and different groups of stakeholders – that results in a particular frame gaining influence and regulative function. We see this happening currently in the institutionalisation of the ‘precautionary principle’ as the dominant frame concerning alcohol consumption in pregnancy (Thom, Herring and Milne, Chapter 5).

Frames can gain or lose influence depending on their degree and level of institutionalisation. Medical cannabis, for instance, may be undergoing a frame shift as perceptions and regulatory systems change from seeing cannabis use, even for medical purposes, as illegal and harmful to accepting that its prescribed use for certain conditions may be beneficial (EMCDDA, 2018).

Any field of activity can have more than one frame (alternative frames) and some frames may be competing or in open conflict. For example, frames depicting alcohol consumption derived from the alcohol industry may be at odds with frames derived from public health advocates. People who smoke may frame their activity as coping with adverse circumstances or as an enjoyable (legal) way to relax, whereas those who object to smoking may see the behaviour as unhealthy and harmful to others. For many years, illicit drugs have been framed negatively, rejecting any alternative frame that focuses on the benefits or pleasures of drug use. Communities framed by the police, media and outsiders as ‘no go’ areas may be viewed in a very different – and more positive – light by residents (MacGregor and O’Gorman, Chapter 9). Counter-frames are common and may be intentionally developed as a form of resistance or challenge to existing frames. Potter and Klein (Chapter 12) report how home cultivation of cannabis is cast in positive terms as an activity undertaken for therapeutic purposes, often with altruistic intent, and how cannabis growers are at pains to distance themselves from being framed as part of the ‘real’ criminal world. Resistance can come from organisations as well as from individuals; MacGregor and O’Gorman (Chapter 9) note how local authority services resisted some of the shaming aspects of the ‘Troubled Families’ programme: ‘almost all local authorities called their local troubled families work by another name’.

‘Framing’, on the other hand, as Vliegenthart and Van Zoonen (2011) argue, is a process. They draw attention to the importance of frame-building, how a frame comes about and frame effects, the consequences of the frame. Framing offers a way of understanding how a social phenomenon – such as the definition of a particular group or space as ‘risky’ or ‘dangerous’ – is constructed by stakeholders – the media, advocacy groups, political or social movements, researchers, practitioners or other actors. By considering framing as a dynamic process, we can also examine how frames alter and shift and the factors that prompt or hinder such changes. Several of the chapters in this book provide narratives that illustrate framing processes. Sato (Chapter 3) gives an account of how social and political forces, especially condemnation of specific groups of people (at various times – novelists, performers, students, Korean people), played important roles in how methamphetamine use was framed and how, over time, this led to the establishment of the Stimulant Control Law in Japan.

Framing occurs at individual and societal levels. While psychologically based research approaches framing from the individual (micro) level, studies coming from social movement research and from general sociology consider framing in a broader way as a macro-level or meso-level rather than an individual-level phenomenon (Scheufele and Iyengar, 2017). Clearly, these processes are not separate; there is a complex interactive relationship between frames and framing processes happening at the cultural, social group or institutional level and at the level of the individual actor and recipient. Different levels of coexisting frames and framing processes are explored by Duke and Kolind (Chapter 10); they note how international and national frames (macro-level) around drug problems in prison are interpreted and re-framed in institutional settings (meso-level) and how prisoners adapt and respond to the frames, sometimes reframing their involvement in drug use and drug supply in prison (micro-level). Equally, De Kock (Chapter 7) argues strongly for the adoption of an eco-social perspective on problem substance use, especially as it pertains to health inequalities (Solar and Irwin, 2010). This perspective draws attention to how factors at three levels – micro (client and treatment provider), meso (services) and macro (broader health and welfare systems) – intertwine to frame, in this case, Turkish migrants as ‘at risk’ and ‘a risk’, both within their own communities and in the wider society. It highlights the role of multi-level framing in influencing responses and in perpetuating marginal status and health inequalities.

Thus, framing is a critical activity in the construction of social reality because it helps shape the perspectives through which people see the world and which, if powerful, become embedded in policies and institutions. It operates interactively at different levels and it influences action; and it should be viewed as a dynamic process. A basic assumption underpinning the chapters in this book is that substance use is frequently a major part of the frames and framing processes that define certain social groups and the spaces they inhabit as ‘dangerous’ and, in some way, a threat, or an economic cost, to the wider society. Such framing is sometimes unintentional or an unwanted outcome from well-intentioned policy or advocacy; but it can also arise from struggles between political or group interests and from media sensationalism.

The concepts of ‘risk’ and ‘danger’ are prominent aspects of the frames and framing processes linked to substance use and a key element in the frames applied to the people and spaces discussed in this book.

The concept of risk

The term ‘risk’ has been applied to an enormous range of phenomena and, as Gabe (1995) noted, has led to the growth of a ‘risk industry’, incorporating research from many different disciplines. Furedi (2005) links the increasing emphasis on risk, risk averse policy and ‘at risk’ social groups to the politics of fear, commenting that it has fed into the paradigm of ‘vulnerability’, a cultural metaphor implying an intrinsic state of being which deprives individuals of a sense of agency and limits their choices. A similar view is taken by Brown and Wincup (2019) who argue that ‘the current problematisation of vulnerability in English drug policy supports the operation of subtle disciplinary mechanisms to regulate the behaviour of those deemed vulnerable’. Being ‘at risk’ places an individual in a passive, dependent role requiring management and control while the risks themselves assume an active role that drives action. Very often, the social groups discussed in this book are seen as ‘vulnerable’ and ‘at risk’ but, at the same time, they – or their behaviours – are seen as posing a risk, again raising issues of the need for management and control. Risk, in contemporary discourses around substance use and users, implies negative outcomes predominantly due to individual behaviour (rather than external causes) and reflects implicit moral frameworks and judgements with the potential to arouse fear and anxiety and a sense of helplessness (Lupton, 1993).

As already noted, individuals can be both ‘at risk’ and pose a risk; for instance, young people involved in drug dealing in what has become known as ‘county lines’ (spreading drug dealing from major urban locations out to smaller towns and rural settings) are seen as both vulnerable victims of drug dealers and also as a risk to other young people and communities (Coomber and Moyle, 2017). Sato (Chapter 3) paints a similar picture of street kids and vagrant youth in post-war Japan who were seen as both victims of adult hoodlums and as adding to the problem of amphetamine and methamphetamine use that caused them to become involved in delinquent activity. However, as the chapters in this book make abundantly clear, individuals and groups occupy different structural posit...

Table of contents

• Cover
• Half Title
• Series
• Title
• Copyright
• Contents
• List of tables
• List of figures
• Acknowledgements
• List of contributors
• 1 Introduction: risk and substance use
• 2 Substance use, dangerous classes and spaces: a historical perspective
• 3 Methamphetamine users and the process of condemnation in Japan: framing and influence
• 4 Dangerous drugs, dangerous women: declassé women, drugs and sapphic sexuality in 1930s London
• 5 Drinking in pregnancy: shifting towards the ‘precautionary principle’
• 6 Creating safe spaces in dangerous places: ‘Chicks Day’ for women who inject drugs in Budapest, Hungary
• 7 Risk factors and dangerous classes in a European context: the consequences of ethnic framing of and among Turkish drug users in Ghent, Belgium
• 8 The contemporary complexities of Irish Traveller navigation of drug risk environments
• 9 Drink, drugs and the ‘dangerous poor’: fear and loathing in contemporary cities
• 10 Framing and reframing drug ‘problems’ in prison spaces and populations
• 11 Deviant and dangerous: queer adults, smoker-related stigma and tobacco de-normalisation
• 12 Coming out of the closet: risk management strategies of illegal cannabis growers
• 13 Framing substance use problems: influence on key concepts, methods of research and policy orientation
• 14 Conclusion: risk, danger and policies towards psychoactive substances
• Index